The Centers for Medicare & Medicaid Services has initiated bundled payments for hip and knee total joint replacement in an effort to decrease healthcare costs and increase quality of care. The ethical implications of this program have not been studied. This article considers the ethics of patient selection to improve outcomes; specifically, screening patients by body mass index to determine eligibility for total joint replacement. I argue that this type of screening is not ethically defensible, and (...) that the bundled payment program as structured is likely to lead to unfair restrictions on who receives total joint replacements. (shrink)

Given the premise that joint action plays some role in explaining how humans come to understand minds, what could joint action be? Not what a leading account, Michael Bratman's, says it is. For on that account engaging in joint action involves sharing intentions and sharing intentions requires much of the understanding of minds whose development is supposed to be explained by appeal to joint action. This paper therefore offers an account of a different kind of (...) class='Hi'>joint action, an account compatible with the premise about development. The new account is no replacement for the leading account; rather the accounts characterise two kinds of joint action. Where the kind of joint characterised by the leading account involves shared intentions, the new account characterises a kind of joint action involving shared goals. (shrink)

RATIONALE AND AIMS: Total hip and knee replacements, usually, have long waiting lists. There are several prioritization tools for these kind of patients. A new tool should undergo a standardized validation process. The aim of the present study was to validate a new prioritization tool for primary hip and knee replacements. METHODS: We carried out a prospective study. Consecutive patients placed on the waiting list were eligible for the study. Patients included were mailed a questionnaire which included, among other questions, (...) the seven items of the priority tool and the Western Ontario and McMasters Universities Arthritis Index (WOMAC) specific questionnaire. The priority tool gives a score from 0 to 100 points, and three categories (urgent, preferent and ordinary). We studied the content and construct validity. We used Student's t-test or one-way analysis of variance. Correlational analysis was used to evaluate convergent and discriminate validity. RESULTS: The sample consisted of 838 patients (62.3% were female), with mean age of 70.2 years (SD 8.4). A total of 55.5% patients underwent knee replacement. Given that the tool was elaborated by patients and orthopaedic surgeons, it shows a good content validity. The priority score was statistically different (P < 0.001) among the three urgency categories created. The scores of the three WOMAC dimensions showed differences (P < 0.001) by the three urgency categories created. The correlations between the priority score and WOMAC dimensions were 0.79 (function), 0.69 (pain) and 0.51 (stiffness). The correlations between WOMAC items and items from priority tool were greater (0.47-0.69) between items measuring similar constructs than those measuring different constructs (0.27-0.49). These data are similar in both joints. CONCLUSIONS: Results support the validity of the prioritization tool to be used with patients waiting for hip or knee replacement. (shrink)

Separated decision-making for maintenance and spare ordering is unrealistic in the industry, so this paper aims to optimize them together. A joint policy of inspection-based preventive maintenance and spare ordering considering two modes of spare ordering, namely, a regular order and an emergency order, is proposed for single-unit systems using a three-stage failure process. If the system is recognized to be in the minor defective stage, the original inspection interval is shortened and a regular order is placed. However, (...) class='Hi'>replacement is undertaken preventively or correctively if the severe defective stage is identified or a failure occurs. Depending on the system state and the state of the regular ordered spare when replacement is needed, all possible scenarios are considered to construct optimization model I. The decision variables are the optimal inspection interval and the times of shortening the original inspection interval. Additionally, model II on the basis of an assumption that the spare is always ordered at time 0 is also developed. The results from a numerical example illustrated the applicability and the effectiveness of model I compared to model II, and the irregular inspection policy is validated to be cost-saving compared to the regular inspection policy. (shrink)

This paper introduces a new family of cases where agents are jointly morally responsible for outcomes over which they have no individual control, a family that resists standard ways of understanding outcome responsibility. First, the agents in these cases do not individually facilitate the outcomes and would not seem individually responsible for them if the other agents were replaced by non-agential causes. This undermines attempts to understand joint responsibility as overlapping individual responsibility; the responsibility in question is essentially (...) class='Hi'>joint. Second, the agents involved in these cases are not aware of each other's existence and do not form a social group. This undermines attempts to understand joint responsibility in terms of actual or possible joint action or joint intentions, or in terms of other social ties. Instead, it is argued that intuitions about joint responsibility are best understood given the Explanation Hypothesis, according to which a group of agents are seen as jointly responsible for outcomes that are suitably explained by their motivational structures: something bad happened because they didn’t care enough; something good happened because their dedication was extraordinary. One important consequence of the proposed account is that responsibility for outcomes of collective action is a deeply normative matter. (shrink)

Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery.

In this paper I defend anti-realism about race and a new theory of racialization. I argue that there are no races, only racialized groups. Many social constructionists about race have adopted racial formation theory to explain how ‘races’ are formed. However, anti-realists about race cannot adopt racial formation theory, because it assumes the reality of race. I introduce interactive constructionism about racialized groups as a theory of racialization for anti-realists about race. Interactive constructionism moves the discussion away from the dichotomous (...) (social vs. biological) metaphysics that has marred this debate, and posits that racialized groups are the joint products of a broad range of non-racial factors, which interact. (shrink)

Independence of Conditionals (IC) has recently been proposed as a basic rule for causal structure learning. If a Bayesian network represents the causal structure, its Conditional Probability Distributions (CPDs) should be algorithmically independent. In this paper we compare IC with causal faithfulness (FF), stating that only those conditional independences that are implied by the causal Markov condition hold true. The latter is a basic postulate in common approaches to causal structure learning. The common spirit of FF and IC is to (...) reject causal graphs for which the joint distribution looks ‘non-generic’. The difference lies in the notion of genericity: FF sometimes rejects models just because one of the CPDs is simple, for instance if the CPD describes a deterministic relation. IC does not behave in this undesirable way. It only rejects a model when there is a non-generic relation between different CPDs although each CPD looks generic when considered separately. Moreover, it detects relations between CPDs that cannot be captured by conditional independences. IC therefore helps in distinguishing causal graphs that induce the same conditional independences (i.e., they belong to the same Markov equivalence class). The usual justification for FF implicitly assumes a prior that is a probability density on the parameter space. IC can be justified by Solomonoff’s universal prior, assigning non-zero probability to those points in parameter space that have a finite description. In this way, it favours simple CPDs, and therefore respects Occam’s razor. Since Kolmogorov complexity is uncomputable, IC is not directly applicable in practice. We argue that it is nevertheless helpful, since it has already served as inspiration and justification for novel causal inference algorithms. (shrink)

The aim of this paper is to explore the claim that lotteries are more democratic than elections. The paper starts by looking at the two main forms of equality that give lotteries their democratic appeal: an individually equal chance to be selected for office, and the proportionate representation of groups in the legislature. It shows that they cannot be jointly realized and argues that their egalitarian appeal is more apparent than real. Finally, the paper considers the democratic reasons to value (...) randomly selected assemblies, even if claims about their distinctively egalitarian properties are exaggerated. (shrink)

Here is Frege in Foundations of Arithmetic, § 64:The judgment 'Line a is parallel to line b', in symbols: ab, can be taken as an identity. If we do this, we obtain the concept of direction, and say: 'The direction of line a is equal to the direction of line b.' Thus we replace the symbol by the more generic symbol =, through removing what is specific in the content of the former and dividing it between a and b. We (...) carve up the content in a way different from the original way, and this yields us a new concept.Something important is going on in this passage. But at the same time it borders on incoherent. For Frege is saying at least the following:'dir(a ) = dir(b )' has the same content as 'ab'reflecting on that .. (shrink)

The subject of biomaterials science concerns artificial materials used in medical devices to repair or reconstruct natural human tissue damaged by disease or trauma. It embraces the emerging field of tissue engineering, where artificial materials are used as scaffolds to provide the architecture for replacement organs. As such, the field raises numerous ethical issues, which are reviewed in this paper. These include the use of animal models, the testing materials and devices in patients, and what may be viewed as (...) potential abuses, where augmentation and repair are carried out for cosmetic as opposed to clinical reasons. The paper gives detailed consideration of the recent problems of metal-on-metal hip replacements as an exemplar of some of the key ethical issues that arise in this field. (shrink)

Elective surgery can be cancelled when resources are overwhelmed by emergency cases. We hypothesized that such cancellations, on psychological grounds, are followed also by inferior clinical results and we conducted a retrospective survey of patients following joint replacement surgery. Sixty patients having suffered from administrative cancellation prior to their operation during an 18-month period and with six months follow-up were identified and compared with another 60 matched patients after having the same type of surgery but without prior cancellation. (...) All patients received questionnaires on complications and on visual analogue scale (VAS) assessment on subjective wellbeing and quality of life (QoL) at follow-up. The study group reported 50 complications versus 33 for controls (P < 0.03). A borderline significant difference was found for myocardial infarction, 4 versus 0 (P < 0.05). There was no difference in VAS registration and QoL measurements did not quite reach statistical significance (P = 0.06). Cancellations (postponements) of elective surgery for administrative reasons may be followed by inferior clinical results, and this merits further prospective study. (shrink)

In a series of joint papers, Teppo Felin and Nicolai J. Foss recently launched a microfoundations project in the field of strategic management. Felin and Foss observe that extant explanations in strategic management are predominantly collectivist or macro. Routines and organizational capabilities, which are supposed to be properties of firms, loom large in the field of strategic management. Routines figure as explanantia in explanations of firm behavior and firm performance, for example. Felin and Foss plead for a replacement (...) of such macro-explanations by micro-explanations. Such a replacement is needed, Felin and Foss argue, because macro-explanations are necessarily incomplete: they miss out on crucial links in the causal chain that connect macro phenomena with each other. I argue that this argument is flawed. It is based on a doubtful if not outright incorrect understanding and use of Coleman’s diagram. In a sense to be explained below, only if Coleman’s diagram is squared it can accurately account for the relations between individual action and interaction, routines and firm behavior and firm performance. Once Coleman’s diagram is squared, one can see why and how macro-explanations need not miss out on any link in the causal chains that connect macro phenomena. Micro-analyses are still needed, not to highlight and specify causal links that macro-explanations miss out on, but to check whether the many properties that are ascribed to routines in macro-explanations of firm behavior are warranted. (shrink)

Human behavior is the joint product of (i) contingencies of survival responsible for natural selection, and (ii) contingencies of reinforcement responsible for the repertoires of individuals, including (iii) the special contingencies maintained by an evolved social environment. Selection by consequences is a causal mode found only in living things, or in machines made by living things. It was first recognized in natural selection: Reproduction, a first consequence, led to the evolution of cells, organs, and organisms reproducing themselves under increasingly (...) diverse conditions. The behavior functioned well, however, only under conditions similar to those under which it was selected.Reproduction under a wider range of consequences became possible with the evolution of processes through which organisms acquired behavior appropriate to novel environments. One of these, operant conditioning, is a second kind of selection by consequences: New responses could be strengthened by events which followed them. When the selecting consequences are the same, operant conditioning and natural selection work together redundantly. But because a species which quickly acquires behavior appropriate to an environment has less need for an innate repertoire, operant conditioning could replace as well as supplement the natural selection of behavior.Social behavior is within easy range of natural selection, because other members are one of the most stable features of the environment of a species. The human species presumably became more social when its vocal musculature came under operant control. Verbal behavior greatly increased the importance of a third kind of selection by consequences, the evolution of social environments or cultures. The effect on the group, and not the reinforcing consequences for individual members, is responsible for the evolution of culture. (shrink)

Natural language conditionals seem to be subject to three logical requirements: they invalidate Antecedent Strengthening, they validate so-called Simplification of Disjunctive Antecedents, and they allow for the replacement of logically equivalent clauses in antecedent position. Unfortunately, these requirements are jointly inconsistent. Conservative solutions to the puzzle drop Simplification, treating it as a pragmatic inference. I show that pragmatic accounts of Simplification fail, and develop a truthmaker semantics for conditionals that captures all the relevant data. Differently from existing truthmaker semantics, (...) my semantics extends, rather than replaces, standard possible worlds semantics. The main innovation is the notion of a truthmaker in play: this notion is cognitive, rather than metaphysical, and can be defined in a purely syntactic way. (shrink)

Philosophers disagree how abstract, theoretical principles can be applied to instances. This paper generates a puzzle for law theorists, causal theorists and inductivists alike. Intractability can force scientists to use a "semi-empirical" method, in which some of an equation's theoretically-determinable parameters are replaced with values taken directly from the data. This is not a purely deductive or inductive process, nor does it involve causes and capacities in any simple way (Humphreys 1995). I argue the predictive successes of such methods require (...) us to reanalyze our views about the nature of prediction, the status of models, and the goal(s) of science. When laws and experimental evidence are neither individually nor jointly sufficient for prediction, models become the locus of understanding. I analyze an historically important debate about the use of semi-empirical methods to construct potential energy surfaces. (shrink)

The article is devoted to the history of the formation of theological and philosophical conceptual apparatus in Ukrainian texts of the first quarter of the 17th century. The analysis of the principles of the use of lexemes "dobro" and "blaho" in translations of Greek patristic and ascetic works, showed the following trends: The principles of usage of both lexemes depended on the target language – old Ukrainian or Church Slavonic. In the texts in Church Slavonic: the lexeme "blaho" dominates over (...) the lexeme "dobro" that in general corresponds to Greek prototype; "blaho" is consistently reserved for the "high" style and defines the semantic fields associated with the sacral area; the lexeme "dobro" is mainly used at the level of everyday language.. In the texts written in old Ukrainian language: the lexeme "blaho" is missing, it is replaced everywhere by the lexeme "dobro"; the use of the lexeme "dobro" is no traceable distinction between the sacral and the profane semantic fields.. The line of demarcation in the ways of speaking that fixes the differences between high theological discourse that operates with the concepts and everyday language, is not only on the level of language choice, but also on the level at verbalized intellectual activity, fixed in the specific joint variations of word usage within each linguistic usage. (shrink)

Although the characteristics and advantages of interorganizational governance models based on extensive collaboration are well established in the literature, inquiry has only recently extended to sustainable supply chain management, highlighting the potential benefits of combining the integration of social and environmental issues concerning the supply chain with governance models based on joint decision making and extensive cooperation. Yet, firms still differ in both the pervasiveness of such collaborative approaches along the value chain and the extent to which sustainability issues (...) are addressed to the advantage of all parties involved. In an attempt to predict variety in the governance models related to sustainability along the value chain, we propose a theoretical model that identifies and frames four sustainable supply chain governance (SSCG) models, resulting from combinations of supply chain network density and centrality of the focal organizations. We show how, as centrality increases, firms are able to exert influence over their network, coordinating integrated approaches along the value chain. Moreover, as high centrality combines with increasing interconnectedness of the actors within a supply chain network, instrumental approaches are progressively replaced by more relational attitudes aimed at joint value creation among partners. Conditions for SSCG models' success and the main benefits gained by firms in different structural contexts are also discussed. (shrink)

One aspect of the utility of gambling may evidence itself in failures of idempotence, i.e., when all chance outcomes give rise to the same consequence the `gamble' may not be indifferent to its common consequence. Under the assumption of segregation, such gambles can be expressed as the joint receipt of the common consequence and what we call `an element of chance', namely, the same gamble with the common consequence replaced by the status quo. Generalizing, any gamble is indifferent to (...) the joint receipt of its element of chance and a certain consequence, which is called the `kernel equivalent' of the gamble. Under idempotence, the kernel equivalent equals the certainty equivalent. Conditions are reported (Theorem 4) that are sufficient for the kernel equivalents to have the kind of utility representation first discussed by Luce and Fishburn (1991), including being idempotent. This utility representation of the kernel equivalents together with the derived form of utility over joint receipts yields a utility representation of the original structure. Possible forms for the utility of an element of chance are developed. (shrink)

This article explores the relationship between theology and sociology on two levels. The first is in terms of the general disciplinary closure that has marked much of their coexistence, despite the many topics on which they potentially meet. The second level is more specific and concerns the tension in Britain between religious sociology, in which sociology is put to serve faith, and the secular sociology of religion, where religion is studied scientifically. This tension has been addressed before with respect to (...) the history of sociology in France and the United States, but the British case, hitherto relatively unknown, illustrates the potential there was for a more fruitful relationship between sociology and theology in Britain that went undeveloped as the secular sociology of religion eventually replaced early religious sociology. The existence of religious sociology has been written out of the history of the discipline in Britain, such that when theology and sociology began a more serious engagement in the 1970s in Britain and elsewhere, particularly as biblical studies discovered sociology and as theologians and sociologists first met jointly, this earlier dialogue was entirely overlooked. (shrink)

There is an interesting puzzle about the interaction between mereology, topology, and dependence. It is not only interesting in and on itself, but also reveals subtleties about the aforementioned interaction that have gone unnoticed. The puzzle has it that the following plausible claims are jointly inconsistent: wholes depend on their parts; boundaries are parts; boundaries depend on the whole they are part of. In the paper, I first argue that claims – are not as a matter of fact inconsitent insofar (...) as further assumptions are needed to get the puzzle off the ground. I consider several such assumptions, somemore plausible than others. Though I do not take any definite stance as to whether the plusibility of the assumptions considered trump that of claims –, I set forth a suggestion to replace with something similar yet interestingly different. (shrink)

This thesis is divided into three parts, the first and second ones focused on combinatorics and classification problems on discrete and geometrical objects in the context of descriptive set theory, and the third one on generalized descriptive set theory at singular cardinals of countable cofinality.Descriptive Set Theory (briefly: DST) is the study of definable subsets of Polish spaces, i.e., separable completely metrizable spaces. One of the major branches of DST is Borel reducibility, successfully used in the last 30 years to (...) solve and compare many classification problems. One of our goals is the classification of knots, very familiar and tangible objects in everyday life, which also play an important role in modern mathematics. The study of knots and their properties is known as knot theory. Our plan is to gain insight into knots using discrete objects, such as linear and circular orders. This approach was already exploited in [6]. The first part of this work is therefore devoted to countable linear orders and the study of the quasi-order of convex embeddability and its induced equivalence relation. We obtain both combinatorial and descriptive set-theoretic results. We also expand our research to the case of circular orders.Another objective of this first part is to extend the notion of convex embeddability on countable linear orders. We provide a family of quasi-orders of which embeddability is a particular case as well. We study these quasi-orders from a combinatorial point of view and analyse their complexity with respect to Borel reducibility. Furthermore, we extend the analysis of these quasi-orders to the set of uncountable linear orders.The second part of the project deals with classification problems on knots and $3$ -manifolds. The goal here is to apply the results obtained in the first part to the study of proper arcs and knots, establishing lower bounds for the complexity of some natural relations between these geometrical objects. We also obtain some combinatorial results which are particularly interesting when we restrict to the set of wild proper arcs and wild knots, classes which haven’t received much attention so far. These parts are included in the two preprints [4, 5] in collaboration with my supervisor Alberto Marcone, Luca Motto Ros (University of Torino), and Vadim Weinstein (University of Oulu).The second part of this work also includes the classification of non-compact $3$ -manifolds up to homeomorphism (the case of compact $3$ -manifolds has already been solved: indeed, there are only countably many $3$ -manifolds up to homeomorphism; see [7]), and that of Cantor sets of $\mathbb {R}^3$ up to conjugation (answering to Question 5.5 of [3]). Here we resort to algebraic tools. Stone duality gives a neat way to go back-and-forth between totally disconnected Polish spaces and countable Boolean algebras (see [1]). The main ingredient is the Stone space of all ultrafilters on a Boolean algebra. In this work we introduce a weaker concept which we call “blurry filter”. Using blurry filters instead of ultrafilters enables one to extend the class of spaces under consideration beyond totally disconnected. As an application of this method, we show that both homeomorphism on non-compact $3$ -manifolds and conjugation of Cantor sets in $\mathbb {R}^3$ are completely classifiable by countable structures. These results are part of an upcoming paper in collaboration with Vadim Weinstein.The last part of this thesis concerns the natural generalization of descriptive set theory that occurs when countable is replaced by uncountable, called Generalized Descriptive Set Theory (briefly: GDST). In particular, we focus on the case of GDST for a singular cardinal $\kappa $ of countable cofinality. The goal here is to study the generalizations of the Perfect Set Property and the Baire Property to subsets of spaces of higher cardinalities, like the power set $\mathcal {P}(\kappa )$. We consider the question under which large cardinal hypotheses classes of definable subsets of these spaces possess such regularity properties, focusing on rank-into-rank axioms, like I2, and classes of sets definable by $\Sigma _1$ -formulas with parameters from various collections of sets. The obtained results are included in [2], a joint work with my co-supervisor Vincenzo Dimonte and Philipp Lücke (University of Hamburg).Abstract prepared by Martina IannellaE-mail: [email protected]: https://air.uniud.it/handle/11390/1262824. (shrink)

One is often told that sentences expressing or reporting mental states endowed with intentionality—the feature of being “directed upon” an object that some mental states possess—contain contexts that both prevent those sentences to be existentially generalized and are filled by referentially opaque occurrences of singular terms. Failure of existential generalization and referential opacity have been traditionally said to be the basic characterizations of intentionality from a linguistic point of view. I will call those contexts directional contexts. In what follows, I (...) will argue that this traditional conception is incorrect. First, the above characterizations do not provide both necessary and jointly sufficient conditions for directional contexts. Appearances notwithstanding, these characterizations are not the adequate linguistic counterparts of two elements folk-psychologically featuring intentionality, namely existence-independence and the possible apparent aspectual character of the intentional object, the target of a mental state endowed with intentionality. Indeed, they do not retain the prima facie ontological commitment to intentional objects the above elements contain. I will replace failure of existential generalization and referential opacity with other linguistic factors, namely success of mere existentially unloaded particular quantification and pseudo-opacity. I will contend that they provide both necessary and jointly sufficient conditions for directional contexts, and claim that these factors are the adequate counterparts of the above folk-psychological elements, precisely because they retain the prima facie ontological commitment to intentionalia those elements possess. (shrink)

The concept of deliberation in the Ukrainian philosophical discourse is both underestimated and overestimated. Underestimated — as a self-sufficient category that is not reducible to another con- cept, even if it is the concept of consensus or the concept of democracy. Deliberation appears pri- marily as a careful weighing and selection of arguments when making an important decision. Collegiality may or may not be present here, as well as openness. Therefore, the concept of deliber- ation is somewhat overestimated as something (...) that necessarily improves the quality of democratic procedures, and therefore, supposedly, deliberation itself is something democratic in nature. American political philosopher Joshua Cohen drew attention to the fact that deliberation can be of at least three types: individual deliberation, jury deliberation, and oligarch deliberation. The article analyzes these three types of deliberation and found that the closest to the democratic type of government is individual deliberation, or rather, joint deliberation of responsible citizens. While the deliberation of the jury is mostly closed, it is naturally limited access to the extent of the necessary competence of its possible participants. The deliberation of the oligarchs is even more closed and often even secret. However, the article states that it is more appropriate to replace the name «oligarchs» with the term «captains of business»: then the deliberation of the oligarchs ceases to be a cartel conspiracy, and turns into a coordinated protection of the interests of the national economy. However, for this, de- liberation itself is not enough, so not procedural, but other, namely, value factors of decision-making are needed. Democracy benefits from deliberation when the latter is complemented by the liberal and patriotic values of the participants in the deliberation. Already John Locke convincingly argues the importance of citizens achieving a common conscious agreement in state matters. However, for Locke, the very fact of having property was important, while in practice, achieving an effective agreement requires mechanisms for reconciling the positions of owners with very different amounts of property. To some extent, this problem can be solved by John Rawls` concept of justice. (shrink)

Pope Jorge Mario Bergoglio released the "Encyclical Laudato Si': on the care of common home" on June 18, 2015, the same day that the National Oceanic and Atmospheric Administration has shown that the temperature of Earth continues increasing and that May of 2015 was Earth's warmest month, since 1880. By endorsing the scientific knowledge in relation to anthropogenic factors on global warming and by defending actions to confront the causes of climate change and ecosystem degradation, the Holy See has taken (...) a key step to put Catholics at the forefront of global ecological struggle and to encourage the signing of the global treaty to replace the Kyoto Protocol at the 21st Conference of the Parties, that will take place in December in Paris. But the encyclical of Pope Francis proposes a larger task that is to protect the poorest of the poor countries, addressing jointly the human environment and the natural environment from the perspective of an integral ecology. The purpose of this paper is to analyze the advances and limitations of the propositions of the encyclical Laudato Si ' and to expand the dialogue on gender relations and deep ecology. (shrink)

This article evaluates New Zealand’s Medicines Amendment Bill 2011. This Bill is currently before Parliament and will amend the Medicines Act 1981. On June 20, 2011, the Australian and New Zealand governments announced their decision to proceed with a joint scheme for the regulation of therapeutic products such as medicines, medical devices, and new medical interventions. Eventually, the joint arrangements will be administered by a single regulatory agency: the Australia New Zealand Therapeutic Products Agency. The medicines regulations in (...) Australia and New Zealand will be updated as part of this process. The Medicines Amendment Bill addresses some of the well-recognised deficiencies in the Medicines Act 1981. However, a comprehensive overhaul of the Act is not being undertaken. I argue that repealing and replacing the Medicines Act 1981 would be preferable and advisable, given the number of legal difficulties with the Act and, in particular, where it does not align with equivalent current international law. (shrink)

Leibniz's overall view of the relationship between reasoning and computation is discussed on the basis of two broad claims that one finds in his writings, concerning respectively the nature of human reasoning and the possibility of replacing human thinking by a mechanical procedure. A joint examination of these claims enables one to appreciate the wide scope of Leibniz's interests for mechanical procedures, concerning a variety of philosophical themes further developed both in later logical investigations and in methodological contributions to (...) cognitive psychology. (shrink)

The article argues in favour of replacing Dewey’s notion of 'experience' in today's cognitive sciences with Mead’s notion of 'act.' Although Dewey's approach to cognition is an essential contribution to the pragmatist turn of cognitive science and his theory of organic relation is particularly useful for future developments in this field, his notion of 'experience' risks proving to be the weak link in the program of empirical implementation of such a turn. In a perspective that shows a clear empirical intent (...) such as that of the 4E programme, the concept of experience, as intentionally vague and smoky, with its strong metaphysical significance, does not seem to offer a useful operational criterion to exclude from evaluation aspects that should not be considered constitutive of the mental. Moreover, in its openness to the overall determination of the relationship between organism and environment, this notion does not contribute to the definition of the phases that characterize the relational dynamics itself. The essay proposes as a solution to these difficulties to turn the attention to Mead's notion of 'act.' Although Mead's act and Dewey's experience are undoubtedly similar concepts, as the result of elaborations often carried out jointly by the two authors, the act seems more suitable to describe in its different characteristics the ideo-sensori-motor process that characterizes the integrated approach in which perception and action are indissolubly linked. Mead's theory of the act is an epistemological tool particularly useful to the empirical program of the 4E, also offering an interesting contribution to the debate between radical representationalists and enactivists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics ConsultationPat Milmoe McCarrick (bio)(John La Puma, M.D., from the Department of Medicine at Lutheran General Hospital in Chicago, contacted the National Reference Center for Bioethics Literature and suggested bioethics consultation as a topic for the Scope Note Series. He provided an extensive list of citations about ethics consultations collected by him and by David Schiedermayer, M.D., for their new book Ethics Consultation: A Practical Guide.)In Ethics Consultation in (...) Health Care, editors John Fletcher, Norman Quist, and Albert R. Jonsen (I, 1989) define ethics consultation as "the provision of specialized help in identifying, analyzing, and resolving ethical problems that arise in clinical care. In medical ethics the area of consultation has grown rapidly since 1978 when Edmund D. Pellegrino (II, 1978) noted, "we cannot separate technical-moral decisions from the philosophic principles we use to justify them. Medicine and ethics must be engaged with each other at every level."In 1980 Albert Jonsen raised the question of whether an ethicist could be a consultant and said that the ethicist as consultant is a casuist, one whose moral reasoning is based on a system of reasoning that is applied to particular cases. He describes historical casuistry in Western culture, comparing it to modern moral philosophy, and suggests that a "new casuistry seems timely" for ethics consultation (II, Jonsen 1980). By 1984 ethicist Ruth Purtilo recorded her thoughts following an ethics consultation. She raised questions about the ethicist's place on a hospital staff and how to make that role appropriate and beneficial to all concerned, saying that "the ethicist retreats after the consultation; under no circumstances would the outcome of an ethics consultation be that the ethicist became the primary care giver or assumed ongoing responsibility for the clinical management of a case" (II, Purtilo 1984). Nevertheless, in 1992 two physician-ethicists who had been called as ethics consultants for a patient who had requested that he be removed from his ventilator reported that they became the persons who turned off the ventilator and administered the drugs that eased his dying (II, Edwards and Tolle 1992).In recognition of the growing number of persons identifying themselves as [End Page 433] consultants, the Society for Bioethics Consultation was founded in October 1985 as a professional society of persons engaged in bioethics consultation. It encourages and supports consultation, assists in establishing clinical education programs, and raises funds for consultation education. Although the Society has no permanent office, the president (currently, George Kanoti in the Cleveland Clinic Foundation's Bioethics Department) conducts its work and plans an annual meeting.The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) established new criteria concerning ethics in its 1992 Manual (III, JCAHO 1992) and in a special issue of QRB devoted to ethics consultation (I, Defining Quality 1992). These publications undoubtedly have contributed to the increased use of experts in medical ethics. The Manual notes that all organizations seeking accreditation should have some sort of "mechanism for the consideration of ethical issues arising in the care of patients and to provide education to care givers and patients on ethical issues in health care." A health care institution's eligibility for JCAHO accreditation, which is required for federal reimbursement, requires adherence to this specification (III, JCAHO 1992).The new International Directory of Bioethics Organizations provides an index of 129 different groups that indicated to the authors that they offer bioethics consultations. Of these, 83 are in the United States and 46 are in other countries. The ethics consultants included in the directory encompass a broad group of professionals who will assist patients, families, and primary care medical staff in finding solutions to ethical dilemmas resulting from use of new technologies or new treatments in health care. Consultants often come from the health fields: physicians, nurses, and other health personnel, but other professionals are also active as ethics consultants. Lawyers, pastoral counselors, philosophers, and social workers also offer bioethics consultation services (III, Nolen and Coutts 1993).Drs. Siegler, Pellegrino, and Singer wrote in 1990 that "Physician-ethicists and professional ethicists will continue to work side by side in the future. One is not likely to replace the other, nor is this desirable, because... (shrink)

This paper begins by pointing to an obvious difficulty in Merleau-Ponty’s late philosophy: undoing the decisive separation between linguistic connotation and the denotated, undoing the decisive separation between linguistic meaning and the sensible world. This difficulty demands that we understand how the sensible and the symbolic have a sort of spontaneous relation. How can this be? The history of this problem is then traced back to Husserl, and in particular to his The Origin of Geometry. For Husserl, ‘abstract geometry’ is (...) understood to be a self-constituting field that cuts itself off from a ‘pre-geometry.’ The latter sort of geometry has to do with a symbolic and phantasy consciousness that makes differences in an otherwise uniform sensible plenum. Merleau-Ponty is at odds with the idea of an abstract geometry that constitutes its own field. His phenomenology would have this abstract geometry reduced to pre-geometry, and this pre-geometry further reduced to the sensible, which is then not uniform at all. The problem becomes more precisely how the separations of the sensible and the differences between things are already symbolic.The paper suggests that a way to think through Merleau-Ponty’s problem can be found in a January 1960 Working Note to The Visible and the Invisible called “The Invisible, the negative, vertical Being.” This note, with its references to “joints and members” and “disjunction and dis-membering” is very likely a reference to, and correction of, Heidegger’s 1943 essay on Heraclitus. The point for Merleau-Ponty seems to be a radicalization of the Heraclitean coinstantiation of opposites. His reading allows him to resist understanding the sensible as a self-identity and replace it instead with disarticulation, disintegration, or even perhaps disruption. To show this very disruption is, the paper finally argues, to show the sensible with its phantasmagorical character. Finally, by way of conclusion, the paper takes a turn to sculpture precisely to discuss how we might grasp a sensible that is not uniform but always being shaped and differentiated; and how the symbolic is exactly in, enjambed with, this spacing apart. Ce texte commence par signaler une difficulté évidente dans l’oeuvre tardive de Merleau-Ponty : défaire la séparation décisive entre la connotation linguistique et la dénotation, défaire la séparation décisive entre la signification linguistique et le monde sensible. Cette difficulté requiert de comprendre comment le sensible et le symbolique se trouvent dans une sorte de relation spontanée. Comment cela se fait-il? L’histoire de ce problème remonte à Husserl et à son Origine de la géométrie. Pour Husserl, la « géométrie abstraite » est comprise comme un champ qui se constitue lui-même et qui se détache d’une « pré-géométrie ». Cette dernière sorte de géométrie est liée à une conscience symbolique et imaginative qui fait des différences dans un espace sensible autrement uniforme. Merleau-Ponty n’est pas favorable à l’idée d’une géométrie abstraite qui constitue son propre champ. Sa phénoménologie vise à réduire la géométrie abstraite à la pré-géométrie, et cette dernière au sensible, qui dès lors n’est plus du tout uniforme. Le problème consiste alors à montrer comment les séparations du sensible et les différences entre les choses sont toujours déjà symboliques.La contribution ici suggère qu’une solution peut être trouvée dans la note de travail du Visible et l’invisible de janvier 1960, intitulée « L’Invisible, le négatif, l’Être vertical ». Cette note, qui parle de « jointure et membrure » et de « dis-jonction et dé-membrement », est sans doute une référence à, et une correction l’essai de Heidegger de 1943 sur Héraclite. Le propos de Merleau-Ponty semble être une radicalisation de la co-instantiation héraclitéenne des opposés. Son interprétation lui permet de résister à la conception du sensible comme identité à soi et de la remplacer par la désarticulation, la désintégration ou même peut-être le bouleversement (disruption). Le fait de montrer ce bouleversement consiste précisément à montrer le sensible avec son caractère fantasmatique. Finalement, en guise de conclusion, le texte se tourne vers la sculpture pour discuter une notion du sensible comme étant non uniforme mais toujours déjà formé et différencié, et une notion de symbolique comme étant exactement dans cet espacement. Questo testo inizia portando l’attenzione su un evidente problema nella filosofia dell’ultimo Merleau-Ponty: annullare la separazione decisiva tra connotazione linguistica e ciò che viene denotato, annullare la separazione decisiva tra significato linguistico e mondo sensibile. Questo problema richiede una comprensione della relazione spontanea tra sensibile e simbolico. Come ciò è possibile? La storia di questo problema risale fino ad Husserl, ed in particolare al suo L’origine della geometria. Per Husserl, la ‘geometria astratta’ è da concepire come un campo che si costituisce da sé, distaccandosi da una ‘pre-geometria’. L’ultima tipologia di geometria ha a che fare con una coscienza simbolica e immaginativa, che crea delle differenze in un altrimenti uniforme plenum sensibile. Merleau-Ponty non concorda con l’idea di una geometria astratta che costituisca il proprio campo. La sua fenomenologia intende piuttosto riportare la geometria astratta alla pre-geometria, e quest’ultima al sensibile, che quindi è tutto fuorché uniforme. Il problema diventa allora, più precisamente, come mostrare che le separazioni del sensibile e delle differenze tra le cose siano già simboliche. Questo testo suggerisce che una soluzione per pensare questo problema in Merleau-Ponty possa essere trovata in una nota di lavoro al Visibile e l’invisibile del gennaio 1960, intitolata “L’invisibile, il negativo, l’essere verticale”. Questa nota, con i suoi riferimenti a “spazio topologico e il tempo di congiunzione e di membratura”, e ancora “di dis-giunzione e dis-membramento”, è molto probabilmente un riferimento, ed insieme una correzione, al saggio di Heidegger su Eraclito del 1943. Il punto, per Merleau-Ponty, sembra essere una radicalizzazione del concetto eracliteo di compresenza degli opposti. La sua lettura gli permette di resistere alla comprensione del sensibile come un’auto-identità, per rimpiazzarla invece con una disarticolazione, disintegrazione, o perfino interruzione. Mostrare quest’interruzione è, come argomentiamo in questo testo, mostrare il sensibile con il suo carattere fantasmagorico. Infine, tirando le conclusioni, questo testo si rivolge alla scultura, per discutere come sia possibile afferrare un sensibile che non sia uniforme, ma sempre in-formato e in differenziazione, e come la simbolica sia sempre in – e intrecciata con – questa spaziatura, questa distanziazione. (shrink)

One aspect of the utility of gambling may evidence itself in failures of idempotence, i.e., when all chance outcomes give rise to the same consequence the `gamble' may not be indifferent to its common consequence. Under the assumption of segregation, such gambles can be expressed as the joint receipt of the common consequence and what we call `an element of chance', namely, the same gamble with the common consequence replaced by the status quo. Generalizing, any gamble is indifferent to (...) the joint receipt of its element of chance and a certain consequence, which is called the `kernel equivalent' of the gamble. Under idempotence, the kernel equivalent equals the certainty equivalent. Conditions are reported (Theorem 4) that are sufficient for the kernel equivalents to have the kind of utility representation first discussed by Luce and Fishburn (1991), including being idempotent. This utility representation of the kernel equivalents together with the derived form of utility over joint receipts yields a utility representation of the original structure. Possible forms for the utility of an element of chance are developed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Rhetoric, Reflection, and Emancipation: Farrell and Habermas on the Critical Studies of CommunicationG. Thomas GoodnightThere are moments in history that appear to be alive with emancipatory possibilities. Such were the years moving toward the end of the long twentieth century. In spring 1989, students protested the communist regime in China; the Tiananmen Square massacre initiated an episode of opposition and commenced China’s modern journey toward global reengagement. Revolutions in (...) Europe that autumn were more peaceful. On August 23 two million Estonian, Latvian, and Lithuanian citizens held hands and announced the Baltic Way as a departure from Soviet rule. Transitions rapidly followed in Hungary, Bulgaria, and East Germany, culminating in the Velvet Revolution where on November 17 student protests were beaten back by police in Prague only to be followed three days later by an assembly of 200,000 demanding the transfer of power from the Communist Party. On December 3, George Bush and Mikhail Gorbachev jointly announced an imminent end to the fifty-year-old Cold War. During this time of hopeful transition, two scholars were at work refiguring the philosophical mission of the Frankfurt school, transforming critique from its early totalizing posture into the critical study of communication.Thomas B. Farrell and Jürgen Habermas were trained in different traditions but adjacent disciplines, communication and sociology. Their works [End Page 421] share a commitment to philosophical inquiry directed toward critique and understanding the cultural, social, and linguistic constitution of communication. As a rhetorician and as a philosopher, these scholars share an evident passion for scholarly argument and for engagement with the controversies of public culture. In different ways, both were at work during the portentous years of transition from the Cold War to new democracies and incipient globalization. Each constructed a guarded program of hope in the possibilities of communicative reflection and reasoning. In the post-World War II era, such a broad, positive vision took long to develop. After the brutal realities of the Holocaust became publicly known in the late 1940s, “the generous faith in rationality and the possibilities of human progress which underlay much of earlier historical thought seems discredited today” (Katznelson 2003, 2). The Enlightenment possibilities for reason had been invested in the technical efficiency of modern institutions that produced the capacity to kill systematically without constraints. Ira Katznelson points to a generation of scholars—including individuals at Chicago, Columbia, the New School, and others—who began in the 1950s to engage in a project that would “shade the Enlightenment’s philosophical anthropology, thicken its defenses against evil, deepen its capacity to reason, and restore” an Enlightenment more critical and less susceptible to co-optation by the excesses of nationalism, ideology, and evil (2003, 2). The work of Farrell and Habermas belongs to the extended post-Holocaust moment, where the possibilities of reflective reason in ethical and moral deliberations were set carefully on a road to personal and collective emancipation.Max Horkheimer saw in the modern, postwar welfare state little reason for optimism. Writing in 1946 at the beginning of the Cold War, he concluded: “Language has been reduced to just another tool in the gigantic apparatus of production in modern society” (1974, 22). “Salestalk” by “the surrogates of culture” creates an “illusory triumph of democratic progress that consumes the intellectual substance on which democracy has lived” (Horkheimer 1974, 31). Scientifically engineered propaganda renders public opinion as “a substitute for reason.” With such tools, the forces of barbarism are always waiting in the wings to seize power. Early on, Habermas shared these views. His thesis, in The Structural Transformation of the Public Sphere (1989a), tracks the opening possibilities of communicative reasoning in the liminal spaces of eighteenth-century coffeehouses where frank talk replaced hierarchically driven politeness, the development of these talks into the practices of deliberative democracy, and the decline of deliberative democracy with the union of the state and mass media in producing spectacles in [End Page 422] support of rituals of legitimation. Habermas broke with Horkheimer over the dissertation, however. A thesis of decline, by itself, leaves open only the route of totalizing critique. While never far from critique of institutional practices, Habermas spent his career in opening a positive... (shrink)

To william james, conscious life was a stream; to Edmund Husserl, a flow. These metaphors point to the marvelous continuity of experience as it weaves through the world of thought and things. We might similarly talk about the flow of the body, as I reach for my cup of coffee. A physiologist could decompose the action, isolating the contribution of each muscle and joint to the whole. This functional analysis would constitute one form of explanation of the movement. As (...) we replace "I grab the cup" with the physiologist's account, there is a shift in level of description and a turn toward underlying processes, but the physiologist has added nothing to nature. Explanation of this sort, functional reduction, is simply a .. (shrink)

We propose developing the theory of consequences of morasses relevant in mathematical applications in the language alternative to the usual one, replacing commonly used structures by families of sets originating with Velleman’s neat simplified morasses called 2-cardinals. The theory of related trees, gaps, colorings of pairs and forcing notions is reformulated and sketched from a unifying point of view with the focus on the applicability to constructions of mathematical structures like Boolean algebras, Banach spaces or compact spaces. The paper is (...) dedicated to the memory of Jim Baumgartner whose seminal joint paper :109–129, 1987) with Saharon Shelah provided a critical mass in the theory in question. A new result which we obtain as a side product is the consistency of the existence of a function \ with the appropriate \-version of property \ for regular \ satisfying \. (shrink)

Though the realm of biology has long been under the philosophical rule of the mechanistic magisterium, recent years have seen a surprisingly steady rise in the usurping prowess of process ontology. According to its proponents, theoretical advances in the contemporary science of evo-devo have afforded that ontology a particularly powerful claim to the throne: in that increasingly empirically confirmed discipline, emergently autonomous, higher-order entities are the reigning explanantia. If we are to accept the election of evo-devo as our best conceptualisation (...) of the biological realm with metaphysical rigour, must we depose our mechanistic ontology for failing to properly “carve at the joints” of organisms? In this paper, I challenge the legitimacy of that claim: not only can the theoretical benefits offered by a process ontology be had without it, they cannot be sufficiently grounded without the metaphysical underpinning of the very mechanisms which processes purport to replace. The biological realm, I argue, remains one best understood as under the governance of mechanistic principles. (shrink)

Popper’s popular critics – Kuhn, Feyerabend, and Lakatos – replace his older, Wittgenstein-style critics, now defunct. His new critics played with the idea of criticism as beneficial, in vain search of variants of these that could better appeal to the public. Some of their criticism of Popper is valid but marginal for the dispute about rationality. He was Fallibilist; they hedged about it. He viewed learning from experience as learning from error; they were unclear about it. His view resembles Freud’s (...) reality principle; they hedged about this too, as they defended the stupid idea of constructive criticism. He stressed his criticism of the view of science as inductive; they endorsed it. They differed from him significantly regarding their intended readers: he had addressed those who readily admit criticism and his popular critics addressed those who find it hard to admit openly that criticism upsets them somewhat. Current popular criticism of Popper’s ideas shows yet again the logical relation between the critical attitude and liberalism: liberalism without critically mindedness is permissible, scarcely the other way around. Hence, we better read the objection that Popper’s popular critics have launched against him not as criticism proper, but as somewhat reasonable protest against his use of the highest standards in his relentless advocacy of liberalism and of criticism in his valuation of science and of democracy as joint. (shrink)

What do we mean when we say that some group believes something? Do we simply mean that all the members of the group believe it, or are we acknowledging the existence of some kind of group agent? According to Margaret Gilbert, talk about group mental states refers to the specific kind of agreements she calls joint commitments — that is, to collectively believe something means to be committed with others to believe it. In my article, I will first present (...) Gilbert’s approach in more detail but will ultimately show that this approach is problematic and will refute it. I will briefly consider the most common solution to the problems Gilbert’s account faces, which lies in replacing collective beliefs with acceptances, but I will show that this solution will not do either. The solution I will then present will be based on Daniel Dennett’s intentional strategy, which is a method of interpreting the things around us and predicting their behaviour by treating them as rational agents with relevant intentions. I will try to show that all the problematic cases of collective belief can be explained by applying the intentional strategy to the groups in question. (shrink)

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According to distributed virtue reliabilism (Palermos, 2020b), epistemic collaborations—such as Transactive Memory Systems and Scientific Research Teams—can be held epistemically responsible at the collective level. This raises the question of whether participants of epistemic collaborations are exempt from being held individually responsible. In response, this paper explores two possible ways in which attributions of individual responsibility may still be appropriate within epistemic collaborations: (I) Individuals can be held epistemically responsible for their individual shortcomings, but no amount of individual epistemic responsibility (...) can replace collective epistemic responsibility. (II) Even if it is denied that participants of epistemic collaborations can be held epistemically responsible at the individual level, they may be held structurally, perhaps morally, and even legally responsible at the individual level for breaking joint commitments necessary for the effective coordination of the epistemic collaboration. (shrink)

Recent scientific studies suggest that the destabilisation of the earth's climate and biodiversity loss are not separate, but interdependent phenomena. In this context, some have proposed the creation of a ‘Global Safety Net’ of ecoregions that should be preserved to stop further biodiversity loss, preventing at the same time the growth of CO2 emissions produced by deforestation and allowing natural carbon removal. In this article, I suggest that a first step to achieve this might be to replace permanent sovereignty over (...) natural resources in these areas with permanent guardianship. I propose to take some inspiration from a model that has already been implemented over an entire continent with a fair degree of success. In 1959, the Antarctic Treaty froze the sovereign claims of seven countries over Antarctica. However, these countries plus 47 others today have been remarkably successful at jointly preserving the continent for peace, science, and the protection of the environment, especially since the signature of the Environmental Protocol in 1991. After outlining some principles that could give form to a Global Environmental Protocol for Ecoregions, I address a series of objections and offer some concluding remarks. (shrink)