A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

Stew Cohen is a sceptic when it comes to epistemic obligations to gather evidence. On his view, epistemic requirements to update on evidence relevant to p only get off the ground insofar as one is already attending to whether p. In this paper, I do two things: first, I put forth two worries for Cohen's scepticism, having to do with restrictions on 'ought implies can', and the nature of the evidential having relation. Second, I defend an account of epistemic obligations (...) to attend, on which the corresponding epistemic norms drop out of epistemic functions. (shrink)

This paper has two aims: it develops and defends a fully-fledged account of the epistemic normativity of conjecture it goes sharply against orthodoxy, in arguing that conjecture is epistemically more demanding than assertion. According to the view defended here, one’s conjecture that p is permissible only if one knows that one has warrant, but not sufficient warrant to believe that p. I argue for my account on three independent grounds: the Bach and Harnish account of the nature of communicative speech (...) acts, the plausible normative relation between assertion and other constatives, and the normativity of belief in conjunction with constatives’ epistemic function. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 93-96 [Access article in PDF] Phenomenological Methods in Psychiatry:A Necessary First Step M. Gupta and L. Rex Kay Keywords: behavior, empathy, human science, methodology, natural science, phenomenology. WE ARE GRATEFUL to the journal for prviding the opportunity for exchange and discussion of some of the themes raised in our paper, "The impact of phenomenology on North American psychiatric assessment" and we are pleased (...) to be able to reply to the two excellent commentaries by McMillan and Morley. Both McMillan and Morley question the prospect of employing phenomenology and its methods in psychiatric assessment, and in psychiatric practice more generally. McMillan questions the utility of such a step, and Morley is pessimistic about its feasibility. We shall address each author's concerns in turn.Initially, let us restate the aims of our paper to contextualize our arguments and those made in the commentaries. First, we sought an understanding of what is meant by North American psychiatrists, working within the DSM framework, when they refer to the phenomenological approach to psychiatric assessment. To elucidate this meaning, we compared the contemporary North American usage to a small number of definitions of phenomenology, particularly those definitions that were, and are now, applied to clinical psychiatric work. Contrary to McMillan's suggestion, we did not intend to state definitively what should or should not count as phenomenological, but rather to compare North American psychiatric assessment to what typically has counted as phenomenological. Second, we sought to examine phenomenology's influence on North American psychiatric practice, particularly psychotherapy.Morley argues that such influences usually exemplify the inappropriate appending of phenomenology to psychiatric practice rather than true integration of different paradigms. Although we do not disagree with this general contention, we will argue that the deployment of phenomenological methods in psychiatric assessment is a necessary first step toward the kind of integration he proposes.McMillan makes two related but unintegrated points. First, he argues that objective, behavioral data are phenomenological, according to his broad definition of the term. Second, he proposes that, if the behavioral and the phenomenological are different, we are better off staying with the behavioral when it comes to psychiatric nosology. Let us consider these two points in succession.McMillan seeks to broaden Jasper's definition of phenomenology to include objective observations [End Page 93] as phenomenological. To this end, he distinguishes methods from aims. He summarizes Jasper's definition of phenomenology as "an empirical method for investigating 'individual psychic experience (p 55)" and claims that this is a statement of aim or objectives. He then urges us to "consider the merits of different phenomenological methodologies in terms of their success in achieving this objective" whether or not they utilize "all the methods" of phenomenology. This is much like saying that if we treat waving one's hand as a method for greeting someone, we are then free to treat the objective of the wave as one of greeting someone, and then say that anything that serves as a greeting is, by definition, a "wave." Whatever else McMillan's objective observations are, he has not convinced us that they are phenomenological, anymore than we are likely to convince you that a kiss on the lips is really just a wave.Nonetheless, it is worthwhile seeing what McMillan does with this argument. He tells us that we can "read the first-person experience from behavior in a fairly accurate and informative way." He uses the example of a father gazing at his young child and notes that it is not unreasonable to infer that he is experiencing loving and nurturing feelings. It is, indeed, not unreasonable to draw such an inference. But it is far more reasonable to infer that the father is experiencing a cacophony of feelings, including, but not limited to, love, concern, anxiety, pride, envy, hope, and sadness (Stern 1995, 18-58). If we are able to distinguish which of these feelings is dominant at any given moment—which we are—and if we are also able to track subtle shifts in such feelings... (shrink)

This paper develops and defends novel accounts of accurate and reasonable doubt. We take a cue from Sosa's telic epistemic normative picture to argue that one’s degree of doubt that p is accurate just in case it matches the level of veritic risk involved in believing that p. In turn, on this account, reasonable doubt is doubt that is generated by a properly functioning cognitive capacity with the function of encoding veritic risk.

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

Introduction Patient safety is essential for healthcare quality and a global concern. The rapid advancement of medical technology presents ethical challenges for critical care nurses, who navigate complex decision-making processes. Given their close relationships with patients, nurses are uniquely positioned to address patient safety issues. Thus, enhancing nurses’ moral sensitivity and ethical values is increasingly important. Objective This study aims to explore the relationship between moral sensitivity and attitude towards patient safety in critical care nurses. Methods This cross-sectional, descriptive-correlational study (...) was conducted from June to September 2022 in three hospitals affiliated with Hamadan University of Medical Sciences in Iran. Participants were nurses in intensive care units (ICUs), selected via convenience sampling. A total of 382 nurses completed questionnaires assessing demographic information, moral sensitivity, and patient safety attitudes. Data analysis was performed using descriptive statistics, t-tests, ANOVA, Pearson’s correlation, and multiple regression in SPSS 26. Ethical considerations: This research received ethical approval from the Ethics Committee of Hamadan University of Medical Sciences. Participants provided informed consent regarding the study’s objectives, and their confidentiality was strictly upheld throughout the research. Results The nurses’ average age and work experience were 38.6 years and 12.4 years, respectively. Mean scores for moral sensitivity and patient safety attitude were 81.65 ± 2.69 and 51.47 ± 2.21, indicating high levels and a significant positive correlation. Factors such as increasing age, work experience, fewer working hours, and completion of ethics training were linked to more positive attitudes towards patient safety ( p <.05). Regression analysis showed that 42.8% of the variability in attitudes towards patient safety could be explained by moral sensitivity and demographic characteristics. Conclusion This study highlights the relationship between moral sensitivity and patient safety attitudes among critical care nurses, emphasizing the importance of education, experience, and training in shaping ethical values. Enhancing moral sensitivity is vital for reducing risky behaviors and improving patient safety outcomes in critical care settings. (shrink)

This article argues that Mona Hatoum's video Measures of Distance presents us with an example of Jean-Luc Marion's saturated phenomenon. Partial and deeply textured images of Hatoum's mother have p...

We apply an online optimization process based on machine learning to the production of Bose-Einstein condensates. BEC is typically created with an exponential evaporation ramp that is optimal for ergodic dynamics with two-body s-wave interactions and no other loss rates, but likely sub-optimal for real experiments. Through repeated machine-controlled scientific experimentation and observations our ’learner’ discovers an optimal evaporation ramp for BEC production. In contrast to previous work, our learner uses a Gaussian process to develop a statistical model of the (...) relationship between the parameters it controls and the quality of the BEC produced. We demonstrate that the Gaussian process machine learner is able to discover a ramp that produces high quality BECs in 10 times fewer iterations than a previously used online optimization technique. Furthermore, we show the internal model developed can be used to determine which parameters are essential in BEC creation and which are unimportant, providing insight into the optimization process of the system. (shrink)

United States of America demographic profiles illustrate a nation rich in cultural and racial diversity. Approximately 29% of the population are minorities and demographic projections indicate an increase to 50% by the year 2050. This creates a highly mobile and constantly changing environment, revealing the need for new levels of cultural awareness and sensitivity. These issues are particularly critical in the medical community where medical professionals must understand the impact cultural differences and barriers can have on evaluation, treatment, and rehabilitation. (...) During times of stress, such as when injury strikes, problems associated with lack of cultural sensitivity are intensified. Cultural diversity is of particular concern when standard measures for diagnosis and prognosis are derived from established norms for responding, because culture defines norms. This paper details a ten point checklist designed to facilitate cultural awareness and sensitivity in medical settings to ensure maximum successful recovery and outcomes for all patients. (shrink)

P S Wilson; Interests and Educational Values, Journal of Philosophy of Education, Volume 8, Issue 2, 30 May 2006, Pages 181–199, https://doi.org/10.1111/j.1467-.

DeRose famously argued that, given that assertability varies with practical context, we cannot combine a biconditional knowledge norm of assertion with classical invariantism. The first aim of this paper is to show that De Rose's argument is ultimately unsuccessful. Second, I develop a view, entitled Assertion Functionalism, which combines the knowledge norm with classical invariantism and at the same time offers an appealing account of the intuitive variability of proper assertion.

Reflecting recent findings by anaesthesiologists and psychologists, these proceedings discuss: implicit memory function, the use of therapeutic suggestion during anaesthesia, effective drug combinations to achieve maximum impact, monitoring the depth of anaesthesia and patient awareness.

Ce travail pose la question des critères de la „progression biologique“ , d'après les documents fossiles, dans le monde des organismes, c'est-à-dire de ce perfectionnement qui ne s'arrête pas à l'intérieur du cadre d'un phylum donné, comme le „perfectionnement de l'adaptation“, mais qui conduit, au-de-là de phylums de rang différent, à des types supérieurs, par exemple, des Poissons pas les Amphibies et les Reptiles jusqu'aux Mammifères ou aux Oiseaux. Deux groupes de critères y sont recensés en détail, leur contenu est (...) exposé, et on les examine pour voir s'ils caractérisent sans ambiguïté la „progression biologique“. Le premier groupe comprend les critères de „différenciation croissante“ et „d'intégration harmonique”. Ils sont fondés sur la différenciation morphophysiologique ou plus exactement sur la „totalité” des organismes, c'est-à-dire leur multiplicité dans l'unité. Le second groupe de critères, à savoir „indépendance croissante du milieu” et „autonomie individuelle croissante”, part des relations de l'organisme au milieu et aux autres formes vivantes et souligne la „subsistence” des individus, c'est-à-dire leur plus ou moins grande indépendence ou leur stabilité interne. Comme „totalité” et „subsistence” sont les éléments décisifs d'une définition biologique de l'individu, on peut dire que la „progression biologique“ d'un organisme est d'autant plus élevée que sa totalité et subsistence et par là son être individuel sont plus accusés.Tous les critères mentionnés ne sont pas uniformes. Les motifs de leur imprécision sont divers. Tout d'abord, il n'y a pas encore de définition unique et complète de l'individu biologique, de sorte qu'on ne peut circonscrire d'une manière univoque ce qui confère à un organisme une individualité plus forte ou moins forte. Ensuite les lignées au-delà desquelles s'accomplissent des perfectionnements, et dont l'une reste intérieur au phylum , tandis que l'autre le transcende , sont entrelacées si intimement et d'une façon si particulière qu'elles ne se laissent pas séparer franchement et décrire rigoureusement selon leurs signes distinctifs. Tout représentant d'un phylum, peu importe son palier, est en effet nécessairement inséré dans un milieu et en quelque façon spécialisé. Il n'existe pas des types à caractères phylétiques purs, qui ne montrent dans aucune direction un „perfectionnement de l'adaptation”, mais seulement des marques caractéristiques de la „progression biologique”. Enfin nous ne connaissons pas les restes fossiles que le développement ou la formation des grands phylums du règne animal, à savoir du rameau des Vertébrés et des divers groupes des Invertébrés, mais non pas le plus intéressant et le plus important, leur „progression biologique” jusqu'au degré d'organisation qu'ils présentent déjà à l'époque du Silurien ou plutôt du Cambrien. C'est cela seulement qui permettrait une vue plus profonde sur la nature de la „progression biologique”.Die Arbeit stellt die Frage nach den Kriterien des fossil belegten Biologischen Aufstiegs” der Organismenwelt, d.h. derjenigen Vervollkommnung, die sich nicht innerhalb des Rahmens eines gegebenen Bauplans hält, wie die „Anpassungsvervollkommnung”, sondern über verschiedenrangige Baupläne hinweg zu höheren Typen führt, z.B. von den Fischen über die Amphibien und Reptilien zu den Säugern bzw. Vögeln. Ausführlich werden zwei Gruppen von Kriterien besprochen, ihr Inhalt dargelegt und ihre Eindeutigkeit zur Charakterisierung des „Biologischen Aufstiegs” untersucht. Die erste Gruppe umfasst die Kriterien der „zunehmenden Differenzierung” und „harmonischeren Integration”. Diese legen die morphologisch-physiologische Differenzierung oder genauer die „Ganzheit” der Organismen zugrunde, d.h. ihre Vielheit in der Einheit. Die zweite Kriteriengruppe, nämlich „zunehmende Umweltunabhängigkeit” und „zunehmende individuelle Autonomie”, geht von den Beziehungen des Organismus zur Umwelt und zu andern Lebensformen aus und betont die „Subsistenz” der Individuen, d.h. ihr grösseres oder geringeres Losgelöstsein oder ihre Selbständigkeit. Da nun „Ganzheit” und „Subsistenz” die entscheidenden Elemente einer biologischen Definition des Individuums sind, lässt sich sagen, dass der „Biologische Aufstieg” eines Organismus um so höher ist, je stärker seine Ganzheit und Subsistenz und damit sein Individuumsein ist.Eindeutigkeit kommt allen genannten Kriterien nicht zu. Die Gründe für ihre Unschärfe sind verschiedener Art. Zunächst gibt es noch keine eindeutige und vollständige Definition des biologischen Individuums, so dass sich nicht eindeutig umreissen lässt, was einem Organismus eine stärkere oder weniger starke Individualität verleiht. Dann sind die Linien, über die sich Vervollkommnungen vollziehen und von denen die eine innerhalb des Bauplans bleibt , die andere aber über ihn hinausführt so innig und in so eigenartiger Weise miteinander verflochten, dass sie sich nicht sauber scheiden und in ihren charakteristischen Merkmalen genau beschreiben lassen. Jeder Vertreter eines Bauplans, ganz gleich von welcher Ranghöhe, ist nämlich notwendig in eine Umwelt eingepasst und irgendwie spezialisiert. Es gibt keine Typen mit reinen Bauplanmerkmalen, die nach keiner Richtung hin eine „Anpassungsvervollkommnung”, sondern nur Merkmale des „Biologischen Aufstiegs” aufweisen. Schliesslich kennen wir fossil nur die Entfaltung oder Ausgestaltung der Grossbaupläne des Tierreichs, nämlich des Wirbeltierstammes und der verschiedenen Gruppen der Wirbellosen, nicht aber das Interessanteste und Wichtigste, nämlich ihren „Biologischen Aufstieg” zu der organisatorischen Höhe, mit der sie sich im Silur bzw. im Kabrium bereits vorstellen. Das erst würde einen tieferen Einblick in das Wesen des „Biologischen Aufstiegs” vermitteln.This article deals with the question of the criteria for the “biological ascent” of the organic world, resting on fossil evidence. That is, of that improvement which is not only restricted to the framework of a given “general structure” as is the “improvement of adaptation”, but which also leads beyond general structures of differentiated levels to a higher type,e.g. from the fishes through the amphibians and reptiles to the mammals or birds. Two groups of criteria are discussed at length, their content exposed and their univocity for the characterisation of this “biological ascent” is examined. The first group includes the criteria of “increasing differentiation” and “more harmonious integration”. The basis for these is the morphological-physiological differentiation, or more exactly, the “totality” of the organisms,i.e., their variety-in-unity. The second group of criteria, “increasing independence of environment” and “increasing individual autonomy”, is derived from the relationships of the organism to its environment and to other living forms, and stresses the “subsistence” of individuals,i.e., their greater or lesser degree of independence or self-sufficiency. Now since “totality” and “subsistence” are the decisive elements in a biological definition of the individual, it may be said that the “biological ascent” of an organism is higher, the more perfect its totality and subsistence and therefore its individuality is.The criteria mentioned are not univocal. The reasons for this lack of clarity are varied. First of all, there is no univocal and complete definition of the biological individual, so that it cannot be exactly stated just what gives an organism a more or less perfect individuality. Then the lines, along which improvements are made, and according to which the one remains within the general structure and the other goes beyond the general structure , are so intimately and singularly bound together, that they cannot be cleanly distinguished, and their characteristic notes exactly described. For each representative of a general structure, regardless of its level, is necessarily fitted into an environment and somehow or other specialised. There are no types with only notes of the general structure which show in no direction an “improvment of adaption”, but only the signs of “biological ascent”. Finally, we only have fossil evidence for the development or deployment of the “great general structures” of the animal world, namely that of the vertebrates and of the different groups of invertebrates, not for the most interesting and most important, that is, their “biological ascent” to the level of organisation with which they are found in the Silurian or Cambrian periods. Only that would give us a deeper insight into the essence of “biological ascent”. (shrink)

An edition of the letters of Erasmus, regarded as one of the greatest humanist writers. All 12 volumes of this work have been reissued, complete with their scholarly apparatus of commentary and notes, as well as plates.