Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task of ensuring that the right sorts of information gets to the right sorts of people remains. We argue that the many efforts underway to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations. This in turn requires that the management of information and knowledge within healthcare (...) organizations be combined with models of resources and processes of patient care that are based on a general ontology of social interaction. The Health Level 7 (HL7) is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. HL7 has advanced a widely used messaging standard that enables healthcare applications to exchange clinical and administrative data in digital form. HL7 focuses on the interface requirements of the entire healthcare system and not exclusively on the requirements of one area of healthcare such as pharmacy, medical devices, imaging or insurance transactions. This has inspired the development of a powerful abstract model of patient care called the Reference Information Model (RIM). The present paper begins with an overview of the core classes of the HL7 (Version 3) RIM and a brief discussion of its “actcentered” view of healthcare. Central to this account is what is called the life cycle of events. A clinical action may progress from defined, through planned and ordered, to executed. These modalities of an action are represented as the mood of the act. We then outline the basis of an ontology of organizations, starting from the theory of speech Acts, and apply this ontology to the HL7 RIM. Special attention is given to the sorts of preconditions that must be satisfied for the successful performance of a speech act and to the sorts of entities to which speech acts give rise (e.g. obligations, claims, commitments, etc.). Finally we draw conclusions for the efficient communication and management of medical information and knowledge within and between healthcare organizations, paying special attention to the role that medical documents play in such organizations. (shrink)

There are compelling medical, ethical, and legal arguments that support mandating use of a central institutional review board for the review of clinical trials performed at multiple institutional sites. Progress against serious diseases depends on this.

To entertain an idea is to take it in, pay attention to it, give it breathing room, dwell with it for a time. The practice of entertaining ideas suggests rumination and meditation, inviting us to think of philosophy as a form of hospitality and a kind of mental theatre. In this collection, organized around key words shared by philosophy and performance, the editors suggest that Shakespeare's plays supply readers, listeners, viewers, and performers with equipment for living. In plays ranging from (...) A Midsummer Night's Dream to King Lear and The Winter's Tale, Shakespeare invites readers and audiences to be more responsive to the texture and meaning of daily encounters, whether in the intimacies of love, the demands of social and political life, or moments of ethical decision. Entertaining the Idea features established and emerging scholars, addressing key words such as role play, acknowledgment, judgment, and entertainment as well as curse and care. The volume also includes longer essays on Shakespeare, Kant, Husserl, and Hegel as well as an afterword by theatre critic Charles McNulty on the philosophy and performance history of King Lear. (shrink)

The claim that there are nonpurposive functional statements is critically examined by looking at nine translation schemata, several of which are drawn from recent literature. All but one or two fail, suggesting that all functional statements (a) are causal (and not about probabilities or necessary conditions), and (b) have implicit reference to goals. If so, then the possibility of nonpurposive functional statements rests squarely on the possibility of nonpurposive goals.

We examine the influence of word choices on mathematical practice, i.e. in developing definitions, theorems, and proofs. As a case study, we consider Euclid’s and Euler’s word choices in their influential developments of geometry and, in particular, their use of the term ‘polyhedron’. Then, jumping to the twentieth century, we look at word choices surrounding the use of the term ‘polyhedron’ in the work of Coxeter and of Grünbaum. We also consider a recent and explicit conflict of approach between Grünbaum (...) and Shephard on the one hand and that of Hilton and Pedersen on the other, elucidating that the conflict was engendered by disagreement over the proper conceptualization, and so also the appropriate word choices, in the study of polyhedra. (shrink)

Semantic role is the actual role a participant plays in some real or imagined situation, apart from the linguistic encoding of those situations. Semantic roles, also known as thematic roles, are one of the oldest classes of constructs in linguistic theory. Semantic roles are used to indicate the role played by each entity in a sentence and are ranging from very specific to very general. Also, semantic roles are useful in natural language processing. They have proved attractive because they provide (...) a way of representing commonalities across different uses of the same predicate or across uses of distinct but semantically related predicates that may be obscured because arguments with certain semantic roles may have various syntactic realisations. Thus they provide a level of abstraction for the statement of generalisations concerning a variety of linguistic phenomena. In particular, argument realisation generalisations are often stated over a thematic hierarchy, a ranking of semantic roles. However, semantic roles have not lived up to their initial promise. It has proved impossible to find a small set of roles that can be applied across all verbs in a language, let alone across languages. Advances in Research on Semantic Roles provide more sustained discussion of the notion of semantic role. It often traces the development of the notion, as well as its place within current linguistic theory. In addition, it introduces several approaches to semantic role inventories, highlighting the similarities and differences among them, and discusses the limitations both of particular approaches and of semantic role approaches in general. Semantic roles continue to be useful in stating linguistic generalisations, and so descriptive, if not theoretical, uses of semantic role labels persist across subfields, including language acquisition, psycholinguistics, and neurolinguistics. (shrink)

The Propertian speaker's private erotic gaze evolves into Foucault's "panoptic" gaze of state control, illustrating in the process the early and formative years of Augustan social ideology and its relation to urban renewal. Composed almost a decade before the passage of social legislation in 18 B.C.E. ( leges Iuliae ), Propertius 2.31—the ecphrasis of the temple to Apollo on the Palatine—and its companion piece 2.32 anticipate the radical redefinition of imperial power under Augustus, the encroachment of the state into the (...) private domains of family and sexuality, and the eventual use of such legislation as a "strategy of surveillance.". (shrink)

Suppose you are on a commercial airplane that is flying at 35,000 feet. Next to you sits a man who appears to be sleeping. In fact, this man has been drugged and put upon the plane without his knowledge or consent. He has never flown on a plane before and, indeed, has no idea what an airplane is. Suddenly the man awakes and looks around him. Terrified by the alien environment in which he finds himself, he searches for a door (...) or window from which to make an escape. As luck would have it, he is seated right next to a window exit and he begins to pull the handle that will open the window. You are aware that opening the window exit at this altitude will cause the cabin to quickly depressurize and that this man, you, and probably several other passengers will be sucked out the window to your deaths. You desperately want to stop him from opening the window. Now assume that for some reason it is impossible to prevent him physically from performing the deadly act. Your only option is to rationally persuade him to leave the window exit alone. You cry out to him and, with both hands on the handles, he turns to face you and waits to hear what you have to say. What sort of argument would you make? (shrink)

Severian of Gabala’s homilies and Pseudo-Theodoret’s Quaestiones et responsiones ad Orthodoxos exhibit some notable parallels. Such links show that a marginal current of the Antiochene school was still thriving by the end of the 5th century, i.e. the most probable date of QRO.

The abilities to attribute an action to its proper agent and to understand its meaning when it is produced by someone else are basic aspects of human social communication. Several psychiatric syndromes, such as schizophrenia, seem to lead to a dysfunction of the awareness of one’s own action as well as of recognition of actions performed by other. Such syndromes offer a framework for studying the determinants of agency, the ability to correctly attribute actions to their veridical source. Thirty normal (...) subjects and 30 schizophrenic patients with and without hallucinations and/or delusional experiences were required to execute simple finger and wrist movements, without direct visual control of their hand. The image of either their own hand or an alien hand executing the same or a different movement was presented on a TV-screen in real time. The task for the subjects was to discriminate whether the hand presented on the screen was their own or not. Hallucinating and deluded schizophrenic patients were more impaired in discriminating their own hand from the alien one than the non-hallucinating ones, and tended to misattribute the alien hand to themselves. Results are discussed according to a model of action control. A tentative description of the mechanisms leading to action consciousness is proposed. (shrink)

De Vries' mutation theory has not stood the test of time. The supposed mutations of Oenothera were in reality complex recombination phenomena, ultimately explicable in Mendelian terms, while instances of large-scale mutations were found wanting in other species. By 1915 the mutation theory had begun to lose its grip on the biological community; by de Vries' death in 1935 it was almost completely abandoned. Yet, as we have seen, during the first decade of the present century it achieved an enormous (...) popularity. As this paper has tried to suggest, one of the principal reasons for this was that de Vries' theory served as a banner around which a whole crowd of disaffected Darwinians or anti-Darwinians could rally. However, not all of those who favored de Vries did so for quite the same reasons. Underlying the multitude of views ran several common threads: a dissatisfaction with current Darwinian theory born out of misunderstanding natural selection, a general misunderstanding of the nature of species, and a prejudice against speculative, nontestable theories in biology.Supporters of de Vries were not the only opponents of Darwinism, nor was the mutation theory the only alternative to natural selection. In the early twentieth century a number of theories had been proposed to explain away the problems which Darwin had left unsolved. There was the idea of orthogenesis, championed by the American paleontologists Cope, Osborn and others; organic selection (or orthoplasy) was championed by M. M. Baldwin and C. Lloyd Morgan; there were the concepts of convergent evolution proposed by Hermann Friedmann, the theory of physiological selection by John George Romanes, and the concepts of reproductive divergence by H. M. Vernon. Virtually none of these men either accepted or were strong supporters of the de Vriesian theory, for each had his own particular ‘ism” to advocate as the major factor in evolution. The existence of a large number of such theories, each purporting to be the explanation, was characteristic of evolutionary theory at the turn of the century. It is to a large extent the emphasis on such fragmentary concepts that retarded development of the comprehensive theory of evolution which emerged in the 1920's and 1930's. For the historian, however, a study of these alternative theories is instructive in trying to understand the inherent difficulties which Dawwinian theory posed to biologists at the time. De Vries' mutation theory serves historically as a mirror to reflect the critical mood of a generation hostile to the theory of natural selection.It has often been claimed that it was impossible to understand the mechanism of natural selection until it could be placed in genetic and mathematical terms. It is certainly true that great strides have been made in population genetics and the treatment of evolutionary concepts with mathematical tools in the last forty years. But the very people who developed the genetical and mathematical approach to evolution were already convinced of the essential correctness of Darwinian theory before they started. Advances in an understanding of Mendelian heredity aided greatly in solving one important issue for evolutionists: the origin of variations. And the rigor with which selection acted could best be studied by observing changes in gene frequencies (calculated mathematically) over a number of generations. But as this paper has shown, two of the basic problems which biologists faced in evaluating Darwinian theory at the turn of the century-the nature of species, and the criteria of what constituted an acceptable explanation in biological science-could not be answered directly by mathematics. What mathematical and genetical theory did do was to help convince the skeptics of the validity of the Darwinian proposition.The change in explanatory criteria which many hailed as de Vries' most important contribution to evolutionary theory seems to have been part of a general emergence of twentieth-century biology from the domination of theorizers in the nineteenth. It also marked the emergence of America from the domination of biological, and particularly evolutionary, influence of Europeans. The change occurred in three areas: in the kinds of questions asked: testable versus non-testable; in the kind of data sought: quantitative versus qualitative; and in the kinds of theories proposed: analytical and reductive—the attempt to see complex processes in terms of simpler components-as opposed to synthetic and speculative. Although ultimately wrong in his idea, de Vries and his theories rode high on the wave of “experimentalism” which was the harbinger of a new era in evolutionary theory. (shrink)

Today, economic theory is a mathematical theory, but that was not always the case. Major changes in the ways economists presented their arguments to one another occurred between the late 1930s and the early 1950s; over that period the discipline became mathematized. Professor Weintraub, a noted scholar of the modern history of economic thought, argues that those changes were not merely cosmetic: The mathematical forms of the arguments significantly altered the substance of the arguments. Stabilizing Dynamics is particularly concerned with (...) the ways in which the rich and confusing talk of the 1930s evolved, over a fifteen-year period, into technical analysis of some mathematical structures. The author describes the context for the history of that change, locating it in the broader intellectual currents, and shows how the history of modern economics can be seen as a confluence of several disparate traditions. Historiographically, this book offers one of the first constructivist accounts of modern economic analysis. (shrink)

Heidegger commentator J. L. Mehta includes in his book the following quote from Heidegger: “Der Wanderschaft in der Wegrichtung zum Fragwürdigen ist nicht Abenteur sondern Heimkehr.” Adapting this idea to the purpose of my own project in this article, I propose: Wandering on the Footpath of Freedom is both an Adventure and a Homecoming! The aim of this article is to explore the idea of freedom as it is developed in the philosophy of Martin Heidegger. The strategy here is to (...) examine the salient remarks of several commentators, including Mehta, William Richardson, Werner Brock, Charles Guignon, Rüdiger Safransky, and others. Some of the ideas explored here are: transcendence, overtness, authenticity, poetry and resoluteness. (shrink)

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without (...) the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants’ own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain. (shrink)

Interpretation of the classics in political theory seems to go in waves. For a while we had John Locke, the bourgeois thinker. Now we seem to be in a Locke-as-radical-democrat phase. Locke-the-bourgeois had problems of its own, but a radically democratic Locke -- not just the old Locke as liberal democrat but Locke as quasi-Leveller -- strains the interpretative imagination more than most; yet in recent years, several different kinds of argument have been advanced in support of it, both textual (...) and contextual. The most effective argument has proceeded by situating Locke in the context of radical Whig politics in the 1670s and '80s, the struggles over religious toleration and the royal succession, in particular the �Exclusion Crisis� of 1679-81. This contextual argument has been accompanied by various textual interpretations having to do with Locke's conceptions of property, consent, representation, the right of revolution and natural law. Among other things, these are supposed to show that while Locke had nothing explicit to say about the extent of the franchise, the weight of evidence suggests that he would have supported a fairly wide franchise, perhaps even something like the (almost) manhood suffrage advocated by the Levellers (at least according to some, and probably the most convincing, interpretations of their ideas). Most recently, in these pages, Martin Hughes, building on the work of James Tully and Richard Ashcraft in particular, has pushed the argument as far as it can probably go. His argument on taxation and suffrage has provided a motivation here for a wider exploration of Locke's views on representation, consent and the franchise. (shrink)

Insight experiences are sudden, persuasive, and can accompany valuable new ideas in science and art. In this preregistered experiment, we aim to validate a novel visceral and continuous measure of insight problem solving and to test whether real-time and embodied feelings of insight can predict correct solutions. We report several findings. Consistent with recent work, we find a strong positive relationship between Aha moments and accuracy for problems that demand implicit processing. We also found that the intensity of the insight (...) experience further predicted the accuracy of solutions and participants naturally embodied the intensity of their insight experiences by squeezing the dynamometer more tightly. Intriguingly, this unintentional embodiment further predicted the accuracy of solutions. We suggest that the dynamometer complements previous measures by (1) simultaneously capturing both process and feeling in real-time, (2) highlights the value of measuring Aha moments on a continuum of intensity, and (3) firmly establishes that the impulsive feeling of Aha can carry information about the veracity of an idea. We discuss the findings in light of a recent theoretical account of how feelings of insight may act as a heuristic to select ideas from the stream of consciousness. (shrink)

This article proposes a geostatistical solution for area-to-point spatial prediction (downscaling) taking into account boundary effects. Such effects are often poorly considered in downscaling, even though they often have significant impact on the results. The geostatistical approach proposed in this article considers two types of boundary conditions (BC), that is, a Dirichlet-type condition and a Neumann-type condition, while satisfying several critical issues in downscaling: the coherence of predictions, the explicit consideration of support differences, and the assessment of uncertainty regarding the (...) point predictions. An updating algorithm is used to reduce the computational cost of area-to-point prediction under a given BC. In a case study, area-to-point prediction under a Dirichlet-type BC and a Neumann-type BC is illustrated using simulated data, and the resulting predictions and error variances are compared with those obtained without considering such conditions. (shrink)

The formal theory of equality of opportunity emerged as a response – a friendly amendment – to Ronald Dworkin's (1981) characterization of resource egalitarianism, as defined by the allocation that would emerge from insurance contracts arrived at behind a thin veil of ignorance. This article compares several of the prominent versions of this response, put forth in the period 1993–2008. I argue that a generalization of Roemer's (1998) proposal is the most satisfactory approach. Inherent in that generalization is an indeterminism, (...) which reflects a philosophical problem: that we do not know what comprise the ethically correct rewards to effort. The indeterminism should be resolved, I propose, by an ancillary theory which limits the degree of inequality which is acceptable. (shrink)

Universal access to health care is still a dream rather than a reality in the United States. This is partly because a rule of rescue, by impelling us to help people in need, urges us to ignore the limits of our health care policies wherever those limits would adversely affect a given individual. As the rule of rescue undermines whatever limits we set on health care entitlements, it can thwart the cost containment so essential to expanding access. Rather than accept (...) unlimited expense, we have thus far declined to universalize health care. The situation is exacerbated by an economic insulation shielding patients and physicians from the costs of care, prompting both to regard health care as free, an unlimited right. To reverse this costly entitlement mentality and place reasonable limits on rescue, patients must exercise greater personal responsibility for the costs of their care by directly experiencing some of the economic consequences of their health care decisions. Several mechanisms are available to accomplish this goal without posing economic barriers to needed care or penalizing people for becoming ill. Keywords: Clinton health plan, rationing, rule of rescue CiteULike Connotea Del.icio.us What's this? (shrink)

A venerable view holds that a border between perception and cognition is built into our cognitive architecture and that this imposes limits on the way information can flow between them. While the deliverances of perception are freely available for use in reasoning and inference, there are strict constraints on information flow in the opposite direction. Despite its plausibility, this approach to the perception-cognition border has faced criticism in recent years. This article develops an updated version of the architectural approach, which (...) I call the dimension restriction hypothesis (DRH). According to DRH, perceptual processes are constrained to compute over a bounded range of dimensions, while cognitive processes are not. This view allows that perception is cognitively penetrable, but places strict limits on the varieties of penetration that can occur. The article argues that DRH enjoys both theoretical and empirical support, and also defends the view against several objections. (shrink)

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who (...) were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit. (shrink)

This study examined the role of temporal orientation and affective frame in the execution of ethical decision-making strategies. In reflecting on a past experience or imagining a future experience, participants thought about experiences that they considered either positive or negative. The participants recorded their thinking about that experience by responding to several questions, and their responses were content-analyzed for the use of ethical decision-making strategies. The findings indicated that a future temporal orientation was associated with greater strategy use. Likewise, a (...) positive affective frame was associated with greater strategy use. Future orientation may permit better strategy execution than a past orientation because it facilitates more objective, balanced contemplation of the reflected-upon situation and minimizes potential self-threat associated with past behavior. A positive affective frame likely improves strategy execution because it facilitates active analysis of the experience. Future directions and implications of these findings are discussed. (shrink)