ABSTRACTComparative effectiveness studies, referred to here as “usual-care” trials, seek to compare current medical practices for the same medical condition. Such studies are presumed to be safe and involve only minimal risks. However, that presumption may be flawed if the trial design contains “unusual” care, resulting in potential risks to subjects and inaccurately informed consent. Three case studies described here did not rely on clinical evidence to ascertain contemporaneous practice. As a result, the investigators drew inaccurate conclusions, misinformed research participants, (...) and subjects’ safety was compromised. Before approving usual-care protocols, IRBs and scientific review committees should evaluate the quality and completeness of information documenting usual-care practices. Guidance from governmental oversight agencies regarding evidence-based documentation of current clinical practice could prevent similar occurrences in future usual-care trials. Accurate information is necessary to ensure that trials comply with government regulations that require minimizing research risks to subjects and accurate informed consent documents. (shrink)

Ruth Abbey presents a close study of Nietzsche's works, Human, All Too Human, Daybreak, and The Gay Science. Although these middle period works tend to be neglected in commentaries on Nietzsche, they repay careful attention. Abbey's commentary brings to light important differences across Nietzsche's oeuvre that have gone unnoticed, filling a serious gap in the literature.

William James (1842-1910) was both a philosopher and a psychologist, nowadays most closely associated with the pragmatic theory of truth. The essays in this Companion deal with the full range of his thought as well as other issues, including technical philosophical issues, religious speculation, moral philosophy and political controversies of his time. The relationship between James and other philosophers of his time, as well as his brother Henry, are also examined. By placing James in his intellectual landscape the volume will (...) be particularly useful to teachers and students outside philosophy in such areas as religious studies, history of ideas, and American studies. New readers and nonspecialists will find this the most convenient and accessible guide to James currently available. Advanced students and specialists will find a conspectus of recent developments in the interpretation of James. (shrink)

Four questions are raised about the semantics of Quantified Modal Logic. Does QML admit possible objects, i.e. possibilia? Is it plausible to admit them? Can sense be made of such objects? Is QML committed to the existence of possibilia? The conclusions are that QML, generalized as in Kripke, would seem to accommodate possibilia, but they are rejected on philosophical and semantical grounds. Things must be encounterable, directly nameable and a part of the actual order before they may plausibly enter into (...) the identity relation. QML is not committed to possibilia in that the range of variables may be restricted to actual objects. Support of the conclusions requires some discussion of substitution puzzles; also, the semantical distinction between proper names which are directly referring, and descriptions even where the latter are "rigid designators". Views of W.V. Quine, B. Russell, K. Donnellan, D. Kaplan as well as S. Kripke are invoked or evaluated in conjunction with these issues. (shrink)

‘According to informational semantics, if it's necessary that a creature can't distinguish Xs from Ys, it follows that the creature can't have a concept that applies to Xs but not Ys.’ There is, indeed, a form of informational semantics that has this verificationist implication. The original definition of information given in Dretske'sKnowledge and the Flow of Information, when employed as a base for a theory of intentional representation or ‘content,’ has this implication. I will argue that, in fact, most of (...) what an animal needs to know about its environment is not available as natural information of this kind. It is true, I believe, that there is one fundamental kind of perception that depends on this kind of natural information, but more sophisticated forms of inner representation do not. It is unclear, however, exactly what ‘natural information’ is supposed to mean, certainly in Fodor's, and even in Dretske's writing. In many places, Dretske seems to employ a softer notion than the one he originally defines. I will propose a softer view of natural information that is, I believe, at least hinted at by Dretske, and show that it does not have verificationist consequences. According to this soft informational semantics, a creature can perfectly well have a representation of Xs without being able to discriminate Xs from Ys. (shrink)

“Teleosemantics and Pushmi-Pullyu Representations” (call it “TP-PR,” this journal 2014 79.3, 545–566) argues that core teleosemantics, particularly as defined in Millikan (Language, thought and other biological categories, MIT Press, Cambridge, 1984, J Philos 86(6):281–297, 1989, White queen psychology and other essays for Alice, MIT Press, Cambridge, 1993, Philosophical perspectives, Ridgeview Publishing, Alascadero, 1996, Varieties of meaning, MIT Press, Cambridge, 2004–2008), seems to imply that all descriptive representations are at the same time directive and that directives are at the same time (...) descriptive, hence that all representations are pushmi-pullyu representations. A pushmi-pullyu representation is at once indicative and imperative, telling both what the case is and what to do about it. The usefulness at all of the notion of a pushmi-pullyu representation is then questioned. I have recently found several new papers, dissertations, discussions, in which TP-PR is treated as definitive. However, the conclusions of TP-PR rest on misunderstandings of my position, so although the date is late, clarification seems still to be in order. I will indicate a few significant corrections that need to be made to TP-PR’s description of my position (originally called “biosemantics”) and explain central features of biosemantics that are omitted in TP-PR’s description of basic teleosemantics and which are incompatible with the main argument and conclusions of TP-PR. I will try to clarify and explain the value of the notion of a pushmi-pullyu representation. (shrink)

In the current research landscape, there are increasing demands for research to be innovative and cutting-edge. At the same time, concerns are voiced that as a consequence of neoliberal regimes of research governance, innovative research becomes impeded. In this paper, I suggest that to gain a better understanding of these dynamics, it is indispensable to scrutinise current demands for innovativeness as a distinct way of ascribing worth to research. Drawing on interviews and focus groups produced in a close collaboration with (...) three research groups from the crop and soil sciences, I develop the notion of a project-innovation regime of valuation that can be traced in the sphere of research. In this evaluative framework, it is considered valuable to constantly re-invent oneself and take ‘first steps’ instead of ‘just’ following up on previous findings. Subsequently, I describe how these demands for innovativeness relate to and often clash with other regimes of valuation that matter for researchers’ practices. I show that valuations of innovativeness are in many ways bound to those of productivity and competitiveness, but that these two regimes are nevertheless sometimes in tension with each other, creating a complicated double bind for researchers. Moreover, I highlight that also the project-innovation regime as such is not always in line with what researchers considered as a valuable progress of knowledge, especially because it entails a de-valuation of certain kinds of long-term epistemic agendas. I show that prevailing pushes for innovativeness seem to be based on a rather short-sighted temporal imaginary of scientific progress that is hardly grounded in the complex realities of research practices, and that they can reshape epistemic practices in potentially problematic ways. (shrink)

Too much contemporary bioethical discourse is weak on science, lazily citing and adopting science fiction scenarios rather than science facts in the framing of analyses and policies. We challenge bioethicists to take more seriously the role of providing informed insight into and oversight over contemporary science and its implications and applications. Bioethicists must work harder to understand the fast-changing truths and limits of basic science, and they must incorporate only appropriate and authentic science into their discourse, just as they did (...) in the past when addressing the quandaries of clinical medicine. The field of bioethics is not so old and entrenched that its future is assured. Bioethicists must make themselves useful to society in order to deserve and retain the public's trust. They can best do this by ensuring that decision making and public policy are grounded in facts, not fictions and fantasies. (shrink)

Spiritual practices such as prayer have been shown to improve health and quality of life for those facing chronic or terminal illness. The early Christian healing tradition distinguished between types of prayer and their role in healing, placing great emphasis on the healing power of more integrated relational forms of prayer such as prayers of gratitude and contemplative prayer. Because autonomic tone is impaired in most disease states, autonomic homeostasis may provide insight into the healing effects of prayer. I report (...) on observations in five volunteers engaging in five types of prayer. Using heart rate variability as a measure of autonomic tone and adaptability, I review the potential correlation of type of prayer with autonomic rebalance as measured specifically by psychophysiological coherence ratios. The five types—supplication, devotion, intercession, gratefulness, and contemplative prayer—elicited varying degrees of improvements in heart rate variability and corresponding psychophysiological coherence. These observations suggest a correlation of innate healing to prayer type that is consistent with teachings from the Christian healing tradition and with modern research. Further research is warranted to verify these hypotheses. (shrink)

Deacon’s target article is a welcome contribution not only on “biological information” but, more generally, on representation in cognitive science. Some kind of explanation and justification for use of the terms “representation” and “interpretant” for primordial autogen system would be helpful. A connection between the notions of “information” and “representation” can be elaborated more in this respect.

Lack of clarity about underlying philosophical commitments leads to lack of clarity at other levels of analysis. Here I show that the literature on so-called “causal mechanisms” is rife with conceptual problems, stemming from insufficient rigor with respect to the metaphysics of causation.

Over the last four decades computers and the internet have become an intrinsic part of all our lives, but this speed of development has left related philosophical enquiry behind. Featuring the work of computer scientists and philosophers, these essays provide an overview of an exciting new area of philosophy that is still taking shape.

In diesem Band werden neueste Forschungen zur Physikerin, Mathematikerin und Philosophin Emilie Du Châtelet vorgestellt. Emilie Du Châtelet genoss in der deutschen Aufklärung eine hohe Reputation. Sie verband Leibniz Metaphysik mit der Physik von Newton und gelangte zu erstaunlichen Ergebnissen, die die Physik auf den Weg zu Einsteins Energieformel führte. Ihre Werke wurden sofort ins Deutsche übersetzt, Kant nimmt in seiner ersten Dissertation von 1747 auf sie Bezug. Die Sammlung stellt Texte vor, die den Einfluss der deutschen Aufklärung auf Du (...) Châtelets und Du Châtelets Einfluss auf die deutsche Philosophie diskutieren. Die großen Namen der Epoche stehen hier zur Debatte, Leibniz, Wolff, Boskovic, Euler, Friedrich II, Voltaire, La Mettrie und viele weitere Größen der Aufklärung werden in ihrem Zusammenhang mit Du Châtelet vorgestellt. (shrink)

A young man, terminally ill and in extreme suffering, asks to be removed from life support, requesting morphine first so he'll be asleep when the machine stops. His physician agrees, but the hospital's chief administrator intervenes, arguing that the morphine might itself cause death, leaving the physician open to criminal indictment for murder. To placate the administrator, the doctor and patient reach a grim compromise: life support will be disconnected first, and only after manifest signs of suffering appear will the (...) physician administer the morphine, to alleviate pain. The patient's request is ultimately respected, but many staff members feel he has been made to suffer needlessly. This is just one of many cases Ruth Macklin discusses in Enemies of Patients, an eye-opening look at the growing number of forces that are hostile to the interests of patients, including hospital administrators, lawyers who represent hospitals, insurance companies, government regulations, and even some well intentioned physicians. Macklin, a highly regarded medical ethicist, the author of Mortal Choices and the subject of a New York Times Magazine cover story, provides a behind-the-scenes look at how the patient's ethical rights are often violated. She describes, for instance, how a new breed of hospital administrator, the risk manager, acts consistently as an enemy of the patient, often urging physicians to continue aggressive, expensive treatments for critically ill patients--even when the patient and doctor agree the treatment should cease--for fear of lawsuits, bad publicity, or criminal indictment. (Macklin points out, for instance, that even though no physician has ever been convicted of a crime for withdrawing treatment from a patient in a permanent vegetative state, hospital lawyers and risk managers regularly assert that there is a danger of criminal liability in such cases.) The government also can become an enemy of patients. The most egregious case, according to Macklin, is the Federal government's "gag rule" which has prohibited health care facilities that receive Title X funds from discussing abortion with pregnant women, violating the patient's right to full information. And physicians themselves can become enemies of patients. Some, seeing themselves as fiscal gatekeepers, ration expensive health care procedures on financial rather than medical grounds. Some physicians refuse to treat patients who don't follow their advice (a cardiologist, for instance, who will not take care of patients who smoke) and others won't treat patients who pose a threat of lawsuit (such as a California woman in need of life-sustaining dialysis, who had previously sued another physician). Packed with numerous case histories drawn from the author's experience in a major urban medical center, Enemies of Patients will give readers a better understanding of their rights as patients and show them how to forge an alliance with their doctors against common enemies. (shrink)

Four key guidance points in the UNAIDS guidance document, Ethical Considerations in HIV Preventive Vaccine Research, are compared wit.

Ob die Welt, die wir erleben, außerhalb von uns vorhanden sei oder uns allein durch unsere Einbildungskraft vorgestellt werde, ist seit Descartes die bestimmende Frage neuzeitlicher Erkenntnistheorie. Erstmals Fichte hat ausgeführt, daß jeder Versuch ihrer Beantwortung notwendig in einen unendlichen Zirkel führt, in welchem unser Erleben in dialektischer Bewegung bald als Wahrnehmung, bald als Einbildung erscheint. Wie dieser Zirkel das Denken und Empfinden der frühromantischen Dichtergeneration aufs tiefste durchdringt, wirkt er zugleich als strukturierendes Prinzip ihrer literarischen Produktion. Der Einbildungskraft, deren (...) Wirkungsmacht alle frühromantischen Texte aufs eindringlichste bezeugen, wird dabei unterschiedliche Wertschätzung zuteil. (shrink)

""This is an excellent source of ideas on using the media to enrich science teaching and engage pupils.

El conflicto donatista, de gran incidencia en el África romana de los siglos IV y V, puso de manifiesto los supuestos sobre la coexistencia que poseían las partes antagonistas. La postura donatista se sostiene en acontecimientos históricos (la entrega de los Libros Sagrados a las autoridades), pero también en las eclesiologías de Tertuliano y Cipriano de Cartago. Inciden en éstas la concepción de la iglesia como iglesia de los mártires y la presunción de la inminencia del fin de los tiempos. (...) Esta concepción realiza una hermenéutica del lugar, ya que África es afirmada como el único lugar del cristianismo, por contraposición a todos los otros lugares, donde ya el cristianismo no existe, y una hermenéutica del tiempo, pues la historia y su posibilidad de libertad parece haberse detenido en virtud de los actos que se han efectuado. San Agustín propone el criterio dialógico de la ciudad como posibilidad práctica de la coexistencia y la libertad. (shrink)