In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 99-102 [Access article in PDF] Living with Contested Knowledge and Partial Jennifer Clegg and Richard Lansdall-Welfare THESE CAREFUL AND CONSTRUCTIVE comments bring grist to our mill. Before responding to them, we observe first that they offer no substantive challenge to our thesis: ambiguities associated with meaning in the disabled life make it more likely that professional service providers will (...) make dogmatic responses to bereavement, and perhaps other essentially contested topics, responses that are defended by isolationism.Some welcome ideas came from left field to refresh our thinking, such as Colman's observations on the gendered nature of care. She reminded us that although the audit from which these cases came was established to investigate bereavement in general among adults with intellectual disability, its rough and ready sampling failed to ensure the expected range of bereavement types. Somehow the bereavements constructed as relevant for audit all transpired to concern the death of mothers. Moreover, of the six relatives who agreed to be interviewed concerning these bereavements, two were stepfathers and four were sisters. Colman underlines the invisibility of care work usually done by female family members: how wise or less wise decisions create the conditions for bereavement reactions, and how changes to care arrangements following bereavement fall most heavily on them. Traustadottir (2002) discussed the way new care initiatives often put pressure on female family members and staff to do more unpaid work. For example, Circles of Support encourages them to include people with intellectual disability in their personal social networks, without considering the personal costs. Such observations have yet to emerge from the umbrella of feminist research. Separatism has served feminism well, but issues of women and care do need to find their place in mainstream reviews.Another useful reminder from Colman is that the person with intellectual disability is not the only concern to families, although only a few adult services manage to hold wider systemic factors in mind (Clegg and Burnham 2000). If the person may make naïve comments at a funeral that would devastate family members whose needs take priority, the person will be excluded.The potency of bereavement was discussed twice. Casenave suggests that because "disability is a loss experience" bereavement resonates with it, casting some doubt onto the suggestion that our thesis generalizes to other contested topics. Reinders criticizes clinicians for being purblind to the tragic. The anonymous reviewer who questioned [End Page 99] the relevance of our discussion of the quality of "presence," a quality Reinders considers highly relevant, illustrates the point better than we can. Recognizing the way clinicians have little "patience with the notion of the tragic" encourages reflection on what other human experiences fail to capture our attention.Although these are all potentially valuable directions, we focus here on comments that may enhance our ability to work without dogma. Since at least the 1980s, clinicians in intellectual disability have criticized the discipline for using linear and univariate rather than complex and multivariate theories, and for a naïve search for magic answers (reviewed in Clegg 1993). It is our contention that little has changed, and that uncertain meaning and normalization combine to create ideal conditions for dogma. Reinders' exposition of the various uses of meaning in our article and in different linguistic and historical traditions develops a vital but neglected topic in intellectual disability, which we consider in some detail. We conclude by arguing that developments require us to distance ourselves from the universality and commonality inherent to normalization, and create new ways to appreciate particularity and diversity.The gist of Reinders' complex argument appears to be that the problems we identify in managing bereavement in intellectual disability stem from a modernist understanding of meaning that is erroneous. Implicitly, those who eschew its pursuit demonstrate the greater wisdom, because neither dialogue nor activities such as reflection can generate meaning that is unattainable. If we understand his position correctly, he contrasts two principal understandings of meaning: comprehension and apprehension.Comprehension is the illusory modernist idea that humans are agents who make sense of themselves... (shrink)

In some situations, a decision is best represented by an incompletely analyzed act: conditionally on a given event A, the consequences of the decision on sub-events are perfectly known and uncertainty becomes probabilizable, whereas the plausibility of this event itself remains vague and the decision outcome on the complementary event ${\bar{A}}$ is imprecisely known. In this framework, we study an axiomatic decision model and prove a representation theorem. Resulting decision criteria aggregate partial evaluations consisting of (i) the conditional expected (...) utility associated with the analyzed part of the decision, and (ii) the best and worst consequences of its non-analyzed part. The representation theorem is consistent with a wide variety of decision criteria, which allows for expressing various degrees of knowledge on ( ${A, \bar{A}}$ ) and various types of attitude toward ambiguity and uncertainty. This diversity is taken into account by specific models already existing in the literature. We exploit this fact and propose some particular forms of our model incorporating these models as sub-models and moreover expressing various types of beliefs concerning the relative plausibility of the analyzed and the non-analyzed events ranging from probabilities to complete ignorance that include capacities. (shrink)

Recent results from neuroimaging appear to indicate that some patients in a vegetative state have partially intact awareness. These results may demonstrate misdiagnosis and suggest the need not only for alternative forms of treatment, but also for the reconsideration of end-of-life decisions in cases of disorders of consciousness. This article addresses the second consequence. First, I will discuss which aspects of consciousness may be involved in neuroimaging findings. I will then consider various factors relevant to ethical end-of-life decision-making, and (...) analyse whether and to what extent the above consequence applies to these factors. It will be shown that knowledge of the existence of partial awareness in patients with disorders of consciousness only influences end-of-life decision-making if certain background assumptions are made. (shrink)

Off-shoring is a business decision increasingly being considered as a strategic option to effect expected cost savings. This exploratory study focuses on the moral recognition of off-shoring using ethical decision making embedded within affective events theory. Perceived magnitude of consequences and time pressure are hypothesized as affective event characteristics that lead to decision makers’ empathy responses. Subsequently, cognitive and affective empathy influence the decision makers’ moral recognition. Decision makers’ prior knowledge of off-shoring was also predicted to interact with (...) perceptions of the affective event characteristics to influence cognitive and affective empathy. Findings from a limited sample of human resource management professionals suggest that perceptions of magnitude of consequences and cognitive empathy directly relate to moral recognition and that affective empathy partially mediates the relationship between perceptions of the magnitude of consequences and moral recognition. The three-way interaction of the perceptions of magnitude of consequences, time pressure, and prior knowledge of off-shoring was marginally related to cognitive empathy. Interpretations of the findings, validity issues, limitations, future research directions, and management implications are provided. (shrink)

Integrated pest management (IPM) has been widely promoted in the developing world, but in many regions its adoption rates have been variable. Experience has shown that to ensure IPM adoption, the complexities of local agro-production systems and context-specific folk knowledge need to be appreciated. Our research explored the linkages between farmer knowledge, pest management decision making, and ecological attributes of subsistence maize agriculture. We report a case study from four rural communities in the highlands of southeast Honduras. Communities (...) were typified by their agro-environments, IPM training history, and levels of infestation by a key maize pest, the fall armyworm (Spodoptera frugiperda Smith). Although variable, infestation levels generally did not justify pest management intervention. Consequently, crop losses from this pest were considered of low importance and most farmers proceeded in a rational fashion by refraining from action in their fields. Farmers attributed the low degree of pest infestation predominantly to abiotic causal factors (rainfall, temperature). The role of natural enemies in controlling this pest (i.e., biological control) was deemed of low importance by farmers; nevertheless, a broad array of such organisms was mentioned by farmers as operating in their maize crop. Farmers’ knowledge of natural enemies only partially matched scientific knowledge and was associated with the ecological features of their respective field settings. Local knowledge about natural enemies was mainly restricted to abundant and easily observable predatory species. Farmers who were knowledgeable about biological control were also familiar with a larger variety of pest management alternatives than uninformed farmers. Management options covered a wide range of curative techniques, including conservation biological control. Farmers who relied on insecticides to manage pest outbreaks knew less about biological control and pesticide alternatives. In contrast, farmers who received IPM training mentioned more types of natural enemies and were familiar with a broader range of alternative pest management tactics. Our research suggests that IPM training modifies local knowledge to better fit its environmental context. This paper provides insights in the environmental context of local agro-ecological knowledge and its linkage with pest management decision making. It also constitutes a basis for modifying IPM extension programs to deliver locality-specific technologies while strengthening the local knowledge base. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Respecting the Boundaries of Knowledge:Teaching Christian Discernment with Humility and Dignity, a Response to Paul O. IngramSandra Costen KunzNatural Science and Buddhist Philosophy and Practice as Resources for Christian Spiritual DiscernmentBoundary Questions Arise When Teaching Spiritual Discernment in Western ContextsMy response to Paul Ingram's chapter titled "Constrained by Boundaries" in The Boundaries of Knowledge in Buddhism, Christianity, and Science1 will examine ways the Buddhist-Christian-natural science "trilogue" (...) he advocates might address some recurring problems encountered when teaching spiritual discernment in Western Christian contexts. These problems are examples of what Ingram calls boundary questions. He describes boundary questions as issues raised within a tradition of learning (such as an academic discipline or a religious community) that cannot be completely resolved within this tradition because of the culturally constructed "constraints" of the scope of its investigations and the assumptions and methods with which it makes its investigations. Ingram argues that boundary questions push hard against the cultural constraints that define a tradition. He gives examples of ways these questions can engender renewal within a tradition of learning if they are addressed honestly in conversation with another tradition (or traditions) of learning. This requires humility, but such conversation can help a tradition distinguish between the cultural constraints that still sharpen its core discovery processes and those that impede its quest in its current context.I will argue that dichotomous habits of thought endemic in modern Western cultures have constructed unnecessary boundary constraints within Western Christian theological anthropology and practical theology. I have watched Western Christians who are trying to discover God's guidance through spiritual discernment slam up against these constraints, and I have listened to the recurring boundary questions they [End Page 175] pose at these borders. Dichotomous assumptions and methods of investigation often weaken Western Christian spiritual discernment processes.I will suggest that particular Buddhist and natural science theories and practices of discovering knowledge—and some of the knowledge these practices have discovered—can be useful in teaching Christians spiritual discernment. This is because they can widen the scope of what human beings notice. This scope includes what people notice in their mental imagery, in the practices of their culture, and in creation around them. Spiritual discernment, as I describe it, involves the interplay of human imagination and discovery with God's guidance of all of creation, including human imagination and discovery. The human side of this interplay is made possible by the human spirit that (following practical theologian James E. Loder [1931-2001]) I describe as those unique human capacities that (1) allow us to reflect on our thinking and thus make partially free unselfish choices, and (2) draw us toward loving harmony with our creator and fellow creatures.2I am writing as a practical theologian specializing in Christian education who has studied cognitive neuroscience and Buddhist philosophy and practice. My job is to prepare those who lead Christian churches and schools to teach Christians how to continue Jesus's mission to rescue this world. I believe the most effective way I can help Christian organizations engage in positive, long-term social transformation is to teach their leaders how to teach their members time-tested spiritual discernment practices framed within the context of Christian faith.Spiritual Discernment and Christian Spiritual DiscernmentI assume that all cultures and communities that have sustained a healthy life together have done so in part because at least some of their members have practiced at least some form of spiritual discernment. Therefore I assume all healthy Christian and non-Christian religious communities have developed practices of spiritual discernment. I do distinguish, however, between spiritual discernment in general and specifically Christian spiritual discernment. Drawing on Christian, Buddhist, and neuroscience perspectives on decision making, creative problem solving, and behavioral change, I describe spiritual discernment in general as a transformative "process of divine-human cooperative imagination, focused upon reconfiguring the relationships among the actors and the other factors in a specific situation. This reconfiguration often begins in the imaginative rearrangement of mental images of these relationships, and continues in concrete social actions which eventually result in the actual rearrangement of social structures."3I thus describe spiritual discernment as... (shrink)

Institutional Review Board decisions hinge on the availability and interpretation of information. This is demonstrated by the following well-known historical example. In 2001, 24-year-old Ellen Roche died from respiratory distress and organ failure as a result of her participation in a study at Johns Hopkins Asthma and Allergy Center. The non-therapeutic physiological study, “Mechanisms of Deep Inspiration-Induced Airway Relaxation,” was designed to examine airway hyperresponsiveness in healthy individuals in order to better understand the pathophysiology of asthma. Participants inhaled hexamethonium, (...) a chemical ganglionic blocker that was not FDA-approved for use as specified in the experimental protocol. Risks of inhaling hexamethonium, including lung damage, had been reported in the 1950s and ‘60s. An investigation conducted after Roche's death determined that the study's principal investigator had failed to adequately search the medical literature; the protocol submitted for IRB review cited articles indexed in online literature databases that went back only as far as the 1970s. (shrink)

The current literature standardly conceives of voting power in terms of decisiveness: the ability to change the voting outcome by unilaterally changing one’s vote. I argue that this classic conception of voting power, which fails to account for partial decisiveness or efficacy, produces erroneous results because it saddles the concept of voting power with implausible microfoundations. This failure in the measure of voting power in turn reflects a philosophical mistake about the concept of social power in general: a (...) failure to recognize that an agent can exercise individual social power with others’ assistance, in virtue of the group’s collective power, sometimes even when she could not unilaterally scuttle the group’s collective power. I therefore develop a conception of efficacy that admits of degrees and defend a Recursive Measure of voting power that takes partial efficacy into account. (shrink)

There are two general classes of social conventions: conventions of coordination, and conventions of partial conflict. In coordination problems, the interests of the agents coincide, while in partial conflict problems, some agents stand to gain only if other agents unilaterally make certain sacrifices. Lewis' (1969) pathbreaking analysis of convention in terms of game theory focuses on coordination problems, and cannot accommodate partial conflict problems. In this paper, I propose a new game-theoretic definition of convention which generalizes previous (...) game-theoretic definitions (Lewis 1969, Vanderschraaf 1995), and which can be used to characterize norms of justice in partial conflict situations. I argue that the key structural property necessary for a social arrangement to be a convention is that it be conditionally self-enforcing, in the sense that: (i) each agent has a decisive reason to follow her end of the arrangement given that she expects all to do likewise, (ii) given a different set of expectations, some agents would have had a decisive reason to deviate, and (iii) these facts are common knowledge. This leads to a definition of convention as a strict correlated equilibrium (Aumann 1974) together with appropriate common knowledge conditions. Examples are given in which it is shown how this more general account of convention can be used to analyze norms of justice as well as coordination problems. It is only a general sense of common interest; which sense all the members of the society express to one another, and which induces them to regulate their conduct by certain rules. I observe, that it will be for my interest to leave another in the possession of his goods, provided he will act in the same manner with regard to me. He is sensible of a like interest in the regulation of his conduct. When this common sense of interest is mutually express'd, and is known to both, it produces a suitable resolution and behavior. And this may properly be call'd a convention or agreement betwixt us,.. (shrink)

John–Michael Kuczynski says the “paradox of analysis” can be resolved with the proper definition of “partial knowledge.” He says that this definition will not do: (K) S has partial knowledge of x = dfS knows some, but not all, of x’s parts. He offers an alternative account of incomplete or partial knowledge. I argue here that: (a) Kuczynski’s chief criticisms of (K) are defective; (b) his proposed solution to the paradox of analysis has (...) no clear application to the paradox in its familiar forms; and (c) his solution may not avoid the puzzle about partial knowledge it was designed to resolve. (shrink)

The Choquet expected utility model deals with nonadditive probabilities (or capacities). Their dependence on the information the decision-maker has about the possibility of the events is taken into account. Two kinds of information are examined: interval information (for instance, the percentage of white balls in an urn is between 60% and 100%) and comparative information (for instance, the information that there are more white balls than black ones). Some implications are shown with regard to the core of the (...) capacity and to two additive measures which can be derived from capacities: the Shapley value and the nucleolus. Interval information bounds prove to be satisfied by all probabilities in the core, but they are not necessarily satisfied by the nucleolus (when the core is empty) and the Shapley value. We must introduce the constrained nucleolus in order for these bounds to be satisfied, while the Shapley value does not seem to be adjustable. On the contrary, comparative information inequalities prove to be not necessarily satisfied by all probabilities in the core and we must introduce the constrained core in order for these inequalities be satisfied. However, both the nucleolus and the Shapley value satisfy the comparative information inequalities, and the Shapley value does it more strictly than the nucleolus. (shrink)

Econometric analysis of discrete choice has made considerable use of random utility models to interpret observed choice behavior. Much empirical research concerns choice problems in which persons act with partial knowledge of the utilities of the feasible actions. Economists use random expected utility models to analyze such choice problems. A common practice is to specify fully the expectations that persons hold, in which case choice analysis reduces to inference on preferences alone. However, the expectations assumptions made in (...) empirical research rarely have much foundation. To enable more credible research, this paper considers inference when one specifies a set of expectations that decision makers may plausibly hold. I first pose the idea in abstraction and then specialize to binary response with linear utilities, where the analysis is particularly straightforward. I initially assume that decision makers possess unique subjective probability distributions on the states of nature and make choices that maximize expected utility. I later consider the possibility that persons place only partial probabilistic structure on the states of nature and make undominated choices. (shrink)

This book introduces readers to the concept of the neutrosophic set which can deal with dynamic and complex decision-making problems. With the complexity of the socio-economic environment, today's decision-making is one of the most notable ventures, whose mission is to decide the best alternative under numerous known or unknown criteria. This book provides a large amount of theoretical and practical information about the latest research in the field, allowing readers to gain an extensive understanding of both the fundamentals (...) and applications of neutrosophic sets to solve different kinds of decision-making problems and mathematical programming such as medical diagnosis, pattern recognition, construction problems, technology selection etc. (shrink)

We defend the view of epistemic `must' as weak and claim that `must p' is used when the speaker does not know p. Novel arguments for this well-known account are provided. The theory is extended to epistemic future.

THIS ESSAY APPLIES CONCEPTS AND VALUE JUDGMENTS FROM WITHIN the Jewish tradition to the range of questions raised by genetic testing for BRCA1/2 mutations as well as possible prophylactic interventions to prevent breast cancer; in so doing, it models a Jewish methodology for approaching contemporary situations through the lens of classical Judaism. It notes the Jewish tradition's robust skepticism about the value of partial knowledge and its repeated admonitions against predicting future events based on incomplete data. The essay (...) also weighs Jewish tradition's strong imperative to aggressively pursue good health against Judaism's equally strong reluctance to attempt to predict future events based on partial data. This essay offers few definitive conclusions about Jewish law; instead, it shows that Jewish tradition can tolerate and support several different choices simultaneously. Jewish sources can guide individuals through the decision-making process without prescribing specific behaviors. (shrink)

This article concerns the prescriptive function of decision analysis. Consider an agent who must choose an action yielding welfare that varies with an unknown state of nature. It is often asserted that such an agent should adhere to consistency axioms which imply that behavior can be represented as maximization of expected utility. However, our agent is not concerned the consistency of his behavior across hypothetical choice sets. He only wants to make a reasonable choice from the choice set that (...) he actually faces. Hence, I reason that prescriptions for decision making should respect actuality. That is, they should promote welfare maximization in the choice problem the agent actually faces. Any choice respecting weak and stochastic dominance is rational from the actualist perspective. (shrink)

Feelings of knowing (FoK) are introspective self-report ratings of the felt likelihood that one will be able to recognize a currently unrecallable memory target. Previous studies have shown that FoKs are influenced by retrieved fragment knowledge related to the target, which is compatible with the accessibility hypothesis that FoK is partly based on currently activated partial knowledge about the memory target. However, previous results have been inconsistent as to whether or not FoKs are influenced by the (...) accuracy of such information. In our study (N = 26), we used a recall-judge-recognize procedure where stimuli were general knowledge questions. The measure of partial knowledge was wider than those applied previously, and FoK was measured before rather than after partial knowledge. The accuracy of reported partial knowledge was positively related to subsequent recognition accuracy, and FoK only predicted recognition on trials where there was correct partial knowledge. Importantly, FoK was positively related to the amount of correct partial knowledge, but did not show a similar incremental relation with incorrect knowledge. (shrink)

Recent epistemology has introduced a new criterion of adequacy for analyses of knowledge: such an analysis, to be adequate, must be compatible with the common view that knowledge is better than true belief. One account which is widely thought to fail this test is reliabilism, according to which, roughly, knowledge is true belief formed by reliable process. Reliabilism fails, so the argument goes, because of the "swamping problem". In brief, provided a belief is true, we do (...) not care whether or not it was formed by a reliable process. The value of reliability is "swamped" by the value of truth: truth combined with reliability is no better than truth alone. This paper approaches these issues from the perspective of decision theory. It argues that the "swamping effect" involves a sort of information-sensitivity that is well modelled decision-theoretically. It then employs this modelling to investigate a strategy, proposed by Goldman and Olsson, for saving reliabilism from the swamp, the so-called "conditional probability solution". It concludes that the strategy is only partially successful. (shrink)

Recent epistemology has introduced a new criterion of adequacy for analyses of knowledge: such an analysis, to be adequate, must be compatible with the common view that knowledge is better than true belief. One account which is widely thought to fail this test is reliabilism, according to which, roughly, knowledge is true belief formed by reliable process. Reliabilism fails, so the argument goes, because of the "swamping problem". In brief, provided a belief is true, we do (...) not care whether or not it was formed by a reliable process. The value of reliability is "swamped" by the value of truth: truth combined with reliability is no better than truth alone. This paper approaches these issues from the perspective of decision theory. It argues that the "swamping effect" involves a sort of information-sensitivity that is well modelled decision-theoretically. It then employs this modelling to investigate a strategy, proposed by Goldman and Olsson, for saving reliabilism from the swamp, the so-called "conditional probability solution". It concludes that the strategy is only partially successful. (shrink)

Resumen: Este ensayo tiene como propósito fundamentar teóricamente el carácter situado del conocimiento de la vida cotidiana. Como punto de partida, apoyándonos en la noción de “forma de vida” de Ludwig Wittgenstein, postulamos que nuestras decisiones son, fundamentalmente, usos prácticos de sistemas de reglas históricamente construidas y, por consiguiente, irreductibles a procedimientos algorítmicos de evaluación racional costo-beneficio. Posteriormente, para abordar la cuestión sobre las condiciones que hacen posible la incorporación subjetiva de estas reglas y, con ello, nuestro sentido práctico, recuperamos (...) algunos planteamientos de las tesis del “trasfondo” de John Searle y habitus de Pierre Bourdieu. Luego de esta discusión, a partir de la perspectiva de los conocimientos situados de Donna Haraway, proponemos que la conformación de dicho sentido es siempre parcial, esto es, sujeto a prácticas articulatorias encarnadas. Finalmente, tras exponer sucintamente los principales aspectos críticos de las tesis “trasfondo” y habitus, argumentamos que la perspectiva de los conocimientos situados representa una alternativa plausible para fundamentar teórica y metodológicamente una nueva aproximación al conocimiento de la vida cotidiana.: This essay argues for a situated character of knowledge of everyday life. As a starting point, relying on Ludwig Wittgenstein's notion of “form of life”, we propose that our decisions are fundamentally practical uses of historically constructed rules systems and, therefore, those are irreducible to algorithmic procedures of rational cost-benefit evaluation. Later, to address the question of the conditions that make possible the subjective incorporation of these rules and, with it, our practical sense, we recover some approaches from the “background” thesis of John Searle and habitus by Pierre Bourdieu. After this discussion, from Donna Haraway's perspective of situated knowledge, we propose that the conformation of that sense is always partial; that is, related to embodied articulatory practices. Finally, we argue that the perspective of situated knowledge represents a plausible alternative to theoretically and methodologically support an approach to knowledge of everyday life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Empire Writes Back, With A VengeanceDenis DuttonOne of the more uplifting aspects of the turn toward theory in recent years has been the growth of postcolonial cultural studies. Postcolonial studies are in actuality constituted by counterdiscoursive, decolonizing practices which acknowledge the recognition of minority discourses, deconstructing hegemonic texts and imperialist metanarratives, opposing unduly overprivileging Western canonical paradigms of “literature,” and—well, you know what I mean. As Benita (...) Parry so lucidly explains, “The labor of producing a counter-discourse displacing imperialism’s dominative system of knowledge rests with those engaged in developing a critique from outside its cultural hegemony.” And what an awesome labor it is. The noted postcolonial theorist Georg M. Gugelberger sums things up by saying (I’m not inventing this) “postcolonialism can be conceptualized as the last bulwark against an encroaching total capitalism.”But what of the struggling masses of oppressed peoples whose interests and cultural sensitivities are so caringly looked after by practitioners of postcolonial studies? How do they feel about the fact that the only thing standing between them and “total capitalism” is resistance being mounted in a comparative literature department in Idaho, or someplace? This is a question seldom asked, let alone answered. Fortunately, new light has been thrown on the matter with the arrival of a booklet at this journal. Indian History from Above and Below, by Rukun Advani, is published by Ram Advani, probably a member of the family, in Lucknow. It is dedicated to “all Bengali intellectuals and those whose dollar salaries rise in proportion with obscurity and jargon.” Advani notes in his preface that although Bengali intellectuals talk torrents in their native tongue, when they [End Page 198] disseminate their thoughts abroad, they translate into a “clogged, colonial, unfluid flow,” with footnotes such as: “Derrida; ibid.; see my recent essay on the modes and moods of Foucault in JPS, III.iii, 3–333; on Lacan, see Lacan, On Lacan; Barthes, how many times a day do you have one in summer; idem., do you really?; differentiated peasantry; undifferentiated peasantry; for a feminist, though partially anthropologized, hermeneutic-critical discourse on the post-colonial subversive dimensions of the undifferentiated middle peasant in Midnapore district in June 1959, see the provocative controversy between Ranajit da and Amiya da in Gayatri di, ed., Gendered, Gendered, O Most Gendered: Epistemology and the Male Menopause in Bengal between June 1959 and July 1959 (Oxford University Press, forty years later).”The first of the booklet’s two essays, “Indian History from Below: a Swiftian Consideration,” discusses a neglected but “important arena of subaltern existence, namely the history of belching, wind-breaking and defecation.” Just to name these three functions posits “a bourgeois hierarchy of disgust with what Marx, in one of his most decisively Derridesque reflections, termed ‘The Asiatic Commode of Production.’” Beginning with the Foucauldian notion of “the peasant’s overdetermined relative autonomy from the olfactory,” Advani describes “the Barthesian notion of the impossibility of critical transcendence by the historian into either the symbiotic acculturation of the pastness, and indeed the presentness, of the present-subject, or indeed the even greater epistemological and hermeneutic problems posed by attempting a recreation of the ontological presuppositions of the peasant.” Much of this is elaborated in the classic essay by Professor Lavatri Lavatory Spewhack, “The Post-Colonial Lavatory and Its Radical Implications for Nomenclaturing Among Gendered and Subalternized Third World Expatriate-Marxist-Feminists in the First and Second Worlds: A Derivative Discourse Decoded.”The debt that Rukun Advani owes to Professor Spewhack is clear from the sheer number of his references to books and articles by her. These include, on the subject of toileting, Master Disgusted, Native Disgusting: a Perspective on Peasants from 250,000 Dollars per Annum, “On the Symbolic Hegemony of Subsection Numbers in a Gendered and Subalternized Post-Colonial Context: A Derivative Discourse Decoded” (in The Phenomenology of Praxis and the Praxis of Phenomenology in a Postmodern Residential Colony), “The Violence of Steam and the Episteme of Violence: Foucault’s Views on Hot Air Balloons” (in Obscurata), and even parts of her autobiography: The Larger than Life of Lavatri Lavatory [End Page 199] Spewhack (chapter titled “My Collected Phonecalls and Faxes”). While some... (shrink)

This article draws on the concept of “performance” to argue for greater recognition of preexisting practices in the configuration of users. Through an Australian case study of a computer-based dairy decision-support system introduced via a two-day workshop to participating farmers, the article examines the assembling of imputed farmer users in the design of the software. It then explores how the designer and trainers attempt, through the decision-support system, to mobilize their network and align the imputed user with farmers' preexisting (...) performances. The case study highlights that attempts to make workable on-farm the “new” performances of users inscribed in the software are highly contingent on farmers' preexisting knowledge practices. These “old” performances problematize the designer's and trainers' version of imputed users and contribute to partial translation of the decision-support system. A focus on performance is argued to provide a useful starting point in mapping the effects of preexisting knowledge practices on attempts to enroll users in technosocial programs. (shrink)

A knowledge-based decision theory faces what has been called the prodigality problem : given that many propositions are assigned probability 1, agents will be inclined to risk everything when betting on propositions which are known. In order to undo probability 1 assignments in high risk situations, the paper develops a theory which systematically connects higher level goods with higher-order knowledge.

The initial successes in recent years in harnessing machine learning technologies to improve medical practice and benefit patients have attracted attention in a wide range of healthcare fields. Particularly, it should be achieved by providing automated decision recommendations to the treating clinician. Some hopes placed in such ML-based systems for healthcare, however, seem to be unwarranted, at least partially because of their inherent lack of transparency, although their results seem convincing in accuracy and reliability. Skepticism arises when the physician as (...) the agent responsible for the implementation of diagnosis, therapy, and care is unable to access the generation of findings and recommendations. There is widespread agreement that, generally, a complete traceability is preferable to opaque recommendations; however, there are differences about addressing ML-based systems whose functioning seems to remain opaque to some degree—even if so-called explicable or interpretable systems gain increasing amounts of interest. This essay approaches the epistemic foundations of ML-generated information specifically and medical knowledge generally to advocate differentiations of decision-making situations in clinical contexts regarding their necessary depth of insight into the process of information generation. Empirically accurate or reliable outcomes are sufficient for some decision situations in healthcare, whereas other clinical decisions require extensive insight into ML-generated outcomes because of their inherently normative implications. (shrink)

Based on a mixed-methods study involving triad tasks and ethnobiological models, we analyze local categories and knowledge of key ethnospecies of fish exploring partial overlaps between artisanal fishers’ and academic knowledge in a fishing community in northeast Brazil. We argue that fishers’ and academic knowledge overlaps may provide common ground for transdisciplinary collaboration, while their partiality requires reflection on epistemological and ontological differences. Here, we show how knowledge of artisanal fishers can complement academic knowledge (...) and bring about tensions that need to be addressed through intercultural dialogue. By integrating a general philosophical framework of partial overlaps with a mixed-methods study on fishers’ knowledge, we show how ethnobiology can contribute to reflective and empirically-grounded transdisciplinary practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Empire Writes Back, With A VengeanceDenis DuttonOne of the more uplifting aspects of the turn toward theory in recent years has been the growth of postcolonial cultural studies. Postcolonial studies are in actuality constituted by counterdiscoursive, decolonizing practices which acknowledge the recognition of minority discourses, deconstructing hegemonic texts and imperialist metanarratives, opposing unduly overprivileging Western canonical paradigms of “literature,” and—well, you know what I mean. As Benita (...) Parry so lucidly explains, “The labor of producing a counter-discourse displacing imperialism’s dominative system of knowledge rests with those engaged in developing a critique from outside its cultural hegemony.” And what an awesome labor it is. The noted postcolonial theorist Georg M. Gugelberger sums things up by saying (I’m not inventing this) “postcolonialism can be conceptualized as the last bulwark against an encroaching total capitalism.”But what of the struggling masses of oppressed peoples whose interests and cultural sensitivities are so caringly looked after by practitioners of postcolonial studies? How do they feel about the fact that the only thing standing between them and “total capitalism” is resistance being mounted in a comparative literature department in Idaho, or someplace? This is a question seldom asked, let alone answered. Fortunately, new light has been thrown on the matter with the arrival of a booklet at this journal. Indian History from Above and Below, by Rukun Advani, is published by Ram Advani, probably a member of the family, in Lucknow. It is dedicated to “all Bengali intellectuals and those whose dollar salaries rise in proportion with obscurity and jargon.” Advani notes in his preface that although Bengali intellectuals talk torrents in their native tongue, when they [End Page 198] disseminate their thoughts abroad, they translate into a “clogged, colonial, unfluid flow,” with footnotes such as: “Derrida; ibid.; see my recent essay on the modes and moods of Foucault in JPS, III.iii, 3–333; on Lacan, see Lacan, On Lacan; Barthes, how many times a day do you have one in summer; idem., do you really?; differentiated peasantry; undifferentiated peasantry; for a feminist, though partially anthropologized, hermeneutic-critical discourse on the post-colonial subversive dimensions of the undifferentiated middle peasant in Midnapore district in June 1959, see the provocative controversy between Ranajit da and Amiya da in Gayatri di, ed., Gendered, Gendered, O Most Gendered: Epistemology and the Male Menopause in Bengal between June 1959 and July 1959 (Oxford University Press, forty years later).”The first of the booklet’s two essays, “Indian History from Below: a Swiftian Consideration,” discusses a neglected but “important arena of subaltern existence, namely the history of belching, wind-breaking and defecation.” Just to name these three functions posits “a bourgeois hierarchy of disgust with what Marx, in one of his most decisively Derridesque reflections, termed ‘The Asiatic Commode of Production.’” Beginning with the Foucauldian notion of “the peasant’s overdetermined relative autonomy from the olfactory,” Advani describes “the Barthesian notion of the impossibility of critical transcendence by the historian into either the symbiotic acculturation of the pastness, and indeed the presentness, of the present-subject, or indeed the even greater epistemological and hermeneutic problems posed by attempting a recreation of the ontological presuppositions of the peasant.” Much of this is elaborated in the classic essay by Professor Lavatri Lavatory Spewhack, “The Post-Colonial Lavatory and Its Radical Implications for Nomenclaturing Among Gendered and Subalternized Third World Expatriate-Marxist-Feminists in the First and Second Worlds: A Derivative Discourse Decoded.”The debt that Rukun Advani owes to Professor Spewhack is clear from the sheer number of his references to books and articles by her. These include, on the subject of toileting, Master Disgusted, Native Disgusting: a Perspective on Peasants from 250,000 Dollars per Annum, “On the Symbolic Hegemony of Subsection Numbers in a Gendered and Subalternized Post-Colonial Context: A Derivative Discourse Decoded” (in The Phenomenology of Praxis and the Praxis of Phenomenology in a Postmodern Residential Colony), “The Violence of Steam and the Episteme of Violence: Foucault’s Views on Hot Air Balloons” (in Obscurata), and even parts of her autobiography: The Larger than Life of Lavatri Lavatory [End Page 199] Spewhack (chapter titled “My Collected Phonecalls and Faxes”). While some... (shrink)

In contrast to Constructivist Views, which construe perceptual cognition as an essentially reconstructive process, this article recommends the Deictic View, which grounds perception in perceptual-demonstrative reference and the use of deictic tracking strategies for acquiring and updating knowledge about individuals. The view raises the problem of how sensory-motor tracking connects to epistemic and integrated forms of tracking. To study the strategies used to solve this problem, we report a study of the ability to track distal individuals when only their (...) directions can be perceived and not their locations. We introduce a new experimental paradigm named the 'Modified Traveling Salesman Problem' (MTSP), which requires subjects to visit n invisible targets in a 2D display once each. Surprisingly, subjects are competent at this task for up to 10 targets. We consider two types of tracking strategies that subjects might use: 'location-based' strategies and 'deictic direction-based' strategies. A number of observations suggest that subjects used the latter, at least for larger numbers of targets. We hypothesize that subjects used perceptual-demonstrative reference and deictic strategies (i) to perform the sensory-motor tracking of directional segments, (ii) to bind the segments with their updated status in the task, and (iii) to perform the epistemic tracking of invisible targets by means of perception-based inferences. (shrink)

This note establishes a new identification result for additive random utility discrete choice models. A decision-maker associates a random utility Uj+mj\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$U_{j}+m_{j}$$\end{document} to each alternative in a finite set j∈1,…,J\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$j\in \left\{ 1,\ldots,J\right\} $$\end{document}, where U=U1,…,UJ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathbf {U}=\left\{ U_{1},\ldots,U_{J}\right\} $$\end{document} is unobserved by the researcher and random with an unknown joint distribution, while the perturbation m=m1,…,mJ\documentclass[12pt]{minimal} (...) \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathbf {m}=\left $$\end{document} is observed. The decision-maker chooses the alternative that yields the maximum random utility, which leads to a choice probability system m→Pr1|m,…,PrJ|m\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathbf { m\rightarrow }\left,\ldots,\Pr \left \right) $$\end{document}. Previous research has shown that the choice probability system is identified from the observation of the relationship m→Pr1|m\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \mathbf {m}\rightarrow \Pr \left $$\end{document}. We show that the complete choice probability system is identified from observation of a relationship m→∑j=1sPrj|m\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathbf {m}\rightarrow \sum _{j=1}^{s}\Pr \left $$\end{document}, for any sshrink)

The paper starts out by distinguishing two closely related hypotheses about extended cognition. According to the strong hypothesis, there are no intrinsic representations in the brain. This is a version of the extended-mind view defended by Andy Clark and Richard Menary. On the weak hypothesis, there are intrinsic representations in the brain but some types of cognition, knowledge or memory are constituted by particular types of external devices or environmental factors that extend beyond the skull and perhaps beyond the (...) skin. This type of view was defended, for example, by Andy Clark and David Chalmers. After drawing this distinction and clarifying the notions of causal influence and constitution, I defend the second weaker hypothesis with respect to procedural knowledge and knowledge of action and show why this sort of view supports what we might call a ‘situationist-friendly virtue epistemology’. (shrink)

We develop a conceptually clear, intuitive, and feasible decision procedure for testing satisfiability in the full multi\-agent epistemic logic \CMAELCD\ with operators for common and distributed knowledge for all coalitions of agents mentioned in the language. To that end, we introduce Hintikka structures for \CMAELCD\ and prove that satisfiability in such structures is equivalent to satisfiability in standard models. Using that result, we design an incremental tableau-building procedure that eventually constructs a satisfying Hintikka structure for every satisfiable input (...) set of formulae of \CMAELCD\ and closes for every unsatisfiable input set of formulae. (shrink)

Temporal epistemic logics are known, from results of Halpern and Vardi, to have a wide range of complexities of the satisfiability problem: from PSPACE, through non-elementary, to highly undecidable. These complexities depend on the choice of some key parameters specifying, inter alia, possible interactions between time and knowledge, such as synchrony and agents' abilities for learning and recall. In this work we develop practically implementable tableau-based decision procedures for deciding satisfiability in single-agent synchronous temporal-epistemic logics with interactions between (...) time and knowledge. We discuss some complications that occur, even in the single-agent case, when interactions between time and knowledge are assumed and show how the method of incremental tableaux can be adapted to work in EXPSPACE, respectively 2EXPTIME, for these logics, thereby also matching the upper bounds obtained for them by Halpern and Vardi. (shrink)

Several philosophers have proposed Knowledge-Based Decision Theories (KDTs)—theories that require agents to maximize expected utility as yielded by utility and probability functions that depend on the agent’s knowledge. Proponents of KDTs argue that such theories are motivated by Knowledge-Reasons norms that require agents to act only on reasons that they know. However, no formal derivation of KDTs from Knowledge-Reasons norms has been suggested, and it is not clear how such norms justify the particular ways in which (...) KDTs relate knowledge and rational action. In this paper, I suggest a new axiomatic method for justifying KDTs and providing them with stronger normative foundations. I argue that such theories may be derived from constraints on the relation between knowledge and preference, and that these constraints may be evaluated relative to intuitions regarding practical reasoning. To demonstrate this, I offer a representation theorem for a KDT proposed by Hawthorne and Stanley (2008) and briefly evaluate it through its underlying axioms. -/- In section 1, I present knowledge-based decision theories generally and the versions of such theories suggested in the literature. In section 2, I argue that KDTs and theories of practical reasoning conjoined with Knowledge-Reasons norms generate constraints on the same relation—the relation between knowledge and preference. In section 3, I present a formal framework in which constraints on this relation may be expressed and from which KDTs may be derived. In section 4, I present a representation theorem for a specific KDT. In section 5, I briefly evaluate the axioms of the theory, and in section 6, I conclude. (shrink)

In this paper the machinery of Hybrid Logic and the logic of public announcements are merged. In order to bring the two logics together properly the underlying hybrid logic has been changed such that nominals only partially denote states. The hybrid logic contains nominals, satisfaction operators, the downarrow binder as well as the global modality. Following this, an axiom system for the Hybrid Public Announcement Logic is presented and using reduction axioms general completeness is proved. The general completeness allows for (...) an easy way of adding distributed knowledge. Furthermore, it turns out that distributed knowledge is definable using satisfaction operators and the downarrow binder. (shrink)

When a risk is exchanged, the exact value for the minimum price (positive or negative) that the purchaser (investor, or insurer) is willing to pay is given by the certainty equivalent wealth level, which in turn depends on his specific utility function. When this utility function is unknown, then only a sufficient condition on the price can ever be found. This paper provides methods for calculating such a sufficient condition, when only limited information on the utility function is known.

BackgroundCompetent end-of-life care is an essential component of total health care provision, but evidence suggests that it is often deficient. This study aimed to evaluate the knowledge and attitudes about key end-of-life issues and principles of good death among doctors in clinical settings.MethodsA cross-sectional study was conducted among allopathic medical doctors working in in-ward clinical settings of tertiary care hospitals in Sri Lanka using a self-administered questionnaire with open- and close-ended questions as well as hypothetical clinical scenarios. Univariate (...) and logistic regression analysis were used to identify the independent factors associated with knowledge and attitudes.ResultsOf the responders who had not been a caregiver for a terminally ill relative (n = 390), 57.9% were men with a mean age of 36.5 years (SD = 8.2). Compared to undergraduate (65.6%; n = 256), only 27.4% (n = 107) had received end-of-life care training at postgraduate level. Only 65.9% of doctors favoured disclosing terminal prognosis to patients; 27.7% of doctors were aware of advance directives; 14.6% were aware of the correct time of death when certifying brain death; 70.3% felt more comfortable in withholding than withdrawing life-sustaining treatment; 61.3% were aware of do-not-attempt cardiopulmonary resuscitation (DNACPR) decisions while 26.7% felt reluctant to administer it; 15.1% thought that all life-sustaining therapy should be withdrawn with a DNACPR decision; and only17.9% were able to name the four principles of medical ethics while 57.9% could not name a single. Participants scored a mean of 9.2 (SD = 3.9) of a maximum 14 points when tested on principles of a ‘good death’. Doctors who had pursued postgraduate studies were more likely to be aware of breaking bad news (adjusted-Odds-Ratio:1.99; 95%CI = 1.19–3.32), advance directives (adjusted-OR: 4.15; 95%CI = 2.49–6.94), aware of certifying the correct time of death (adjusted-OR:2.37; 95%CI = 1.33–4.2) and less reluctant to make DNACPR decisions (adjusted-OR:1.74; 95%CI = 1.13–2.68). Doctors who had worked in ICU were more comfortable withholding than withdrawing treatment (adjusted-OR:1.99; 95%CI = 1.2–3.31).ConclusionsKnowledge and attitudes about end-of-life care, good death and principles of medical ethics among doctors in Sri Lanka were suboptimal. Structured training of end-of-life care needs to be integrated within curricula and in-service training. (shrink)

There is a duality in our everyday view of belief. On the one hand, we sometimes speak of credence as a matter of degree. We talk of having some level of confidence in a claim (that a certain course of action is safe, for example, or that a desired event will occur) and explain our actions by reference to these degrees of confidence – tacitly appealing, it seems, to a probabilistic calculus such as that formalized in Bayesian decision theory. On (...) the other hand, we also speak of belief as an unqualified, or flat-out, state (‘plain belief’ as it is sometimes called), which is either categorically present or categorically absent. We talk of simply believing or thinking that something is the case, and we cite these flat-out attitudes in explanation of our actions – appealing to classical practical reasoning of the sort formalized in the so-called ‘practical syllogism’.1 This tension in everyday discourse is reflected in the theoretical literature on belief. In formal epistemology there is a division between those in the Bayesian tradition, who treat credence as graded, and those who think of it as a categorical attitude of some kind. The Bayesian perspective also contrasts with the dominant view in philosophy of mind, where belief is widely regarded as a categorical state (a token sentence of a mental language, inscribed in a functionally defined ‘belief box’, according to one popular account). A parallel duality is present in our everyday view of desire. Sometimes we talk of having degrees of preference or desirability; sometimes we speak simply of wanting or desiring something tout court, and, again, this tension is reflected in the theoretical literature. What should we make of these dualities? Are there two different types of belief and desire – partial and flat-out, as they are sometimes called? If so, how are they related? And how could both have a role in guiding rational action, as the everyday view has it? The last question poses a particular challenge in relation to flat-out belief and desire.. (shrink)

Although the role of imagination in moral reasoning is often neglected, recent literature, mostly of pragmatist signature, points to imagination as one of its central elements. In this article we develop some of their arguments by looking at the moral role of imagination in practice, in particular the practice of neonatal intensive care. Drawing on empirical research, we analyze a decision-making process in various stages: delivery, staff meeting, and reflection afterwards. We show how imagination aids medical practitioners demarcating moral categories, (...) tuning their actions, and exploring long-range consequences of decisions. We argue that imagination helps to bring about at least four kinds of integration in the moral decision-making process: personal integration by creating a moral self-image in moments of reflection; social integration by aiding the conciliation of the diverging perspectives of the people involved; temporal integration by facilitating the parties to transcend the present moment and connect past, present, and future; and epistemological integration by helping to combine the various forms of knowledge and experience needed to make moral decisions. Furthermore, we argue that the role of imagination in these moral decision-processes is limited in several significant ways. Rather than being a solution itself, it is merely an aid and cannot replace the decision itself. Finally, there are also limits to the practical relevance of this theoretical reflection. In the end, it is up to care professionals as reflective practitioners to re-imagine the practice of intensive care and make the right decisions with hope and imagination. (shrink)

Fassio and Gao (2021) object to a knowledge-based decision theory on the ground that it cannot deal with unsuccessful inquiry. One way for inquiry to fail is not to know what one should know. If one’s inquiry fails in this way, is a subsequent choice in any way wrong when based on one’s limited actual knowledge? This paper discusses two strategies for dealing with this problem. On a first strategy, there is nothing wrong with such (...) a choice (but something went wrong prior to one’s choice). On a second strategy, there is something wrong with one’s choice and a knowledge-based decision theory should require that one’s decisions be based on the knowledge one should have, not merely on the knowledge one actually has. (shrink)

This article is concerned with the question of how to argue about morality and ethics in relation to a severe and deadly hereditary disease. It is inspired by the uneasiness I have felt on a number of occasions when “right and wrong” is being discussed by persons at risk, professionals and in particular when discussed by outsiders. This task is not an easy one and the article tries to lay out more groundwork than it arrives at conclusions. Below follows (...) a brief introduction to my framework and some of the concepts that are important for my way of outlining the arguments that follow. Then I take a closer look at genetic knowledge, responsibility and decision making, because these seem to be important issues in my field of study. I have added ignorance to the list in order to discuss a further aspect of dealing with hereditary disease. Interestingly, ignorance (understood both as being ignorant of and ignoring) seems to be commonly applicable to describing persons living at risk for Huntington’s Disease (HD). So what does everyday conduct of life look like from an “ignorance” perspective? And how can we discuss and argue about morality and ethics taking these seemingly diverse ways of living at risk into account? Posing this question, I hope to contribute to new reflections on possibilities and constraints in people’s lives with HD as well as in research and to open up new ways of discussing “right and wrong”. (shrink)

Background/Aim: The law on consent has changed in Scotland with the introduction of the Adults with Incapacity Act 2000. This Act introduces the concept of proxy consent in Scotland. Many patients in intensive care are unable to participate in the decision making process because of their illness and its treatment. It is normal practice to provide relatives with information on the patient’s condition, treatment, and prognosis as a substitute for discussion directly with the patient. The relatives (...) of intensive care patients appeared to believe that they already had the right to consent on behalf of an incapacitated adult. The authors’ aim was to assess the level of knowledge among relatives of intensive care patients of both the old and new law using a structured questionnaire.Methods: The next of kin of 100 consecutive patients completed a structured questionnaire. Each participant had the questions read to them and their answers recorded. Patients were not involved in the study.Results: Few were aware of the changes. Most thought that they previously could give consent on behalf of an incapacitated adult. Only 13% have ever discussed the preferences for life sustaining treatment with the patient but 84% felt that they could accurately represent the patient’s wishes.Conclusions: There appeared to be a lack of public awareness of the impending changes. The effectiveness of the Act at improving the care of the mentally incapacitated adult will depend largely on how successful it is at encouraging communication and decision making in advance of incapacity occurring. (shrink)

to appear in Lambert, E. and J. Schwenkler (eds.) Transformative Experience (OUP) -/- L. A. Paul (2014, 2015) argues that the possibility of epistemically transformative experiences poses serious and novel problems for the orthodox theory of rational choice, namely, expected utility theory — I call her argument the Utility Ignorance Objection. In a pair of earlier papers, I responded to Paul’s challenge (Pettigrew 2015, 2016), and a number of other philosophers have responded in similar ways (Dougherty, et al. 2015, Harman (...) 2015) — I call our argument the Fine-Graining Response. Paul has her own reply to this response, which we might call the Authenticity Reply. But Sarah Moss has recently offered an alternative reply to the Fine-Graining Response on Paul’s behalf (Moss 2017) — we’ll call it the No Knowledge Reply. This appeals to the knowledge norm of action, together with Moss’ novel and intriguing account of probabilistic knowledge. In this paper, I consider Moss’ reply and argue that it fails. I argue first that it fails as a reply made on Paul’s behalf, since it forces us to abandon many of the features of Paul’s challenge that make it distinctive and with which Paul herself is particularly concerned. Then I argue that it fails as a reply independent of its fidelity to Paul’s intentions. (shrink)

This paper examines the ethical conundrum between a hospital's ethos of relieving distress, investigation and treatment, and its concurrent duties under English law to administer tests of decision-making capacity and safeguarding protection where it believes the patient may lack this capacity. Delirium, characterised by a precipitous decline in mental functioning exhibiting the shared symptomology of recoverable depressive disorders and terminal dementia, is not uncommon after emergency admission of elderly patients into acute medical hospital wards. The use of functional capacity testing (...) as a benchmark for decision-making capacity for post-discharge residence has been criticised as outdated, conceptually floored, subjective, lacking central guidance, transparent process, and accountability. A study of patient experience demonstrates the potential for hospital misuse of capacity testing, the failure of functional testing to differentiate decision making capacity from the disability of partial cognitive impairment, and how hospital capacity processes can interact and amplify patient pathology thereby decreasing recovery prospects. Prioritisation of mental capacity obligations above thorough investigation of emergent mental pathology and relief of patient anguish, results in extended detention in medical wards lacking bespoke facilities. Further understanding of patient experience is needed to inform policy with interventions tailored to avoid harm and increase wellbeing. (shrink)

This paper analyzes the coordination challenge a partial cartel faces when payoff asymmetries between potential cartel insiders and potential cartel outsiders are large. We introduce two experimental treatments: a standard treatment where a complete cartel can be supported in a Nash equilibrium and a modified treatment where a complete cartel and a partial cartel can both be supported in a Nash equilibrium. To assess the role of communication both treatments are additionally run with a “chat option,” yielding (...) four treatments in total. Our results show that subjects frequently reject the formation of partial cartels in the modified treatments. In all treatments with communication subjects are more likely to form complete cartels than partial cartels. The implications of these results are important for antitrust: payoff asymmetries between cartel members and outsiders may jeopardize the formation of partial cartels. Yet complete cartels may be formed instead, if institutional mechanisms with frequent communication are used to form cartels. (shrink)

The aim of this study was to explore experiences of participation in treatment planning decisions from the perspective of patients recently treated for colorectal cancer. Ten patients were purposively selected and interviewed. Constant comparative analysis, the core concept of grounded theory, was used. The dimensions were developed and organized into the main theme of ‘compliant participation in serious decisions’, which was composed of the two variations: complying with participation; and complying without participation. Complying with participation was (...) characterized by feelings of self-confidence and self-competence and by open dialogue between the participants, significant others and the physician. Complying without participation was characterized by participants’ feelings of uncertainty and distress, and of being rushed into submitting to decisions without having time to reflect on the information provided or the opportunity to influence the treatment and care process. To participate builds on open and affirming dialogue, information and knowledge about the illness. Patient participation in treatment and care decision making is interpreted as a health promoting way of coping with illness. (shrink)

1. Real-world applications, such as monitoring urban wastewater networks, commonly process large volumes of multi-source, heterogeneous data to support reasoning, query answering and decision-makin...