For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from (...) the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings. (shrink)

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. (...) Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors. (shrink)

I explore some early modern philosophical thought about the relation of beauty and wisdom, a theme first expressed in Plato's Symposium. The thinkers I consider most centrally are two women, Lucrezia Marinella and Mary Astell, though I also consider the writers Aphra Behn and Sarah Scott. While women in particular might have a special interest in appropriating the Platonic image of the ladder of desire, this ought not to be conceived as a 'women's issue'. Rather, I suggest, this strand of (...) thought is connected with a central philosophical question of the early modern period, the nature of thought and consciousness. J'étudie ici quelques réflexions philosophiques de l'âge moderne portant sur la relation entre beauté et sagesse, thème d'abord développé dans Le Banquet de Platon. Les penseurs auxquels je m'intéresse principalement sont Lucrecia Marinella et Mary Astell, même si je m'appuie aussi sur les écrivaines Aphra Behn et Sarah Scott. Bien que les femmes en particulier puissent avoir un intérêt spécifique à s'approprier l'image platonicienne de l'échelle désir, cela n'autorise pas à concevoir cette question comme un « problème de femmes ». Je suggère, au contraire, que ce courant de pensée est relié à une question philosophique centrale à l'époque moderne, celle de la nature de la pensée et de la conscience. (shrink)

I explore some early modern philosophical thought about the relation of beauty and wisdom, a theme first expressed in Plato's Symposium. The thinkers I consider most centrally are two women, Lucrezia Marinella and Mary Astell, though I also consider the writers Aphra Behn and Sarah Scott. While women in particular might have a special interest in appropriating the Platonic image of the ladder of desire, this ought not to be conceived as a 'women's issue'. Rather, I suggest, this strand of (...) thought is connected with a central philosophical question of the early modern period, the nature of thought and consciousness. J'étudie ici quelques réflexions philosophiques de l'âge moderne portant sur la relation entre beauté et sagesse, thème d'abord développé dans Le Banquet de Platon. Les penseurs auxquels je m'intéresse principalement sont Lucrecia Marinella et Mary Astell, même si je m'appuie aussi sur les écrivaines Aphra Behn et Sarah Scott. Bien que les femmes en particulier puissent avoir un intérêt spécifique à s'approprier l'image platonicienne de l'échelle désir, cela n'autorise pas à concevoir cette question comme un « problème de femmes ». Je suggère, au contraire, que ce courant de pensée est relié à une question philosophique centrale à l'époque moderne, celle de la nature de la pensée et de la conscience. (shrink)

Last year, as some of you may recall, I took it upon my chairly shoulders to solve the problem of causation, where this problem can be stated this way: What is causation? According to the analysis I offered, C is a cause of E if and only if C makes E happen. I am happy to report that, in the year since delivering this account of causation, no objections have arisen. The critics have been silenced. Indeed, my colleague Dan Hausman, (...) the Herbert Simon Professor of Philosophy, reports that he is no longer satisfied with the view he expressed in his recent book on causation, and I have no doubt that his change of mind is due in no small part to my seminal contribution to this subject. If you would permit me a joke, I think I “made happen” a change in Dan’s mind. I should also mention that we are now fortunate to have amongst us Carolina Sartorio, whose own analysis of causation, arrived at independently, seems but a stylistic variant of my own. Where I see causes as things that make things happen, she sees them as things that make a difference. I think, but can’t be certain, that our analyses come to the same thing. Perhaps if she hadn’t muddied the waters with all those numbered propositions and ‘ifs’ and ‘thens’ we could settle the matter. (shrink)

SummaryAccording to Dummett's understanding of Frege, the sense of a denoting expression is a procedure for determining its denotation. The purpose of this article is to pursue this suggestion and develop a semi‐formal interpretation of Fregean sense for the special case of a first‐order language of arithmetic. In particular, we define the sense of each arithmetic expression to be a hypothetical process to determine the denoted number or truth value. The sense‐process is “hypothetical” in that the senses of some expressions (...) cannot be completed in a finite number of steps. The motivation for this work is to explicate an intensional notion of effectiveness in terms of the senses of function names. It is proposed, in particular, that an expression is effective if and only if its sense can be completed in a finite number of steps. It is shown that a function is computable if and only if it has an effective name.RésuméSelon la lecture que Dummet donne de Frege, le sens ?on;une expression consiste en une procédure pour déterminer sa dénotation. Le but de cet article est de développer cette suggestion par une interprétation semi‐formelle du sens frégéen dans le cas particulier ?on;un langage de premier ordre en arithmétique. En particulier, nous définissons comme sens de toute expression mathématique un procédé hypothétique pour déterminer le nombre dénoté ou la valeur de vérité. Le procédé créateur de sens est hypothetique en ce sens que les sens de certaines expressions ne peuvent pas être donnés en un nombre fini de pas. Le but de cette étude est ?on;expliciter une notion intensionnelle ?on;effectuabilite en termes de sens des noms de fonction. II est en particulier propose qu'une expression soit dite effectuable si et seulement si son sens peut être épuisé en un nombre fini de pas. On montre qu'une fonction est calculable si et seulement si elle a un nom effectuable.ZusammenfassungDummets Auffassung von Frege gemäss besteht der Sinn eines denotierenden Ausdruckes in einem Verfahren, das dessen Denotation bestimmt. Es ist der Zweck der vorliegenden Arbeit, die‐sen Vorschlag weiterzufuUhren und eine halbformale Interpretation des Fregeschen Sinnes fiir den besonderen Fall der Sprache erster Stufe der Arithmetik zu entwickeln. Es wird im besonderen der Sinn eines jeden arithmetischen Ausdruckes als hypothetisches Verfahren zur Bestimmung der denotierten Zahl oder des Wahrheitswertes definiert. Die Sinngebung ist insofern hypothe‐tisch, als der Sinn gewisser Ausdrucke nicht in einer endlichen Zahl von Schritten gegeben wer‐den kann. Das Anliegen der Arbeit grundet in der Absicht, einen intensionalen Begriff der Effek‐tivitat aufgrund des Sinnes von Funktionsnamen zu erlautern. Es wird im besonderen festgelegt, dass ein Ausdruck dann und nur dann effektiv sei, wenn sein Sinn in einer endlichen Zahl von Schritten erreicht werden kann. Es wird gezeigt, dass eine Funktion genau dann berechenbar ist, wenn sie einen effektiven Namen hat. (shrink)

Stewart Shapiro's ambition in Vagueness in Context is to develop a comprehensive account of the meaning, function, and logic of vague terms in an idealized version of a natural language like English. It is a commonplace that the extensions of vague terms vary according to their context: a person can be tall with respect to male accountants and not tall (even short) with respect to professional basketball players. The key feature of Shapiro's account is that the extensions of (...) vague terms also vary in the course of conversations and that, in some cases, a competent speaker can go either way without sinning against the meaning of the words or the non-linguistic facts. As Shapiro sees it, vagueness is a linguistic phenomenon, due to the kinds of languages that humans speak; but vagueness is also due to the world we find ourselves in, as we try to communicate features of it to each other. (shrink)

A la fin du XIXe siècle, l'image de la femme criminelle est devenue une obsession nationale en France. Partout on vendait des pamphlets et des gravures relatant ces crimes en détail. Même les journaux en parlaient à loisir. Tout en analysant la criminalité féminine de fin-de-siècle à Paris, Ann-Louise Shapiro raconte des histoires remplies de détails fascinants sur la vie quotidienne, le système judiciaire et la place des femmes dans la société. L'auteur explore plusieurs perspectives ..

A la fin du XIXe siècle, l'image de la femme criminelle est devenue une obsession nationale en France. Partout on vendait des pamphlets et des gravures relatant ces crimes en détail. Même les journaux en parlaient à loisir. Tout en analysant la criminalité féminine de fin-de-siècle à Paris, Ann-Louise Shapiro raconte des histoires remplies de détails fascinants sur la vie quotidienne, le système judiciaire et la place des femmes dans la société. L'auteur explore plusieurs perspectives...

The authors developed this textbook in response to an increasing interest in ethics, and a growing number of courses on this topic that are now being offered in educational leadership programs. It is designed to fill a gap in instructional materials for teaching the ethics component of the knowledge base that has been established for the profession. The text has several purposes: First, it demonstrates the application of different ethical paradigms (the ethics of justice, care, critique, and the profession) through (...) discussion and analysis of real-life moral dilemmas that educational leaders face in their schools and communities. Second, it addresses some of the practical, pedagogical, and curricular issues related to the teaching of ethics for educational leaders. Third, it emphasizes the importance of ethics instruction from a variety of theoretical approaches. Finally, it provides a process that instructors might follow to develop their own ethics unit or course. * Part I provides an overview of why ethics is so important, especially for today's educational leaders, and describes a multiparadigm approach essential to practitioners as they grapple with ethical dilemmas. * Part II deals with the dilemmas themselves. Ethical dilemmas written by the authors' graduate students bring readers face-to-face with the kinds of dilemmas faced by practicing administrators in urban, suburban, and rural settings in an era full of complexities and contradictions. * Part III focuses on pedagogy and provides teaching notes for the instructor. The authors discuss the importance of self-reflection on the part of both instructors and students, and model how they thought through their own personal and professional ethical codes as well as reflected upon the critical incidents in their lives that shaped their teaching and frequently determined what they privileged in class. (shrink)

Moving beyond both realist and anti-realist accounts of mathematics, Shapiro articulates a "structuralist" approach, arguing that the subject matter of a mathematical theory is not a fixed domain of numbers that exist independent of each other, but rather is the natural structure, the pattern common to any system of objects that has an initial object and successor relation satisfying the induction principle.

The central contention of this book is that second-order logic has a central role to play in laying the foundations of mathematics. In order to develop the argument fully, the author presents a detailed description of higher-order logic, including a comprehensive discussion of its semantics. He goes on to demonstrate the prevalence of second-order concepts in mathematics and the extent to which mathematical ideas can be formulated in higher-order logic. He also shows how first-order languages are often insufficient to codify (...) many concepts in contemporary mathematics, and thus that both first- and higher-order logics are needed to fully reflect current work. Throughout, the emphasis is on discussing the associated philosophical and historical issues and the implications they have for foundational studies. For the most part, the author assumes little more than a familiarity with logic comparable to that provided in a beginning graduate course which includes the incompleteness of arithmetic and the Lowenheim-Skolem theorems. All those concerned with the foundations of mathematics will find this a thought-provoking discussion of some of the central issues in the field today. (shrink)

Between the years 1643 and 1649, Princess Elisabeth of Bohemia and René Descartes exchanged fifty-eight letters—thirty-two from Descartes and twenty-six from Elisabeth. Their correspondence contains the only known extant philosophical writings by Elisabeth, revealing her mastery of metaphysics, analytic geometry, and moral philosophy, as well as her keen interest in natural philosophy. The letters are essential reading for anyone interested in Descartes’s philosophy, in particular his account of the human being as a union of mind and body, as well as (...) his ethics. They also provide a unique insight into the character of their authors and the way ideas develop through intellectual collaboration. Philosophers have long been familiar with Descartes’s side of the correspondence. Now Elisabeth’s letters—never before available in translation in their entirety—emerge this volume, adding much-needed context and depth both to Descartes’s ideas and the legacy of the princess. Lisa Shapiro’s annotated edition—which also includes Elisabeth’s correspondence with the Quakers William Penn and Robert Barclay—will be heralded by students of philosophy, feminist theorists, and historians of the early modern period. (shrink)

Two currently much discussed views about truth, truth pluralism and truth relativism, are found in Sellars’s writings. I show that his motivations for adoping these views are interestingly different from those shared by most of their recent advocates. First, I explain how Sellars comes to embrace a version of truth pluralism. I argue that his version overcomes a difficulty confronting pluralists, albeit at a serious cost. Then I argue that Sellars’s truth pluralism isn’t motivated by his interest in domains of (...) discourse beyond the “matter-of-factual.” Rather, the key to his truth pluralism, his analysis of truth as “semantical assertibility,” is motivated by the same consideration that leads him to adopt truth relativism. This is his interest in applying semantic notions to discourse that embodies conceptual structures other than ours. Despite their common motivation, I conclude that Sellars’s relativism is independent of, and indeed stands in tension with, the analysis of truth that underlies his pluralism. (shrink)

The collected essays in this volume encompass a wide-ranging spectrum of philosophical, scientific, and literary topics as they relate to the theory and strategy of interpretation.

Wilkinson's (1) critique of psychoanalysis and psychoanalytically oriented psychotherapy is weakened by inconsistent use of crucial terms, a systematically biased selectivity in reviewing empirical evidence and prior debates, and a failure to address issues crucial for a scientific understanding of psychotherapy.

Since Hilary Putnam offered multiple realization as an empirical hypothesis in the 1960s, philosophical consensus has turned against the idea that mental processes are identifiable with brain processes, and multiple realization has become the keystone of the 'antireductive consensus' across philosophy of science. Thomas W. Polger and Lawrence A. Shapiro offer the first book-length investigation of multiple realization, which serves as a starting point to a series of philosophically sophisticated and empirically informed arguments that cast doubt on the generality (...) of multiple realization in the cognitive sciences. They argue that mind-brain identities have played an important role in the growth and achievements of the cognitive sciences, and suggest that there is little prospect for multiple realization in an empirically-based theory of mind. This leads Polger and Shapiro to offer an alternative framework for understanding explanations in the cognitive sciences, as well as in chemistry, biology, and other non-basic sciences. (shrink)

This new anthology of early modern philosophy enriches the possibilities for teaching this period by highlighting not only metaphysics and epistemology, but also new themes such as virtue, equality and difference, education, the passions, and love. It contains the works of forty-three philosophers, including traditionally taught figures such as Descartes, Spinoza, Leibniz, Locke, Berkeley, Hume, and Kant, as well as less familiar writers such as Lord Shaftesbury, Anton Amo, Julien Offray de La Mettrie, and Denis Diderot. It also highlights the (...) contributions of women philosophers, including Margaret Cavendish, Anne Conway, Gabrielle Suchon, Sor Juana Inéz de la Cruz, and Emilie Du Châtelet. (shrink)

We examine George Boolos's proposed abstraction principle for extensions based on the limitation-of-size conception, New V, from several perspectives. Crispin Wright once suggested that New V could serve as part of a neo-logicist development of real analysis. We show that it fails both of the conservativeness criteria for abstraction principles that Wright proposes. Thus, we support Boolos against Wright. We also show that, when combined with the axioms for Boolos's iterative notion of set, New V yields a system equivalent to (...) full Zermelo-Fraenkel set theory with a principle of global choice. This advances Boolos's longstanding interest in the foundations of set theory. (shrink)

In this paper, I use the cases of intuitionistic arithmetic with Church’s thesis, intuitionistic analysis, and smooth infinitesimal analysis to argue for a sort of pluralism or relativism about logic. The thesis is that logic is relative to a structure. There are classical structures, intuitionistic structures, and (possibly) paraconsistent structures. Each such structure is a legitimate branch of mathematics, and there does not seem to be an interesting logic that is common to all of them. One main theme of my (...) ante rem structuralism is that any coherent axiomatization describes a structure, or a class of structures. If one weakens the logic, then more axiomatizations become coherent. (shrink)

Democracy and justice are often mutually antagonistic ideas, but in this innovative book Ian Shapiro shows how and why they should be pursued together. Justice must be sought democratically if it is to garner legitimacy in the modern world, he claims, and democracy must be justice-promoting if it is to sustain allegiance over time. _Democratic Justice_ meets these criteria, offering an attractive vision of a practical path to a better future. Wherever power is exercised in human affairs, Shapiro (...) argues, the lack of democracy will be experienced as injustice. The challenge is to democratize social relations so as to diminish injustice, but to do this in ways that are compatible with people’s values and goals. Shapiro shows how this can be done in different phases of the human life cycle, from childhood through the adult worlds of work and domestic life, retirement, old age, and approaching death. He spells out the implications for pressing debates about authority over children, the law of marriage and divorce, population control, governing the firm, basic income guarantees, health insurance, retirement policies, and decisions made by and for the infirm elderly. This refreshing encounter between political philosophy and practical politics will interest all those who aspire to bequeath a more just world to our children than the one we have inherited. (shrink)

The revisionary approach to semantic paradox is commonly thought to have a somewhat uncomfortable corollary, viz. that, on pain of triviality, we cannot affirm that all valid arguments preserve truth (Beall2007, Beall2009, Field2008, Field2009). We show that the standard arguments for this conclusion all break down once (i) the structural rule of contraction is restricted and (ii) how the premises can be aggregated---so that they can be said to jointly entail a given conclusion---is appropriately understood. In addition, we briefly rehearse (...) some reasons for restricting structural contraction. (shrink)

Next SectionIntensification of poverty and degradation of health infrastructure over recent decades in countries most affected by HIV/AIDS present formidable challenges to clinical research. This paper addresses the overall standard of health care (SOC) that should be provided to research participants in developing countries, rather than the narrow definition of SOC that has characterised the international debate on standards of health care. It argues that contributing to sustainable improvements in health by progressively ratcheting the standard of care upwards for research (...) participants and their communities is an ethical obligation of those in resource-rich countries who sponsor and implement research in poorer ones. (shrink)

I respond to Fishkin?s critique of my book The State of Democratic Theory. I reiterate my defense of a competitive model of democracy geared to reducing domination, rather than Fishkin?s deliberative model that deploys structured discussion to enlighten mass preferences. In light of the literatures on framing effects and the value of mutually independent judgments, I question whether the procedures Fishkin recommends would produce outcomes that are better informed rather than differently informed. Recognizing that deliberation might sometimes be helpful in (...) reducing domination, I note that sometimes it will not, and I fault Fishkin for his indiscriminate embrace of exceedingly costly deliberative mechanisms that promise dubious benefits? notably his and Bruce Ackerman?s?Deliberation Day? (shrink)

Cells are cognitive entities possessing great computational power. DNA serves as a multivalent information storage medium for these computations at various time scales. Information is stored in sequences, epigenetic modifications, and rapidly changing nucleoprotein complexes. Because DNA must operate through complexes formed with other molecules in the cell, genome functions are inherently interactive and involve two-way communication with various cellular compartments. Both coding sequences and repetitive sequences contribute to the hierarchical systemic organization of the genome. By virtue of nucleoprotein complexes, (...) epigenetic modifications, and natural genetic engineering activities, the genome can serve as a read-write storage system. An interactive informatic conceptualization of the genome allows us to understand the functional importance of DNA that does not code for protein or RNA structure, clarifies the essential multidirectional and systemic nature of genomic information transfer, and emphasizes the need to investigate how cellular computation operates in reproduction and evolution. (shrink)

We have some of our properties purely in virtue of the way we are. (Our mass is an example.) We have other properties in virtue of the way we interact with the world. (Our weight is an example.) The former are the intrinsic properties, the latter are the extrinsic properties. This seems to be an intuitive enough distinction to grasp, and hence the intuitive distinction has made its way into many discussions in philosophy, including discussions in ethics, philosophy of mind, (...) metaphysics, epistemology and philosophy of physics. Unfortunately, when we look more closely at the intuitive distinction, we find reason to suspect that it conflates a few related distinctions, and that each of these distinctions is somewhat resistant to analysis. (shrink)

This chapter wades into the growing discussion surrounding embodied cognition and predictive processing. After surveying a recent debate between Jakob Hohwy and Andy Clark, it articulates two outstanding issues facing discussions of compatibility. It argues that headway on these issues can be made by drawing on the resources of philosophy of science.

In this paper, I examine Marie Thiroux D’Arconville’s moral psychology as presented in two of her works: Des Passions [On the Passions] and De L’Amitié [On Friendship]. This moral psychology is somewhat unique as it centers human action on three principal sentiments: l’amour, which is best understood as lust or a physical love; l’ambition, the principal human vice; and l’amitié, a characteristic friendship proper to the truly virtuous. I aim to show that these three passions tell a story of moral (...) development. Through l’amour we come to form projects and engage in goal directed action, and thus become moral agents. While l'ambition is, for her, the cause of many of the horrors of human history, I suggest that Thiroux D’Arconville also sees it as the passion through which we come to form collective projects. Finally, in her account of l’amitié we can find her account of virtue. Interestingly, while Thiroux D’Arconville talks of virtue as a matter of choosing well, she does not offer a voluntarist account of choice. Rather, I argue, she models moral choices on a naturalist Stoic model. I will also discuss Thiroux D’Arconville’s very interesting remarks on relations between men and women, including those regarding sexual desires, marriage, and friendship. (shrink)

It is commonly believed that Edmund Husserl (1859-1938), well known as the founder of phenomenology and as the teacher of Heidegger, was unable to free himself from the framework of a classical metaphysics of subjectivity. Supposedly, he never abandoned the view that the world and the Other are constituted by a pure transcendental subject, and his thinking in consequence remains Cartesian, idealistic, and solipsistic. The continuing publication of Husserl’s manuscripts has made it necessary to revise such an interpretation. Drawing upon (...) both Husserl’s published works and posthumous material, Husserl’s Phenomenology incorporates the results of the most recent Husserl research. It is divided into three parts, roughly following the chronological development of Husserl’s thought, from his early analyses of logic and intentionality, through his mature transcendental-philosophical analyses of reduction and constitution, to his late analyses of intersubjectivity and lifeworld. It can consequently serve as a concise and updated introduction to his thinking. (shrink)

Building on recent work, I present sequent systems for the non-classical logics LP, K3, and FDE with two main virtues. First, derivations closely resemble those in standard Gentzen-style systems. Second, the systems can be obtained by reformulating a classical system using nonstandard sequent structure and simply removing certain structural rules (relatives of exchange and contraction). I clarify two senses in which these logics count as “substructural.”.

Critical temporalities: thinking the event -- Hiroshima temporalities -- Hurricane Katrina bio-temporalities -- Keeping time: the rhythms of work and the arts of resistance -- Fictions of time: necro-biographies.

To be healed is to make ourselves whole, embracing our lost voices and forgotten selves that have been denied and therefore hidden. Debbie Shapiro examines this intimate connection between the mind and body in Your Body Speaks Your Mind, revealing insights into how our emotional and psychological states affect us physically. Comparing various medical approaches, Shapiro intersperses case studies, research and exercises as she explores the bodymind connection -- how unresolved thoughts and feelings affect our health and manifest (...) as illness in specific parts of the body. This healing guide explores the structural body from the head to the toes, and the inner relationship of each part. We are given tools for using the power of the mind and heart to heal the body through breath awareness, movement, re-laxation, meditation, creative visualization, and other complementary healing techniques. In Your Body Speaks Your Mind, we find that the path back to health is a journey of self trust and inner strength. In the process we come to a different purpose, one that gives rise to a new priority: that of our salvation, our freedom, and a discovery of our true potential. (shrink)

The present work is a systematic study of five frameworks or perspectives articulating mathematical structuralism, whose core idea is that mathematics is concerned primarily with interrelations in abstraction from the nature of objects. The first two, set-theoretic and category-theoretic, arose within mathematics itself. After exposing a number of problems, the book considers three further perspectives formulated by logicians and philosophers of mathematics: sui generis, treating structures as abstract universals, modal, eliminating structures as objects in favor of freely entertained logical possibilities, (...) and finally, modal-set-theoretic, a sort of synthesis of the set-theoretic and modal perspectives. (shrink)