“Through centuries of scourges and disasters, brought about by your code of morality, you have cried that your code had been broken, that the scourges were punishment for breaking it, that men were too weak and too selfish to spill all the blood it required. You damned man, you damned existence, you damned this earth, but never dared to question your code. . . . You went on crying that your code was noble, but human nature was not good enough (...) to practice it. And no one rose to ask the question: Good?—by what standard? (shrink)

Despite the importance of discussions over the epistemic role that artificially intelligent decision support systems ought to play, there is currently a lack of these discussions in both the AI literature and the epistemology literature. My goal in this paper is to rectify this by proposing an account of the epistemic role of AI decision support systems in medicine and discussing what this epistemic role means with regard to how these systems ought to be utilized. In particular, I argue that (...) AI decision support systems are not epistemic superiors, inferiors, or peers. Instead, I recommend that they be classified in an epistemic category of their own, as “epistemic nudges.” With my proposed account of the epistemic role of AI decision support systems, I aim to provide answers the following two questions: 1. How ought disagreements between a clinician and an AI decision support system be handled? 2. How ought responsibility and accountability be allocated when an AI decision support system used by a human clinician in decision-making results in harm? (shrink)

Denies that human senses cannot be trusted, that logic is arbitrary, and that concepts have no basis in reality and discusses universals.

The relationship between Rand and Branden changed over eighteen yaears from student and teacher, to friends, to colleagues, to lovers and finally antagonists.

Georg Wilhelm Friedrich Hegel's 'Philosophy of Nature' has often been accused of promoting a view of nature fundamentally at odds with the modern scientific understanding of nature. I show this accusation to be false by pointing to two aspects of Hegel's treatment of nature: its rejection of the 'a priori/a posteriori' distinction, and its connection to Hegel's conception of autonomy as freedom from givenness. I give a reading of Hegel's treatment of the laws of motion along these lines, and I (...) close with some points connecting this reading of Hegel to contemporary philosophy (specifically John McDowell and Catherine Malabou). (shrink)

Since man’s mind is his basic tool of survival, his means of gaining knowledge to guide his actions-the basic condition he requires is the freedom to think and to act according to his rational judgment. This does not mean that a man must live alone and that a desert island is the environment best suited to his needs. Men can derive enormous benefits from dealing with one another. A social environment is most conducive to their successful survival—but only on certain (...) conditions. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This dissertation focuses on the ethical implications of implementing artificial intelligence in healthcare. Three approaches are considered regarding the role that artificial intelligence ought to play in healthcare: 1. the neo-luddite approach, which urges against the implementation of artificial intelligence in healthcare altogether; 2. The substitutive approach, which favours the goal of ultimately substituting artificial intelligence systems for human clinicians; and 3. The assistive approach, which favours the implementation of artificial intelligence systems in healthcare, but only as a tool to (...) assist, rather than replace, human clinicians. The dissertation begins by looking at what excellence in the practice of medicine entails and deriving some formal duties of clinician, before proceeding to assess the risks or threats that different approaches to the use of AI may pose to the practice. The first position evaluated is the neo-luddite approach. In evaluating this approach, some arguments in its favour are considered, including worries regarding biased algorithms, decreased communication with patients, confidentiality, the resurgence of paternalism, the potential for unethical design, overdependence on AI, and inscrutability. After responding to these concerns and rejecting the neo-luddite approach, the dissertation shifts its focus on to the assistive and substitutive approaches. Before evaluating these two approaches, the concepts of “assistance” and “substitution” are analyzed and definitions of assistive and substitutive technology are provided. With these definitions at hand, the remaining two approaches are assessed, beginning with the substitutive approach, which is then rejected for reasons related to both AI’s limited capacity to foster a strong patient-clinician relationship (due to its limited capacity for compassion, recognition, communication, creating trust, and respecting patient autonomy) and concerns on a more systemic level (including its likelihood to cause responsibility gaps and produce erroneous and biased decisions). The final part of the dissertation focuses on the assistive approach. Issues related to clinician-AI disagreement and the use of opaque decision support systems are addressed and recommendations for handling these issues (derived after a discussion of the epistemic role of assistive AI) are provided. The dissertation concludes with the recommendation that the assistive approach offers a superior outlook for the future of medicine. (shrink)

All disciplines have their histories in addition to their theories. In general, the history of a set of problems is treated separately from the nature of the problems themselves. The axioms of a given discipline may be the object of external inquiry but are not usually subject to historical examination. In this way, psychoanalysis has been investigated, even challenged, by a variety of other disciplines: biology, linguistics, history, philosophy, literature, and so forth. One may ask whether psychoanalysis can also become (...) its own object, effectively distancing itself from itself. Will historical scrutiny provide criticism from within and thereby alter the nature of psychoanalysis?It has been our observation that the history of the creation of psychoanalysis and of the psychoanalytic movement suggests deficiencies and omissions within psychoanalytic theory. This implies something far beyond the simple idea that no serious examination of theoretical problems can occur without an understanding of their history. Not only the past but the future of psychoanalysis, both as a theory and as a clinical practice, may well depend on the conscious assessment and assimilation of its own history. “The Secret of Psychoanalysis: History Reads Theory” is intended in part as an introduction to Nicolas Abraham’s “Notes on the Phantom” which will, in turn, illuminate the theoretical and practical scope of this essay.A history of Freudian psychoanalysis could be written based on the voices of dissenting insiders, without including schismatics such as Carl Jung, Alfred Adler, Wilhelm Stekel, and others who eventually developed independent systems of thought. The detailed interpretation of such firsts is already a consecrated approach to psychoanalytic history. But much remains to be learned from the internal criticism of those who have participated in Freud’s movement or have sought sympathetically to understand the birth and progress of Freudian psychoanalysis. Most of the disagreements concern theoretical and clinical issues or the clocked access to documents that are essential to the history assessment of psychoanalysis. This is Ludwig Marcuse’s case as he writes to Ernest Jones on 10 October 1957.1 1. Ludwig Marcuse is the author of Freud und sein Bild vom Menschen [Freud and his image of man] . Nicholas Rand, assistant professor of French at the University of Wisconsin—Madison, is completing a book on the notion of hiding in literature, philosophy, and psychoanalysis. Maria Torok is the author of The Wolf Man’s Magic Word , recently published in translation. “The Secret of Psychoanalysis” is part of a book-length study Rand and Torok are writing on Freud and psychoanalytic theory. (shrink)

In many countries, health technology assessment organizations determine the economic value of new drugs and make recommendations regarding appropriate pricing and coverage in national health systems. In the US, recent policy proposals aimed at reducing drug costs would link drug prices to six countries: Australia, Canada, France, Germany, Japan, and the UK. We reviewed these countries’ methods of HTA and guidance on price and coverage recommendations, analyzing methods and guidance documents for differences in the methodologies HTA organizations use to conduct (...) their evaluations and considerations they use when making recommendations. We found important differences in the methods, interpretations of HTA findings, and condition-specific carve-outs that HTA organizations use to conduct evaluations and make recommendations. These variations have ethical implications because they influence the recommendations of HTA organizations, which affect access to the drug through national insurance and price negotiations with manufacturers. The differences in HTA approaches result from the distinct political, social, and cultural contexts of each organization and its value judgments. New cost-containment policies in the US should consider the ethical implications of the HTA reviews that they are considering relying on to negotiate drug prices and what values should be included in US pricing policy. (shrink)

A collection of essays argues that philosophy is an essential element of human life--a force that shapes human character and national culture and destiny--and offers the rational philosophy of Objectivism as an alternative.

Ideas of the contemporary novelist on capitalism, individual liberty, and free enterprise, illustrated by extracts from her four novels.

The authors respond to a letter by Mitchell Berger in the March‐April 2024 issue of the Hastings Center Report concerning their essay “Securing the Trustworthiness of the FDA to Build Public Trust in Vaccines.”.

A misconception regarding the ultrastructural basis of myocardial failure has been observed in laboratory studies involving medical students and practicing physicians, in medical textbooks, and in clinical instruction of students. This misconception attributes heart failure to overextension of individual cardiac muscle fibres and their sarcomeres, resulting in a mechanically based decline in contractile force production. The basis of the misconception is a set of component misconceptions which interact in reciprocally supportive ways. The interlocking nature of the component misunderstandings strengthens the (...) overall misconception, making it difficult to undermine. A contributor to many aspects of the faulty account of heart failure is a tendency toward oversimplification of complex phenomena in learning, instruction, and scientific research. Implications for medical education are considered. Keywords: mental models, knowledge representation, reductionism, myocardium, heart failure, physiology CiteULike Connotea Del.icio.us What's this? (shrink)

This second visit to the place of Virgil's birth was made partly in actuality—for my wife and I, before taking part in the Virgilian Cruise of last summer, spent two delightful days at Pietole with our hosts, the Signori Prati, and our guest and friend Bruno Nardi—and partly in a renewed pondering of the arguments presented by my friend Professor Conway both in his earlier article and in his recent review of the question, to which, as he says, I had (...) urged him to return. I promised him at the time that if he should not speak the last word on the subject, I would still further defend the view commonly accepted until he bestowed an extraordinary publicity on Calvisano and Carpenedolo. He declares that I maintain the traditional site at Pietole, ‘though not perhaps with very great confidence.’ He further implies that I ‘do not want to accept the evidence of Probus because “I prefer” to believe a mediaeval tradition.’ Let me assure him and the reader that I do not regard a mediaeval tradition per se as better proof than the certain statement of an ancient authority. I have been led, by studies in various fields, to respect tradition in general until it is disproved, and to lay the burden of the argument on those who would disprove it. But the mere sight of something hoary and mediaeval does not prompt me to exclaim, ‘Media Aetas locuta est; causa finita est’ I relish the attempts of an iconoclast to destroy rigid error, and accept his destruction if it is accomplished. In the present case, however, I have ‘very great confidence’ that Conway's assault on the tradition has come to naught. Possibly some new and unexpected evidence may yet be discovered, showing that Virgil was born at Calvisano, or Carpenedolo, or at some other site than Pietole—but nobody has presented it yet. (shrink)

In his Logic, Hegel argues that evaluative judgments are comparisons between the reality of an individual object and the standard for that reality found in the object's own concept. Understood in this way, an object is bad insofar as it fails to be what it is according to its concept. In his recent Life and Action, Michael Thompson has suggested that we can understand various kinds of natural defect in a similar way, and that if we do, we can helpfully (...) see intellectual and moral badness—irrationality and vice—as themselves varieties of natural defect. In this paper, I argue that Hegel's position on animal individuality denies the claim that irrationality and vice are forms of natural defect. Hegel's account of the individuality proper to the animal organism in the Philosophy of Nature clearly disallows evaluative judgments about animals and thereby establishes a well-defined conceptual distinction between natural defect and intellectual or ethical—i.e., broadly spiritual or geistliche—defect. Hegel thus provides a way of maintaining the difference between nature and spirit within his broader commitment to a post-Kantian conception of substantial form. (shrink)

We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how (...) at its best, it can contribute to the provision of PCC. PA is a means of cost saving and as such it has mixed success. The example of the US demonstrates how implementation of PA has increased health inequalities whereas best practice has the potential to reduce them. In contrast, systems of universal coverage, like those in Europe, may use the cost savings of PA to better address individuals' care and PCC. The conclusion we offer therefore is an optimistic one, pointing towards areas of supportive overlap between PCC and PA where usually the incongruities are most evident. (shrink)

In this beautifully written and brilliantly reasoned book, Ayn Rand throws a new light on the nature of art and its purpose in human life. Once again Miss Rand eloquently demonstrates her refusal to let popular catchwords and conventional ideas stand between her and the truth as she has discovered it. The Romantic Manifesto takes its place beside The Fountainhead as one of the most important achievements of our time.