Deep brain stimulation of the subthalamic nucleus or the globus pallidus is an established treatment for Parkinson’s disease that yields a marked and lasting improvement of motor symptoms. Yet, DBS benefit on gait disturbances in PD is still debated and can be a source of dissatisfaction and poor quality of life. Gait disturbances in PD encompass a variety of clinical manifestations and rely on different pathophysiological bases. While gait disturbances arising years after DBS surgery can be related to disease progression, (...) early impairment of gait may be secondary to treatable causes and benefits from DBS reprogramming. In this review, we tackle the issue of gait disturbances in PD patients with DBS by discussing their neurophysiological basis, providing a detailed clinical characterization, and proposing a pragmatic programming approach to support their management. (shrink)

In their article, Sedlakova and Trachsel (2023) propose a holistic, ethical, and epistemic analysis of conversational artificial intelligence (CAI) in psychotherapeutic settings. They mainly descri...

Kant’s critique/doctrine distinction tracks the difference between a canon for the understanding’s proper use and an organon for its dialectical misuse. The latter reflects the dogmatic use of reason to attain a doctrine of knowledge with no antecedent critique. In the 1790s, Fichte collapses Kant’s distinction and redefines dogmatism. He argues that deriving a canon is essentially dialectical and thus yields an organon: critical idealism is properly a doctrine of science or Wissenschaftslehre. Criticism is furthermore said to refute dogmatism, by (...) which Fichte means Spinozism. Schelling repudiates Fichte’s position in his Philosophical Letters by reviving Kant’s distinction. First, ‘critique’ for Schelling names a canon that is valid for all systems—including Spinozism—and thus favours none—not even the Wissenschaftslehre. Second, Schelling coins ‘dogmaticism’ to refer to what Kant calls ‘dogmatism’: reason’s uncritical claim to doctrine. Hence, he says all systems—even Fichte’s—are susceptible to the ‘enthusiasm’ of mistaking themselves for doctrines or ‘objects of knowledge’, instead of subjectively valid ‘objects of freedom’. I reconstruct Schelling’s argument for reviving Kant’s distinction, while noting two consequences for German idealism. First, if criticism favours no system, a system’s origin cannot be an act of knowledge, e.g., intellectual intuition, but only an act of endorsement. Second, if dogmaticism entails enthusiasm, a system’s goal cannot be absolute knowledge, but only infinite striving. Hence, by retrieving Schelling’s notion of dogmaticism, we can both gain a better understanding of the Letters and register the impact of a core Kantian distinction on the German idealist project. (shrink)

Machine learning (ML) systems play an increasingly relevant role in medicine and healthcare. As their applications move ever closer to patient care and cure in clinical settings, ethical concerns about the responsibility of their use come to the fore. I analyse an aspect of responsible ML use that bears not only an ethical but also a significant epistemic dimension. I focus on ML systems’ role in mediating patient–physician relations. I thereby consider how ML systems may silence patients’ voices and relativise (...) the credibility of their opinions, which undermines their overall credibility status without valid moral and epistemic justification. More specifically, I argue that withholding credibilitydue tohow ML systems operate can be particularly harmful to patients and, apart from adverse outcomes, qualifies as a form of testimonial injustice. I make my case for testimonial injustice in medical ML by considering ML systems currently used in the USA to predict patients’ risk of misusing opioids (automated Prediction Drug Monitoring Programmes, PDMPs for short). I argue that the locus of testimonial injustice in ML-mediated medical encounters is found in the fact that these systems are treated asmarkers of trustworthinesson which patients’ credibility is assessed. I further show how ML-based PDMPs exacerbate and further propagate social inequalities at the expense of vulnerable social groups. (shrink)

Artificial intelligence-based (AI) technologies such as machine learning (ML) systems are playing an increasingly relevant role in medicine and healthcare, bringing about novel ethical and epistemological issues that need to be timely addressed. Even though ethical questions connected to epistemic concerns have been at the center of the debate, it is going unnoticed how epistemic forms of injustice can be ML-induced, specifically in healthcare. I analyze the shortcomings of an ML system currently deployed in the USA to predict patients’ likelihood (...) of opioid addiction and misuse (PDMP algorithmic platforms). Drawing on this analysis, I aim to show that the wrong inflicted on epistemic agents involved in and affected by these systems’ decision-making processes can be captured through the lenses of Miranda Fricker’s account of hermeneutical injustice. I further argue that ML-induced hermeneutical injustice is particularly harmful due to what I define as an automated hermeneutical appropriation from the side of the ML system. The latter occurs if the ML system establishes meanings and shared hermeneutical resources without allowing for human oversight, impairing understanding and communication practices among stakeholders involved in medical decision-making. Furthermore and very much crucially, an automated hermeneutical appropriation can be recognized if physicians are strongly limited in their possibilities to safeguard patients from ML-induced hermeneutical injustice. Overall, my paper should expand the analysis of ethical issues raised by ML systems that are to be considered epistemic in nature, thus contributing to bridging the gap between these two dimensions in the ongoing debate. (shrink)

The study of the history of ideas is usually devoted to big problems and to concluded debates. We have attempted to analyze a current theory whose fate and explanatory power is still not determined. The term microparadigm is used to define a currently and widely accepted theory limited in time and in the field of application, compared to the greater problems usually investigated by historians of science. Among the characteristics defining a microparadigm we found: 1) the status of an accepted (...) theory with creative scientific power; 2) the presence of anomalies and unproven inferences; 3) a limited field of application; 4) the peculiarity of interaction with non-scientific ideas. In this context, we discuss the rise of the current microparadigm concerning the pathogenesis and biology of lymphoid neoplasms. We show that the current view of the neoplastic lymphoid cells as populations frozen at a particular differentiative stage has been creative for the last 10 years, thus allowing the generation of a large body of data that would not have been collected within the previous view of the leukemic cell as completely “anarchic”. This paradigm, although containing some anomalies, has survived the impact of molecular biology in hematology and is still creative. We think that microparadigms are widely distributed in everyday science and that an analysis of them is as useful for active scientist as is the study of macroparadigms, which by themselves cannot be representative of everyday science. Finally, the study of microparadigms while they are still operative can be useful to evidence the weakness of the theory and to suggest where new data should be sought. (shrink)

Meillassoux seeks knowledge of transcendental reality, blaming Kant for the ‘correlationist’ proscription of independent access to either thought or being. For Meillassoux, correlationism blocks an account of the meaning of ‘ancestral statements’ regarding reality prior to humans. I examine three charges on which Meillassoux’s argument depends: (1) Kant distorts ancestral statements’ meaning; (2) Kant fallaciously infers causality’s necessity; (3) Kant’s transcendental idealism cannot grasp ‘the great outdoors’. I reject these charges: (1) imposes a Cartesian misreading, hence Meillassoux’s false assumption that, (...) for Kant, objects don’t exist without subjects; (2) misreads Kant, who infers causality’s necessity from the possibility of experience; (3) casts Kant’s idealism as subjective, ignoring his perspectival portrayal of it. (shrink)

Overconfidence is typically damaging to one’s reputation as a trustworthy source of information. Previous research shows that the reputational cost associated with conveying a piece of false information is higher for confident than unconfident speakers. When judging speaker trustworthiness, individuals do not exclusively rely on past accuracy but consider the extent to which speakers expressed a degree of confidence that matched the accuracy of their claims (their “confidence-accuracy calibration”). The present study experimentally examines the interplay between confidence, accuracy and a (...) third factor, namely evidence, in the assessment of speaker trustworthiness. Experiment 1 probes the hypothesis that overconfidence does not backfire when a confident but inaccurate claim is justified: the trustworthiness of a confident speaker who turns out to be wrong is restored if the confidence expressed is based on strong evidence (good confidence-evidence calibration). Experiment 2 investigates the hypothesis that confidence can backfire if a confident and accurate claim is not justified: the trustworthiness of a confident speaker who turns out to be right is damaged if the confidence expressed is based on weak evidence (bad confidence-evidence calibration). Our results support both hypotheses and thus suggest that “confidence-evidence calibration” plays a crucial role in the assessment of speaker trustworthiness. (shrink)

The present study investigated whether humans are more likely to trust people who are coordinated with them. We examined a well-known type of linguistic coordination, lexical entrainment, typically involving the elaboration of “conceptual pacts,” or partner-specific agreements on how to conceptualize objects. In two experiments, we manipulated lexical entrainment in a referential communication task and measured the effect of this manipulation on epistemic and practical trust. Our results showed that participants were more likely to trust a coordinated partner than an (...) uncoordinated one, but only when the latter broke previously established conceptual pacts. (shrink)

Much research has focused on the effects of pathogenic mitochondrial mutations on health. Notwithstanding, the mechanisms regulating the link between these mutations and their effects remain elusive in several cases. Here, we propose that certain mitochondrial mutations may disrupt function of a set of mitochondrial‐transcribed small RNAs, perturbing communication between mitochondria and nucleus, leading to disease. Our hypothesis synthesises two lines of supporting evidence. First, several mitochondrial mutations cannot be directly linked to effects on energy production or protein synthesis. Second, (...) emerging studies have described the existence of small RNAs encoded by the mitochondria and proposed their involvement in RNA interference. We present a roadmap to testing this hypothesis. (shrink)

In this paper, we discuss epistemic and ethical concerns brought about by machine learning (ML) systems implemented in medicine. We begin by fleshing out the logic underlying a common approach in the specialized literature (which we call the _informativeness account_). We maintain that the informativeness account limits its analysis to the impact of epistemological issues on ethical concerns without assessing the bearings that ethical features have on the epistemological evaluation of ML systems. We argue that according to this methodological approach, (...) epistemological issues are _instrumental_ to and _autonomous_ of ethical considerations. This means that the informativeness account considers epistemological evaluation uninfluenced and unregulated by an ethical counterpart. Using an example that does not square well into the _informativeness account_, we argue for ethical assessments that have a substantial influence on the epistemological assessment of ML and that such influence should not be understood as merely informative but rather regulatory. Drawing on the case analyzed, we claim that within the theoretical framework of the informativeness approach, forms of epistemic injustice—especially _epistemic objectification_—remain unaddressed. Our analysis should motivate further research investigating the regulatory role that ethical elements play in the epistemology of ML. (shrink)

Doernberg and Truog (2023) provide an insightful analysis of the role of medical professionals in what they call spheres of morality. While their framework is useful for inquiring into the moral de...

In my paper entitled ‘Testimonial injustice in medical machine learning’,1 I argued that machine learning (ML)-based Prediction Drug Monitoring Programmes (PDMPs) could infringe on patients’ epistemic and moral standing inflicting a testimonial injustice.2 I am very grateful for all the comments the paper received, some of which expand on it while others take a more critical view. This response addresses two objections raised to my consideration of ML-induced testimonial injustice in order to clarify the position taken in the paper. The (...) first maintains that my critical stance toward ML-based PDMPs idealises standard medical practice. Moreover, it claims that the ML-induced testimonial injustice I discuss is not substantially different from situations in which it emerges in human–human interactions. The second claims that my analysis does not establish a link to issues of automation bias, even if these are to be considered the core of testimonial injustice in ML. In the following, I address each objection in turn. Gillett3 argues that my critical stance towards using risk prediction tools such as PDMPs implies the idealisation of standard (ie, non-ML-mediated) modes of clinical practice. Considering certain uses of ML in a different setting, that is, psychiatry, the author goes as far as claiming that ‘traditional models of clinical practice in psychiatry are far from a utopia, free from epistemic injustice, which Pozzi’s argument risks proposing’. Since this statement does not represent what I intend to suggest, I am glad to have the possibility to clarify …. (shrink)

Given the risks of misinformation, addressees need to calibrate their trust towards communicators effectively. One way to do this is to evaluate the evidence speakers rely on (their evidential warrant) or claim to have (their evidential claims) when providing testimony. We review key findings in experimental psychology and experimental pragmatics to uncover the mechanisms underlying this form of trust calibration. This will ultimately shed light on the psychological foundations of principles that guide the evaluation of testimony in legal contexts, such (...) as the law against hearsay. (shrink)

Bazzocchi disposes the text of the Tractatus in a user-friendly manner, exactly as Wittgenstein's decimals advise. This discloses the logical form of the book by distinct reading units, linked into a fashioned hierarchical tree. The text becomes much clearer and every reader can enjoy, finally, its formal and literary qualities.

Resumen: Alfonsina Storni es una escritora que se ha labrado un lugar dentro del canon literario argentino, por mucho tiempo bajo una imagen de escritora que anudaba sentimentalismo, fatalidad y poesía “femenina”, aunque más recientemente la crítica literaria de orientación feminista haya desmontado esa imagen. Este trabajo se interesa, no obstante, por los años en que Alfonsina Storni publicaba sus primeros poemarios y comenzaba a pugnar por un lugar en el incipiente campo literario, dominantemente masculino. El objetivo es visualizar, desde (...) una perspectiva de género, las prácticas culturales emergentes, dominantes y residuales que contribuyeron o condicionaron su camino hacia la profesionalización como escritora, en un contexto de cambios por los procesos modernizadores y de avances del movimiento feminista.: Alfonsina Storni is a writer who has forged a position within the Argentinian literary canon, under the image of a writer who revokes sentimentalism, fatality and “feminine” poetry. Recently, the feminist-oriented literary criticism has dismantled this image finding out other areas in her literary production. This work is focused on the years in which Alfonsina Storni published her first collections of poems and started struggling for a certain position in the emerging literary field, which was mainly under male domain. Taking a gender perspective, the aim is to visualize emerging dominant, and residual cultural practices that contributed or determined her path towards becoming a professional writer, in a context of changes due to modernizing processes and the feminist movement advance. (shrink)

Lo scritto traduce il tentativo di rendere in forma dialogica alcuni dei principali ragionamenti emersi da un percorso di Dottorato di ricerca, in particolare ponendo lo sguardo sugli attuali cambiamenti nella pratica del leggerescrivere e provando a prefigurarne di nuovi. I due personaggi sulla scena interpretano altrettanti distinti approcci alla questione cardine: i nuovi dispositivi multimediali, i diversi supporti digitali renderanno obsoleto l'oggetto "libro" per come noi, uomini moderni, l'abbiamo fino ad oggi conosciuto? La nuova era segnerÀ necessariamente il dissolversi (...) della civiltÀ del libro? (shrink)