Anselm: I agreed that Pegasus is a flying horse according to the stories people tell, the paintings painters paint and so on . That is, Pegasus is a flying horse in the understanding of storytellers, their readers and the artists who depict Pegasus. You asked whether flying is not an unmediated causal power . Well, it could be an unmediated causal power if you or I had it, but not if a being with only mediated powers had it. And so (...) poor Pegasus, a being whose powers are only those given him by storytellers and artists, has only the mediated power of flying that they have given him. He flies in the thoughts and depictions of beings with unmediated powers. Still, Pegasus has not only the mediated power to fly but also the mediated power to entertain us, and perhaps even inspire us. Fool: But people could tell stories about you, too, about how you sprouted wings and flew onto the roof of Canterbury Cathedral. Anselm: Alas, if it were only in stories that I could do that, then flying would not be an unmediated causal power of mine. I would still have unmediated causal powers all right, and so would be greater than Pegasus. But flying is not one of my unmediated causal powers. However, something than which nothing greater can be conceived would, and does, as I have proved in my Proslogion, have unmediated causal powers – indeed, much greater unmediated causal powers than any poor mortals like you and me.1 •↵1 For …. (shrink)

After summarizing my own views of 'I' and the first-person perspective, I consider a well-known autistic, Temple Grandin, who claims that she thinks only in pictures, not in language. I argue, to the contrary, that Grandin's mental life as she describes it in fact requires language, which, as a writer, she undoubtedly has. Finally, I turn to the question of whether thought as Temple Grandin describes it is independent of language.

Jean Baudrillard has posited a theory of ‘the precession of simulacra’, arguing that it is no longer possible to tell the difference between an image and the meaning it purports to represent because technology allows the image to precede its meaning. Christa Wolf, while researching Cassandra: A Novel and Four Essays (1984), traveled to Greece and discovered the ways in which language in the rational, Western model of civilization has been distorted. Both Baudrillard and Wolf are disturbed by the ways (...) in which sign systems can be manipulated and generated, and both demonstrate the effect this has in the political and cultural arenas. This analysis intends to show how Baudrillard’s theories play out in Wolf’s narrative, and how Wolf resolves the problems thus posed through the shock of the aesthetic experience, which forces communication while it defies representation. (shrink)

In this book, Mark Rowlands challenges the Cartesian view of the mind as a self-contained monadic entity, and offers in its place a radical externalist or environmentalist model of cognitive processes. Drawing on both evolutionary theory and a detailed examination of the processes involved in perception, memory, thought and language use, Rowlands argues that cognition is, in part, a process whereby creatures manipulate and exploit relevant objects in their environment. This innovative book provides a foundation for an unorthodox but increasingly (...) popular view of the nature of cognition. (shrink)

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Human vision supports social perception by efficiently detecting agents and extracting rich information about their actions, goals, and intentions. Here, we explore the cognitive architecture of perceived animacy by constructing Bayesian models that integrate domain‐specific hypotheses of social agency with domain‐general cognitive constraints on sensory, memory, and attentional processing. Our model posits that perceived animacy combines a bottom–up, feature‐based, parallel search for goal‐directed movements with a top–down selection process for intent inference. The interaction of these architecturally distinct processes makes perceived (...) animacy fast, flexible, and yet cognitively efficient. In the context of chasing, in which a predator (the “wolf”) pursues a prey (the “sheep”), our model addresses the computational challenge of identifying target agents among varying numbers of distractor objects, despite a quadratic increase in the number of possible interactions as more objects appear in a scene. By comparing modeling results with human psychophysics in several studies, we show that the effectiveness and efficiency of human perceived animacy can be explained by a Bayesian ideal observer model with realistic cognitive constraints. These results provide an understanding of perceived animacy at the algorithmic level—how it is achieved by cognitive mechanisms such as attention and working memory, and how it can be integrated with higher‐level reasoning about social agency. (shrink)

The twenty‐six‐year‐old patient requested a prophylactic bilateral mastectomy with reconstruction because of an extensive family history of cancer. She reported that she had developed melanoma at twenty‐five; that her mother, sister, aunts, and a cousin all had breast cancer; that a cousin had ovarian cancer at nineteen; and that a brother was treated for esophageal cancer at fifteen. The treating team was skeptical about this history, and they could find no documentation of the patient's reported melanoma. The surgeon wrote the (...) patient's primary care physician, explaining that he had seen the patient and planned to proceed with the bilateral mastectomy and reconstruction. The primary care physician responded that he was unable to substantiate several of the patient's claims; some of his colleagues believed the family history to be fabricated. Trying to make sense of the discrepancies, the genetic counselor called a counselor colleague who had met with this patient. The colleague suggested that the in‐house genetic counselor “google” the patient. The search revealed two Facebook pages linked to the patient. In one, apparently a personal profile, the patient stated that in addition to battling stage four melanoma, she had recently been diagnosed with breast cancer. She provided a link to a site where she solicited donations to attend a summit for young cancer patients. The other Facebook page featured numerous pictures of her with a bald head, as though she has been through chemotherapy. The genetic counselor showed the Facebook pages to the surgeon, who then decided not to operate. Should health care professionals “google” their patients? (shrink)

This article examines 17 substance-abusing women's perceptions of their mothering practices in the context of a residential substance-abuse treatment program for women with children and pregnant women. Using in-depth semistructured interviews and observations of treatment groups, the participants' cultural knowledge about mothering is explored. Although the women in this study described how their substance-abusing lifestyle had a negative impact on their children, they also detailed practices that illustrated that they felt capable as parents. The women were silent about how race, (...) gender, or class arrangements affected their lives; their stories, however, showed active avoidance and manipulation of the contemporary ideology of mothering. (shrink)

We investigated people's ability to infer others’ mental states from their emotional reactions, manipulating whether agents wanted, expected, and caused an outcome. Participants recovered agents’ desires throughout. When the agent observed, but did not cause the outcome, participants’ ability to recover the agent's beliefs depended on the evidence they got. When the agent caused the event, participants’ judgments also depended on the probability of the action ; when actions were improbable given the mental states, people failed to recover the agent's (...) beliefs even when they saw her react to both the anticipated and actual outcomes. A Bayesian model captured human performance throughout, consistent with the proposal that people rationally integrate information about others’ actions and emotional reactions to infer their unobservable mental states. (shrink)

Two putative functions of emotion experience ? its roles in intentional action and in social understanding ? were investigated using a group of individuals (repressors) known to have impaired anxiety experience. Repressors, low-anxious, high-anxious, and defensive high-anxious individuals were asked to give a public presentation, and then given the opportunity to avoid the presentation. Repressors were the group most likely to avoid giving the presentation, but were the least likely to give an emotional explanation for their avoidance. By contrast, they (...) were not less likely than other groups to provide negative emotional explanations of another person?s behaviour in a film clip. We concluded that: (1) repressors are impaired in self- but not in other-explanation using emotion, implying that ?simulation? is not the method used by repressors to ground their folk psychology, (2) the intentional avoidance shown by repressors is indicative of some intact first-order phenomenal anxiety experience but that they lack second-order awareness of this anxiety experience. (shrink)

Les États cheminent entre concurrence et convergence, les entreprises trans-nationales entre opportunisme et autorégulation. Il est futile d’imaginer qu’un ordre unifié et stable émerge de cette tension. Le monde normatif des entreprises transnationales doit plutôt être compris en appréhendant la direction de ses changements, et non pas en cher-chant à trouver un état d’équilibre. Pour l’auteur, les convections essentielles relèvent tant des efforts des États pour ajuster leur pouvoir normatif et promouvoir leur attractivité dans un monde globalisé, que de la (...) perméabilité croissante des entreprises et de leurs dirigeants à certains objectifs sociétaux qui vont au-delà du juridique et qui viennent se rajouter à la performance financière comme indicateurs complémentaires de la vitalité d’une entreprise. (shrink)

We can understand viewed scenes and extract task-relevant information within a few hundred milliseconds. This process is generally supported by three cortical regions that show selectivity for scene images: parahippocampal place area (PPA), medial place area (MPA) and occipital place area (OPA). Prior studies have focused on the visual information each region is responsive to, usually within the context of recognition or navigation. Here, we move beyond these tasks to investigate gaze allocation during scene viewing. Eye movements rely on a (...) scene’s visual representation to direct saccades, and thus foveal vision. In particular, we focus on the contribution of OPA, which is i) located in occipito-parietal cortex, likely feeding information into parts of the dorsal pathway critical for eye movements, and ii) contains strong retinotopic representations of the contralateral visual field. Participants viewed scene images for 1034 ms while their eye movements were recorded. On half of the trials, a 500 ms train of five transcranial magnetic stimulation (TMS) pulses was applied to the participant’s cortex, starting at scene onset. TMS was applied to the right hemisphere over either OPA or the occipital face area (OFA), which also exhibits a contralateral visual field bias but shows selectivity for face stimuli. Participants generally made an overall left-to-right, top-to-bottom pattern of eye movements across all conditions. When TMS was applied to OPA, there was an increased saccade latency for eye movements toward the contralateral relative to the ipsilateral visual field after the final TMS pulse (400ms). Additionally, TMS to the OPA biased fixation positions away from the contralateral side of the scene compared to the control condition, while the OFA group showed no such effect. There was no effect on horizontal saccade amplitudes. These combined results suggest that OPA might serve to represent local scene information that can then be utilized by visuomotor control networks to guide gaze allocation in natural scenes. (shrink)

This study uses a “science pipeline” model and cross-national data to examine women's participation in science education and occupations in seven countries. Gender stratification in later science education and in science occupations is found in every country examined. Young women's participation in science education decreases with each stage in the science pipeline, but there is considerable cross-national variation in the extent of gender stratification in science. Findings show greater gender stratification in science occupations than in science education, suggesting factors other (...) than training help maintain inequality in high-status science occupations. (shrink)

Routine infant circumcision is one of the most common surgical procedures performed in the U.S. Despite its broad societal acceptance, the practice is not without controversy. The stories included in this symposium offer rich insight into the diverse set of attitudes, values, and beliefs related to the practice of circumcision. They additionally offer insight into the complex web of personal, interpersonal, and social dynamics that inform the circumcision choices parents make for their children, the reasons parents make them, and how (...) others can influence decisional choices. More broadly, these narratives raise important ethical questions mirrored today in broader contemporary bioethical and public discourse on the scope and limits of parental authority to make decisions for their children, power dynamics in medical decision making, and the ethics of healthcare activism. In this commentary, I discuss three sets of themes related to the ethics of circumcision running through the symposium narratives, comment on the ethical tensions and questions which emerge from each set of themes, gently problematize some of the rhetoric surrounding the ethical permissibility of circumcision, and gesture towards the future of bioethical inquiry on circumcision discourse. (shrink)

Introduction: Evidence supporting the use of music interventions to maximize arousal and awareness in adults presenting with a disorder of consciousness continues to grow. However, the brain of a child is not simply a small adult brain, and therefore adult theories are not directly translatable to the pediatric population. The present study aims to synthesize brain imaging data about the neural processing of music in children aged 0-18 years, to form a theoretical basis for music interventions with children presenting with (...) a disorder of consciousness following acquired brain injury.Methods: We conducted a systematic review with narrative synthesis utilizing an adaptation of the methodology developed by Popay and colleagues. Following the development of the narrative that answered the central question “what does brain imaging data reveal about the receptive processing of music in children?”, discussion was centered around the clinical implications of music therapy with children following acquired brain injury.Results: The narrative synthesis included 46 studies that utilized EEG, MEG, fMRI, and fNIRS scanning techniques in children aged 0-18 years. From birth, musical stimuli elicit distinct but immature electrical responses, with components of the auditory evoked response having longer latencies and variable amplitudes compared to their adult counterparts. Hemodynamic responses are observed throughout cortical and subcortical structures however cortical immaturity impacts musical processing and the localization of function in infants and young children. The processing of complex musical stimuli continues to mature into late adolescence.Conclusion: While the ability to process fundamental musical elements is present from birth, infants and children process music more slowly and utilize different cortical areas compared to adults. Brain injury in childhood occurs in a period of rapid development and the ability to process music following brain injury will likely depend on pre-morbid musical processing. Further, a significant brain injury may disrupt the developmental trajectory of complex music processing. However, complex music processing may emerge earlier than comparative language processing, and occur throughout a more global circuitry. (shrink)

Patient safety has only recently been subjected to wide-spread systematic study. Healthcare differs from other high risk industries in being more diverse and multi-contextual, and less certain and regulated. Also many patient safety problems are low-frequency events associated with many, varied contributing factors. The subject of this paper is the epistemology of patient safety (the science of the method of finding out about patient safety). Patient safety research is considered here on the background of a risk management framework which requires (...) researchers to: • Understand the context - as a subset of healthcare quality, services and systems research, with technical and human behavioural (cultural) components and a range of external and internal organisational influences, a wide range of research disciplines is necessary • Identify the risks - identify the things that go wrong and the frequency and nature of different types of incidents from sources such as medical record review, observational studies, audit, incident and medico-legal reports • Analyse the risks - deconstruct the things that go wrong, identifying contributing factors and trying to detect trends and patterns in contributing factors, detection, mitigation factors, ameliorating factors and actions taken to reduce risk • Evaluate the risks - decide on priorities, identifying preventive and corrective strategies and judging the risk- and cost-benefit of potential corrective strategies such as standardisation or simplification of a process or device • Manage the risk - evaluate and scope preventive and/or corrective strategies and then implement these, or place the problem on a risk register pending solution, or accept that what is needed is unaffordable • Communicate and consult - use interactive sessions, audit, on-going feedback, reminders and patient mediated prompts • Monitor and review the state of the problem - get baseline trends and patterns so that changes can be tracked and properly attributed to an intervention A hierarchy of levels of evidence has been proposed for clinical research and we argue that insufficient weighting has been given to lower ranked levels of research and to qualitative research, although critical interpretive synthesis is now gaining acceptance in mainstream thinking (e.g. by the Cochrane Collaboration). Fundamental challenges remain including how to grasp the elusive concept of patient safety, how to quantify, characterise and cost the problems, how to judge the extent to which harm can be attributed to errors, violations or system failures, how to identify contributing factors and the extent to which they can be implicated, how to judge whether incidents or their precursors are preventable, how to generate strong evidence to make healthcare safer and how to translate research into practice. Future directions include addressing the mundane as well as rare, dramatic events, and developing further research in non-hospital settings and in developing countries. In summary, a mixture of qualitative and quantitative methods, using information from all available data sources and combining retrospective, real time and prospective study designs, is necessary to address some of the more difficult patient safety problems. (shrink)

Editors Wanda Teays, John-Stewart Gordon, and Alison Dundes Renteln have assembled the works of an interdisciplinary, international team of experts in bioethics into a comprehensive, innovative and accessible book. Topics covered range from torture and lethal injection to euthanasia, sex selection, vulnerable human subjects, to health equity, safety and public health, and environmental disasters like Bhopal, Fukushima, and more.

This article explores the relationship between gender, technology, language, and how infants and children born with disorders of sexual development are shaped into intelligible members of the community. The contemporary medical model maintains that children ought to be both socially and surgically assigned and reared as one particular gender. Gender scholar Suzanne Kessler rejects this position and argues for the acceptance of greater genital variability through the use of language. Using a Heideggerian lens, the main question I seek to answer (...) in this article is: does Kessler’s approach succeed in its aim to better treat individuals born with disorders of sexual development? I argue that Kessler is successful in offering practical solutions for persons with intersexed conditions to exist and flourish as intelligible members of the community, but that her project ultimately relies on power to “challenge forth” greater acceptance of genital variance. Building on the work of Kessler and Heidegger, I argue that a better approach to making intelligible the existence of an infant born with a disorder of sexual development is not to rely on the manipulation of language, but to instead reinvigorate a sense of the sacred in response to having an intersex condition. (shrink)

ABSTRACT During the current COVID-19 pandemic, we are experiencing physical viruses infecting our bodies, virtual viruses infecting our computers, and symbolic viruses infecting our thinking. This essay takes up each of these interruptions in a collective attempt to better understand how we are rhetorically and where we might go politically from here.

There is little information about the content of ethics consultations in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance (...) in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is need.. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page 18-20, October 2012.