In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Search for Unity in Diversity: The "Permanent Hegelian Deposit" in the Philosophy of John DeweyFrank X. RyanJames A. Good A Search for Unity in Diversity: The "Permanent Hegelian Deposit" in the Philosophy of John Dewey Lanham, MD: Lexington Books, 2006. xxx + 288 pp.Among the revelations of Dewey's rare moments of autobiographical reflection, none has generated more curiosity and investigative zeal than his 1930 claim to have (...) "drifted" from Hegel in the decade following his move from Michigan to Chicago in 1894. Beginning with Morton White's Origin of Dewey's Instrumentalism (1943), biographers have divided on the question of whether Dewey's later philosophy was more strongly influenced by William James's experimental psychology or F. J. E. Woodbridge's Aristotelian naturalism. Despite their differences, both approaches are essentially empirical and realistic, and thus the majority of sympathetic commentators have agreed that Dewey was a realist, albeit of a decidedly unorthodox stripe. For them the notion that Dewey retained any significant commitment to idealism, given its virtual eradication at the beginning of the twentieth century, would damage his influence and legacy.It has been something of a puzzle, accordingly, that in the same autobiographical essay Dewey alludes to a "permanent Hegelian deposit." For years Richard Rorty has claimed this differentiates a "good" Dewey committed to "social flourishing" from a "bad" Dewey prone to metaphysical dalliance. But the first systematic inquiry into Dewey's enduring Hegelianism is John R. Shook's Dewey's Empirical Theory of Knowledge and Reality (2000). Shook argues convincingly that Dewey never abandoned idealism, but rather transformed it into an experimental naturalism by doing away with both "mind-stuff" and equally noxious "things-in-themselves." In many ways James Good's A Search for Unity in Diversity is a bookend to Shook's project, though Good further differentiates Anglo-American Neo-Hegelianism from Hegel himself. According to Good, Dewey endorsed a Humanistic/Historicist interpretation of Hegel rooted in the reciprocal engagement of individuals and societies, rather than the supernatural and architectonic absolute championed by Neo-Hegelians such as T. H. Green, and F. H. Bradley. With [End Page 216] top-notch scholarship and scrupulous attention to detail, A Search for Unity in Diversity is both an excellent intellectual biography and a penetrating plea for a radical reinterpretation of Dewey's contribution to philosophy. I'll briefly sketch the historical account before addressing the more controversial claims about the "permanent Hegelian deposit."Even readers familiar with the half-dozen book-length treatments of Dewey's development will find this account refreshing and informative. Good's professional credentials as a historian shine as he recreates the rough and bustling Burlington of Dewey's youth. In the 1870s, German idealism was considered the epitome of political liberalism and progressive education, and Dewey's journey toward the "inclusive philosophical idea" of the social began in an environment swirling with the crosscurrents of Kant, Hegel, and Schelling. At the White Street Congregational Church, Lewis Barstow preached a liberal orthodoxy that was essentially "man-building" (102), and Good presents a convincing case for the likelihood that even in boyhood Dewey never viewed God as an aloof law-giver or cosmic architect, but as a process unifying the individual and the social within a natural world of unlimited potential. At the University of Vermont Dewey encountered a struggling rural college transformed into the first bastion of American transcendentalism by James Marsh, who inspired a "Burlington philosophy" that rejected atomistic empiricism for a holistic integrity of knowing and doing, facts and values, and pure and practical reasons (57–59).In noting the influence of the "St. Louis Hegelians" upon Dewey, most biographers have focused on W. T. Harris, the prominent founder of The Journal of Speculative Philosophy who published Dewey's earliest submissions and offered encouragement that led to his pursuit of graduate work at Johns Hopkins. Good augments this familiar tale with fascinating depictions of equally influential yet lesser-known Hegelians such as H. C. Brokmeyer, Denton Snider, and Thomas Davidson. At a time when European Hegelianism was polarized between, on the one hand, reactionary apologists for traditional Christianity and Prussian militarism and, on the other, radical... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Search for Unity in Diversity: The "Permanent Hegelian Deposit" in the Philosophy of John DeweyFrank X. RyanJames A. Good A Search for Unity in Diversity: The "Permanent Hegelian Deposit" in the Philosophy of John Dewey Lanham, MD: Lexington Books, 2006. xxx + 288 pp.Among the revelations of Dewey's rare moments of autobiographical reflection, none has generated more curiosity and investigative zeal than his 1930 claim to have (...) "drifted" from Hegel in the decade following his move from Michigan to Chicago in 1894. Beginning with Morton White's Origin of Dewey's Instrumentalism (1943), biographers have divided on the question of whether Dewey's later philosophy was more strongly influenced by William James's experimental psychology or F. J. E. Woodbridge's Aristotelian naturalism. Despite their differences, both approaches are essentially empirical and realistic, and thus the majority of sympathetic commentators have agreed that Dewey was a realist, albeit of a decidedly unorthodox stripe. For them the notion that Dewey retained any significant commitment to idealism, given its virtual eradication at the beginning of the twentieth century, would damage his influence and legacy.It has been something of a puzzle, accordingly, that in the same autobiographical essay Dewey alludes to a "permanent Hegelian deposit." For years Richard Rorty has claimed this differentiates a "good" Dewey committed to "social flourishing" from a "bad" Dewey prone to metaphysical dalliance. But the first systematic inquiry into Dewey's enduring Hegelianism is John R. Shook's Dewey's Empirical Theory of Knowledge and Reality (2000). Shook argues convincingly that Dewey never abandoned idealism, but rather transformed it into an experimental naturalism by doing away with both "mind-stuff" and equally noxious "things-in-themselves." In many ways James Good's A Search for Unity in Diversity is a bookend to Shook's project, though Good further differentiates Anglo-American Neo-Hegelianism from Hegel himself. According to Good, Dewey endorsed a Humanistic/Historicist interpretation of Hegel rooted in the reciprocal engagement of individuals and societies, rather than the supernatural and architectonic absolute championed by Neo-Hegelians such as T. H. Green, and F. H. Bradley. With [End Page 216] top-notch scholarship and scrupulous attention to detail, A Search for Unity in Diversity is both an excellent intellectual biography and a penetrating plea for a radical reinterpretation of Dewey's contribution to philosophy. I'll briefly sketch the historical account before addressing the more controversial claims about the "permanent Hegelian deposit."Even readers familiar with the half-dozen book-length treatments of Dewey's development will find this account refreshing and informative. Good's professional credentials as a historian shine as he recreates the rough and bustling Burlington of Dewey's youth. In the 1870s, German idealism was considered the epitome of political liberalism and progressive education, and Dewey's journey toward the "inclusive philosophical idea" of the social began in an environment swirling with the crosscurrents of Kant, Hegel, and Schelling. At the White Street Congregational Church, Lewis Barstow preached a liberal orthodoxy that was essentially "man-building" (102), and Good presents a convincing case for the likelihood that even in boyhood Dewey never viewed God as an aloof law-giver or cosmic architect, but as a process unifying the individual and the social within a natural world of unlimited potential. At the University of Vermont Dewey encountered a struggling rural college transformed into the first bastion of American transcendentalism by James Marsh, who inspired a "Burlington philosophy" that rejected atomistic empiricism for a holistic integrity of knowing and doing, facts and values, and pure and practical reasons (57–59).In noting the influence of the "St. Louis Hegelians" upon Dewey, most biographers have focused on W. T. Harris, the prominent founder of The Journal of Speculative Philosophy who published Dewey's earliest submissions and offered encouragement that led to his pursuit of graduate work at Johns Hopkins. Good augments this familiar tale with fascinating depictions of equally influential yet lesser-known Hegelians such as H. C. Brokmeyer, Denton Snider, and Thomas Davidson. At a time when European Hegelianism was polarized between, on the one hand, reactionary apologists for traditional Christianity and Prussian militarism and, on the other, radical... (shrink)

XXX. An epitaph from Aphrodisias and the calendar of the province of Asia in Ihe Byzantine Empire. The document dates very precisely four events ranging from 521 to 551. The months are indicated by numbers, a peculiarity which erroneous attempts have been made to relate to the Julian Calendar. The calendar of the province of Asia is the only one that allows a concordance to be made here between the day of the month and the day of the week. Late (...) inscriptions from other cities in Asia Minor show that this provincial calendar remained in use until the end of Antiquity. XXXI. An epitaph from Adrianople under Justin II. The deceased Komentiolos, who belonged to the Great Church in Constantinople, was at the same time a tent-maker, παπυλιωνάριος (name of a new profession). The names of Justin II and Caesar Tiberius have already been identifîed in the date of death ; to them that of the empress Sophia has been erroneously added. The usual chronological formula in fact requires a post-consular date, followed by the number 9, corresponding to the years 575-577. XXXII. "How far? As far as here." Several pagan epitaphs comment ironically on the human career, answering the question "How far?" with "As far as here." Christians did not find this manifestation of popular wisdom displeasing, and it is equally well attested in Christian inscriptions in Northern Syria. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

Contemplating Suicide: The Language and Ethnics of Self Harm By Gavin J. Fairbairn Routledge, 1995. Pp. xxx. ISBN 415?10606. £12.95(pbk). Religious Transformation in Western Society. The End of Happiness By Harvie Ferguson, Routledge, 1992. Pp. xvi + 269. ISBN 0?415?02574?5. £XX.xx. Feminism and the Self: The Web of Identity By Morwenna Griffiths Routledge, 1995. Pp. 191. ISBN 0?415?09821?1. £12.99 (pbk). Faith, Scepticism and Personal Identity. A Festschrift for Terence Penelhum Edited by J.J. Macintosh and H. A. Meynell University of Calgary (...) Press, 1994. Pp. vii + 304. CAN$27.95. The Shape of Space (second edition) By Graham Nerlich Cambridge University Press, 1994. ISBN 0?521?45645?2. Logical Learning Theory: A Human Teleology and its Empirical Support By Joseph F. Rychlak University of Nebraska Press, 1994. Pp. 387. ISBN 0?8032?3904?1. £32.95 Philosophical Idealism and Christian Belief By Alan P.F. Sell University of Wales Press, 1995. Pp. x + 338. (shrink)

Cambridge Texts in the History of Philosophy: Series Editors, Karl Ameriks and Desmond M. Clarke. Ren Descartes, Meditations on First Philosophy with Selections from the Objections and Replies . Translated and edited by John Cottingham. Cambridge, Cambridge University Press, 1996. Pp. xlvi + 120. 25., 7.95 pb. ISBN 0-521-55252-4 (hb.). ISBN 0-521-55818-2 (pb.). Ralph Cudworth, A Treatise Concerning Eternal and Immutable Morality with A Treatise of Freewill . Edited by Sarah Hutton. Cambridge, Cambridge University Press, 1996. Pp. xxxvi + 218. (...) 37.50 hb., 13.95 pb., ISBN 0-521-47362-4 (hb.). ISBN 0-521-47918-5 (pb.). Anne Conway: The Principles of the Most Ancient and Modern Philosophy . Translated and edited by Allison P. Coudert and Taylor Corse. Cambridge, Cambridge University Press, 1996. Pp. xxxix + 73. 35.00 hb., 12.95 pb. ISBN 0-521-47335-7 (hb.). ISBN 0-521-47904-5 (pb.). Julien Offray de La Mettrie: Machine Man and Other Writings . Translated and edited by Ann Thomson. Cambridge, Cambridge University Press, 1996. Pp. xxx + 179. 35.00 (hb.), 12.95. ISBN 0-521-47258-X (hb.). ISBN 0-521-47849-9 (pb.). (shrink)

Human genetics has uncovered a vast trove of medically relevant changes in our genomes—variants and mutations that are both far more common and difficult to interpret than experts anticipated. What will this mean as we move into an era of genomic or “precision” medicine? For over a century the overriding goal of human genetics was to explain the inheritance of traits and conditions that hailed from disciplines like medicine, psychology, and criminology. Yet today, genomics research is calling prevailing categories of (...) human illness and difference into question. Genetic mutations are increasingly used to reclassify disease, disability, and developmental difference—a process I call genomic designation. In recent decades, this has led to the formation of support groups, foundations, specialist clinics, and dedicated literatures for genomically designated conditions like the XXX, NGLY1, Fragile X, and 1p36 Deletion Syndromes. Drawing heavily on the case of 22q11.2 Deletion Syndrome, this paper explains how a genetic test result can radically alter the way a patient is understood and treated. Finding a 22q11.2 microdeletion can lead patients, parents, and caregivers to recast other diagnoses as mere symptoms of an underlying genetic disorder. A 22q11.2DS diagnosis can also redirect medical judgment and practice towards evaluations and even interventions that were not clinically indicated. Finally, a genomically designated diagnosis like 22q11.2DS can realign the very boundary between the normal and the pathological, leading experts and caregivers to reframe clinically nonsignificant findings like an IQ of eighty-seven as the symptom of a genetic disorder. In this way, the growing avalanche of positive genetic test results is disrupting classification and practice in a wide range of disciplines, bringing new populations under the gaze of medical genetics in the process. I conclude by discussing a few salient implications for bioethics and the social studies of science and medicine. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Books ReceivedThe Act of Being: The Philosophy of Revelation in Mullā Sadrā. By Christian Jambet. Brooklyn: Zone Books, 2006. Pp. 497. Hardcover $38.95.Analysis in Śaṅkara Vedānta: The Philosophy of Ganeswar Misra. Edited by Bijayananda Kar. New Delhi: Indian Council of Philosophical Research, 2006. Pp. xxv + 190. Hardcover Rs. 240.00.Bhakti and Philosophy. By R. Raj Singh. Lanham: Lexington Books, 2006. Pp. 112. Hardcover $65.00.Brahman and the Ethos of Organization. (...) By Leonard R. Silos. Paseo de Roxas: Asian Institute of Management, 2006. Pp. xix + 344. Price not given.Buddhist Inclusivism: Attitudes Towards Religious Others. By Kristin Beise Kiblinger. Burlington, VT: Ashgate Publishing Company, 2005. Pp. viii + 145. Hardcover $89.95.Classical Northern Wu Style Tai Ji Quan: The Fighting Art of the Manchurian Palace Guard. By Tina Chunna Zhang and Frank Allen. Berkeley: Blue Snake Books, 2006. Pp. xiii + 203. Paper $21.95.Classical Sāṃkhya and Yoga: An Indian Metaphysics of Experience. By Mikel Burley. London and New York: Routledge, 2007. Pp. xiv + 226. Price not given.Comparative Philosophy and Religion in Times of Terror. Edited by Douglas Allen. Lanham: Lexington Books, 2006. Pp. xiv + 257. Hardcover $62.00. Paper $32.00.Contemplative Science: Where Buddhism and Neuroscience Converge. By B. Alan Wallace. New York: Columbia University Press, 2007. Pp. vii + 211. Hardcover $29.50, £19.00.Contexts and Dialogue: Yogācāra Buddhism and Modern Psychology on the Subliminal Mind. By Tao Jiang. Honolulu: University of Hawai'i Press, 2006. Pp. xi + 198. Paper $20.00.Dialogue Transcultural. Edited by Yue Diayun et al. Nanjing: Jiangsu Peoples Press, 2006. Pp. 335. Price not given.Dōgen on Meditation and Thinking: A Reflection on His View of Zen. By Hee-Jin Kim. Albany: State University of New York Press, 2006. Pp. xiii + 169. Hardcover $65.50. Paper $21.95.The Garden of Loneliness: A Translation of Jayshankar Prasad's Āṅsū, "Tears." By Charles S. J. White. Delhi: Motilal Banarsidass, 2006. Pp. xv + 136. Hardcover Rs. 295. [End Page 608]The Happening of Tradition: Vallabha on Anumāna in Nyāyalīlāvatī. By Anna-Pya Sjödin. Stockholm: Elanders Gotab, 2006. Pp. 195. Price not given.Head, Eyes, Flesh, and Blood: Giving Away the Body in Indian Buddhist Literature. By Reiko Ohnuma. 2006. Pp. xvii + 372. Hardcover $45.00, £29.00.Hwa Yu T'ai Chi Ch'uan: Unlocking the Mysteries of the Five-Word Song. By Glenn D. Newth. Berkeley: Blue Snake Books, 2007. Pp. xiii + 160. U.S. $18.95. Can $24.95.A Jewish Philosopher of Baghdad: 'Izz al-Dawla Ibn Kammūna (d. 683/1284) and His Writings. By Reza Pourjavady and Sabine Schmidtke. Leiden and Boston: Brill, 2006. Pp. xii + 274. Hardcover $130.00, €100.Letting Be: Fred Dallmayr's Cosmopolitical Vision. Edited by Stephen F. Schneck. Notre Dame: University of Notre Dame Press, 2006. Pp. x + 382. Paper $35.00.Myth and the Existential Quest. By Vassilis Vitsaxis and translated by Deborah Brown Kazazis and Vassilis Vitsaxis. Boston: Somerset Hall Press, 2006. Pp. 301. Hardcover $49.95. Paper $39.95.Nietzsche-Buddha-Zarathustra: Eine West-Ost Konfiguration. By Michael Skowron. Daegu: Kyungpook National University Press, 2006. Pp. 293. Paper $18.00, Won 17,000.Popularizing Buddhism: Preaching as Performance in Sri Lanka. By Mahinda Deegalle. Albany: State University of New York Press, 2006. Pp. xiii + 241. Hardcover $65.00. Paper $21.95.Ramana Maharashi: The Sage of Arunachala. By Arvind Sharma. New Delhi: Penquin Group, 2006. Pp. 215. Hardcover Rs. 295.Readings in Han Chinese Thought. Edited and translated by Mark Csikszentmihalyi. Indianapolis and Cambridge: Hackett Publishing Company, 2006. Pp. xxx + 220. Hardcover $39.95. Paper $14.95.Religions of Korea in Practice. Edited by Robert E. Buswell Jr. Princeton and Oxford: Princeton University Press, 2007. Pp. xx + 542. Paper $24.95, £15.95.The Scripture on Great Peace: The Taiping jing and the Beginnings of Daoism. By Barbara Hendrischke. Berkeley: University of California Press, 2006. Pp. x + 410. Hardcover $60.00, £38.95.The Self 's Awareness of Itself: Bhaṭṭa Rāmakantha's Arguments against the Buddhist Doctrine of No-Self. By Alex Watson. Vienna: Sammlung de Nobili, 2006. Pp. 433. Price not given... (shrink)

Deep brain stimulation (DBS) to different sites allows interfering with dysfunctional network function implicated in major depression. Because a prominent clinical feature of depression is anhedonia--the inability to experience pleasure from previously pleasurable activities--and because there is clear evidence of dysfunctions of the reward system in depression, DBS to the nucleus accumbens might offer a new possibility to target depressive symptomatology in otherwise treatment-resistant depression. Three patients suffering from extremely resistant forms of depression, who did not respond to pharmacotherapy, psychotherapy, (...) and electroconvulsive therapy, were implanted with bilateral DBS electrodes in the nucleus accumbens. Stimulation parameters were modified in a double-blind manner, and clinical ratings were assessed at each modification. Additionally, brain metabolism was assessed 1 week before and 1 week after stimulation onset. Clinical ratings improved in all three patients when the stimulator was on, and worsened in all three patients when the stimulator was turned off. Effects were observable immediately, and no side effects occurred in any of the patients. Using FDG-PET, significant changes in brain metabolism as a function of the stimulation in fronto-striatal networks were observed. No unwanted effects of DBS other than those directly related to the surgical procedure (eg pain at sites of implantation) were observed. Dysfunctions of the reward system--in which the nucleus accumbens is a key structure--are implicated in the neurobiology of major depression and might be responsible for impaired reward processing, as evidenced by the symptom of anhedonia. These preliminary findings suggest that DBS to the nucleus accumbens might be a hypothesis-guided approach for refractory major depression. (shrink)

This essay illustrates what the Chinese family-based and harmony-oriented model of medical decision making is like as well as how it differs from the modern Western individual-based and autonomy-oriented model in health care practice. The essay discloses the roots of the Chinese model in the Confucian account of the family and the Confucian view of harmony. By responding to a series of questions posed to the Chinese model by modern Western scholars in terms of the basic individualist concerns and values (...) embedded in the modern Western model, we conclude that the Chinese people have justifiable reasons to continue to apply the Chinese model to their contemporary health care and medical practice. (shrink)

Cognitive Science, Volume 46, Issue 4, April 2022.

La dernière philosophie de Pareyson, pour l'essentiel condensée dans le volume posthume Ontologie de la liberté, composée de fragments articulés entre eux, est une philsophie et même une métaphysique de la liberté, mais officiellement elle se présente comme une herméneutique de l'expérience chrétienne et accessoirement comme une pensée tragique.

L'A. souligne la portée philosophique des écrits de Paul Claudel en rappelant que cette philosophie est avant tout religieuse, qu'elle est théologie. Retraçant les événements religieux marquants de sa vie, il en examine le reflet dans son oeuvre où se mêlent divers thèmes philosophiques.

L'A. examine ici le regard que la philosophie porte sur la Bible. Pour ce faire, il ne s'intéresse qu'au sacrifice d'Abraham et il observe ce qu'en disent des philosophes comme Hegel ou Kant. A leur attitude réprobatrice, l'A. oppose celle de Sören Kierkegaard et de son ouvrage Crainte et tremblement. Celui-ci fait d'Abraham un intrépide chevalier de la foi qui abolit le chevalier tragique et résigné. Il en va tout autrement chez Kafka, Raïssa Maritain et Giulio Lequier dont l'A. rapporte (...) fidèlement les écrits consacrés à Abraham. (shrink)