Health technology assessment (HTA) is often biased in the sense that it neglects relevant perspectives on the technology in question. To incorporate different perspectives in HTA, we should pursue agreement about what are relevant, plausible, and feasible research questions; interactive technology assessment (iTA) might be suitable for this goal. In this way a kind of procedural ethics is established. Currently, ethics too often is focussed on the application of general principles, which leaves a lot of confusion as to what really (...) is the matter in specific cases; in an iTA clashes of values should not be approached by use of such ethics. Instead, casuistry, as a tool used within the framework of iTA, should help to articulate and clarify what is the matter, as to make room for explication and consensus building. (shrink)

Interactive technology assessment (iTA) provides an answer to the ethical problem of normative bias in evaluation research. This normative bias develops when relevant perspectives on the evaluand (the thing being evaluated) are neglected. In iTA this bias is overcome by incorporating different perspectives into the assessment. As a consequence, justification of decisions based on the assessment is provided by stakeholders having achieved agreement. In this article, agreement is identified with wide reflective equilibrium to show that it indeed has the potential (...) of justifying decisions. We work out several conditions for this agreement to be achievable and just. (shrink)

ABSTRACTSolving a conflict between two response options in an interference task has been found to increase control in a subsequent conflict situation. The present research examined whether such conflict adaptation persists in the presence of distractors that have motivational relevance and are therefore competing for attentional resources. In an adjusted flanker task, motivational distractors were presented together with the current trial while the previous trial never included any distractor. Accumulated evidence across three studies showed that motivational distractors reduced the conflict (...) adaptation effect. This was found irrespective of the location at which the distractor occurred, and independent of its valence. Study 3 and a merged data analysis ruled out low-level alternative explanations. In line with a dual competition account (P... (shrink)

Psychologists' emerging interest in spirituality and religion as well as the relevance of each phenomenon to issues of psychological importance requires an understanding of the fundamental characteristics of each construct. On the basis of both historical considerations and a limited but growing empirical literature, we caution against viewing spirituality and religiousness as incompatible and suggest that the common tendency to polarize the terms simply as individual vs. institutional or ′good′ vs. ′bad′ is not fruitful for future research. Also cautioning against (...) the use of restrictive, narrow definitions or overly broad definitions that can rob either construct of its distinctive characteristics, we propose a set of criteria that recognizes the constructs' conceptual similarities and dissimilarities. Rather than trying to force new and likely unsuccessful definitions, we offer these criteria as benchmarks for judging the value of existing definitions. (shrink)

This article discusses studies and politicalinitiatives concerned with enhancing publicinvolvement in major technological decisions.It argues that such decisions should include asignificant role for the mass media, andrespect for the diverse relations betweenscience and governance. The notion of`regulated worlds' is proposed as a startingpoint in a discourse that brings together themass media, science management, anddeliberative democracy.

Interactive technology assessment is a novel approach to evaluating (health) technology, which philosophically draws from the works of Rawls and Habermas. That is, it seeks to organise a practical setting for discursive ethics in order to find a legitimate basis for policy to be pursued when the technology under scrutiny features a moral controversy. Interactive technology assessment involves a cycle of interviews with all stakeholders, who are explicitly asked to respond (anonymously) to the concerns and issues raised by other participants. (...) This cycle is completed repeatedly, so that a process of vicarious learning develops. This process aims at identifying issues agreed and disagreed upon, on the basis of which widely endorsed policy recommendations can be formulated. This chapter involves an interactive technology assessment of paediatric cochlear implantation. The rationale, the design, and the results are explained, as well as the main ethical aspects of the procedure. (shrink)

Health technology assessment (HTA) is often biased in the sense that it neglects relevant perspectives on the technology in question. To incorporate different perspectives in HTA, we should pursue agreement about what are relevant, plausible, and feasible research questions; interactive technology assessment (iTA) might be suitable for this goal. In this way a kind of procedural ethics is established. Currently, ethics too often is focussed on the application of general principles, which leaves a lot of confusion as to what really (...) is the matter in specific cases; in an iTA clashes of values should not be approached by use of such ethics. Instead, casuistry, as a tool used within the framework of iTA, should help to articulate and clarify what is the matter, as to make room for explication and consensus building. (shrink)

From 1991 to 1994 the Dutch Health Insurance Council financed research on Extracorporeal Membrane Oxygenation (ECMO). This is a technique for providing cardiopulmonary bypass to patients with pulmonary and/or cardiac failure. Most often, these patients are premature neonates. During ECMO, blood is drained from the right atrium, pumped along a membrane where gas exchange takes place, and then redirected to the aorta. To prevent blood clotting, heparin is added. However, with the heparin added, the risk of hemorrhage is considerably increased. (...) Therefore, both the chance of surviving and the chance of severe disability are higher with ECMO than with conventional treatment (i.e., ventilator support). (shrink)

From 1991 to 1994 the Dutch Health Insurance Council financed research on Extracorporeal Membrane Oxygenation . This is a technique for providing cardiopulmonary bypass to patients with pulmonary and/or cardiac failure. Most often, these patients are premature neonates. During ECMO, blood is drained from the right atrium, pumped along a membrane where gas exchange takes place, and then redirected to the aorta. To prevent blood clotting, heparin is added. However, with the heparin added, the risk of hemorrhage is considerably increased. (...) Therefore, both the chance of surviving and the chance of severe disability are higher with ECMO than with conventional treatment. (shrink)

A possible explanation for policy implementation failure is that the views of the policy’s target groups are insufficiently taken into account during policy development. It has been argued that involving these groups in an interactive process of policy development could improve this. We analysed a project in which several target populations participated in workshops aimed to optimise the utilisation of an expensive novel drug (interferon beta) for patients with Multiple Sclerosis. All participants seemed to agree on the appropriateness of establishing (...) a central registry of Multiple Sclerosis patients and developing guidelines. Nevertheless, these policy measures were not implemented. Possible explanations include (1) the subject no longer had high priority when the costs appeared lower than expected, (2) the organisers had paid insufficient attention to the perceived problems of parties involved, and (3) changes within the socio-political context. The workshops in which representatives of the policy’s target populations participated did not provide enough interactivity to prevent policy implementation failure. (shrink)

The book deals with the notion of Downward Causation from a wide array of perspectives, including physics, biology, psychology, social science, communication studies, text theory, and philosophy. The book includes proponents as well as opponents discussing the validity of the notion.

Originally published in 1969. This book explains what is wrong with the traditional methodology of "inductive" reasoning and shows that the alternative scheme of reasoning associated with Whewell, Pierce and Popper can give the scientist a useful insight into the way he thinks.

P. B. Downing; VII.—Subjunctive Conditionals, Time Order, and Causation, Proceedings of the Aristotelian Society, Volume 59, Issue 1, 1 June 1959, Pages 125–140.

Health technology assessment consists of thesystematic study of the consequences of theintroduction or continued use of the technology in aparticular context, with the explicit objective toarrive at a judgment of the value or merit of thetechnology. Ideally, it is aimed at assessing allaspects of a given technology or group oftechnologies, including non-technical, e.g.socio-ethical, aspects. However, methods for assessingsocio-ethical implications of health technology arerelatively undeveloped and few mechanisms exist totake action based on the results of such evaluations.Still, the examples of cochlear (...) inplants and other cases illustratethat HTA is not a matter of merely collecting thefacts about a technology. The facts must beplausible and relevant from a particular framework,which is not always shared by different groups. It ishere that socio-ethical aspects are encountered. Ifhealth technology assessment aims to enhance theaccountability of the decision making processregarding funding and use of health technology, it isa major challenge to assessors of health technologiesto deal adequately with existing value pluralism. Inthis respect interactive evaluation may have somethingto offer. (shrink)

Imperatives cannot be true, but they can be obeyed or binding: `Surrender!' is obeyed if you surrender and is binding if you have a reason to surrender. A pure declarative argument — whose premisses and conclusion are declaratives — is valid exactly if, necessarily, its conclusion is true if the conjunction of its premisses is true; similarly, I suggest, a pure imperative argument — whose premisses and conclusion are imperatives — is obedience-valid (alternatively: bindingness-valid) exactly if, necessarily, its conclusion is (...) obeyed (alternatively: binding) if the conjunction of its premisses is. I argue that there are two kinds of bindingness, and that a vacillation between two corresponding variants of bindingness-validity largely explains conflicting intuitions concerning the validity of some pure imperative arguments. I prove that for each of those two variants of bindingness-validity there is an equivalent variant of obedience-validity. Finally, I address alternative accounts of pure imperative inference. (shrink)

About one third of patients with epilepsy have seizures refractory to the medical treatment. Electrical stimulation mapping is the gold standard for the identification of “eloquent” areas prior to resection of epileptogenic tissue. However, it is time-consuming and may cause undesired side effects. Broadband gamma activity recorded with extraoperative electrocorticography during cognitive tasks may be an alternative to ESM but until now has not proven of definitive clinical value. Considering their role in cognition, the alpha and beta bands could further (...) improve the identification of eloquent cortex. We compared gamma, alpha and beta activity, and their combinations for the identification of eloquent cortical areas defined by ESM. Ten patients with intractable focal epilepsy participated in a delayed-match-to-sample task, where syllable sounds were compared to visually presented letters. We used a generalized linear model approach to find the optimal weighting of each band for predicting ESM-defined categories and estimated the diagnostic ability by calculating the area under the receiver operating characteristic curve. Gamma activity increased more in eloquent than in non-eloquent areas, whereas alpha and beta power decreased more in eloquent areas. Diagnostic ability of each band was close to 0.7 for all bands but depended on multiple factors including the time period of the cognitive task, the location of the electrodes and the patient’s degree of attention to the stimulus. We show that diagnostic ability can be increased by 3–5% by combining gamma and alpha and by 7.5–11% when gamma and beta were combined. We then show how ECoG power modulation from cognitive testing can be used to map the probability of eloquence in individual patients and how this probability map can be used in clinical settings to optimize ESM planning. We conclude that the combination of gamma and beta power modulation during cognitive testing can contribute to the identification of eloquent areas prior to ESM in patients with refractory focal epilepsy. (shrink)

This article examines how local experiments and negotiation processes contribute to social and field-level learning. The analysis is framed within the niche development literature, which offers a framework for analyzing the relation between projects in local contexts and the transfer of local experiences into generally applicable rules. The authors examine 2 case studies drawn from a meta-analysis of 27 new energy projects. The case studies, both pertaining to biogas projects for local municipalities, illustrate the diversity of applications for a technology (...) through processes of local variation and selection. The authors examine the diversity of expectations and the negotiation and alignment of these expectations underlying the diversity of local solutions. Moreover, the authors address how the transfer of lessons from individual local experiments can follow different pathways and yet always require due attention to the social and cultural limits to the transferability of solutions. (shrink)

Central to Thomas Sprat's History of the Royal Society was the description and justification of the method adopted and advocated by the Fellows of the Society, for it was thought that it was their method which distinguished them from ancients, dogmatists, sceptics, and contemporary natural philosophers such as Descartes. The Fellows saw themselves as furthering primarily a novel method, rather than a system, of philosophy, and the History gave expression to this corporate self-perception. However, the History's description of their method (...) was not necessarily accurate. Rather, as will be argued below, by a combination of subtle misrepresentation and selective exposition, Sprat portrayed a method which would further the aims of social and ecclesiastical stability and material prosperity, essential for the Royal Society since its continued existence depended upon the creation of a social basis for the institutionalized pursuit of natural philosophy. Some link had to be forged between the activities of the Society and the intellectual and social aspirations of the Restoration. To understand the intent and meaning of Sprat's History and the method there portrayed, we must therefore look to the institutional needs which it fulfilled. (shrink)

Originally published in 1957, The Uniqueness of the Individual is a collection of 9 essays published from the ten years preceding publication. The essays deal with some of the central problems of biology. These are among the questions put and answered from the standpoint of modern experimental biology. What is ageing and how is it measured? What theories have been held to account for it, and with what success? Did ageing evolve, and if so how? Is Lamarckism and adequate explanation (...) of evolutionary process? Does evolution sometimes go wrong? Do human beings evolve in a way peculiar to themselves? Other essays touch upon the problems of scientific method and of growth and transformation. This book will be of interest to natural historians, evolutionists and anthropologists. (shrink)

The reception of Buffon's Histoire Naturelle in the Enlightenment has not received the historical attention it deserves. Drawing primarily on archival sources, this paper examines Aberdeen reactions to the Histoire during the period c. 1750–1800. As pedagogues, the Aberdonians endeavoured to maintain intellectual orthodoxy, and hence they attacked Buffon for his apparent materialism and atheism. Moreover, the Aberdonians rejected Buffon's critique of taxonomy because they based their natural history courses on classifications of the three kingdoms of nature, and because they (...) attempted to use classification systems in nosology and the study of the human mind. Finally, in the 1790s Aberdeen readings of the Histoire were profoundly affected by the fears aroused by the French Revolution. (shrink)

Greek ontology eventually developed a notion variously described as ‘timeless’, ‘atemporal’, or ‘non-durational’ eternity. In Proclus and Simplicius it is already a school-commonplace, with a stable vocabulary in which aiōn is sharply distinguished from what is merely aïdios. Plotinus had perfected this notion beforehand, believing not only that he found it in Plato, but that Plato had developed it on Parmenidean grounds.

Book reviewed in this article:F.H. Bradley, Collected Works Volumes 1–5.

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)