Many countries currently invest in technologies and data infrastructures to foster precision medicine (PM), which is hoped to better tailor disease treatment and prevention to individual patients. But who can expect to benefit from PM? The answer depends not only on scientific developments but also on the willingness to address the problem of structural injustice. One important step is to confront the problem of underrepresentation of certain populations in PM cohorts via improved research inclusivity. Yet, we argue that the (...) perspective needs to be broadened because the (in)equitable effects of PM are also strongly contingent on wider structural factors and prioritization of healthcare strategies and resources. When (and before) implementing PM, it is crucial to attend to how the organisation of healthcare systems influences who will benefit, as well as whether PM may present challenges for a solidaristic sharing of costs and risks. We discuss these issues through a comparative lens of healthcare models and PM-initiatives in the United States, Austria, and Denmark. The analysis draws attention to how PM hinges on—and simultaneously affects—access to healthcare services, public trust in data handling, and prioritization of healthcare resources. Finally, we provide suggestions for how to mitigate foreseeable negative effects. (shrink)

Marine chronometers, often considered precision instruments, proliferated in navigational practices during the nineteenth century. This paper examines their use in the hands of naval officers in the early-nineteenth century. It argues that both the instruments and their operators required careful management and regulation. In addition, officers learnt and adapted observatory practices relating to the process of data collection and management. Through these means, chronometric data was collected, organized, and reduced to negotiate accurate results.

Precision medicine is an emerging approach to treatment and disease prevention that relies on linkages between very large datasets of health information that is shared amongst researchers and health professionals. While studies suggest broad support for sharing precision medicine data with researchers at publicly funded institutions, there is reluctance to share health information with private industry for research and development. As the private sector is likely to play an important role in generating public benefits from precision medicine (...) initiatives, it is important to understand what the concerns are and how they might be mitigated. This study reports outcomes of a deliberative method of citizen engagement in Singapore that asked whether sharing precision medicine data with private industry would be permissible, and if so, under what circumstances. Findings from this citizens’ jury suggest sharing with industry would be permissible under certain conditions that are set out in nine recommendations. Implications of the recommendations and their underlying assumptions for policy decision makers are discussed. This study aligns with prior international studies which found conditional acceptance for data sharing with private industry, a public benefit requirement, specific reluctance to share with insurance companies and an emphasis on accountability and transparency to demonstrate trustworthiness. However, our results differ from prior studies in that opt-in consent did not dominate the deliberations as jurors were able to set it aside as an assumed prerequisite for participation in a precision medicine programme. (shrink)

Precision Medicine has become a common label for data-intensive and patient-driven biomedical research. Its intended future is reflected in endeavours such as the Precision Medicine Initiative in the USA. This article addresses the question whether it is possible to discern a new ‘medical cosmology’ in Precision Medicine, a concept that was developed by Nicholas Jewson to describe comprehensive transformations involving various dimensions of biomedical knowledge and practice, such as vocabularies, the roles of patients and physicians and the (...) conceptualisation of disease. Subsequently, I will elaborate my assessment of the features of Precision Medicine with the help of Michel Foucault, by exploring how precision medicine involves a transformation along three axes: the axis of biomedical knowledge, of biomedical power and of the patient as a self. Patients are encouraged to become the managers of their own health status, while the medical domain is reframed as a data-sharing community, characterised by changing power relationships between providers and patients, producers and consumers. While the emerging Precision Medicine cosmology may surpass existing knowledge frameworks; it obscures previous traditions and reduces research-subjects to mere data. This in turn, means that the individual is both subjected to the neoliberal demand to share personal information, and at the same time has acquired the positive ‘right’ to become a member of the data-sharing community. The subject has to constantly negotiate the meaning of his or her data, which can either enable self-expression, or function as a commanding Superego. (shrink)

Precision medicine and digital phenotyping are two prominent data-based approaches within digital medicine. While precision medicine historically used primarily genetic data to find targeted treatment options, digital phenotyping relies on the usage of big data deriving from digital devices such as smartphones, wearables and other connected devices. This paper first focusses on the aspect of data type to explore differences and similarities between precision medicine and digital phenotyping. It outlines different ways of data collection and production and (...) the consequences thereof. Second, it shows how these sorts of data influence dominant beliefs in the field: The field of precision medicine relying on the dominant understanding of ‘genetic determinism’ imported from genetics, digital phenotyping building on the logic of ‘data fundamentalism’. In the end, the analysis shows how digital data informs potentials as well as challenges of precision medicine and digital phenotyping: a better health care for individuals connected with individualisation and responsibilisation for all, with a prognosed shift from reactive to preventive medicine. Additionally, data-based approaches might facilitate epistemological and ontological redirections for the whole field of medicine that will also affect knowledge production and a reassessment of the value of different types of knowledge with all its consequences. Institutionally, it might lead to shifts in distribution of power to experts in big data related technologies, i.e. private companies. (shrink)

The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients’ empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical (...) dimensions is needed. Drawing on scholarship of nationalism and democracy, we discuss the PMI's construction of what we term “genomic citizenship”; the possible normative obligations arising therefrom; and the ethical, legal, and social challenges that will ensue. Although the PMI is a work in progress, discussion of the existing and emerging issues can facilitate the development of policies, structures, and procedures that can maximize the initiative's ability to produce equitable and socially sensitive outcomes. Our analysis can also be applied to other population-based, precision medicine research programs. (shrink)

Through the use of culturally appropriate videos on precision medicine research (PMR) that were developed and tailored to five racial and ethnic groups of patients, and subsequent focus-group discu...

Precision livestock farming promises to allow modern, large-scale farms to replicate, at scale, caring farmers who know their animals. PLF refers to a suite of technologies, some only speculative. The goal is to use networked devices to continuously monitor individual animals on large farms, to compare this information to expected norms, and to use algorithms to manage individual animals automatically. Supporters say this could not only create an artificial version of the partially mythologized image of the good steward caring (...) for his or her animals, but to also improve on it. As one paper in favor of PLF has said, “We can not only replace the farmer’s ‘eyes and ears’ to each individual animal as in the past, but several other variables will soon be measurable in practice” Livestock production and society, Wageningen Academic Publishers, Wageningen, pp 287–292, 2006). Yet these methods of monitoring and control raise a host of ethical issues, including alienation of laborers, further consolidation of farms, and further cover for meat consumption. In this paper, I will address these ethical issues, and suggest a different, under-examined concern: namely, that though PLF may indeed improve the lives of livestock, and the sustainability of livestock operations, it is possible that it will do so at the cost of a loss of identity and relationships for farmers, as well as for the animals in their charge. (shrink)

Blended learning has gained increasing popularity in colleges and universities with mixed results. Precision teaching can effectively promote learning performance. The relation between perceived precision teaching and the learning performance of college students in a blended learning environment is investigated in this paper. In the research survey is featuring a structural model, 256 college students who attended blended learning courses featuring precision teaching participated. The model results revealed that PPT is directly and positively related to self-efficacy and (...) learning motivation. Self-efficacy and learning motivation are directly and positively related to cognitive, teaching, and social presence. Additionally, cognitive, teaching, and social presence are directly and positively related to learning performance. Therefore, PPT is remotely and indirectly related to learning performance. These findings provide a new perspective for the theoretical study on blended learning performance and provide a realistic reference for precision teaching practice in the blended learning environment. (shrink)

BackgroundIn precision medicine biomarkers stratify patients into groups that are offered different treatments, but this may conflict with the principle of equal treatment. While some patient characteristics are seen as relevant for unequal treatment and others not, it is known that they all may influence treatment decisions. How biomarkers influence these decisions is not known, nor is their ethical relevance well discussed.MethodsWe distributed an email survey designed to elicit treatment preferences from Norwegian doctors working with cancer patients. In a (...) forced-choice conjoint analysis pairs of hypothetical patients were presented, and we calculated the average marginal component effect of seven individual patient characteristics, to estimate how each of them influence doctors’ priority-setting decisions.ResultsA positive biomarker status increased the probability of being allocated the new drug, while older age, severe comorbidity and reduced physical function reduced the probability. Importantly, sex, education level and smoking status had no significant influence on the decision.ConclusionBiomarker status is perceived as relevant for priority setting decisions, alongside more well-known patient characteristics like age, physical function and comorbidity. Based on our results, we discuss a framework that can help clarify whether biomarker status should be seen as an ethically acceptable factor for providing unequal treatment to patients with the same disease. (shrink)

Although continued investments in nanotechnology are made, atomically precise manufacturing (APM) to date is still regarded as speculative technology. APM, also known as molecular manufacturing, is a token example of a converging technology, has great potential to impact and be affected by other emerging technologies, such as artificial intelligence, biotechnology, and ICT. The development of APM thus can have drastic global impacts depending on how it is designed and used. This paper argues that the ethical issues that arise from APM (...) - as both a standalone technology or as a converging one - affects the roles of stakeholders in such a way as to warrant an alternate means furthering responsible innovation in APM research. This paper introduces a value-based design methodology called Value Sensitive Design (VSD) that may serve as a suitable framework to adequately cater to the values of stakeholders. Ultimately, it is concluded that VSD is a strong candidate framework for addressing the moral concerns of stakeholders during the preliminary stages of technological development. (shrink)

Ground Representationism is the position that for each phenomenal feature there is a representational feature that accounts for it. Against this thesis, Ned Block (The Puzzle of Phenomenal Precision, 2015) has provided an intricate argument that rests on the notion of “phenomenal precision”: the phenomenal precision of a percept may change at a different rate from its representational counterpart. If so, there is then no representational feature that accounts for a specific change of this phenomenal feature. Therefore, (...) Ground Representationism cannot be generally true. -/- Although the notion of phenomenal precision is intuitive, it is admittedly in need of clarification. Here I reconstruct Block’s argument by suggesting a way of estimating phenomenal precision that is based on the assumption that parts of perceptual wholes can share phenomenal features independently of their place in the whole. Understood like this, the overall argument shows what it is supposed to show. -/- A more thorough look at the notion of phenomenal precision suggests tension with Block’s other work: in order to be non-trivial, we have to accept that some of our phenomenality is not concrete, but only generic. Such “solely generic phenomenology”, however, is a position mainly held by opponents to Block’s Access- vs. Phenomenal Consciousness-distinction. Interpreting phenomenal imprecision as constituted by introspective imprecision does not suffice as a way out. It seems that phenomenal precision is either trivial, self-contradictory, or incompatible with Block’s position elsewhere. So some additional elucidation on this crucial notion is needed. (shrink)

The success of precision medicine depends on obtaining large amounts of information about at-risk populations. However, getting consent is often difficult. Why? In this commentary I point to the differentials in social status involved. These differentials are inevitable once personal information is surrendered, but are particularly intense when the studied populations are socioeconomically or socioculturally disadvantaged and/or ethnically stigmatized groups. I suggest how the deep distrust of the latter groups can be partially justified as a lack of confidence that (...) their core values or interests will sufficiently be taken into account. Hence, the ethical challenge here lies not in avoiding status differentials, but in dealing with them appropriately. Scientists should not assume trust from others but adopt a norm of “demonstrating trustworthiness”. (shrink)

Berichte zur Wissenschaftsgeschichte, Volume 45, Issue 3, Page 487-498, September 2022.

Video surveillance plays a vital role in maintaining the social security although, until now, large uncertainty still exists in danger understanding and recognition, which can be partly attributed to intractable environment changes in the backgrounds. This article presents a brain-inspired computing of attention value of surrounding environment changes with a processes-based cognition model by introducing a ratio valueλof EC-implications within considered periods. Theoretical models for computation of warning level of EC-implications to the universal video recognition efficiency are further established. Imbedding (...) proposed models into the online algorithms is suggested as a future research priority towards precision security for critical applications and, furthermore, schemes for a practical implementation of such integration are also preliminarily discussed. (shrink)

_More Precisely_ is a rigorous and engaging introduction to the mathematics necessary to do philosophy. Eric Steinhart provides lucid explanations of many basic mathematical concepts and sets out the most commonly used notational conventions. He also demonstrates how mathematics applies to fundamental issues in various branches of philosophy, including metaphysics, philosophy of language, epistemology, and ethics. This second edition adds a substantial section on decision and game theory, as well as a chapter on information theory and the efficient coding of (...) information. (shrink)

The use of forward models is well established in cognitive and computational neuroscience. We compare and contrast two recent, but interestingly divergent, accounts of the place of forward models in the human cognitive architecture. On the Auxiliary Forward Model account, forward models are special-purpose prediction mechanisms implemented by additional circuitry distinct from core mechanisms of perception and action. On the Integral Forward Model account, forward models lie at the heart of all forms of perception and action. We compare these neighbouring (...) but importantly different visions and consider their implications for the cognitive sciences. We end by asking what kinds of empirical research might offer evidence favouring one or the other of these approaches. (shrink)

Precision medicine is an emerging approach to individualized care. It aims to help physicians better comprehend and predict the needs of their patients while effectively adopting in a timely manner the most suitable treatment by promoting the sharing of health data and the implementation of learning healthcare systems. Alongside its promises, PM also entails the risk of exacerbating healthcare inequalities, in particular between ethnoracial groups. One often-neglected underlying reason why this might happen is the impact of structural racism on (...) PM initiatives. Raising awareness as to how structural racism can influence PM initiatives is paramount to avoid that PM ends up reproducing the pre-existing health inequalities between different ethnoracial groups and contributing to the loss of trust in healthcare by minority groups. We analyse three nodes of a process flow where structural racism can affect PM’s implementation. These are: the collection of biased health data during the initial encounter of minority groups with the healthcare system and researchers, the integration of biased health data for minority groups in PM initiatives and the influence of structural racism on the deliverables of PM initiatives for minority groups. We underscore that underappreciation of structural racism by stakeholders involved in the PM ecosystem can be at odds with the ambition of ensuring social and racial justice. Potential specific actions related to the analysed nodes are then formulated to help ensure that PM truly adheres to the goal of leaving no one behind, as endorsed by member states of the United Nations for the 2030 Agenda for Sustainable Development. Structural racism has been entrenched in our societies for centuries and it would be naïve to believe that its impacts will not spill over in the era of PM. PM initiatives need to pay special attention to the discriminatory and harmful impacts that structural racism could have on minority groups involved in their respective projects. It is only by acknowledging and discussing the existence of implicit racial biases and trust issues in healthcare and research domains that proper interventions to remedy them can be implemented. (shrink)

How many hairs must a person lose before they become bald? There doesn’t seem to be an easy way of answering this. This is because “bald”, along with a large number of other words, is vague. This vagueness causes problems and Anna Mahtani specialises in thinking very precisely about these problems….

We construct four models containing one supercompact cardinal in which level by level equivalence between strong compactness and supercompactness and level by level inequivalence between strong compactness and supercompactness are precisely controlled at each non‐supercompact measurable cardinal. In these models, no cardinal κ is ‐supercompact, where is the least inaccessible cardinal greater than κ.

St. Thomas Aquinas’ exposition of the Liber de causis, one of the few extended commentaries on this influential work, has received much greater detailed attention during recent decades. Nonetheless, interpretations have diverged concerning how this Neoplatonic source was assimilated and refined by Aquinas. It is not only important to comprehend the originality of procedures and accomplishment of St. Thomas in relation to his work for the sake of historical precision. Equally important is the intention of both the author and (...) his commentator, which is to contribute to our grasp of reality in terms of fundamental metaphysical principles. (shrink)

This paper problematizes the precision medicine approach embraced by the All of Us Research Program (US) and by Genomics England (UK) in terms of benefits distribution, by arguing that current “diversity and inclusion” efforts do not prevent exclusiveness, unless the framing and scope of the projects are revisited in public health terms. Grounded on document analysis and fieldwork interviews, this paper analyzes efforts to address potential patterns of exclusion upstream (from participating in precision medicine research) and downstream (from (...) benefitting from precision medicine outputs). It argues that efforts for inclusion upstream are not corresponded downstream, and this unbalance jeopardizes the equitable capacities of the projects. It concludes that enhanced focus on socio-environmental determinants of health and aligned public health interventions as precision medicine outputs would be to the benefit of all and especially of those who are most at risk of (upstream as well as downstream) exclusion. (shrink)

Both in the case of colloquial language and in the case of specialized scientific language we always have to face the essential issue : what must we do in order not to be misled by an incorrect use of language? When we refer in general to being misled by some use of language we have two cases in mind: primo, when the language in question wrongly performs its communicative function so that the speaker is unable to convey his ideas to (...) the listener, and, secundo, when the language by means of which we think imposes on us, through its structure and forms fixed by tradition (in the case of natural languages), incorrect ideas about reality (cf. the issues of hypostases). The causes of such and similar difficulties are varied. These difficulties, among other things, suggest the idea that language is not only an instrument, but also an object of research, an idea which induced twentieth century philosophers to engage in the study of language in its ontological, gnosiological, and methodological aspects. The method of semantic analysis, understood as a method of analysis of meanings of words, is directed precisely against these shortcomings of language. That method is meant to prevent semantic and logical errors that encumber the process of thinking with difficulties and hamper communication both with others and with oneself. Among other causes, these errors are due to the ambiguity and vagueness of words. (shrink)

Precision livestock farming (PLF) is the management of livestock using the principles and technology of process engineering. Key to PLF is the dense monitoring of variegated parameters, including animal growth, output of produce (e.g. milk, eggs), diseases, animal behaviour, and the physical environment (e.g. thermal micro-environment, ammonia emissions). While its proponents consider PLF a win-win strategy that combines production efficiency with sustainability goals and animal welfare, critics emphasise, inter alia, the potential interruption of human-animal relationships. This paper discusses the (...) notion that the objectification of animals by PLF influences the developmental pathways of conventional industrial farming. We conduct a conceptual analysis of objectification by comparing discussions in feminist ethics and animal ethics. We find that in animal ethics, objectification includes deontological arguments regarding instrumentalisation, de-animalisation, alienation, commodification and quantification of animals. The focus on socio-political context and relationality connects these debates to central ideas in care ethics. We adopt a care ethics perspective to assess the implications of the objectification of animals in livestock farming. The basic claim is that sensory knowledge symbolised by the farmers’ unity of hand, head and heart would make it harder to objectify animals than abstract and instrumental reasoning where the pursuit of knowledge is intertwined with the pursuit of control, as in mainstream PLF. Despite of what can be considered as a good caring relationship between farmers and animals that is mediated by PLF, people involved in conventional industrial farming still seem to become further detached from farmers and animals, because the PLF system itself is objectifying. PLF redefines the notion of care, in terms of data transparency, standardisation of methods for analysis, real-time collection and processing of data, remote control, and the use of digital platforms. This creates new expectations and requires a redistribution of responsibilities within a wider scope of relations in the value chain. (shrink)

In “Obligations of the Gift” Sandra Lee (2021) suggests that social norms of reciprocity and the expectations and obligations associated with gift-giving afford a framework for addressing social justice considerations in precision medicine. Lee is particularly concerned with obligations to marginalized or oppressed racial and ethnic groups, which are also historically under-represented populations in precision medicine. Obligations arise, Lee argues, through the “gift” that research participants make when they contribute their data or biospecimens to precision medicine research. (...) This conceptualization of research participation is distinct from an altruistic donation model that explicitly precludes obligations of reciprocity. I agree with Lee’s overall project to support social justice aims by better recognizing responsibilities of researchers to their research participants, and increasing diverse participation in biomedical research. However, I am not convinced that the account of “the gift” she deploys can achieve the social justice goals she intends because it risks replicating rather than resisting problematic conceptions of labor, property, and ownership of selves and others. However, an alternate conceptualization of “the gift” found in the work of 20th century French philosopher Jacques Derrida recasts ethical obligations on the part of precision medicine to those who contribute their data and biospecimens for precision medicine research. (shrink)

A prominent feature of late nineteenth-century psychology was its intense preoccupation with precision. Precision was at once an ideal and an argument: the quest for precision helped psychology to establish its status as a mature science, sharing a characteristic concern with the natural sciences. We will analyse how psychologists set out to produce precision in 'mental chronometry', the measurement of the duration of psychological processes. In his Leipzig laboratory, Wundt inaugurated an elaborate research programme on mental (...) chronometry. We will look at the problem of calibration of experimental apparatus and will describe the intricate material, literary, and social technologies involved in the manufacture of precision. First, we shall discuss some of the technical problems involved in the measurement of ever shorter time-spans. Next, the Cattell-Berger experiments will help us to argue against the received view that all the precision went into the hardware, and practically none into the social organization of experimentation. Experimenters made deliberate efforts to bring themselves and their subjects under a regime of control and calibration similar to that which reigned over the experimental machinery. In Leipzig psychology, the particular blend of material and social technology resulted in a specific object of study: the generalized mind. We will then show that the distribution of precision in experimental psychology outside Leipzig demanded a concerted effort of instruments, texts, and people. It will appear that the forceful attempts to produce precision and uniformity had some rather paradoxical consequences. (shrink)

“Actionability” is a key concept in precision oncology. Its precise definition, however, remains contested. This article undertakes a philosophical analysis of “actionability” to aid in conceptual clarification. We map distinct concepts of actionability, arguing that each is best understood as a contextually objective category articulated to mitigate risk of “conceptual slippage.” We defend “interactive pluralism,” acknowledging the need for distinct concepts but also for conceptual interaction in practice. This article thus offers insights for both practitioners and philosophers, clarifying approaches (...) to actionability for scientists and clinicians and serving as a case study to test competing views on scientific pluralism. (shrink)

An intuitive idea concerning degrees of precision is widely accepted, and it is that we increase precision of theories by paying attention to ever decreasing orders of magnitude of measurements which we incorporate in these theories. We increase precision of measuring or of predicting measurement of length, for instance, if we pay attention not only to centimeters but also to millimeters, microns, angstroms, and so on. And our theories are precise to centimeters, then to millimeters, and so (...) on respectively. The idea is that increased precision is the process of capturing a point within nested intervals, and that this is reflected both in experimental and in theoretical progress. An intuitive analogy may be drawn with series of photos made by a camera which approaches the moon's surface. A corollary from this intuitive idea which has been stated by a number of writers is that observation reports and theories are not overthrown even when superseded by more accurate observation because within the limits of their own precision-range they are still valid. When a law in physics is stated, it is stated usually without such qualifications; but this is a mere matter of convenience, we are told. The idea is that a tacit proviso is understood and the law should be understood to be not the statement “such and such is the case” but the statement “within this and that limit of accuracy such and such is the case”; in such a formulation, the law, once verified, remains unshaken regardless of further progress in the field. (shrink)

The science of metrology characterizes the concept of precision in exceptionally loose and open terms. That is because the details of the concept must be filled in—what I call narrowing of the concept—in ways that are sensitive to the details of a particular measurement or measurement system and its use. Since these details can never be filled in completely, the concept of the actual precision of an instrument system must always retain some of the openness of its general (...) characterization. The idea that there is something that counts as the actual precision of a measurement system must therefore always remain an idealization, a conclusion that would appear to hold very broadly for terms and the concepts they express. (shrink)

Argues for a failure of correspondence between perceptual representation and what it is like to perceive. If what it is like to perceive is grounded in perceptual representation, then, using considerations of veridical representation, we can show that inattentive peripheral perception is less representationally precise than attentive foveal perception. However, there is empirical evidence to the contrary. The conclusion is that perceptual representation cannot ground what it is like to perceive.

This article maps out the lexical landscape of precision from the late seventeenth to the early eighteenth century and investigate the various meanings of precision, both as a word and a concept, within the Paris Observatory and beyond. It argues that precision was first an attribute of instruments supposed to produce numerical measurements, like clocks and divided circles or sectors attached to optical devices. Less often, precision was applied to observers, the handling of instruments, and observational (...) methods, including mathematical corrections applied to raw data. When all these aspects were combined the numerical result finally was also deemed to be precise. Moving to the debate about the shape of the Earth that shook the Academy of Sciences in the 1730s, it follows the way in which wider audiences were conveyed the various meanings of precision. Between the Cartesian resistance to the emergence of a professional science of precision and the pedagogical approach followed by the Newtonians such as Maupertuis, it argues that Cassini III embraced the professionalism of modern science, but did not feel that methodological precision was out of the reach of an educated public. While Maupertuis has seemed content with a discussion focusing on the precision of instruments and results, Cassini III set himself the hefty task of producing an accessible account of precision as a method of inquiry. (shrink)

Amid public health concerns over climate change, “precision public health” is emerging in next generation approaches to practice. These novel methods promise to augment public health operations by using ever larger and more robust health datasets combined with new tools for collecting and analyzing data. Precision strategies to protecting the public health could more effectively or efficiently address the systemic threats of climate change, but may also propagate or exacerbate health disparities for the populations most vulnerable in a (...) changing climate. How PPH interventions collect and aggregate data, decide what to measure, and analyze data pose potential issues around privacy, neglecting social determinants of health, and introducing algorithmic bias into climate responses. Adopting a health justice framework, guided by broader social and climate justice tenets, can reveal principles and policy actions which may guide more responsible implementation of PPH in climate responses. (shrink)

Autism Spectrum Condition presents a challenge to social and relational accounts of the self, precisely because it is broadly seen as a disorder impacting social relationships. Many influential theories argue that social deficits and impairments of the self are the core problems in ASC. Predictive processing approaches address these based on general purpose neurocognitive mechanisms that are expressed atypically. Here we use the High, Inflexible Precision of Prediction Errors in Autism approach in the context of cultural niche construction to (...) explain atypicalities of the relational self, specifically its minimal, extended, and intersubjective aspects. We contend that the social self in ASC should not be seen as impaired, but rather as an outcome of atypical niche construction. We unpack the scientific, ethical, and practical consequences of this view, and discuss implications for how the challenges that autistic persons face should be approached. (shrink)

Evidence-Based Medicine (EBM) and Personalized Medicine (PM) share a common goal: reducing the gap between the results of biomedical research and their clinical application. PM is, however, often presented as a “new paradigm” for medicine, just as EBM was in the 1990s. It covers a wide variety of projects but the core idea that generally unites them is the ambition of better taking account of individual specificities than did EBM with its statistical and population-centred approach. In this article, I concentrate (...) on PM in cancerology, the essence of which is to target treatments based on the molecular profile of the patient. This targeting is made possible by gaining better knowledge about the molecular mechanisms of cancers. The classification of patients as a function of their molecular profile entails the creation of patient sub-groups. This creates a problem for the traditional evaluation of therapeutic treatment promoted by EBM, in particular the use of randomized trials using sizeable cohorts. But a better understanding of the mechanisms and the greater precision of treatments could reduce the need for these trials. Does PM thus represent the revenge of a physio-pathological and mechanistic culture in clinical research against the statistical and empirical one of EBM? My objective is to show how current practices of PM leads to epistemological changes in our estimation of what count as relevant types of information and proof in medicine, in particular in the field of therapeutic evaluation. I defend the idea that PM, far from obviating the need for statistical approaches and the search for correlations, ultimately poses new challenges for EBM. PM drives EBM to strengthen the articulation and the integration of statistical and mechanistic data with a view to providing a better service for each patient. (shrink)

Various arguments have recently been put forward to support the existence of vague or fuzzy objects. Nevertheless, the only possibly compelling argument would support, not the existence of vague objects, but indeterminately existing objects. I argue for the non‐existence of any vague entities—either particulars or properties ‐ in the mind‐independent world. Even so, many philosophers have claimed that to reduce vagueness to semantics is of no avail, since linguistic vagueness betrays semantic incoherence and this is no less a problem than (...) is ontological incoherence. After spelling out why there are fewer essentially vague concepts than usually thought. I claim that only the linguistic competence of the whole speaking community for each word can draw the sharp boundaries for its concept, even if these are unknowable in practice and still leave a precise range of indetermination. This could explain both the existence of boundaries and our non‐removable ignorance of them, fulfilling the intuitions of the epistemic theory of vagueness with the supervaluationist's indeterminacy. (shrink)

Gifts have served as a fundamental aspect of the human experience across time, even as their precise roles and functions have shifted. In the past, bioethicists and others have drawn upon anthropol...

We explore the extent to which ancient Greek authors formulated concepts that approximate or encompass our modern notions of precision and accuracy. First, we focus on estimates and measurements of geographic features, astronomical times and positions, and weight. These raise further questions about whether the quantities reported were measured, estimated, or rounded. While ancient sources discuss the use of instruments, it is not always clear that the aim was to achieve what we would today regard as ‘precision’. Next, (...) we briefly consider round numbers, observing that they could carry symbolic meaning, while unrounded numbers could give an impression of hard-won achievement. Finally, we examine uses of the word akribeia. This is often translated as ‘precision’ or ‘exactness’, and Greek writers sometimes used akribeia to denote an ideal for their inquiries. A brief look at its uses by a number of Greek writers will on the one hand show the mismatch with our term ‘precision’, and on the other hand throw some light on the aims of Greek investigators. (shrink)

Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced the so-called precision medicine paradigm, a model for medical research that uses innovative techniques for data collection and analysis to reevaluate traditional theories of disease. The goal of precision medicine is to improve diagnostics by restratifying the patient population on the basis of a deeper understanding of disease processes. This paper argues that precision is ill-fitting for psychiatry for two reasons. First, in psychiatry, (...) unlike in fields like oncology, precision medicine has been understood as an attempt to improve medicine by casting out, rather than merely revising, traditional taxonomic tools. Second, in psychiatry the term “biomarker” is often used in reference to signs or symptoms that allow patients to be classified and then matched with treatments; however, in oncology “biomarker” usually refers to a disease mechanism that is useful not only for diagnostics, but also for discovering causal pathways that drug therapies can target. Given these differences between how the precision medicine paradigm operates in psychiatry and in other medical fields like oncology, while precision psychiatry may offer successful rhetoric, it is not a promising paradigm. (shrink)

En este ensayo propongo una lectura de los contornos de la primera Meditación. Con ella intento resaltar una dimensión importante del pensamiento de Descartes en torno a la virtud de la precisión. Contrasto la preocupación por la verdad en la vida cotidiana y en la indagación cartesiana, exploro la manera en que Descartes enfrenta algunos riesgos epistémicos en el curso de su meditación, señalo algunos aspectos de su concepción de la agencia epistémica y concluyo con una breve disquisición alrededor de (...) la apuesta de Pascal. (shrink)

_More Precisely_ provides a rigorous and engaging introduction to the mathematics necessary to do philosophy. It is impossible to fully understand much of the most important work in contemporary philosophy without a basic grasp of set theory, functions, probability, modality and infinity. Until now, this knowledge was difficult to acquire. Professors had to provide custom handouts to their classes, while students struggled through math texts searching for insight. _More Precisely_ fills this key gap. Eric Steinhart provides lucid explanations of the (...) basic mathematical concepts and sets out most commonly used notational conventions. Furthermore, he demonstrates how mathematics applies to many fundamental issues in branches of philosophy such as metaphysics, philosophy of language, epistemology, and ethics. (shrink)