Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient’s values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge (...) the information needs of the individual patient. The aim of this paper is to describe ‘core information sets’ which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this ‘core information’. We propose that such information addresses the ‘reasonable patient’ standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice. (shrink)

Robert Nozick's adherence to Locke's puzzling doctrine about punishment can seem strange. Why does Nozick follow Locke in claiming that individuals in a state of nature have a right to punish any wrongdoer?Here reflection on this question proceeds by stages to a conclusion that Nozick as well as any other state-of-nature theorist of similar stripe should find disturbing. For, as we shall see, what Nozick describes as the general right of a minimal state to punish cannot arise within a state (...) of nature from the more plausible right of individuals to punish only those who harm them. (shrink)

Seeing art is not as easy as it looks, because there is more to seeing art than meets the eye. This essay examines some of the presuppositions involved in seeing something as art. In opposition to the view of A.C. Danto that to see something as art is merely to identify it as art, I shall suggest that to see something as art is to appreciate it in a specifiable way. In addition, I shall argue that considerations sometimes deemed adventitious (...) are in fact inescapably involved in the appreciation of all works of art, and in particular, that it is impossible to entirely eliminate intentional and genetic considerations from our critical Judgments. (shrink)

A working hypothesis of computationalism is that Mind arises, not from the intrinsic nature of the causal properties of particular forms of matter, but from the organization of matter. If this hypothesis is correct, then a wide range of physical systems (e.g. optical, chemical, various hybrids, etc.) should support Mind, especially computers, since they have the capability to create/manipulate organizations of bits of arbitrarily complexity and dynamics. In any particular computer, these bit patterns are quite physical, but their particular physicality (...) is considered irrelevant (since they could be replaced by other physical substrata). (shrink)

This study examines the family environments and hormone profiles of 316 individuals aged 2 months-58 years residing in a rural village on the east coast of Dominica, a former British colony in the West Indies. Fieldwork was conducted over an eight-year period (1988–1995). Research methods and techniques include radioimmunoassay of cortisol and testosterone from saliva samples (N=22,340), residence histories, behavioral observations of family interactions, extensive ethnographic interview and participant observation, psychological questionnaires, and medical examinations.Analyses of data indicate complex, sex-specific effects (...) of family environment on endocrine function. Male endocrine profiles exhibit greater sensitivity to presence of father than do female endocrine profiles. Father-absent males tend to have (a) low cortisol levels during infancy, (b) high or abnormal cortisol profiles during childhood and adolescence, and (c) high cortisol and low testosterone levels during adulthood compared with those of males raised with a resident father. These results indicate that early family environment has significant effects on endocrine response throughout male life histories. (shrink)

Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care or traditional indemnity insurance. Historically, there have been two distinct bases for arguing that physicians should not consider costs in their clinical decisions—an “aspirational ethic” that exhorts physicians to treat all patients the same regardless of their ability to pay, and an “agency ethic” that calls on physicians to (...) be trustworthy advisors to their patients. In the setting of greater patient cost-sharing, physicians' aspiration and agency roles increasingly conflict. Satisfactorily navigating the new terrain of consumer-driven healthcare requires physicians to consider these two roles and how they can best be reconciled so as to maximize quality of care while respecting the heterogeneity of patients' financial resources and willingness to pay. (shrink)

The Danish scholar Jan Pinborg made outstanding contributions to our understanding of medieval language study. The papers in this volume clearly demonstrate the wealth of Pinborg's scholarly interests and the extent of his influence.Though centered on medieval theories of grammar and language, the collection ranges in time from the fourth century B.C. to the seventeenth century A.D.; theories of the pronoun, of mental language, of supposition, of figurative expressions and of mereology are among the topics discussed; and the papers deal (...) with both humble anonymous teachers of grammar and with such well-known men as Aristotle, Plotinus, Augustine, Peter of Spain, Roger Bacon, Robert Kilwardby, Thomas Aquinas, Dante, William of Ockham, Domingo de Soto, and Suárez. The papers are in English, German, or French. (shrink)

Self-knowledge is the focus of considerable attention from philosophers: Knowing Our Own Minds gives a much-needed overview of current work on the subject, bringing together new essays by leading figures. Knowledge of one's own sensations, desires, intentions, thoughts, beliefs, and other attitudes is characteristically different from other kinds of knowledge: it has greater immediacy, authority, and salience. The contributors examine philosophical questions raised by the distinctive character of self-knowledge, relating it to knowledge of other minds, to rationality and agency, externalist (...) theories of psychological content, and knowledge of language. Together these original, stimulating, and closely interlinked essays demonstrate the special relevance of self-knowledge to a broad range of issues in epistemology, philosophy of mind, and philosophy of language. (shrink)

The Infectious Disease Ontology (IDO) is a suite of interoperable ontology modules that aims to provide coverage of all aspects of the infectious disease domain, including biomedical research, clinical care, and public health. IDO Core is designed to be a disease and pathogen neutral ontology, covering just those types of entities and relations that are relevant to infectious diseases generally. IDO Core is then extended by a collection of ontology modules focusing on specific diseases and pathogens. In this paper we (...) present applications of IDO Core within various areas of infectious disease research, together with an overview of all IDO extension ontologies and the methodology on the basis of which they are built. We also survey recent developments involving IDO, including the creation of IDO Virus; the Coronaviruses Infectious Disease Ontology (CIDO); and an extension of CIDO focused on COVID-19 (IDO-CovID-19).We also discuss how these ontologies might assist in information-driven efforts to deal with the ongoing COVID-19 pandemic, to accelerate data discovery in the early stages of future pandemics, and to promote reproducibility of infectious disease research. (shrink)

Many system architects select their system methodologies without explicit consideration of the philosophical perspectives that impact their decisions. This paper describes how the concepts of ontology and epistemology apply in systems science. Ontology is how we specify terms of reference for existence, allowing us to understand the theory of existence via an ‘existence framework’. Epistemology, the theory of knowledge, allows us to explore new models and theories of knowledge acquisition so the best system-based methodologies can be deployed to solve complex (...) system problems. After introducing these concepts, the paper presents system science issues and assesses the impact of ontological, axiological and epistemological perspectives on system methodology selection, research, system design and deployment. An ontological viewpoint such as realism, as an objective view is contrasted versus nationalism, a personal perceptional view. An epistemological viewpoint is explored comparing knowledge as a product of sensory perception or rational reflection. The paper’s significant contribution is that it helps system architects understand that their philosophical views of systems science impact their system methodology choices. (shrink)

We are currently seeing a revival of interest in Aquinas's moral thought among Christian ethicists, both Protestant and Catholic. Although recent studies of his moral thought have touched on a number of topics, the majority of these have focused on his account of the virtues and their place in the Christian life. Probing the questions of the relation of virtue and law, the role of reason and will, and the place of the passions in Aquinas's moral theology, I will examine (...) recent studies by Diana Cates, Pamela Hall, Simon Harak, James Keenan, Daniel Nelson, Daniel Westberg, and Paul Waddell. In different ways these studies return us repeatedly to the vexed and unresolved question of the scope of human freedom. (shrink)

Since its publication in 1965, Brian Barry's seminal work has occupied an important role in the revival of Anglo-American political philosophy. A number of ideas and terms in it have become part of the standard vocabulary, such as the distinction between "ideal-regarding" and "want-regarding" principles and the division of principles into aggregative and distributive. The book provided the first precise analysis of the concept of political values having trade-off relations and its analysis of the notion of the public interest (...) has also been significant. (shrink)

The present paper examines the arguments and data presented by Nisbett and Wilson relevant to their thesis that subjects do not have access to their own cognitive processes. It is concluded that their review of previous research is selective and incomplete and that the data they present in behalf of their thesis does not withstand a demand characteristics analysis. Furthermore, their use of observer-subject similarity as evidence of subjects' inability to access cognitive processes makes tests of their hypothesis confounded and, (...) at the same time, reveals limitations in the application of the pre-inquiry quasi-control to research on social behavior. Problems with postexperiment questionnaires, such as the demand characteristics of the inquiry procedure are also considered. Although there are difficulties in assessing subjects' cognitive processes, many of these may be overcome through the application of novel techniques and research conducted on more traditional methods. In contrast to the view that subjects have limited access to cognitive processes and that their verbal reports are not valid, it is concluded that subjects' verbalizations are a rich source of psychological data which must be pursued if we are to tap their cognitive processes and are to gain an adequate understanding of human behavior. (shrink)