Name der Zeitschrift: Semiotica Jahrgang: 2015 Heft: 207 Seiten: 327-368.

The coronavirus pandemic made the biopolitics of infection control the core object of states around the world. Globally, states governed spheres usually free of state control, implementing various restrictions, closing down society in the process. This is possible due to the state's capacities to act through and over society, grounded in the state's powers. I argue that while the pandemic has led to useful and interesting state-centric Foucauldian literature on the politics of COVID-19, this literature has not fully taken the (...) theoretical lessons of the pandemic into account. Explicating these lessons, I discuss how the pandemic invites us to reconsider the Foucauldian approach to the state. The purpose of this article is to combine the Foucauldian theory of power with a Weberian state theory based on Michael Mann's work on the state and the sources of power, so to lay the foundations for a Weberian-Foucauldian theory of the state. (shrink)

Digital Voice Assistants have become a ubiquitous technology in today’s home and childhood environments. Inspired by original study on how children’s ontological conceptualizations of life and technology were systematically associated with their real-world exposure to robotic entities, the current study explored this association for children in their middle childhood and with different levels of DVA-exposure. We analyzed correlational survey data from 143 parent–child dyads who were recruited on ‘Amazon Mechanical Turk’. Children’s ontological conceptualization patterns of life and technology were measured (...) by asking them to conceptualize nine prototypical organically living and technological entities with respect to their biology, intelligence, and psychology. Their ontological conceptualization patterns were then associated with their DVA-exposure and additional control variables. Compared to biology and psychology, intelligence was a less differentiating factor for children to differentiate between organically living and technological entities. This differentiation pattern became more pronounced with technological affinity. There was some evidence that children with higher DVA-exposure differentiated more rigorously between organically living and technological entities on the basis of psychology. To the best of our knowledge, this is the first study exploring children’s real-world exposure to DVAs and how it is associated with their conceptual understandings of life and technology. Findings suggest although psychological conceptualizations of technology may become more pronounced with DVA-exposure, it is far from clear such tendencies blur ontological boundaries between life and technology from children’s perspective. (shrink)

How to handle orphan drugs for rare diseases is a pressing problem in current health-care. Due to the group size of patients affecting the cost of treatment, they risk being disadvantaged in relation to existing cost-effectiveness thresholds. In an article by Niklas Juth it has been argued that it is irrelevant to take indirectly operative factors like group size into account since such a compensation would risk discounting the use of cost, a relevant factor, altogether. In this article we analyze (...) Juth’s argument and observe that we already do compensate for indirectly operative factors, both outside and within cost-effectiveness evaluations, for formal equality reasons. Based on this we argue that we have reason to set cost-effectiveness thresholds to integrate equity concerns also including formal equality considerations. We find no reason not to compensate for group size to the extent we already compensate for other factors. Moreover, groups size implying a systematic disadvantage also on a global scale, i.e. taking different aspects of the health condition of patients suffering from rare diseases into account, will provide strong reason for why group size is indeed relevant to compensate for. (shrink)

In this paper we explore the relation between health-care needs and patients’ desires within shared decision-making in a context of priority setting in health care. We begin by outlining some general characteristics of the concept of health-care need as well as the notions of SDM and desire. Secondly we will discuss how to distinguish between needs and desires for health care. Thirdly we present three cases which all aim to bring out and discuss a number of queries which seem to (...) arise due to the double focus on a patient’s need and what that patient desires. These queries regard the following themes: the objectivity and moral force of needs, the prediction about what kind of patients which will appear on a micro level, implications for ranking in priority setting, difficulties regarding assessing and comparing benefits, and implications for evidence-based medicine. (shrink)

Intensive research is carried out to develop a disease-modifying drug for Alzheimer’s disease. The development of drug candidates that reduce Aß or tau in the brain seems particularly promising. However, these drugs target people at risk for AD, who must be identified before they have any, or only moderate, symptoms associated with the disease. There are different strategies that may be used to identify these individuals. Each of these strategies raises different ethical challenges. In this paper, we analyse these challenges (...) in relation to the risk stratification for AD necessary for using these drugs. We conclude that the new drugs must generate large health benefits for people at risk of developing AD to justify the ethical costs associated with current risk stratification methods, benefits much larger than current drug candidates have. This conclusion raises a new set of ethical questions that should be further discussed. No data are available. (shrink)

How should scarce healthcare resources be distributed? This is a contentious issue that became especially pressing during the pandemic. It is often emphasised that studies exploring public views about this question provide valuable input to the issue of healthcare priority setting. While there has been a vast number of such studies it is rarely articulated, more specifically, what the results from these studies would mean for the justification of principles for priority setting. On the one hand, it seems unreasonable that (...) public values would straightforwardly decide the ethical question of how resources should be distributed. On the other hand, in a democratic society, it seems equally unreasonable that they would be considered irrelevant for this question. In this paper we draw on the notion of reflective equilibrium and discuss the relevance and roles that empirical studies may plausibly have for justification in priority setting ethics. We develop a framework for analysing how different kinds of empirical results may have different kinds of implications for justification. (shrink)

When considering the introduction of a new intervention in a budget constrained healthcare system, priority setting based on fair principles is fundamental. In many jurisdictions, a multi-criteria approach with several different considerations is employed, including severity and cost-effectiveness. Such multi-criteria approaches raise questions about how to balance different considerations against each other, and how to understand the logical or normative relations between them. For example, some jurisdictions make explicit reference to a large patient benefit as such a consideration. However, since (...) patient benefit is part of a cost-effectiveness assessment it is not clear how to balance considerations of greater patient benefit against considerations of severity and cost-effectiveness. The aim of this paper is to explore the role of a large patient benefit as an independent criterion for priority setting in a healthcare system also considering severity and cost-effectiveness. By taking the opportunity cost of new interventions (i.e., the health forgone in patients already receiving treatment) into account, we argue that patient benefit has a complex relationship to priority setting. More specifically, it cannot be reasonably concluded that large patient benefits should be given priority if severity, cost-effectiveness, and opportunity costs are held constant. Since we cannot find general support for taking patient benefit into account as an independent criterion from any of the most discussed theories about distributive justice: utilitarianism, prioritarianism, telic egalitarianism and sufficientarianism, it is reasonable to avoid doing so. Hence, given the complexity of the role of patient benefit, we conclude that in priority practice, a large patient benefit should not be considered as an independent criterion, on top of considerations of severity and cost-effectiveness. (shrink)

Why do some people withdraw from biobank studies? To our knowledge, very few studies have been done on the reflections of biobank ex-participants. In this article, we report from such a study. 16 years ago, we did focus group interviews with biobank participants and ex-participants. We found that the two groups interestingly shared worries concerning the risks involved in possible novel uses of their biobank material, even though they drew opposite conclusions from their worries. Revisiting these interviews today reveals a (...) remarkable relevance to present concerns, since the possible developments that worried ex-participants and participants 16 years ago now are becoming realities. Drawing on conceptual distinctions by sociologist and philosopher Niklas Luhmann, we argue that while ex-participants express a loss of trust in the biobank institution to manage the use of their biobank material in a legitimate way, remaining participants expressed confidence in the management of the biobank institution to secure their interests. This analysis brings out important aspects of emerging trends in biobank research participation. (shrink)

It is uncontroversial to claim that the extent to which health care interventions benefit patients is a relevant consideration for health care priority setting. However, when effects accrue to the individual patient, effects of a more indirect kind may accrue to other individuals as well, such as the patient's children, friends, or partner. If, and if so how, such relational effects should be considered relevant in priority setting is contentious. In this paper, we illustrate this question by using disease‐modifying drugs (...) for Alzheimer's disease as a case in point. The ethical analysis begins by sketching the so‐called prima facie case for ascribing moral weight to relational effects and then moves on to consider a number of objections to it. We argue that, whereas one set of objections may be dismissed, there is another set of arguments that poses more serious challenges for including relational effects in priority setting. (shrink)

In this study of an economic field and its relationships to a cultural field, we apply Pierre Bourdieu’s central concepts of economic capital, cultural capital, symbolic capital and field, and thus follow in a tradition that at the outset was considered to be post-structuralism, but which by Bourdieu later has been brought into the realm of realism. We have mapped relationships between the actors and thus the field structures that these relationships entail. The fields in which a segment of an (...) art world is operating is represented in multi-dimensional figures which illustrate relationships and bonds between the different categories of organizations. Some of the business actors we have studied are engaging in cultural activities with a great deal of autonomy, others are connected to the cultural field in less active ways. In participating in the cultural field they are in different ways and to different extents accumulating symbolic capital including prestige and honor. The method we have applied is multiple correspondence analysis which was frequently used by Bourdieu. (shrink)

In Gustavsson et al,1 we discussed the ethical issues that arise when identifying the relevant population for disease-modifying drugs targeting Alzheimer disease. More specifically, we focused on novel immunotherapies aimed at amyloid β and tau, two relevant biomarkers. The commentaries to our paper2 3 acknowledge our conclusion: screening for AD involve ethical costs that cannot be justified unless a drug with clinically relevant effect becomes available. Since Aduhelm is the only immunotherapy targeting AD currently approved by the Food and Drug (...) Administration, we use that as a …. (shrink)

Monetary valuation of ecosystem services is a widely used approach to quantify the benefits supplied by the natural environment to society. An alternative approach is the monetary valuation of ecosystem functions, which is defined as the capacity of the ecosystem to supply services. Using two European case-study areas, this paper explores the relative advantages of the two valuation approaches. This is done using a conceptual analysis, a qualitative application, and an overall comparison of both approaches. It is concluded that both (...) approaches can be defended on theoretical grounds, and – if properly applied – will provide the same value estimates. However, valuation of ecosystem services is preferred from a practical point of view. Because there is no one-to-one match between functions and services, researchers should be consistent in their valuation approach. To avoid overlooking or overlapping of values, valuation should either be solely based on functions, or solely based on services. (shrink)

Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in (...) Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

In a recent extended essay, philosopher Daniel Hausman goes a long way towards dismissing severity as a morally relevant attribute in the context of priority setting in healthcare. In this response, we argue that although Hausman certainly points to real problems with how severity is often interpreted and operationalised within the priority setting context, the conclusion that severity does not contain plausible ethical content is too hasty. Rather than abandonment, our proposal is to take severity seriously by carefully mapping the (...) possibly multiple underlying accounts to well-established ethical theories, in a way that is both morally defensible and aligned with the term’s colloquial uses. (shrink)

In recent years, the issue of accepting a higher cost per health improvement for orphan drugs has been the subject of discussion in health care policy agencies and the academic literature. This article aims to provide an analysis of broadly egalitarian arguments for and against accepting higher costs per health improvement. More specifically, we aim to investigate which arguments one should agree upon putting aside and where further explorations are needed. We identify three kinds of arguments in the literature: considerations (...) of substantial equality, formal equality, and opportunity cost. We argue that considerations of substantial equality do not support higher costs per health improvement orphan drugs, even if such considerations are considered valid. On the contrary, arguments of formal equality may support accepting a higher cost per health improvement for orphan drugs. However, in order to do so, a number of both normative and empirical issues must be resolved; these issues are identified in the article. For instance, it must be settled to what extent the opportunity cost in terms of foregone health for other patients is acceptable in order to uphold formal equality. We conclude that certain arguments can be set aside, and future focus should be put on the unresolved normative and empirical issues related to formal equality and opportunity cost. (shrink)

In Parkinson’s disease, the fronto-striatal network is involved in motor and cognitive symptoms. Working memory updating training engages this network in healthy populations, as observed by improved cognitive performance and increased striatal BOLD signal. This two-part study aimed to assess the feasibility of WM updating training in PD and measure change in cognition, movement and functional brain response in one individual with PD after WM updating training. A feasibility and single-subject study were performed in which patients with PD completed computerized (...) WM updating training. The outcome measures were the pre-post changes in criterion and transfer cognitive tests; cognitive complaints; psychological health; movement kinematics; and task-related BOLD signal. Participants in the feasibility study showed improvements on the criterion tests at post-test. FL displayed the largest improvements on the criterion tests and smaller improvements on transfer tests. Furthermore, FL reported improved cognitive performance in everyday life. A shorter onset latency and smoother upper-limb goal-directed movements were measured at post-test, as well as increased activation within the striatum and decreased activation throughout the fronto-parietal WM network. This two-part study demonstrated that WM updating training is feasible to complete for PD patients and that change occurred in FL at post-test in the domains of cognition, movement and functional brain response. (shrink)

Combining information from two or possibly several blocks of data is gaining increased attention and importance in several areas of science and industry. Typical examples can be found in chemistry, spectroscopy, metabolomics, genomics, systems biology and sensory science. Many methods and procedures have been proposed and used in practice. The area goes under different names: data integration, data fusion, multiblock analyses, multiset analyses and a few more. This book is an attempt to give an up-to-date treatment of the most used (...) and important methods within an important branch of the area; namely methods based on so-called components or latent variables. These methods have already obtained an enormous attention in for instance chemometrics, bioinformatics, machine learning and sensometrics and have proved to be important both for prediction and interpretation. The book is primarily a description of methodologies, but most of the methods will be illustrated by examples from the above-mentioned areas. The book is written such that both users of the methods as well as method developers will hopefully find sections of interest. In the end of the book there is a description of a software package developed particularly for the book. This package is freely available in R and covers many of the methods discussed. To distinguish the different type of methods from each other, the book is divided into five parts. Part I is introduction and preliminary concepts. Part II is the core of the book containing the main unsupervised and supervised methods. Part III deals with more complex structures and, finally, Part IV discusses alternative unsupervised and supervised methods. The book ends with Part V discussing the available software. Our recommendation for reading the book are as follows. A minimum read of the book would involve chapters 1, 2, 3, 5 and 7. Chapters 4, 6 and 8 are more specialized and chapters 9 and 10 contain methods we think are more advanced or less obvious to use. We feel privileged to have so many friendly colleagues who were willing to spend their time on helping us to improve the book by reading separate chapters. We would like to express our thanks to: Rasmus Bro, Margriet Hendriks, Ulf Indahl, Henk Kiers, Ingrid MaÌ⁽ge, Federico Marini, AÌ⁽smund Rinnan, Rosaria Romano, Lars Erik Solberg, Marieke Timmerman, Oliver Tomic, Johan Westerhuis and Barry Wise. Of course, the correctness of the final text is fully our responsibility! (shrink)

This wide-ranging collection of essays contains eighteen original articles by authors representing some of the most important recent work on Wittgenstein. It deals with questions pertaining to both the interpretation and application of Wittgenstein s thought and the editing of his works. Regarding the latter, it also addresses issues concerning scholarly electronic publishing. The collection is accompanied by a comprehensive introduction which lays out the content and arguments of each contribution. Contributors: Knut Erik Tranoy, Lars Hertzberg, Georg Henrik (...) von Wright, Marie McGinn, Cora Diamond, James Conant, David G. Stern, Eike von Savigny, P.M.S. Hacker, Hans-Johann Glock, Allan Janik, Kristof Nyiri, Antonia Soulez, Brian McGuinness, Anthony Kenny, Joachim Schulte, Herbert Hrachovec, Cameron McEwen.". (shrink)

The first systematic analysis of the Frankfurt School’s research and theorizing on modern antisemitism. Although the Frankfurt School represents one of the most influential intellectual traditions of the twentieth century, its multifaceted work on modern antisemitism has so far largely been neglected. The Politics of Unreason fills this gap, providing the first systematic study of the Frankfurt School’s philosophical, psychological, political, and social research and theorizing on the problem of antisemitism. Examining the full range of these critical theorists’ contributions, from (...) major studies and prominent essays to seemingly marginal pieces and aphorisms, Lars Rensmann reconstructs how the Frankfurt School, faced with the catastrophe of the genocide against the European Jews, explains forms and causes of anti-Jewish politics of hate. The book also pays special attention to research on coded and “secondary” antisemitism after the Holocaust, and how resentments are politically mobilized under conditions of democracy. By revisiting and rereading the Frankfurt School’s original work, this book challenges several misperceptions about critical theory’s research, making the case that it provides an important source to better understand the social origins and politics of antisemitism, racism, and hate speech in the modern world. Lars Rensmann is Professor of European Politics and Society at the University of Groningen in the Netherlands. His books include Arendt and Adorno: Political and Philosophical Investigations (coedited with Samir Gandesha). (shrink)

In 1988 Fodor and Pylyshyn issued a challenge to the newly-popular connectionism: explain the systematicity of cognition without merely implementing a so-called classical architecture. Since that time quite a number of connectionist models have been put forward, either by their designers or by others, as in some measure demonstrating that the challenge can be met (e.g., Pollack, 1988, 1990; Smolensky, 1990; Chalmers, 1990; Niklasson and Sharkey, 1992; Brousse, 1993). Unfortu- nately, it has generally been unclear whether these models actually do (...) have this implication (see, for instance, the extensive philosophical debate in Smolensky, 1988; Fodor and McLaughlin, 1990; van Gelder, 1990, 1991; McLaughlin, 1993a, 1993b; Clark, 1993). Indeed, we know of no major supporter of classical orthodoxy who has felt compelled, by connectionist models and argu- ments, to concede in print that connectionists have in fact delivered a non-classical explanation of systematicity. (shrink)

It is argued that the so‐called principles of “strong centering” and “weak centering” central to the traditional Lewis‐Stalnaker semantics for counterfactuals are both fallacious. A foundation for an alternative semantics without these prinsciples is outlined. The core idea is that the statistically normal worlds – rather than those worlds most qualitatively similar to the actual world – should serve as the semantical fulcrum.

The Gricean paradigm in pragmatics has recently been attacked for its alleged lack of explanatory import, based on the claim that it does not seek accounts of how utterance interpretation actually works, but merely of how it might work. This article rebuts this line of attack by offering a clear and detailed account of the explanatory project of Gricean pragmatics according to which the latter aims for rationalizing explanations of utterance interpretation. It is shown that, on this view, Gricean pragmatics (...) seeks psychological explanations of utterance interpretation that are “cognitively real” in a perfectly clear and robust sense. (shrink)

The distinction between the personal and the subpersonal is often invoked in philosophy of psychology but remains surrounded by confusion. Building on recent work by Zoe Drayson, this paper aims to help further improve this situation by offering a satisfactory explication of the distinction that remains close to Dennett's original intentions. Reasons are offered for construing the distinction as applying to representational (as opposed to worldly) items, for not building contested theoretical assumptions into it, and for taking it to apply (...) in the first instance to descriptive statements and only derivatively to explanations. An explication of the distinction that accords with these points is then developed, according to which the distinction should be drawn in terms of what personal and subpersonal-level statements are ‘transparently about’. The theoretical role of this explication is discussed, and potential objections are addressed. (shrink)

Positive political theorists typically deny the possibility of collective agents by understanding aggregation problems to imply that groups are not rational decision-makers. This view contrasts with List and Pettit’s view that such problems actually imply the necessity of accounting for collective agents in explanations of group behaviour. In this paper, I explore these conflicting views and ask whether positive political theorists should alter their individualist analyses of groups like legislatures, political parties, and constituent assemblies. I show how we fail to (...) appreciate the significance of strategic voting and agenda control by treating groups as agents. I, therefore, conclude that positive political theorists should cling to their individualist approach and maintain that groups are not agents. (shrink)

Kritika okularocentrizma, prevladujoče težnje privilegirati vid na račun drugih čutnih modalnosti v zahodnem mišljenju, je pred nedavnim postala predmet napada poststrukturalističnih in postfenomenoloških mislecev. Kritika okularo-centrizma naj bi okrepila in dopolnila kritiko logo-centrizma in metafizike navzočnosti. Povedano drugače, ta kritika tvori del kritike razsvetljenske racionalnosti. V članku zagovarjam mnenje, da kritika razsvetljenstva pogosto cilja višje kot pa leži njena tarča. Heideggrova kritika »skopične« racionalnosti naše kulture naj bi služila kot radikalna alternativa okularocentričnemu mišljenju. Pokazati skušam, da Heideggrova kritika razsvetljenske racionalnosti (...) in modernosti ni radikalno antiesencialistična in antifundacionalistična, kot trdijo njegovi učenci. Pokazati tudi skušam, da je Heidegger, zaradi svoje problematične politične preteklosti in kritike modernosti, v najboljšem primeru dvomljiv zaveznik v boju proti zatiralski »skopični« racionalnosti. (shrink)

We study first-order concatenation theory with bounded quantifiers. We give axiomatizations with interesting properties, and we prove some normal-form results. Finally, we prove a number of decidability and undecidability results.

The article delineates a model of communication among human minds that is designed to work equally well for all kinds of nonverbal and verbal significance. The model thus allows for detailed analysis of and comparison among all varieties of human communication. In particular, the transitional stage of communication, which is termed the media product, is thoroughly developed and conceptualized in terms of mediality and semiosis. By way of mapping basic media dissimilarities that are vital for differing communicative capacities, the model (...) explains both how various sorts of significance can be transferred among minds, and why they cannot always be realized. The article furthermore suggests a semiotic framework for conceptualizing the familiar notion that communication is also strongly predisposed by surrounding factors such as earlier experiences and cultural influence. (shrink)