Eight focus groups were conducted in four public hospitals in Madrid to explore healthcare professionals’ perceptions of advance directives in order to improve the understanding of their lack of success among physicians and patients. A purposive sample of sixty healthcare professionals discussed ADs and reasons for their infrequent use. Three main themes were identified: perceptions about their meaning, appraisals of their use in clinical practice, and decision-making about them. Healthcare professionals perceived a lack of clarity about their definition and implementation. (...) There is insufficient awareness of their efficacy in improving the quality of clinical relationships and decision-making, and they are often perceived only as a bureaucratic procedure. Advance directives are not integrated in the clinical practice of Madrid’s healthcare specialist services because their application is exceedingly complex, because of insufficient education about them, and because of lack of procedural clarity. Consequently, healthcare professionals are not aware of how ADs could improve clinical decision-making, of when and for whom their use is appropriate, and of who has responsibility for providing ADs-related information to patients. These circumstances contribute to patients’ lack of interest in completing these documents and to physicians’ sceptical views about their usefulness. (shrink)

Since 2002, legislation in Spain has allowed for the creation and documentation of end-of-life decisionmaking. Over the intervening years, the actual implementation of such documents is very low. Through extensive analysis of the literature, this article explores the current status of the use of and attitudes toward advance directives in Spain and then proposes strategies for improvement in their implementation.

Our goal in this paper is to establish a set of criteria for understanding the meaning and sources of attributing (un)fairness to AI algorithms. To do so, we first establish that (un)fairness, like other normative notions, can be understood in a proper primary sense and in secondary senses derived by analogy. We argue that AI algorithms cannot be said to be (un)fair in the proper sense due to a set of criteria related to normativity and agency. However, we demonstrate how (...) and why AI algorithms can be qualified as (un)fair by analogy and explore the sources of this (un)fairness and the associated problems of responsibility assignment. We conclude that more user-driven AI approaches could alleviate some of these difficulties. (shrink)

In the last decade, robustness has been extensively mentioned and discussed in biology as well as in the philosophy of the life sciences. Nevertheless, from both fields, someone has affirmed that this debate has resulted in more semantic confusion than in semantic clearness. Starting from this claim, we wish to offer a sort of prima facie map of the different usages of the term. In this manner we would intend to predispose a sort of “semantic platform” which could be exploited (...) by those who wish to discuss or simply use it. We do this by starting from a core distinction between the robustness of representations, which is a philosophy of science issue, and the representations of robustness, which instead pertains to science. We illustrate our proposal with examples from biology, physics and mathematics. (shrink)

Die Phänomenologie stellt eine der Hauptströmungen der Gegenwartsphilosophie dar und findet in zahlreichen Wissenschaften sowie in Praxis und Therapeutik starke Resonanz. Nach 120 Jahren Wirkungsgeschichte füllt die Bibliothek phänomenologischer Werke zahllose Bücherregale und selbst für Expert:innen ist die Forschungsliteratur mittlerweile unüberschaubar geworden. An allgemeinen Einführungen sowie spezialisierter Fachliteratur mangelt es dabei keineswegs, wohl aber an einem Handbuch, in dem sowohl der Vielfalt der historischen Entwicklungen als auch dem berechtigten Wunsch nach innerer systematischer Kohärenz Rechnung getragen wird. Das Handbuch Phänomenologie schließt (...) diese Lücke. Ausgewiesene Autor:innen bereiten in eigens für diesen Band verfassten Artikeln komplexe sachliche Zusammenhänge übersichtlich auf. Durch seinen Aufbau eignet sich das Handbuch sowohl für Anfänger:innen als auch für Fortgeschrittene. Anhand bündig präsentierter Grundbegriffe und Verfahren konturiert das Handbuch die Spezifik der phänomenologischen Methode, spart dabei jedoch nicht die Kontroversen und methodologischen Neuausrichtungen aus, die von ihrer Lebendigkeit und Vielstimmigkeit zeugen. Ein umfangreicher Schlussteil ist der Rezeption und Anwendung in einzelnen Wirkfeldern gewidmet. Als Hilfsmittel zur eigenständigen Erschließung der phänomenologischen Denkrichtung und zu ihrer Anwendung auf aktuelle Probleme zeichnet sich das Handbuch durch seine Leser:innenfreundlichkeit und einen stark forschungspraktischen Bezug aus. Ein Kompendium, das sich bald als ABC der Phänomenologie etablieren dürfte. (shrink)

This note studies the 1650 edition of Hugo Grotius’s De iure belli ac pacis. Using online and card catalogues, we have located eighty-nine copies, thirty-seven of which we examined in person, with an additional six fully digitised copies online. We hope that this research note on the preliminary results will generate greater interest in this unduly neglected edition. The note shows how, despite the connection established in the history of seventeenth-century politics that emphasized the ties between Grotius and the Peace (...) of Westphalia, the reception of Grotius’s 1650 edition bore no relation to the debates at Osnabrück and Münster. However, this is an influential edition, cherished by collectors and authors. According to our findings, it would be reproduced in a number of later reprints. (shrink)

We concur with Sommer et al. that the processing manifested by P300 is not necessarily conscious. We also note that Verleger is yet again adducing evidence that contradicts an assertion we never made.

This article aims to analyze how the so-called ‘pedagogy of work’ attempts to answer the challenges of unemployment and job insecurity characterizing the labor market in contemporary society. The authors reflect on the concepts of nihilist pedagogies and the ‘end of work’ by distinguishing two approaches: an active and a passive nihilist pedagogy. The passive approach, based on resignation, is opposed to an active attitude in which labor pedagogy offers tools to address current challenges. The authors support the idea that (...) pedagogy as a human-improving science cannot adopt the position of passive nihilism in interpreting work in contemporary society. To better understand the dynamics related to job insecurity and corrective solutions by pedagogy, the authors analyzed the thoughts of three contemporary philosophers: Zygmunt Bauman, Jeremy Rifkin, and Dominique Méda. These authors redefined the concept of work in connection with the transformations because of globalization, the advent of new communication technologies, and digital work. These changes have redefined not only the concept of work but also the models of work pedagogy in the Western world: capitalism and Marxism. Considering the current challenges, the pedagogy of work needs to be rethought, starting from the problem of employability and focusing on the new occupations in demand in the Internet age. By integrating ideas on interpreting work from the theories of Bauman, Rifkin, and Méda, it is possible to propose a pedagogy of work in the age of change and to outline possible values of education inspired by it. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

Les designers et théoriciens Ezio Manzini et Virginia Tassinari répondent à la question posée par le titre du dossier, Design is the answer, but what was the question? Si, d’une part, se pose la question de l’impact social et politique du design et de sa responsabilité dans les changements sociaux, de l’autre s’impose une réflexion sur les modes d’action du design et sur les fondements de cette action. Dans cette perspective, Manzini met en avant les pratiques d’ engendrement et d’ (...) engagement comme stratégies d’action communes et communautaires, alors que Tassinari explique comment la définition du designing (plus que du design) comme une action politique nécessite une remise en question du cadre épistémologique qui la fonde. (shrink)

This volume reviews examples and notions of robustness at several levels of biological organization. It tackles many philosophical and conceptual issues and casts an outlook on the future challenges of robustness studies in the context of a practice-oriented philosophy of science. The focus of discussion is on concrete case studies. These highlight the necessity of a level-dependent description of robust biological behaviors.Experts from the neurosciences, biochemistry, ecology, biology, and the history and the philosophy of life sciences provide a multiplex perspective (...) on the topic. Contributions span from protein folding, to cell-level robustness, to organismal and developmental robustness, to sensorimotor systems, up to the robustness of ecological systems.Several chapters detail neurobiological case-studies. The brain, the poster child of plasticity in biology, offers multiple examples of robustness. Neurobiology explores the importance of temporal organization and multiscalarity in making this robustness-with-plasticity possible. The discussion also includes structures well beyond the brain, such as muscles and the complex feedback loops involved in the peculiar robustness of music perception. Overall, the volume grounds general reflections upon concrete case studies, opening to all the life sciences but also to non-biological and bio-inspired fields such as post-modern engineering. It will appeal to researchers, students, as well as non-expert readers. (shrink)

To understand the endogenous components of the event-related brain potential (ERP), we must use data about the components' antecedent conditions to form hypotheses about the information-processing function of the underlying brain activity. These hypotheses, in turn, generate testable predictions about the consequences of the component. We review the application of this approach to the analysis of the P300 component. The amplitude of the P300 is controlled multiplicatively by the subjective probability and the task relevance of the eliciting events, whereas its (...) latency depends on the duration of stimulus evaluation. These and other factors suggest that the P300 is a manifestation of activity occurring whenever one's model of the environment must be revised. Tests of three predictions based on this “context updating” model are reviewed. Verleger's critique is based on a misconstrual of the model as well as a partial and misleading reading of the relevant literature. (shrink)

INTRODUCTION The Questions of Medical Ethics Call him Andrew. His face is gaunt and unshaven but peaceful. His eyelids are gently closed. ...

For decades, worries about undue inducement have Pervaded clinical research, and are especially common when research is accompanied by payment or conducted in developing countries. Few ethical judgments carry as much moral opprobrium or are thought to undermine the ethical soundness of a clinical trial as thoroughly as undue inducement. Indeed, the admonition to prevent undue inducement is one of the few explicit instructions in the Common Rules requirements for informed consent.Despite their long history and pervasiveness, charges of undue inducement (...) in clinical research are almost always mistaken. Indeed, I will advance an even more radical claim: Aresearch trial that otherwise fulfills the fundamental ethical requirements for human subjects research inherently cannot create the possibility of undue inducement because substantial risk of serious harm isprecluded. Charges of undue inducement tend to express displaced and mislabeled ethical concerns about other aspects of human subjects research. Consequently, claims of undue inducement should rarely be made, and when they are advanced should be treated with skepticism, placing a heavy burden of proofon those advancing such charges. (shrink)

Emanuele Maffi argues that the Theaetetus, one of the most difficult dialogues of Plato, demonstrates the unbridgeable distance between philosophy and sophia, confirmed by the aporetic outcome of the dialogue. The purpose of this work is to demonstrate that this distance is not necessarily an evil, because in the impossibility of reaching sophia lies the very condition of the existence of philosophy. While all other Platonic works attempt to explain the best ways to inhabit the space of philosophy, the (...) Theaetetus sets the conditions for what constitutes the space of philosophy. (shrink)

1. The opinions expressed are the author's own. They do not reflect any position or policy of the National Institutes of Health, Public Health Service, Department of Health and Human Services, or any of the authors affiliated organizations.

Emanuele Avallone, Patrice Bergeron, Dominique Laperle, Michael Quisinsky, Philippe Roy-Lysencourt et Karim Schelkens.

Suppose a meeting had been called among chief medical officers, chief administrative officers, and other leaders from a range of health-related institutions in this country. The question posed for this meeting was simple but unusual: Arethestructuresofourorganizations,systems,andinstitutionsethical? Though it was a question reminiscent for a few of the focus some time before on whether the conduct of individuals in their organization was ethical, this question seemed more demanding. Is it reasonable to consider structures or arrangements as ethical or not; or in (...) other words, is ethics an applicable attribute of organizations? And if it is reasonable to speak of an ethics of organizations, by what method might one discern any kind of an answer? And what of the informal connections that link different organizations … how can they be evaluated? (shrink)

Because rate of force development is an emerging outcome measure for the assessment of neuromuscular function in unfatigued conditions, and it represents a valid alternative/complement to the classical evaluation of pure maximal strength, this scoping review aimed to map the available evidence regarding RFD as an indicator of neuromuscular fatigue. Thus, following a general overview of the main studies published on this topic, we arbitrarily compared the amount of neuromuscular fatigue between the “gold standard” measure and peak, early and late (...) RFD. Seventy full-text articles were included in the review. The most-common fatiguing exercises were resistance exercises, endurance exercises/locomotor activities, isokinetic contractions, and simulated/real sport situations. The most widely tested tasks were knee extension and plantar flexion. The reason for evaluating RFD was lacking in 36% of the studies. On average, the amount of fatigue for MVF was comparable to late RFD but lower compared to both peak RFD and early RFD. Even if the rationale for evaluating RFD in the fatigued state was often lacking and the specificity between test task and fatiguing exercise characteristics was not always respected in the included studies, RFD seems to be a valid indicator of neuromuscular fatigue. Based on our arbitrary analyses, peak RFD and early phase RFD appear even to be more sensitive to quantify neuromuscular fatigue than MVF and late phase RFD. (shrink)

In arguing against a supposed ambiguity, philosophers often rely on the zeugma test. In an application of the zeugma test, a supposedly ambiguous expression is placed in a sentence in which several of its supposed meanings are forced together. If the resulting sentence sounds zeugmatic, that is taken as evidence for ambiguity; if it does not sound zeugmatic, that is taken as evidence against ambiguity. The aim of this article is to show that arguments based on the second direction of (...) the test are misguided: ambiguous expressions, and in particular philosophically contested ones, do not reliably lead to zeugmaticity, so an absence of zeugmaticity provides no meaningful evidence for an absence of ambiguity. (shrink)

Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.

Intentionalism is the view that demonstratives, gradable adjectives, quantifiers, modals and other context‐sensitive expressions are intention‐sensitive: their semantic value on a given use is fixed by speaker intentions. The first aim of this paper is to defend Intentionalism against three recent objections, according to which speakers at least sometimes do not have suitable intentions when using supposedly intention‐sensitive expressions. Its second aim is to thereby shed light on the so far little‐explored question of which kinds of intentions can be semantically (...) relevant. (shrink)

According to Perdurantism, persons are identical to maximal aggregates of appropriately interrelated temporal parts. Within the Perdurantist framework, an epistemic concern arises, targeting the perduring persons’ belief that they are persons, suggesting that, ultimately, they are not in a position to know that they are persons as opposed to temporal parts. Despite the consideration it has received over the years, this concern has not yet been converted into a full-fledged objection. This paper aims to address this gap by exploring the (...) possibility of formulating a coherent Epistemic Objection against Perdurantism. We shall examine several epistemological principles around which such an objection might be built, arguing that none of them, in the end, allows a plausible formulation of the objection. As a result, we shall conclude that the burden of proving that in a Perdurantist setting persons are not in a position to know that they are persons rests with the objectors. (shrink)

Spinoza's writing style has been judged, by various commentators, alternatively as excessively dry or lavishly rich, depending on the precise text that these scholars had in mind when making such judgments. This chapter offers an overview of a selected list of Scholastic debates intersecting the CM. It highlights how Spinoza consciously intervenes in them, showing a certain awareness of the intricacies of Scholastic discourse. Spinoza opens the CM with a discussion of the term “being,” claiming that “being is badly divided (...) into real being and being of reason”. The chapter focuses on how Spinoza can be interpreted as responding to the canonical thought of Francisco Suárez, since the Leiden Scholastics interacted especially with the Escuela de Salamanca. One of Spinoza's main piéces de résistance is the doctrine of the inseparability between the will and intellect of God. Spinoza has a much stronger thesis regarding the “external” identity of God's intellect, power, and will. (shrink)

The understanding of appropriate ethical protections for participants of biomedical research has not been static. It has evolved over time, with the evolution of biomedical research as well as social values. Since World War II, there have been four major paradigms of research and research oversight operative in the United States. These paradigms incorporate different values and provide different approaches to research oversight and the protection of research participants.

Comprehensive in scope and research, this book will be a crucial resource for researchers in the medical sciences, as well as teachers and students alike.

Many recent definitions of lying are based on the notion of what is said. This paper argues that says-based definitions of lying cannot account for lies involving non-literal speech, such as metaphor, hyperbole, loose use or irony. It proposes that lies should instead be defined in terms of assertion, where what is asserted need not coincide with what is said. And it points to possible implications this outcome might have for the ethics of lying.

In Divine Love and Wisdom, Swedish scientist-turned-seer Emanuel Swedenborg tackles the very nature of the universe, describing a loving God who is equally present with all people on earth—regardless of race or religion—and explores the underlying unity of all living things.

In the past few years, machine learning (ML) tools have been implemented with success in the medical context. However, several practitioners have raised concerns about the lack of transparency—at the algorithmic level—of many of these tools; and solutions from the field of explainable AI (XAI) have been seen as a way to open the ‘black box’ and make the tools more trustworthy. Recently, Alex London has argued that in the medical context we do not need machine learning tools to be (...) interpretable at the algorithmic level to make them trustworthy, as long as they meet some strict empirical desiderata. In this paper, we analyse and develop London’s position. In particular, we make two claims. First, we claim that London’s solution to the problem of trust can potentially address another problem, which is how to evaluate the reliability of ML tools in medicine for regulatory purposes. Second, we claim that to deal with this problem, we need to develop London’s views by shifting the focus from the opacity of algorithmic details to the opacity of the way in which ML tools are trained and built. We claim that to regulate AI tools and evaluate their reliability, agencies need an explanation of how ML tools have been built, which requires documenting and justifying the technical choices that practitioners have made in designing such tools. This is because different algorithmic designs may lead to different outcomes, and to the realization of different purposes. However, given that technical choices underlying algorithmic design are shaped by value-laden considerations, opening the black box of the design process means also making transparent and motivating (technical and ethical) values and preferences behind such choices. Using tools from philosophy of technology and philosophy of science, we elaborate a framework showing how an explanation of the training processes of ML tools in medicine should look like. (shrink)

In this paper we show how some reasoning, though fallacious, can appear to be attractive and useful for beings-like-us. Although they do not provide conclusive evidence to support or reject a certain claim the way scientific statements do, they tell us something interesting about how humans build up their arguments and reasons. First of all, we will consider and investigate three main types of fallacies: argumentum ad hominem, argumentum ad verecundiam, and argumentum ad populum. These three fallacies are traditionally considered (...) as examples of a broader category called ignoratio elenchi. Secondly, we show how people who commit these fallacies rely on information about other human beings in their reasoning. That is, they do not follow certain logical procedures that eventually lead them to correct conclusions. But they simply make use of others as social characters. For example, being an authority, being an expert, being part of a class, etc., become the substitutes for more direct evidence to support a certain claim or to make an argument more appealing. (shrink)

O artigo tem o objetivo de apresentar a produção do conhecimento, teses e dissertações que pesquisaram a temática das ações afirmativas no Brasil. Para isso, iniciou-se a pesquisa escolhendo uma base de dados, a BDTD, que permitiu acessar as teses e dissertações produzidas nos Programas de Pós-Graduação no Brasil. Em seguida optou-se por utilizar o termo “ações afirmativas” para realizar a pesquisa bibliográfica dentro da base de dados. As informações obtidas foram sistematizadas em planilha do tipo “excel”. Como resultado, foram (...) localizadas 373 produções do conhecimento sendo 173 na região Sudeste, 82 na região Sul, 68 na região Nordeste, 41 na região Centro-Oeste e 9 na região Norte. (shrink)

Background: The health professionals are involved in the paths of care for patients with different medical conditions. Their life is frequently characterized by psychopathological outcomes so that it is possible to identify consistent burdens. Besides the possibility to develop pathological outcomes, some protective factors such as resilience play a fundamental role in facilitating the adaptation process and the management of maladaptive patterns. Personal characteristics and specific indexes such as burdens and resilience are essential variables useful to study in-depth ongoing conditions (...) and possible interventions. The study was aimed at highlighting the presence and the relations among factors as personal variables, burdens, and resilience, to understand health professionals' specific structure and functions.Methods: The observation group was composed of 210 participants, 55 males, and 155 females, aged from 18 to 30 years old with a mean age of 25.92 years old. The study considered personal characteristics of the subjects, such as age, gender, years of study, days of work per week, hours of work per week, and years of work. Our study had been conducted with the use of measures related to burdens and resilience.Results: The performed analyses consisted of descriptive statistics, correlations, and regressions among the considered variables. Several significant correlations emerged among personal characteristics, CBI, and RSA variables. Specifically, age and work commitment indexes appeared to be significantly related to the development of burdens, differently from the years of study. Significant correlations emerged among personal and RSA variables, indicating precise directions for both domains. Age and gender were identified as predictors to perform multivariate regression analyses concerning CBI factors. Significant dependence relations emerged with reference to all CBI variables.Conclusion: Pathological outcomes and resilience factors represent two sides of the health professionals' experiences, also known as “invisible patients.” Greater knowledge about present conditions and future possibilities is a well-known need in literature so that the current analyses considered fundamental factors. In line with state of the art, future studies are needed in order to deepen elusive phenomena underlying maladjustment. (shrink)