A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

While sympathetic to Tilley’s call for a practical philosophy of religion, I raise three questions: Does Tilley think that one can do philosophy of religion from a position other than that of a committed believer? Does Tilley’s description of the ordinary believer disburden most people from doubt and answerability? Does Tilley’s description of the role of the theologian place too much trust in the theologian? I suggest that some insights from contemporary phenomenology and hermeneutics would lead to a clearer understanding (...) of the role that philosophy of religion can play in the development of a practical philosophy of religion. (shrink)

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical and (...) moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (shrink)

Hegel says that the task of the philosopher in history is to follow the trace of Reason in history, to discern the realization of the freedom which Spirit is. Hegel’s own discerning of Reason in history is tinged with a teleological optimism which is unconfirmed and perhaps even denied by history. This does not mean that the task which Hegel presents should be set aside. Today’s philosopher must still attempt to understand history. The question which seems to focus present attempts (...) to do so is: How can an understanding of history provide us with a grasp of the world in which we live so that we can do what is possible to provide that world with a future? This question reflects a strong sense of finitude. Yet, the questions which guide Hegel are very similar: What is the relation of the finite and the infinite? How does this relation appear on the scene in history? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Truth Will Set You Free, or How a Troubled Philosophical Theory May Help to Understand How People Talk About Their AddictionPatricia A. Ross (bio)Keywordsveridicality of narrative, contingency of theories, belief-behavior, causal connectionConsider the following proposition: If one were to recognize the unsatisfactory implications of maintaining a certain theoretical position, one would thereby be motivated to accept a more adequate theory, which would alter one's beliefs and, in turn, (...) alter the behaviors that are based upon those beliefs. Faith in this proposition is what motivates many of us to teach. But, alas...Allison Mitchell's argument for rethinking addiction intervention—in particular, rethinking twelve-step programs—is premised on this proposition. According to her argument, addicts function with an impoverished sense of self that is reflective of a grossly simplified form of philosophical materialism. By recognizing the limitations of this philosophically unconvincing view, and by, in effect, accepting a better, more complete materialism, addicts can come to modify their self-conception. This modification is instrumental to recovery.A careful consideration of the chain of events being proposed, and the problems with it, is helpful for understanding the limitations of her argument. There are four points that I consider in turn: (1) considering narratives can tell us something about the self-conception of addicts, (2) philosophical materialism can help us to understand and explain something about an addict's self-conception and how it is inadequate, (3) this sense of self is distinct from nonusers and the way in which it is distinct helps to understand the problem of addiction, and (4) a change in self-conception with respect to materialism helps recovery and, thus, our best intervention is one based on having addicts accept a full materialist theory of the self and not a pretheoretic one. [End Page 227]With respect to the first point, it should be noted that Mitchell's overall argument does not depend on whether or not it is true that narratives of addiction tell us something veridical about the self-conception of addicts. Such narratives may simply provide us with a potential theory—a possible worlds scenario—of how addicts conceive of themselves. Mitchell points this out herself. The narratives and the interpretation that she provides of these narrative, "are meant only to highlight a certain pattern of self-expression and conception that may in fact be common in persons who use mind-altering substances; the readings do not establish any empirical matters of fact or philosophical truths, nor do they prove any conclusions about how such persons (must) express themselves or conceive their nature" (Mitchell 2006, 214).Thus, what the argument is actually concerned with are the theoretical claims about the self-conception of addicts that are garnered from these narratives. Nevertheless, because the narratives provide the starting point for Mitchell's argument, it is worth thinking carefully about the epistemic status of this body of literature. In particular, could a consideration of such literature lead us astray in our endeavors to understand how addicts might misconceive of themselves and, if so, in what way? What sort of epistemic status does this information hold?Mitchell is motivated by Wittgensteinian analyses of the relationship between thought and language. The particular idea that she employs from Wittgenstein is that every act of self-expression, whether it is verbal or written narrative, reveals something about the conceptual framework with which the author is working. Thus, one can learn about the author of a narrative—one can acquire a sense of how that individual conceives of him- or herself—by looking at the language that is employed to talk about and describe him- or herself.Mitchell enumerates some problems with this approach. She mentions that the author may fail to make his or her intended sense clear to readers; that the reader's narrative expectations determine the interpretation given to the narrative; that literary narrative may be less direct, less ordinary than everyday uses of language; and that interpreting such narrative via philosophical framework may ascribe to people positions that are more precise and sophisticated than they actually intend (p. 213).Aside from these quite serious problems, it is necessary to recognize... (shrink)

Abstract:This essay suggests that the word decolonial offers analytic power for feminist historians of women. As a category, it creates interpretive space for female experience beyond the elite/subaltern binary, where arguably most women live and work in the modern period. As a reading practice, the decolonial fosters intellectual awareness of social and intellectual practices that neither address the state, as in “anti-imperialism,” nor proffer counter nationalism or counter racialization as responses to coloniality. Offering examples from the archive, the media, and (...) teaching, this essay describes the decolonial as a productive site of women's agency in domains all too easily overlooked when historians focus on the conventional categories of state and nation. (shrink)

This paper defends the view that Frege’s reduction of arithmetic to logic would, if successful, have shown that arithmetical knowledge is analytic in essentially Kant’s sense. It is argued, as against Paul Benacerraf, that Frege’s apparent acceptance of multiple reductions is compatible with this epistemological thesis. The importance of this defense is that (a) it clarifies the role of proof, definition, and analysis in Frege’s logicist works; and (b) it demonstrates that the Fregean style of reduction is a valuable tool (...) for those who would investigate the nature of arithmetical knowledge. (shrink)

Designing for culture through intelligent tutoring systems is on the rise. The needs of military personnel to communicate and understand cultures other than their own in deployments, missions, and work-related assignments have strongly encouraged the creation of culturally aware tutoring systems (CATS) that teach about other cultures. This paper critically analyzes three systems (i.e., ELECT-BiLAT, Tactical Iraqi, and VECTOR) and the frameworks that guided the design and development process. The examination reveals that there is a need for comprehensive guidelines to (...) build CATS. Therefore, the Culture Based Model is offered as a framework to guide the design of culture-based information and communication technologies. (shrink)

We examined differences in the knowledge and beliefs that exist among nurse researchers in the USA (n = 119) regarding informed consent and the use of data from patients’ medical records. Using a mail survey, two domains of ethical knowledge and beliefs were assessed: the legal right to privacy and the moral right to privacy. More than half of the participants were very confident in their knowledge of institutional review board procedures, research ethics, informed consent, the legal right to privacy, (...) and the moral right to privacy. In contrast, most rated themselves as uncertain about US federal research regulations and there was wide variation in knowledge about current federal guidelines. Those who were more confident in their knowledge of or had more practical experience with research ethics, were no more likely to answer correctly a question about current federal guidelines regulating the use of patient data from medical records than those who reported less confidence or experience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Fact Value Dichotomy in Demarcating DisorderPatricia A. Ross (bio)Keywordsdemarcation, values, ontology, epistemologyHaving read numerous articles on the concept of mental disorder, I find it useful to approach new articles on the topic by first sketching out the conceptual framework within which each author places the problem. The goal in doing this is not merely to be able to compare ideas within a remarkably diverse discussion, but also to (...) be able to uncover any presuppositions that underlie the account, as well as assumptions necessary for the argument, which may or may not be warranted. By approaching each new offering in this way, I often find that the solutions proposed depend a great deal on these undisclosed features, and that such presuppositions and assumptions are often questionable, at best, and are sometimes simply unwarranted. Brülde's discussion of mental disorder and values provides a useful example of this method.To determine how we should draw the line between disorder and nondisorder (henceforth, I refer to this as demarcation), Brülde claims that we need to address four questions. We need to determine (1) the extent to which demarcation depends on values and the extent to which it is descriptive, (2) the kinds of values we need to make use of (aesthetic, moral, pragmatic), (3) whether there is an implicit reference to some specific evaluative standard, and (4) whether the value judgments used to demarcate are ontological or epistemological. In putting forth these questions, Brülde identifies what he takes to be the generally agreed upon claim that there are two components necessary for demarcation: a factual component and an evaluative component. These components are distinct from each other and both are necessary—the demarcation cannot be made "by objective means alone," nor is it purely evaluative. Thus, demarcation necessarily involves a distinct value component, and the answers to Brülde's four questions are intended to shed light on how values are involved in determining the evaluative component of demarcation.Working under the assumption that they are distinct, Brülde sets aside discussion of the factual component to focus on the value component. He also tables the first of his four questions (the extent to which demarcation depends on values and the extent to which it is descriptive), citing an over-abundance of literature on the matter. Having thus framed the problem, Brülde turns his full attention to questions two through four, ultimately providing us with the answer that the values needed to demarcate disorders from nondisorders are of several types; mental disorder is both implicitly and explicitly an evaluative term, as well as value laden in both the ontological and epistemic senses. This [End Page 107] framing of the problem provides us with insight into the underlying presuppositions and assumptions that lead to Brülde's conclusion.The first aspect of this framework to consider is the division of demarcation into two distinct components, and the setting aside of the factual component as distinct from, and inconsequential to, the questions concerning values. By proceeding in this way, Brülde's argument rests on the presupposition that we can, and want, to consider the value component in isolation from the factual component. This presupposition raises a number of questions. Is there nothing about the factual component that may help us in our consideration of the value component, or vice versa? Does the factual component confine what we can say or know about the value component in any way. Overall, some justification is needed for accepting that there are two distinct and independent components, as well as for believing that the factual component can be disregarded in this way.Brülde also makes the (explicit) assumption that there is some internal state or process underlying all mental disorders about which we have or will gain factual knowledge that is objective. Implicit in this is the further assumption that this knowledge (regarding internal states or processes) will be all there is to say, scientifically, about the disorder—that is, knowledge concerning internal states and processes are what will comprise the "factual component." But if we can have sociological facts and psychological facts (and I think it is... (shrink)

. Current debates concerning the concept of mental disorder involve many different philosophical issues. However, it is not always clear from these discussions how, or whether, these issues relate to one another, or in exactly what way they are important for the definition of disorder. This article aims to sort through some of the philosophical issues that arise in the current literature and provide a clarification of how these issues are related to one another and whether they are necessary for (...) defining disorder. I argue that the main concern in defining disorder, namely demarcation, is obscured by a number of these other philosophical issues and that a focus on demarcation gives us a means of placing these other issues in a clarifying context. (shrink)

Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

This paper examines the connection between model-theoretic truth and necessary truth. It is argued that though the model-theoretic truths of some standard languages are demonstrably ''''necessary'''' (in a precise sense), the widespread view of model-theoretic truth as providing a general guarantee of necessity is mistaken. Several arguments to the contrary are criticized.

This chapter contains section titled: Life and Works Desgabets's Philosophical System Cartesianism or Robertism?

The primary purpose behind effectiveness research is to determine whether a treatment with demonstrated efficacy has utility when administered to the general population. The main questions these studies are meant to answer are these: Can the typical patient respond to treatment? Is the treatment acceptable to the typical patient? Can the treatment be administered safely and in its entirety in the typical treatment setting? Is the treatment under study significantly better than the community standard of care both from a cost (...) and outcome perspective? Answering these questions is meant to provide sufficient information to providers and policymakers so that effective interventions can be adopted and become the new community standard. For this research to make a meaningful impact on a provider and policymaker's decision to change the status quo, study interventions should be compared to the existing community standard of treatment, often referred to as treatment as usual (TAU). From an ethical perspective, this decision may not always be the safest choice. In some populations, TAU may mean no treatment at all, and in others TAU may be worse than withholding treatment. The effectiveness researcher is then caught between the pull to do no harm and the need for research to have an impact on change. The purpose of this article is to highlight certain conditions when TAU is ethically acceptable and to discuss alternatives when TAU may be an unethical treatment condition. For purposes of precision, we focus exclusively on psychotherapy effectiveness research rather than system-intervention research or medication-intervention research. (shrink)

Because of historical mistreatment of ethnic minorities by research and medical institutions, it is particularly important for researchers to be mindful of ethical issues that arise when conducting research with ethnic minority populations. In this article, we focus on the ethical issues related to the inclusion of ethnic minorities in clinical trials of psychosocial treatments. We highlight 2 factors, skepticism and mistrust by ethnic minorities about research and current inequities in the mental health care system, that researchers should consider when (...) developing psychosocial interventions studies that include ethnic minorities. (shrink)

A comprehensive look at fictive letters in Greek literature from Homer to Philostratus, first published in 2001. It includes both embedded epistolary narratives in a variety of genres, and works consisting solely of letters, such as the pseudonymous letter collections and the invented letters of the Second Sophistic. The book challenges the notion that Ovid 'invented' the fictional letter form in his Heroides and considers a wealth of Greek antecedents for the later European epistolary novel tradition. Epistolary technique always problematizes (...) the boundaries between fictionality and reality. Based on a process of selection and self-censorship, the letter is a construction, not a reflection, of reality. The author bypasses the question of sincerity for a close look at epistolary self-representation, the function of the letter form and the nature of the relationship between writer and reader in a wide range of ancient Greek texts. (shrink)

This paper explores the complex meanings of paizein and its compound sumpaizein used in connection with young girls and/or Eros in archaic Greek poetry. My basic question is whether the verb necessarily implies a knowing eroticism on the part of the character whom it describes, or whether it is the poet's way of inviting the audience to share his knowledge at the expense of the character, a kind of "wink" of complicity. I argue that there are fundamental ambiguities in this (...) particular use of paizein and that the instability of its semantic field is linked to the liminality of the stage of life to which it commonly refers. When Eros "plays," we know we should be on guard, but a young girl's "play" is somewhat more difficult to interpret. In this context, I suggest that Greek poetry can represent the liminality of a girl's sexual status through the physical setting in which the action takes place: the "players" are placed in a natural environment that reflects their stage in life, namely, the moments just before the loss of innocence, and that locus itself is open to divergent interpretations dependent on the sexual "knowledge" of the viewer. The notion "girls at play" thus resists any single interpretation, as the girls' sexual status always contains within it the potential for rapid and drastic change. (shrink)

Human Specialization in Design and Technology explores emerging trends in learning and training-standardization, customization, personalization-with a unique focus on human needs and conditions. Analyzing evidence from current academic research as well as the popular press, this concise volume defines and examines the trajectory of instructional design and technologies toward more human-centered and specialized products, services, processes, environments, and systems. Examples from education, healthcare, business, and other sectors offer real-world demonstrations for scholars and graduate students of educational technology, instructional design, ICT, (...) and business development. (shrink)

WARD Joseph Joubert and the Critical Tradition Platonism and Romanticism LIBRAIRIE DROZ SA 11, rue Massot GENEVE 1980 ...

Mark Wilson, in his 1985 paper entitled "What Is This Thing Called 'Pain'?: The Philosophy of Science Behind the Contemporary Debate," proposed an account of physicalism that departs significantly from standard approaches. One of the main points of his paper was to explain the flaws in arguments claiming that psychological properties cannot be shown to be physical because of their functional nature. However, the positive proposal that Wilson makes in this article bears further examination. I argue that it not only (...) resolves many problems that have grown up around the topic of physicalism, but that the proposal itself should make us radically rethink some important philosophical questions, especially those concerning explanation and property identification. (shrink)

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)