A Mesoamérica, área cultural onde surgiu uma das poucas civilizações prístinas, tem como um dos elementos mais idiossincráticos a forma particular como lê o tempo. A face mais visível dessa realidade é a existência de um calendário de 260 dias e o modo como este se articula com os demais calendários. Esse processo contribui para conformar a sociedade enquanto tal e articulá-la com a visão que esta tem de si própria e do papel que desempenha num cosmos que a transcende. (...) Neste texto pretendemos dar a conhecer alguns dos factos mais característicos dos ciclos de tempo mesoamericanos, mostrar o seu funcionamento e tentar motivar o interesse por um conhecimento mais profundo de uma estrutura mental colectiva singular, como a que encontramos no México Antigo. (shrink)

Meier et al. describe a pilot study that developed METHAD, an AI-based Medical Ethics Advisor tool that draws on the principlism approach and was tested using text-book cases and clinical et...

The usefulness of machine learning algorithms has led to their widespread adoption prior to the development of a conceptual framework for making sense of them. One common response to this situation is to say that machine learning suffers from a “black box problem.” That is, machine learning algorithms are “opaque” to human users, failing to be “interpretable” or “explicable” in terms that would render categorization procedures “understandable.” The purpose of this paper is to challenge the widespread agreement about the existence (...) and importance of a black box problem. The first section argues that “interpretability” and cognates lack precise meanings when applied to algorithms. This makes the concepts difficult to use when trying to solve the problems that have motivated the call for interpretability. Furthermore, since there is no adequate account of the concepts themselves, it is not possible to assess whether particular technical features supply formal definitions of those concepts. The second section argues that there are ways of being a responsible user of these algorithms that do not require interpretability. In many cases in which a black box problem is cited, interpretability is a means to a further end such as justification or non-discrimination. Since addressing these problems need not involve something that looks like an “interpretation” of an algorithm, the focus on interpretability artificially constrains the solution space by characterizing one possible solution as the problem itself. Where possible, discussion should be reformulated in terms of the ends of interpretability. (shrink)

Whole genome and exome sequencing techniques raise hope for a new scale of diagnosis, prevention, and prediction of genetic conditions, and improved care for children. For these hopes to materialize, extensive genomic research with children will be needed. However, the use of WGS/WES in pediatric research settings raises considerable challenges for families, researchers, and policy development. In particular, the possibility that these techniques will generate genetic findings unrelated to the primary goal of sequencing has stirred intense debate about whether, which, (...) how, and when these secondary or incidental findings should be returned to parents and minors. The debate is even more pronounced when the subjects are adolescents, for whom decisions about return of SFs may have particular implications. In this paper, we consider the rise of “genomic citizenship” and the main challenges that arise for these stakeholders: adolescents' involvement in decisions relating to return of genomic SFs, the types of SFs that should be offered, privacy protections, and communication between researchers and adolescents about SFs. We argue that adolescents' involvement in genomic SF-related decisions acknowledges their status as valuable stakeholders without detracting from broader familial interests, and promotes more informed genomic citizens. (shrink)

Through the use of culturally appropriate videos on precision medicine research (PMR) that were developed and tailored to five racial and ethnic groups of patients, and subsequent focus-group discu...

The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients’ empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical dimensions is needed. (...) Drawing on scholarship of nationalism and democracy, we discuss the PMI's construction of what we term “genomic citizenship”; the possible normative obligations arising therefrom; and the ethical, legal, and social challenges that will ensue. Although the PMI is a work in progress, discussion of the existing and emerging issues can facilitate the development of policies, structures, and procedures that can maximize the initiative's ability to produce equitable and socially sensitive outcomes. Our analysis can also be applied to other population-based, precision medicine research programs. (shrink)

Pandemics first and foremost hit those who are most vulnerable, and the COVID-19 pandemic is not different. Although the infection rate in the nation’s poorest neighborhoods is twice as it is in th...

The once animated efforts in medical phenomenology to integrate the art and

science of medicine (or to humanize scientific medicine) have fallen out of philosophical fashion. Yet the current competing medical discourses of evidencebased medicine and patient-centered care suggest that this theoretical endeavor requires renewed attention. In this paper, I attempt to enliven the debate by discussing theoretical weaknesses in the way the “lived body” has operated in the medical phenomenology literature—the problem of the absent body—and highlight how evidence-based medicine has (...) refigured medical phenomenology’s historical nemesis, “biomedicine.” What we now need is a phenomenology of the embodied subject in the age of evidence-based medicine. (shrink)

Volume 20, Issue 7, July 2020, Page 187-190.

Since the inception of large‐scale human genome research, there has been much caution about the risks of exacerbating a number of socially dangerous attitudes linked to human genetics. These attitudes are usually labeled with one of a family of genetic or genomic “isms” or “ations” such as “genetic essentialism,” “genetic determinism,” “genetic reductionism,” “geneticization,” “genetic stigmatization,” and “genetic discrimination.” The psychosocial processes these terms refer to are taken to exacerbate several ills that are similarly labeled, from medical racism and psychological (...) fatalism to economic exploitation and social exclusion. But as genomic information becomes more familiar in clinical and research settings as well as other life activities, do we need to continue to worry so much about this family of attitudes and their impact on existing problems?In genomics, the underlying anxiety has been that disclosure of genomic information will trigger a series of (seemingly unavoidable) negative responses that will affect individuals, their families, and their communities at large. The fundamental social challenges that hyperbolic genomic messaging, low genomic literacy, and “folk biology” help sustain remain to be addressed. If we hope to break the cycle of genomic isms and ations, we will have to get better at resisting overinterpretations of the relevance that genomics has for people’s future potentials, ancestral vulnerabilities, community memberships, and ethnic affiliations. (shrink)

A framework to support ?Arguing from Experience? using groups of collaborating agents (termed participant agents/players) is described. The framework is an extension of the PISA multi-party arguing from experience framework. The original version of PISA allowed n participants to promote n goals (one each) for a given example. The described extension of PISA allows individuals with the same goals to pool their resources by forming ?groups?. The framework is fully described and its effectiveness illustrated using a number of classification scenarios. (...) The main finding is that by using groups more accurate results can be obtained than when agents operate in isolation. (shrink)

‘Hated in the Nation’ invites us to reflect about our social media responsibility: in this episode, the hashtag #DeathTo sends a swarm of killing bee‐drones to the most unpopular candidate of the day. But, although there are no tiny bee drones yet in real life, it is not uncommon to shame someone online for a variety of reasons, and the consequences can be life‐changing. But, is this online trial truly fair? In this chapter I take some central points from the (...) philosophy of John Rawls and Hannah Arendt to explore under what conditions these online trials might be adequate. (shrink)

This paper offers a theoretical discussion on why the nursing profession has had a delayed response to the issue of climate change. We suggest this delay may have been influenced by the early days of nursing's professionalization. Specifically, we examine nursing's professional mandate, the generally accepted metaparadigm, and the grand theorists’ conceptualizations of both the environment and the nurse–environment relationship. We conclude that these works may have encouraged nurses to conceptualize the environment, as well as their relationship with it, mainly (...) in terms of the individual patient, and as such, nurses have not been encouraged to understand these concepts from a broader perspective. By not having the philosophical and theoretical foundations to understand the environment in relation to society, it is not surprising that nurses have had a delayed response to climate change and may not have viewed it as a professional concern. A planetary health perspective is suggested as a theoretical basis for nursing education, research and practice. Taking on a planetary health perspective could help nurses progress the profession and move healthcare systems towards supporting a climate‐resilient future. (shrink)

Laspro et al. (2024) contemplate the first whole eye transplant (WET) procedure in humans. They discuss the implications of such a procedure on the physical, social, and psychological well-being of...

In recent years, new forms of high-tech controlled environment agriculture (CEA) have received increased attention and investment. These systems integrate a suite of technologies – including automation, LED lighting, vertical plant stacking, and hydroponic fertilization – to allow for greater control of temperature, humidity, carbon dioxide, oxygen, and light in an enclosed growing environment. Proponents insist that CEA can produce sustainable, nutritious, and tasty local food, particularly for the cities of the future. At the same time, a variety of critics (...) raise concerns about its environmental impacts and energy use, high startup costs, and consumer accessibility challenges, among other issues. At this stage, however, relatively little research has explored actual consumer knowledge and attitudes related to CEA processes and products. Guided by theories of sense-making, this article draws from structured interviews with local food consumers in New York City to examine what people know and think about high-tech CEA. From there, it explores the extent to which CEA fits into consumer conceptualizations of what makes for “good food.” Key findings emphasize that significant gaps in public understanding of CEA remain, that CEA products’ success will depend on the ability of the industry to deliver on its environmental promises, and that concerns about “unnatural” aspects of CEA will need to be allayed. Given the price premium at which high-tech CEA products are currently sold, the industry’s expansion will depend in large part on its ability to convince value-oriented food consumers that the products meet the triple-bottom-line of economic, social, and environmental sustainability goals. (shrink)

Autism spectrum disorder (ASD) is a neuro-developmental condition, which requires a multi-disciplinary matrix of treatments, including functional, educational, and emotional interventions. The latter mode of treatment entails particular difficulties, inasmuch as the core deficits of this condition seem to challenge the very premises of traditional psychotherapy. Reciprocity, verbal, and symbolic expression and inter-subjective dynamics are often difficult to attain with clients diagnosed with ASD, and emotional treatment thus often turns out to be a frustrating process, which may well elicit questions (...) as to the efficacy of psychotherapeutic emotional interventions. These core challenges, described in the literature, become particularly acute in view of the increasing number of clients diagnosed on the autistic spectrum in recent years, and the growing need for qualified therapists who have trained for working specifically with this condition. It seems, therefore, that it is high time for systematic research into the lived experience of therapists working with these clients in order to attain a better clinical and theoretical understanding of the condition itself and broaden the range of effective interventions. This study, informed by a phenomenological-hermeneutic approach which guided both the collection of data and its subsequent analysis, aims to address these issues by exploring the particular challenges faced by therapists in this field, the questions that come up in the process, modes of personal and professional coping, and the insights elicited by the therapeutic encounter. The research consisted of in-depth interviews with 28 practicing therapists from a broad range of clinical orientations, including dance/movement, arts, music, and drama therapists, clinical psychologists, and clinical social workers. The essential themes that emerged from the participants’ responses and the analysis of the findings lend support to theoretical and developmental approaches, which focus on the primacy and the foundational role of the concrete body in inter-subjective relationships and in the therapeutic process, and indicate the potential efficacy of somatic and kinetic interventions. The clinical implications of this study are thus highly relevant to the training and support of therapists working with ASD, who should be encouraged to develop greater receptivity to non-verbal modes of interaction in the therapeutic process. (shrink)

Intelligible speakers achieve specific vocal tract constrictions in rapid sequence. These constrictions are associated in theory with speech motor goals. Adult-focused models of speech production assume that discrete phonological representations, sequenced into word-length plans for output, define these goals. This assumption introduces a serial order problem for speech. It is also at odds with children's speech. In particular, child phonology and timing control suggest holistic speech plans, and so the hypothesis of whole word production. This hypothesis solves the serial order (...) problem by avoiding it. When the same solution is applied to adult speech the problem becomes how to explain the development of highly intelligible speech. This is the problem addressed here. A modeling approach is used to demonstrate how perceptual-motor units of production emerge over developmental time with the perceptual-motor integration of holistic speech plans that are also phonological representations; the specific argument is that perceptual-motor units are a product of trajectories (nearly) crossing in motor space. The model, which focuses on the integration process, defines the perceptual-motor map as a set of linked pairs of experienced perceptual and motor trajectories. The trajectories are time-based excursions through speaker-defined perceptual and motor spaces. By hypothesis, junctures appear where motor trajectories near or overlap one another in motor space when the shared (or extremely similar) articulatory configurations in these regions are exploited to combine perceptually-linked motor paths along different trajectories. Junctures form in clusters in motor space. These clusters, along with their corresponding (linked) perceptual points, represent perceptual-motor units of production, albeit at the level of speech motor control only. The units serve as pivots in motor space during speaking; they are points of transition from one motor trajectory to another along perceptually-linked paths that are selected to produce best approximations of whole word targets. (shrink)

It is a thrill to have two scholars whom I admire greatly commenting on my own work. I want to thank Professors Miriam Solomon and Inmaculada de Melo-Martin for their careful reading and attention to the book. I found their positive evaluation of the research very encouraging and still both commentaries offer critical challenges that warrant attention. This response will address two points of discussion: normative theorizing on trust; whether the conceptual resources, specifically the crisis of trust framework, can address (...) the present situation of COVID vaccine hesitancy.Solomon and de Melo-Martin question the limited attention I give to evaluating the propositional claims and the... (shrink)

The public rejection of scientific claims is widely recognized by scientific and governmental institutions to be threatening to modern democratic societies. Intense conflict between science and the public over diverse health and environmental issues have invited speculation by concerned officials regarding both the source of and the solution to the problem of public resistance towards scientific and policy positions on such hot-button issues as global warming, genetically modified crops, environmental toxins, and nuclear waste disposal. The London Royal Society’s influential report (...) “Public Understanding of Science”, which spearheaded the now-thriving area of science... (shrink)

Color conveys critical information about the flavor of food and drink by providing clues as to edibility, flavor identity, and flavor intensity. Despite the fact that more than 100 published papers have investigated the influence of color on flavor perception in humans, surprisingly little research has considered how cognitive and contextual constraints may mediate color–flavor interactions. In this review, we argue that the discrepancies demonstrated in previously-published color–flavor studies may, at least in part, reflect differences in the sensory expectations that (...) different people generate as a result of their prior associative experiences. We propose that color–flavor interactions in flavor perception cannot be understood solely in terms of the principles of multisensory integration but that the role of higher-level cognitive factors, such as expectations, must also be considered. (shrink)

MA Thesis. Biomedical ethics does not lend itself to easy categorisation as either a 'theoretical' or a 'practical' enterprise because inquiry into the quandaries of morality requires both situational and 'translocal' perspectives. These types of investigation bring into question the legitimacy of the theory/practice divide that has dominated intellectual thought since antiquity. This division hinders the development of bioethics by fostering internal dispute within the discipline regarding appropriate methodology and the practice of clinical ethics. In this thesis, I argue that (...) much of these disciplinary disjunctions are due to an undue labeling of bioethics as either 'applied ethics' or 'practical ethics', and a failure to recognise the intricate way in which theory and practice inform each other and are integral and interrelated parts of moral deliberation. I argue for an integration of the theory and practice of bioethics. (shrink)

Written in an effort “to frame questions of culture and power in different terms” from those of Edward Said, this case study of Ottoman Alexandria before the French invasion in 1798 reveals “lines between empowered and powerless, even East and West,” blurred or erased by “cosmopolitan mixing.... So much attention is paid to the way that empires divide people against each other that it is easy to forget how empires have also brought populations together, forcibly at times, yet often with (...) enduring effects. The cosmopolitan possibilities of empire, as opposed to narrower definitions of national belonging, would shape the life of Etienne Roboly,” whose complicated existence in Egypt—as a citizen of both or neither the French state and/nor the Ottoman—is the focus of this study. The author asks her readers to glean from this article two “lessons”: first, that “nation-states, as the briefest glance at twentieth-century history will confirm, have often proved themselves hostile toward minority populations. Yet we have also been taught to see empires as evil things, which makes the second lesson— that empires have sometimes been more accommodating of difference than many independent nations—seem somewhat counterintuitive.... The history of Alex-andria invites us to look at how empire may provide an umbrella of common security for a range of cultures to coexist, and even at times intermingle.” Still, “the larger question is whether and how inclusionary definitions of belonging can be made to oughtweigh exclusionary ones,” regardless of the political context. (shrink)

The exponential growth of genetic knowledge and precision medicine research raises hopes for improved prevention, diagnosis, and treatment options for children with behavioral and psychiatric conditions. Although well-intended, this prospect also raise the possibility — and concern — that behavioral, including psychiatric genetic data would be increasingly used — or misused — outside the clinical context, such as educational settings. Indeed, there are ongoing calls to endorse a “personalized education” model that would tailor educational interventions to children's behavioral and psychiatric (...) genetic makeup. This article explores the justifications for, and prospects and pitfalls of such endeavors. It considers the scientific challenges and highlights the ethical, legal, and social issues that will likely arise should behavioral genetic data become available and are routinely incorporated in student education records. These include: when to disclose students' behavioral and psychiatric genetic profile; whose genomic privacy is protected and by whom; and how students' genetic data may affect education-related decisions. I argue that the introduction of behavioral genetics in schools may overshadow the need to address underlying structural and environmental factors that increase the risk for psychiatric conditions of all students, and that the unregulated use of student behavioral genetic profiles may lead to unintended consequences that are detrimental for individuals, families and communities. Relevant stakeholders — from parents and students to health professionals, educators, and policy-makers — ought to consider these issues before we forge ahead with a genomically informed education system. (shrink)

Medical discourse currently manages two broad visionary movements: "evidence-based medicine," the effort to make clinical medicine more responsive to the medical research, and "patient-centered care," the platform for a more humane health-care encounter. There have been strong calls to synthesize the two as "evidence-based patient-centred care" (Lacy and Backer 2008; see also Borgmeyer 2005; Baumann, Lewis, and Gutterman 2007; Krahn and Naglie 2008), yet many question the compatibility of the two competing programs.This might sound to some like a new version (...) of an old story. Despite the fact that evidence-based medicine and patient-centered care are relatively new programs, the story of their oppositional .. (shrink)

Jamieson, Hangen, Lee, and Yaeager present their empirical findings as evidence for the effects of reappraising arousal on affective responses. This comment highlights the important contribution of the research by Jamieson and colleagues, but offers alternative ways of conceptualizing it.

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should (...) be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

While most of healthcare research and practice fully endorses evidence-based healthcare, a minority view borrows popular themes from philosophy of science like underdetermination and value-ladenness to question the legitimacy of the evidence-based movement’s philosophical underpinnings. While the feminist origins go unacknowledged, those critics adopt a feminist reading of the “gap argument” to challenge the perceived objectivism of evidence-based practice. From there, the critics seem to despair over the “subjective elements” that values introduce to clinical reasoning, demonstrating that they do not (...) subscribe to feminist science studies’ normative program——where contextual values can enable good science and justified decisions. In this paper, I investigate why it is that the critics of evidence-based medicine adopt feminist science’s characterization of the problem but resist the productive solutions offered by those same theorists. I suggest that the common feminist empiricist appeal to idealized epistemic communities is impractical for those working within the current biomedical context and instead offer an alternate stream of feminist research into the empirical content of values (found in the work of Elizabeth Anderson and Sharyn Clough) as a more helpful recourse for facilitating the important task of legitimate and justified clinical decision-making. I use a case study on clinical decision-making to illustrate the fruitfulness of the latter feminist empiricist framework. -/- See response by Sharyn Clough: http://wp.me/p1Bfg0-1aN See reply by Maya Goldenberg: http://wp.me/p1Bfg0-1oY. (shrink)

Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of (...) its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- . (shrink)