Current approaches to formal representation in biomedicine are characterized by their focus on either the static or the dynamic aspects of biological reality. We here outline a theory that combines both perspectives and at the same time tackles the by no means trivial issue of their coherent integration. Our position is that a good ontology must be capable of accounting for reality both synchronically (as it exists at a time) and diachronically (as it unfolds through time), but that these are (...) two quite different tasks, whose simultaneous realization is by no means trivial. The paper is structured as follows. We begin by laying out the methodological and philosophical background of our approach. We then summarize the structure and elements of the Basic Formal Ontology on which it rests, in particular the SNAP ontology of objects and the SPAN ontology of processes. Finally, we apply the general framework to the specific domain of biomedicine. (shrink)

We performed a qualitative analysis of the Thesaurus in order to assess its conformity with principles of good practice in terminology and ontology design. We used both the on-line browsable version of the Thesaurus and its OWL-representation (version 04.08b, released on August 2, 2004), measuring each in light of the requirements put forward in relevant ISO terminology standards and in light of ontological principles advanced in the recent literature. Version 04.08b of the NCI Thesaurus suffers from the same broad range (...) of problems that have been observed in other biomedical terminologies. For its further development, we recommend the use of a more principled approach that allows the Thesaurus to be tested not just for internal consistency but also for its degree of correspondence to that part of reality which it is designed to represent. (shrink)

We present an ontology of pain and of other pain-related phenomena, building on the definition of pain provided by the International Association for the Study of Pain (IASP). Our strategy is to identify an evolutionarily basic canonical pain phenomenon, involving unpleasant sensory and emotional experience based causally in localized tissue damage that is concordant with that experience. We then show how different variant cases of this canonical pain phenomenon can be distinguished, including pain that is elevated relative to peripheral trauma, (...) pain that is caused neuropathically (thus with no necessary peripheral stimulus), and pain reports arising through deception either of self or of others. We describe how our approach can answer some of the objections raised against the IASP definition, and sketch how it can be used to support more sophisticated discrimination of different types of pain resulting in improved data analysis that can help in advancing pain research. (shrink)

In this paper we address the interrelated questions of why and how certain features of an organism’s environment become meaningful to it. We make the case that knowing the biology is essential to understanding the foundation of meaning-making in organisms. We employ Miguel Nicolelis et al’s seminal research on the mammalian somatosensory system to enrich our own concept of brain-objects as the neurobiological intermediary between the environment and the consequent organismic behavior. In the final section, we explain how brain-objects advance (...) the ongoing discussion of what constitutes a biosemiotic system. In general, this paper acknowledges Marcello Barbieri’s call for biology to make room for meaning, and makes a contribution to that end. (shrink)

The strong continuity thesis postulates that the properties of mind are an enriched version of the properties of life, and thus that life and mind differ in degree and not kind. A philosophical problem for this view is the ostensive discontinuity between humans and other animals in virtue of our use of symbols—particularly the presumption that the symbolic nature of human cognition bears no relation to the basic properties of life. In this paper, we make the case that a genuine (...) account of strong continuity requires the identification of some sort of correlate of symbol-use in basic life properties. Our strategy is three-fold: 1) we argue that examples of proto-symbolism in simple living systems would be consistent with an evolutionary trajectory that ultimately produced symbolic cognition in humans; 2) we introduce Gordon Tomkins’ biological notion of ‘symbol’ as something that represents to the organism a feature of its environment that is significant to its survival; and 3) we employ this biological understanding of symbol-use to suggest that the symbolic nature of human cognition can be understood as an enriched version of the basic symbolic properties of life, thus preserving life-mind continuity in this context. (shrink)

How do we find what is clinically significant in the swarms of data being generated by today’s diagnostic technologies? As electronic records become ever more prevalent – and digital imaging and genomic, proteomic, salivaomics, metabalomics, pharmacogenomics, phenomics and transcriptomics techniques become commonplace – fdifferent clinical and biological disciplines are facing up to the need to put their data houses in order to avoid the consequences of an uncontrolled explosion of different ways of describing information. We describe a new strategy to (...) advance the consistency of data in the dental research community. The strategy is based on the idea that existing systems for data collection in dental research will continue to be used, but proposes a methodology in which past, present and future data will be described using a consensus-based controlled structured vocabulary called the Ontology for Dental Research (ODR). (shrink)

Letter commenting on the paper Barry Smith, Louis J. Goldberg, Alan Ruttenberg & Michael Glick, "Ontology and the Future of Dental Research Informatics", Journal of the American Dental Association 141 2010;(10):1173-75 with responses by the authors of the paper.

Abstract A unique aspect of human communication is the utilization of sets of well- delineated entities, the morphology of which is used to encode the letters of the alphabet. In this paper, we focus on Braille as an exemplar of this phenomenon. We take a Braille cell to be a physical artifact of the human environment, into the structure of which is encoded a representation of a letter of the alphabet. The specific issue we address in this paper concerns an (...) examination of how the code that is embedded in the structure of a Braille cell is transferred with fidelity from the environment through the body and into the Braille reader’s brain. We describe four distinct encoding steps that enable this transfer to occur. (shrink)

Face recognition depends upon the uniqueness of each human face. This is accomplished by the patterns formed by the unique relationship among face features. Unique face-patterns are produced by the intrusion of random factors into the process of biological growth and development. Processes are described which enable a unique face-pattern to be represented as a percept in the visual sensory system. The components of the face recognition system are analyzed as is the manner in which the precept is connected through (...) microcircuits to a memory file so that the history of a perceiver’s encounters with a familiar face enables the perceiver to access a memory store that is a record of the outcome of past encounters with the perceived. The importance of the face recognition system in enabling humans to individuate members the social group is discussed, as well as the importance of face recognition in the development of the individual’s social identity and ability to be a collaborative member of the social groups to which it belongs. The role of prosopagnosia—the inability to recognize familiar faces—in furthering an understanding of the face recognition system is examined, as is its importance in demonstrating the crucial nature of face recognition in human social functions. It is proposed that human face recognition is not a unique phenomenon but is an elaboration of processes existing in nonhuman primates as well as in lower animals. (shrink)

Four sequential, sub-processes are identified as the fundamental steps in the processing of signals by big-brained animals. These are, Detection of the signal, its Representation in correlated sensory brain structure, the Interpretation of the signal in another part of the brain and the Expression of the receiver’s response. We label this four-step spatiotemporal process DRIE. We support the view that when the context within which such signals are produced and received is relatively constant, the DRIE process can be ultimately assimilated (...) into the genome, with the Interpretation sub-phase is markedly decreased in duration as speed and efficiency are maximized. With frequent repetition and learning, an analogous result can be attained epigenetically as exemplified in human word and text recognition, allowing tasks critical to primate social function to be accomplished with rapidity and accuracy. (shrink)

SNODENT is a dental diagnostic vocabulary incompletely integrated in SNOMED-CT. Nevertheless, SNODENT could become the de facto standard for dental diagnostic coding. SNODENT's manageable size, the fact that it is administratively self-contained, and relates to a well-understood domain provides valuable opportunities to formulate and test, in controlled experiments, a series of hypothesis concerning diagnostic systems. Of particular interest are questions related to establishing appropriate quality assurance methods for its optimal level of detail in content, its ontological structure, its construction and (...) maintenance. This paper builds on previous–software-based methodologies designed to assess the quality of SNOMED-CT. When applied to SNODENT several deficiencies were uncovered. 9.52% of SNODENT terms point to concepts in SNOMED-CT that have some problem. 18.53% of SNODENT terms point to SNOMED-CT concepts do not have, in SNOMED, the term used by SNODENT. Other findings include the absence of a clear specification of the exact relationship between a term and a termcode in SNODENT and the improper assignment of the same termcode to terms with significantly different meanings. An analysis of the way in which SNODENT is structurally integrated into SNOMED resulted in the generation of 1081 new termcodes reflecting entities not present in the SNOMED tables but required by SNOMED's own description logic based classification principles. Our results show that SNODENT requires considerable enhancements in content, quality of coding, quality of ontological structure and the manner in which it is integrated and aligned with SNOMED. We believe that methods for the analysis of the quality of diagnostic coding systems must be developed and employed if such systems are to be used effectively in both clinical practice and clinical research. (shrink)

The value of any kind of data is greatly enhanced when it exists in a form that allows it to be integrated with other data. One approach to integration is through the annotation of multiple bodies of data using common controlled vocabularies or ‘ontologies’. Unfortunately, the very success of this approach has led to a proliferation of ontologies which itself creates obstacles to integration. The Open Biomedical Ontologies (OBO) consortium has set in train a strategy to overcome this problem. Existing (...) OBO ontologies, including the Gene Ontology, are undergoing a process of coordinated reform and new ontologies being created on the basis of an evolving set of shared principles governing ontology development. The result is an expanding family of ontologies designed to be interoperable, logically well-formed, and to incorporate accurate representations of biological reality. We describe the OBO Foundry initiative, and provide guidelines for those who might wish to become involved. (shrink)

This paper is divided into two parts. Part I focuses on the manner in which the components of the face recognition system work together so that a perceiver, within several hundred milliseconds after seeing a familiar face, is able to both identify the face of the perceived and recall elements of the history of past encounters with the perceived. Face recognition plays a crucial role in enabling both human and nonhuman primates to interact in collaborative social groups. This critical function (...) is accomplished through the unidirectional coded transfer of informational elements from one component to another. Although these informational elements themselves are not meaningful to the perceiving agent, they do nevertheless contain essential bits of information that are necessary for the final formation of the meaningful message. The structural components of the system are identified and the manner in which informational elements are coded and transferred sequentially from component to component in the brain of the perceiver is described. The independent, physically separated components in the face recognition system are bridged by an additional component, an “adaptor”, that mediates the transfer of informational elements from one component to another. The nature of the independent systems, and the manner by which the bridging or adaptor apparatus enables coded information transfer from one system to another is discussed. Part II focuses on the analysis of recognition in human-designed sign systems such as Braille and Morse code. Recognition in human-designed sign systems is notable for the stability of the link between sign and meaning. Face recognition is characterized as being subjective, indicating that the meaning of a sign to a perceiver is variable and dependent on context, whereas human-devised sign recognition is characterized as being objective, indicating that the meaning of a sign is context independent and invariant. Human-designed sign systems require the presence in brain of a referent world. An example of a referent world is the set of letters of the alphabet. Representations of this set are installed in the brain through social mediated learning. Human-designed sets of signs are created to correspond, via a code enabling adaptor structure, to referent worlds in the brain. Human-designed sign systems are the foundations for literacy, a capability only found in humans. (shrink)

The egg behaves as a prospective cell sustaining the developmental processes of the future embryo. In biosemiotic terms, this apparent teleonomic behaviour can be accounted for without referring to the exclusive causal role played by its genetic makeup. We envision two different processes that are uniquely found in the oocyte: (1) the first involves the mechanisms by which large amounts of mRNA accumulate in the ooplasm to establish the embryo axes prior to fertilization; (2) the second involves transfer of an (...) excess of maternally supplied ribosomes to the oocyte to provide the future embryo with newly synthesized proteins. In this paper, we argue that the information required to sustain embryonic development is not due to any physical properties of the zygotic DNA and the maternal mRNAs, but to their spatially and temporally ordered relationship in the zygote’s internal space. (shrink)

This volume collects twelve essays by Sanford C. Goldberg on the topic of social epistemology. The collection falls into two halves: the first half develops a proposal for a programme for social epistemology, its animating vision, foundational questions, and core concepts; the other half focuses on applications of this programme to particular topics. Goldberg characterizes the research programme as the exploration of the epistemic significance of other minds. This programme is dedicated to an examination of the various ways (...) in which we depend epistemically on others, and to describe the proper way to evaluate beliefs according to the sort of dependence they exhibit. It thus provides the basis for identifying and characterizing various dysfunctions of our epistemic communities. The programme is put into practice by exploring such topics as the epistemic agency exhibited in inquiry, the practices that constitute news coverage, the basis for allegations of what we or others should have known, how reliance on another's testimony contrasts with reliance on an instrument, our reliance on others as consumers of testimony, and the epistemic significance of non-epistemic social norms--moral, political, professional, or relationship-based. (shrink)

In Relying on others [Goldberg, S. 2010a. Relying on others: An essay in epistemology. Oxford: Oxford University Press], I argued that, from the perspective of an interest in epistemic assessment, the testimonial belief-forming process should be regarded as interpersonally extended. At the same time, I explicitly rejected the extendedness model for beliefs formed through reliance on a mere mechanism, such as a clock. In this paper, I try to bolster my defense of this asymmetric treatment. I argue that a (...) crucial assumption lying behind the argument I used to establish interpersonal extendedness in testimony cases does not apply to beliefs formed through reliance on instruments. In this respect, at least, there appears to be something epistemically distinctive about relying on another epistemic agent. (shrink)

In this paper I formulate the thesis of the Division of Epistemic Labor as a thesis of epistemic dependence, illustrate several ways in which individual subjects are epistemically dependent on one or more of the members of their community in the process of knowledge acquisition, and draw conclusions about the cognitively distributed nature of some knowledge acquisition.

Elsewhere I and others have argued that evidence one should have had can bear on the justification of one's belief, in the form of defeating one's justification. In this paper, I am interested in knowing how evidence one should have had (on the one hand) and one's higher-order evidence (on the other) interact in determinations of the justification of belief. In doing so I aim to address two types of scenario that previous discussions have left open. In one type of (...) scenario, there is a clash between a subject's higher-order evidence and the evidence she should have had: S's higher-order evidence is misleading as to the existence or likely epistemic bearing of further evidence she should have. In the other, while there is further evidence S should have had, this evidence would only have offered additional support for S's belief that p. The picture I offer derives from two “epistemic ceiling” principles linking evidence to justification: one's justification for the belief that p can be no higher than it is on one's total evidence, nor can it be higher than what it would have been had one had all of the evidence one should have had. Together, these two principles entail what I call the doctrine of Epistemic Strict Liability: insofar as one fails to have evidence one should have had, one is epistemically answerable to that evidence whatever reasons one happened to have regarding the likely epistemic bearing of that evidence. I suggest that such a position can account for the battery of intuitions elicited in the full range of cases I will be considering. (shrink)

Many epistemologists agree that even very young children sometimes acquire knowledge through testimony. In this paper I address two challenges facing this view. The first (building on a point made in Lackey (2005)) is the defeater challenge, which is to square the hypothesis that very young children acquire testimonial knowledge with the fact that children (whose cognitive immaturity prevents them from having or appreciating reasons) cannot be said to satisfy the No-Defeaters condition on knowledge. The second is the extension challenge, (...) which is to give a motivated, extensionally-adequate account of the conditions on testimonial knowledge in early childhood. Neither challenge can be met merely by endorsing externalism about knowledge; but we can meet both by reconceiving the process that eventuates in the child’s consumption of testimony. My central thesis is that this process should be seen as implicating features of the child's social environment. The result is a novel anti-individualistic externalism about knowledge. (shrink)

In this chapter we consider the tension between how pain researchers today typically define pains and the dominant, ordinary conception of pain. While both philosophers and pain scientists define pains as experiences, taking this to correspond with the ordinary understanding, recent empirical evidence indicates that laypeople tend to think of pains as qualities of bodily states. How did this divide come about? To answer, we sketch the historical origins of the concept of pain in Western medicine, providing evidence that during (...) large swaths of this history, medical experts characterized pains as laypeople tend to today—that is, as qualities of bodily states. The conception of pains as experiences that we find in contemporary definitions seems to be a relatively recent development corresponding with changes in the diagnostic tools available to doctors. We argue that this history is important and suggests that the most prominent current scientific definition of pain (IASP) is partly stipulative and fails to match how laypeople most often think of pain. We suggest that either we should acknowledge this stipulative character, or else should amend the IASP definition in a pluralistic fashion that notes both bodily and experiential conceptions of pain. (shrink)

The process of education, and in particular that involving very young children, often involves students' taking their teachers' word on a good many things. At the same time, good education at every level ought to inculcate, develop, and support students' ability to think for themselves. While these two features of education need not be regarded as contradictory, it is not clear how they relate to one another, nor is it clear how (when taken together) these features ought to bear on (...) educational practice itself. This article, which is largely programmatic, aims to provide tentative answers to these questions. (shrink)

One of the central points of contention in the epistemology of testimony concerns the uniqueness (or not) of the justification of beliefs formed through testimony--whether such justification can be accounted for in terms of, or 'reduced to,' other familiar sort of justification, e.g. without relying on any epistemic principles unique to testimony. One influential argument for the reductionist position, found in the work of Elizabeth Fricker, argues by appeal to the need for the hearer to monitor the testimony for credibility. (...) Fricker (1994) argues, first, that some monitoring for trustworthiness is required if the hearer is to avoid being gullible, and second, that reductionism but not anti-reductionism is compatible with ascribing an important role to the process of monitoring in the course of justifiably accepting observed testimony. In this paper we argue that such an argument fails. (shrink)

Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 editions. This (...) update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

The incredible story of the woman--actress, dancer, yogi, globetrotter--who brought yoga to America and to much of the rest of the western world. Born Eugenia Peterson in early 20th century Russia, Indra Devi was a rebel from earliest childhood. In the 1930s she fled to Berlin, and then--driven by her passion for yoga and a fascination with yogic philosophy (and Theosophy)--she journeyed to India, at a time when unaccompanied young European women were unheard of. In India she performed perhaps her (...) greatest feat--convincing even the most recalcitrant yogis, from Krishnamurti to Krishnamacharya, to reveal to her the secrets of their art. She would go on to share what she learned with men and women around the world--teaching Gloria Swanson and Greta Garbo in Hollywood, then moving to Mexico and later to Buenos Aires--helping to usher in the craze for yoga that continues unabated in the U.S. and throughout the world today. Written with vivid clarity, and describing the extraordinary spread and popularization of a philosophical movement, The Goddess Posebrings Indra Devi's little known but wholly remarkable story to life. (shrink)

The generation of animals was a difficult phenomenon to explain in the seventeenth century, having long been a problem in natural philosophy, theology, and medicine. In this paper, I explore how generation, understood as epigenesis, was directly related to an idea of rational nature. I examine epigenesis—the idea that the embryo was constructed part-by-part, over time—in the work of two seemingly dissimilar English philosophers: William Harvey, an eclectic Aristotelian, and Margaret Cavendish, a radical materialist. I chart the ways that they (...) understood and explained epigenesis, given their differences in philosophy and ontology. I argue for the importance of ideas of harmony and order in structuring their accounts of generation as a rational process. I link their experiences during the English Civil war to how they see nature as a possible source for the rationality and concord sorely missing in human affairs. (shrink)

The fusion of law and equity in common law systems was a crucial moment in the development of the modern law. In this volume leading scholars assess the significance of the fusion of law and equity from comparative, doctrinal, historical and theoretical perspectives.

Recently, we proposed a fundamental subdivision of the human cortex into two complementary networks—an “extrinsic” one which deals with the external environment, and an “intrinsic” one which largely overlaps with the “default mode” system, and deals with internally oriented and endogenous mental processes. Here we tested this hypothesis by contrasting decision making under external and internally-derived conditions. Subjects were presented with an external cue, and were required to either follow an external instruction or to ignore it and follow a voluntary (...) decision process . Our results show that a well defined component of the intrinsic system—the right inferior parietal cortex—was preferentially activated during the “free-will” condition. Importantly, this activity was significantly higher than the base-line resting state. The results support a self-related role for the intrinsic system and provide clear evidence for both hemispheric and regional specialization in the human intrinsic system. (shrink)

The goal of this essay is to explore the meaning of experience in William Harvey’s natural philosophy. I begin with Cunningham’s argument that, for Harvey, anatomy was an experience-based science of final causes. But how could one experience final causes? I answer this by first articulating Harvey’s conception of anatomy, before turning to his understanding of experience.What did anatomia mean in the early seventeenth century? Consulting dictionaries, the texts of anatomists, and following Cunningham, we can assert that anatomists conceived of (...) their work as both a manual art and a rational science.1 Medicine had long proved problematic, failing to fit into disciplinary.. (shrink)

John Rawls famously holds that the basic structure is the 'primary subject of justice.'1 By this, he means that his two principles of justice apply only to a society's major political and social institutions, including chiefly the constitution, the economic and legal systems, and (more contentiously) the family structure.2 This thesis — call it the basic structure restriction — entails that the celebrated difference principle has a narrower scope than one might have expected. It doesn't apply directly to choices that (...) individuals make within the basic structure. Individuals can live up to the demands of justice simply by obeying whatever rules are set by, and by doing what is necessary to sustain, the basic .. (shrink)

La logique de Leibniz: d'apres des documents inedits / par Louis Couturat,...Date de l'edition originale: 1901Sujet de l'ouvrage: Leibniz, Gottfried Wilhelm (1646-1716)Logique moderneCollection: Collection historique des grands philosophesCe livre est la reproduction fidele d'une oeuvre publiee avant 1920 et fait partie d'une collection de livres reimprimes a la demande editee par Hachette Livre, dans le cadre d'un partenariat avec la Bibliotheque nationale de France, offrant l'opportunite d'acceder a des ouvrages anciens et souvent rares issus des fonds patrimoniaux de la (...) BnF.Les oeuvres faisant partie de cette collection ont ete numerisees par la BnF et sont presentes sur Gallica, sa bibliotheque numerique.En entreprenant de redonner vie a ces ouvrages au travers d'une collection de livres reimprimes a la demande, nous leur donnons la possibilite de rencontrer un public elargi et participons a la transmission de connaissances et de savoirs parfois difficilement accessibles.Nous avons cherche a concilier la reproduction fidele d'un livre ancien a partir de sa version numerisee avec le souci d'un confort de lecture optimal. Nous esperons que les ouvrages de cette nouvelle collection vous apporteront entiere satisfaction.Pour plus d'informations, rendez-vous sur www.hachettebnf.frhttp: //gallica.bnf.fr/ark: /12148/bpt6k110843d. (shrink)

In this paper I argue, first, that the most influential (and perhaps only acceptable) account of the epistemology of self-knowledge, developed and defended at great length in Wright (1989b) and (1989c) (among other places), leaves unanswered a question about the psychology of self-knowledge; second, that without an answer to this question about the psychology of self-knowledge, the epistemic account cannot be considered acceptable; and third, that neither Wright's own answer, nor an interpretation-based answer (based on a proposal from Jacobsen (1997)), (...) will suffice as an acceptable answer to the psychological question. My general ambition is thus to establish that more work is needed if we are to have a full account of self-knowledge in both its epistemological and psychological aspects. I conclude by suggesting how my thesis bears on those who aim to provide an empirical account of the cognition involved in self-knowledge. (shrink)

No political, economic, or cultural segment of society has escaped the universal impact of recent cataclysmic change. Physicians were no exception. During the 20th century, all members of society, including physicians, have experienced change of enormous speed and magnitude. Futurist Alvin Toffler noted that global societal transformation has created a of personal malaise that poses difficulty for both individual and group adaptation. Toffler further described current change as a fundamental shift and conflict in all aspects of civilization (how we live, (...) work, and relate to each other). Toffler also noted major alterations in the basis for distribution of societal power (who controls what, why, and how). One manifestation of recent change directly affecting all members of society, includingphysicians, has been the social transformation of medicine that has been a power shift from the individual physicians to control by organizations and management. (shrink)

Ernest Lepore and Kirk Ludwig correctly observe that Donald Davidson’s account of radical interpretation is in tension with his Swampman thought experiment. Nonetheless, I argue, they fail to see the extent of Davidson’s tension—and so do not handle it adequately—because they fail to appreciate that the thought experiment pits two incompatible response-dependent accounts of meaning against one another. I take an account of meaning to be response-dependent just in case it links the meaning of terms in an a priori manner (...) to the responses that a suitable subject under suitable conditions could or did have to those terms. That Davidson proposes two such accounts is deeply problematic for his program. After explaining the sense in which Davidson endorses two incompatible response-dependent accounts of meaning, I use that explanation to resolve the tension myself. (shrink)

This article adopts a population-level bioethics approach to analyzing the ethical implications of novel deep-brain stimulation (DBS) technologies. I claim that a microlevel focus on costs and benefits is necessary but insufficient to address the concerns of social justice and health equity that attend the potential utilization of DBS technologies. A macrosocial, population-based analysis notes two ethically significant trends regarding novel health technologies: (1) that they are the prime mover of hyperinflationary health cost trajectories, and (2) that even where they (...) improve overall population health such technologies may expand health inequalities. Such an expansion could exacerbate what Powers and Faden have identified as “densely-woven patterns of disadvantage,” and therein could contravene mandates of social justice. Such concerns of justice and equity are sharpened by the fact that those populations that bear the highest risk of suffering the injuries and illnesses for which DBS technologies might be warranted are among the most disadvantaged groups in American society. Accordingly, ethical analysis of DBS technologies must include an assessment of the evidence suggesting that in their capacity to improve health and compress health inequalities, whole-population approaches that address the upstream factors that shape distributions of neuropsychiatric injuries and illness may be preferable to acute health interventions. However, the article warns against the false-choice fallacy, and notes that whole-population policies and acute care interventions can be simultaneously endorsed. The article concludes by suggesting that the ethical issue of relative priority between these approaches is best framed via a population-level analysis. (shrink)