As a cornerstone of public health, epidemiology has lately undergone substantial changes enabled by, among other factors, the use of biobank infrastructures. In biobank-related research, the return of results to participants constitutes an important and complex ethical question. In this study, we qualitatively investigated how individuals perceive the results returned following their participation in cohort studies with biobanks. In our semi-structured interviews with 31 participants of two such German studies, we observed that some participants overestimate the nature of the personal (...) information they will receive from the study. Although this misestimation does not seem to jeopardize the validity of the consent provided at recruitment, it may still represent a threat for participants’ trust in research and thus their long-term commitment, crucial for such studies. We argue that such misestimation may have ethical consequences on the principles guiding the reflection on the return of results in biobank research, i.e. autonomy, beneficence, non-maleficence and reciprocity. We suggest that shifting from the idea of directly benefiting participants through the return of research results could help focusing on benefiting society as a whole, thereby increasing research trustworthiness of population-based studies using biobanks. (shrink)

Testimony is an invaluable source of knowledge. We rely on the reports of those around us for everything from the ingredients in our food and medicine to the identity of our family members. Recent years have seen an explosion of interest in the epistemology of testimony. Despite the multitude of views offered, a single thesis is nearly universally accepted: testimonial knowledge is acquired through the process of transmission from speaker to hearer. In this book, Jennifer Lackey shows that this (...) thesis is false and, hence, that the literature on testimony has been shaped at its core by a view that is fundamentally misguided. She then defends a detailed alternative to this conception of testimony: whereas the views currently dominant focus on the epistemic status of what speakers believe, Lackey advances a theory that instead centers on what speakers say. The upshot is that, strictly speaking, we do not learn from one another's beliefs - we learn from one another's words. Once this shift in focus is in place, Lackey goes on to argue that, though positive reasons are necessary for testimonial knowledge, testimony itself is an irreducible epistemic source. This leads to the development of a theory that gives proper credence to testimony's epistemologically dual nature: both the speaker and the hearer must make a positive epistemic contribution to testimonial knowledge. The resulting view not only reveals that testimony has the capacity to generate knowledge, but it also gives appropriate weight to our nature as both socially indebted and individually rational creatures. The approach found in this book will, then, represent a radical departure from the views currently dominating the epistemology of testimony, and thus is intended to reshape our understanding of the deep and ubiquitous reliance we have on the testimony of those around us. (shrink)

How, in a secular world, should we resolve ethically controversial and troubling issues relating to health care? Should we, as some argue, make a clean sweep, getting rid of the Hippocratic ethic, such vestiges of it as remain? Jennifer Jackson seeks to answer these significant questions, establishing new foundations for a traditional and secular ethic which would not require a radical and problematic overhaul of the old. These new foundations rest on familiar observations of human nature and human needs. (...) Jackson presents morality as a loose anatomy of constituent virtues that are related in different ways to how we fare in life, and suggests that in order to address problems in medical ethics, a virtues-based approach is needed. Throughout, attention is paid to the role of philosophy in medical ethics, and how it can be used to clarify key notions and distinctions that underlie current debates and controversial issues. By reinstating such concepts as justice, cardinal virtue, and moral duty, Jackson lays the groundwork for an ethics of health care that makes headway toward resolving seeming dilemmas in medical ethics today. This penetrating and accessible book will be invaluable to students of sociology and health care, as well as those who are interested in the ethical uncertainties faced by the medical world. (shrink)

Decision-Making Capacity First published Tue Jan 15, 2008; substantive revision Fri Aug 14, 2020 In many Western jurisdictions the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own medical decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This question has to do with what (...) is commonly called “decisional capacity”, a central concept in health care law and ethics, and increasingly an independent topic of philosophical inquiry. -/- Decisional capacity can be defined as the ability of subjects to make their own medical decisions. Somewhat similar questions of capacity arise in other contexts, such as capacity to stand trial in a court of law and the ability to make decisions that relate to personal care and finances. However, the history behind the more general legal notions of capacity to stand trial and capacity to manage one’s life is different and operates somewhat differently in law (Roth, Meisel, & Litz 1977; Zapf & Roesch 2005). For the purposes of this discussion the notion of decisional capacity will be limited to medical contexts only; most notably, those where decisions to consent or to refuse treatment or participation in clinical research are concerned. (shrink)

Jennifer Church presents a new account of perception, which shows how imagining alternative perspectives and possibilities plays a key role in creating and validating experiences of self-evident objectivity. She explores the nature of moral perception and aesthetic perception, and argues that perception can be both literal and substantive.

The essay defines two different modes of filmic violence: sublime and drastic pictures of violence. Based on the definitions of the sublime by Edmund Burke and Immanuel Kant, I argue that the sublime has the tendency to detach the viewer from possible affective end empathetic response to pictures of bodies in pain on the screen. By contrast, the drastic mode has potential to evoke empathetic reactions. Both modes are grounded in specific ways of showing violence: the sublime mode diminishes the (...) bodies on the screen, the drastic mode shows us the faces in close-up and tries to immerse the viewer in the violence.Both definitions are informed by phenomenological film theory, which positions the body of the viewer at the centre of film reception. Nevertheless, the somatic experience is not the only scope of film reception. Films not only show us a filmic world but also suggest a more or less specific way of seeing the world outside the cinema.To this effect, both ways of staging violence have ideological implications. The sublime violence allows the viewer to experience himself as strong and invulnerable, while drastic pictures of violence tend to victimize the viewer.These assumptions are tested on two exemplary instances: the helicopter scene in Francis Ford Coppolas war movie Apocalypse Now and the shower scene in Alfred Hitchcock’s Psycho. (shrink)

1. Frühe Schriften.--2. Janaer Schriften, 1801-1807.--3. Phänomenologie des Geistes.--4. Nürnberger und Heidelberger Schriften, 1808-1817.--5-6. Wissenschaft der Logik.--7. Grundlinien der Philosophie des Rechts.--8-10. Enzyklopädie der philosophischen Wissenschaften im Grundrisse (1830).--11. Berliner Schriften, 1818-1831.--12. Vorlesungen über die Philosophie der Geschichte.--13-15. Vorlesungen über die Ästhetik.--16-17. Vorlesungen über die Philosophie der Religion.--18-20. Vorlesungen über die Geschichte der Philosophie.

This volume argues that educational problems have their basis in an ideology of binary opposites often referred to as dualism, and that it is partly because mainstream schooling incorporates dualism that it is unable to facilitate the thinking skills, dispositions and understandings necessary for autonomy, democratic citizenship and leading a meaningful life. Bleazby proposes an approach to schooling termed social reconstruction learning, in which students engage in philosophical inquiries with members of their community in order to reconstruct real social problems, (...) arguing that this pedagogy can better facilitate independent thinking, imaginativeness, emotional intelligence, autonomy, and active citizenship. (shrink)

The phenomenon of pain presents problems and puzzles for philosophers who want to understand its nature. Though pain might seem simple, there has been disagreement since Aristotle about whether pain is an emotion, sensation, perception, or disturbed state of the body. Despite advances in psychology, neuroscience, and medicine, pain is still poorly understood and multiple theories of pain abound. The Routledge Handbook of Philosophy of Pain is an outstanding reference source to the key topics, problems and debates in this exciting (...) and interdisciplinary subject and is the first collection of its kind. Comprising over thirty chapters by a team of international contributors the Handbook is divided into nine clear parts: Modelling pain in philosophy Modelling pain in neuroscience Modelling pain in psychology Pain in philosophy of mind Pain in epistemology Pain in philosophy of religion Pain in ethics Pain in medicine Pain in law. As well as fundamental topics in the philosophy of pain such as the nature, role, and value of pain, many other important topics are covered including the neurological pathways involved in pain processing, biopsychosocial and cognitive behavioural models of pain; chronic pain; pain and non-human animals; pain and knowledge; controlled substances for pain; pain and placebo effects; and pain and physician assisted suicide. The Routledge Handbook of Philosophy of Pain is essential reading for students and researchers in philosophy of mind, philosophy of psychology and ethics. It will also be very useful to researchers of pain from any field, especially those in psychology, medicine, and health studies. (shrink)

Most theories of affective influences on judgement and choice take a valence-based approach, contrasting the effects of positive versus negative feeling states. These approaches have not specified if and when distinct emotions of the same valence have different effects on judgement. In this article, we propose a model of emotion-specific influences on judgement and choice. We posit that each emotion is defined by a tendency to perceive new events and objects in ways that are consistent with the original cognitive-appraisal dimensions (...) of the emotion. To pit the valence and appraisal-tendency approaches against one another, we present a study that addresses whether two emotions of the same valence but differing appraisals—anger and fear—relate in different ways to risk perception. Consistent with the appraisal-tendency hypothesis, fearful people made pessimistic judgements of future events whereas angry people made optimistic judgements. In the Discussion we expand the proposed model and review evidence supporting two social moderators of appraisal-tendency processes. (shrink)

A dramatic shift in British and French ideas about empire unfolded in the sixty years straddling the turn of the nineteenth century. As Jennifer Pitts shows in A Turn to Empire, Adam Smith, Edmund Burke, and Jeremy Bentham were among many at the start of this period to criticize European empires as unjust as well as politically and economically disastrous for the conquering nations. By the mid-nineteenth century, however, the most prominent British and French liberal thinkers, including John Stuart (...) Mill and Alexis de Tocqueville, vigorously supported the conquest of non-European peoples. Pitts explains that this reflected a rise in civilizational self-confidence, as theories of human progress became more triumphalist, less nuanced, and less tolerant of cultural difference. At the same time, imperial expansion abroad came to be seen as a political project that might assist the emergence of stable liberal democracies within Europe. Pitts shows that liberal thinkers usually celebrated for respecting not only human equality and liberty but also pluralism supported an inegalitarian and decidedly nonhumanitarian international politics. Yet such moments represent not a necessary feature of liberal thought but a striking departure from views shared by precisely those late-eighteenth-century thinkers whom Mill and Tocqueville saw as their forebears. Fluently written, A Turn to Empire offers a novel assessment of modern political thought and international justice, and an illuminating perspective on continuing debates over empire, intervention, and liberal political commitments. (shrink)

A comprehensive account of the role of the imagination in Hegel's philosophy.

Philosophers of language have long recognized that in opaque contexts, such as those involving propositional attitude reports, substitution of co-referring names may not preserve truth value. For example, the name ‘Clark Kent’ cannot be substituted for ‘Superman’ in a context like:1. Lois believes that Superman can flywithout a change in truth value. In an earlier paper, Jennifer Saul demonstrated that substitution failure could also occur in ‘simple sentences’ where none of the ordinary opacity-producing conditions existed, such as:2. Superman leaps (...) more tall buildings than Clark Kent does.Accounts focusing on opacity were unable to explain our ‘anti-substitution intuitions’ in such cases.In Simple Sentences, Substitution, and Intuitions, Saul extends her earlier work. She provides a comprehensive presentation and criticism of recent accounts of simple sentence substitution failure, and proposes a new approach drawing on psychological evidence about cognitive processing. Saul's purpose is not merely to solve the substitution puzzle cases, but to make …. (shrink)

Delusions play a fundamental role in the history of psychology, philosophy and culture, dividing not only the mad from the sane but reason from unreason. Yet the very nature and extent of delusions are poorly understood. What are delusions? How do they differ from everyday errors or mistaken beliefs? Are they scientific categories? In this superb, panoramic investigation of delusion Jennifer Radden explores these questions and more, unravelling a fascinating story that ranges from Descartes’s demon to famous first-hand accounts (...) of delusion, such as Daniel Schreber’s Memoirs of My Nervous Illness. Radden places delusion in both a clinical and cultural context and explores a fascinating range of themes: delusions as both individually and collectively held, including the phenomenon of folies á deux ; spiritual and religious delusions, in particular what distinguishes normal religious belief from delusions with religious themes; how we assess those suffering from delusion from a moral standpoint; and how we are to interpret violent actions when they are the result of delusional thinking. As well as more common delusions, such as those of grandeur, she also discusses some of the most interesting and perplexing forms of clinical delusion, such as Cotard and Capgras. (shrink)

We applaud Gasper (2018) for reviewing five approaches to operationalizing neutral states. To supplement Gasper’s important contribution, we express the five neutral conditions at the appraisal level with the hope of clarifying their defining features and helping researchers to generate suitable neutral conditions.

This chapter provides a selective survey of prominent theories of the semantics of deontic modals in logic and natural language. We focus on Kratzer’s (1977; 1981; 1991) semantics and extensions to this analysis. Kratzer’s semantics has been far and away the most influential theory of deontic modals, which provide a base case for the interpretation of normative language in general. Understanding the logic and truth-conditions of normative language is one of the core areas of metaethics. It informs our understanding of (...) normative arguments and normative reasoning. As this chapter will emphasize, some forms of normative language don’t allow for the inferences that classical logic trains philosophers to expect. Understanding what inferences are valid for normative language should impact our under-standing of how we reason, and should reason, about the normative. We will first look at how deontic modals are understood in the context of modal logic and natural language. Then we’ll survey some recent debates and discoveries in the literature on deontic modals in natural language. We close with some considerations about the relevance of natural language to metaethics. (shrink)

Saul_Jennifer, Scepticism and Implicit Bias.

College cheating is prevalent, with rates ranging widely from 9 to 95% (Whitley, 1998). Research has been exclusively conducted with enrolled college students. This study examined the prevalence of cheating in a sample of college alumni, who risk less in disclosing academic dishonesty than current students. A total of 273 alumni reported on their prevalence and perceived severity of 19 cheating behaviors. The vast majority of participants (81.7%) report having engaged in some form of cheating during their undergraduate career. The (...) most common forms of cheating were “copying from another student's assignment” and “allowing others to copy from your assignment.” More students reported cheating in classes for their major than other classes. Males and females cheated at the same rates in classes for their major, and males reported higher rates of cheating than females in nonmajor classes. Respondents reported that their top reasons for cheating were “lack of time” and “to help a friend.”. (shrink)

College cheating is prevalent, with rates ranging widely from 9 to 95%. Research has been exclusively conducted with enrolled college students. This study examined the prevalence of cheating in a sample of college alumni, who risk less in disclosing academic dishonesty than current students. A total of 273 alumni reported on their prevalence and perceived severity of 19 cheating behaviors. The vast majority of participants report having engaged in some form of cheating during their undergraduate career. The most common forms (...) of cheating were “copying from another student's assignment” and “allowing others to copy from your assignment.” More students reported cheating in classes for their major than other classes. Males and females cheated at the same rates in classes for their major, and males reported higher rates of cheating than females in nonmajor classes. Respondents reported that their top reasons for cheating were “lack of time” and “to help a friend.”. (shrink)

A fundamental entity is an entity that is ‘ontologically independent’; it does not depend on anything else for its existence or essence. It seems to follow that a fundamental entity is ‘modally free’ in some sense. This assumption, that fundamentality entails modal freedom (or ‘FEMF’ as I shall label the thesis), is used in the service of other arguments in metaphysics. But as I will argue, the road from fundamentality to modal freedom is not so straightforward. The defender of FEMF (...) should provide positive reasons for believing it, especially in light of recent views that are incompatible with it. I examine both direct and indirect routes to FEMF. (shrink)

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

It is well established that language production and comprehension are influenced by information status, for example, whether information is given, new, topical, or predictable, and many scholars suggest that an important component of information status is keeping track of what information is in common ground, and what is not. Information status affects both speakers' choices and how listeners interpret the speaker's meaning. Although there is a wealth of scholarly work on information status, there is no consensus on the mechanisms by (...) which it is used, and in fact relatively little discussion of the underlying representations and psycholinguistic mechanisms. Moreover, a major challenge to understanding information status is that its effects are notoriously variable. This study considers existing proposals about information status, focusing on two questions: how is it represented; and by what mechanisms is it used? I propose that it is important to consider whether representations and mechanisms can be classified as either explicit or emergent. Based on a review of existing evidence, I argue that information status representations are most likely emergent, but the mechanisms by which they are used are both explicit and emergent. This review provides one of the first considerations of information status processing across multiple domains. (shrink)

_A comprehensive account of the role of the imagination in Hegel's philosophy._.

Recent, well-publicized scandals, involving unethical conduct have rekindled interest in academic misconduct. Prior studies of academic misconduct have focussed exclusively on situational factors (e.g., integrity culture, honor codes), demographic variables or personality constructs. We contend that it is important to also examine how␣these classes of variables interact to influence perceptions of and intentions relating to academic misconduct. In a sample of 217 business students, we examined how integrity culture interacts with Prudence and Adjustment to explain variance in estimated frequency of (...) cheating, suspicions of cheating, considering cheating and reporting cheating. Age, integrity culture, and personality variables were significantly related to different criteria. Overall, personality variables explained the most unique variance in academic misconduct, and Adjustment interacted with integrity culture, such that integrity culture had more influence on intentions to cheat for less well-adjusted individuals. Implications for practice are discussed and future research directions are offered. (shrink)

It is commonly thought that moral rules and principles, such as ‘Keep your promises,’ ‘Respect autonomy,’ and ‘Distribute goods according to need ,’ should play an essential role in our moral deliberation. Particularists have challenged this view by arguing that principled guidance leads us to engage in worse decision making because principled guidance is too rigid and it leads individuals to neglect or distort relevant details. However, when we examine empirical literature on the use of rules and principles in other (...) domains, we find that people can learn to use rules discriminately and that rule-based models tend to outperform even expert judgment. I argue that this evidence poses a problem for the moral particularist. If the particularist claims that we should not rely on decision-making rules when making practical decisions and it turns out that these rules help us make better decisions, then the particularists’ prescriptive account is deficient. However, if the particularist claims that we should rely on practical decision-making rules but not on moral rules, she needs to explain how practical rules are different from moral rules and why we should rely on the former but not the latter. (shrink)

Aims and objectives. Participant narratives from a feminist and queer phe- nomenological study aim to broaden current understandings of trauma. Examin- ing structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. Background. Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have (...) an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Design. Analysis of the qualitative data was guided by feminist and queer phe- nomenology. This was well suited to understanding queer women’s storied narra- tives of trauma, including disempowering processes of structural marginalisation. Methods. Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. Results. Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that recon- structs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Conclusions. Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. Relevance to clinical practice. New trauma-informed assessment strategies recon- struct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re- experiencing the process of coming out as queer in opposition to the expectation of heterosexuality. (shrink)

We used a retrospective survey to model the patterns of appraisal, motivation, and coping that uniquely correspond with 12 positive emotions (affection/love, amusement, awe, challenge/det...

Dispositionality is a modal notion of a certain sort. When an object is said to have a disposition, we typically understand this to mean that under certain circumstances, the object would behave in a certain way. For instance, a fragile object is disposed to break when dropped onto a concrete surface. It need not actually break - its being fragile has implications that, so to speak, point beyond the actual world. According to dispositionalism, all modal features of the world may (...) be accounted for in terms of its dispositional features. My aim in this paper is to assess the prospects for dispositionalism by examining the most promising theories. Sections 1 and 2 clarify the assumptions and desiderata of a successful dispositionalist theory of modality. Section 3 introduces the principles governing the dispositionalist theories that apparently meet the desiderata. Sections 4 through 6 show that dispositionalism nonetheless faces three problems: while dispositions help account for modal features of the world that are local, diachronic, or gradable, they cannot account for certain modal features of the world that are global, synchronic, or absolute. I end by discussing the costs of preserving dispositionalism. (shrink)

Neoliberal cultural frames of individual choice inform mothers’ accounts of why they refuse state-mandated vaccines for their children. Using interviews with 25 mothers who reject recommended vaccines, this article examines the gendered discourse of vaccine refusal. First, I show how mothers, seeing themselves as experts on their children, weigh perceived risks of infection against those of vaccines and dismiss claims that vaccines are necessary. Second, I explicate how mothers see their own intensive mothering practices—particularly around feeding, nutrition, and natural living—as (...) an alternate and superior means of supporting their children’s immunity. Third, I show how they attempt to control risk through management of social exposure, as they envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable. Finally, I examine how these mothers focus solely on their own children by evaluating—and often rejecting—assertions that their choices undermine community health, while ignoring how their children benefit from the immunity of others. By analyzing the gendered discourse of vaccines, this article identifies how women’s insistence on individual maternal choice as evidence of commitment to their children draws on and replicates structural inequality in ways that remain invisible, but affect others. (shrink)

BackgroundHuman embryonic stem cells are currently used for developing treatment against Parkinson’s disease (PD). However, the use of ES cells is surrounded with moral concerns. Research regarding the public's attitudes can form an important basis for policymaking. The aim was to explore the perceptions of the public on using donated human embryos for developing treatment of Parkinson’s Disease.MethodsSemi-structured individual qualitative interviews were conducted with 11 members of the general population in Sweden. Interviews were analyzed with thematic content analyses.ResultsFour categories and (...) additional sub-categories; Different views on the embryo requires delicacy, Using embryos to treat Parkinson’s disease, Doing things in the right way, and Communication, media, and public opinion. In general, respondents were positive towards the usage of embryotic stem cells to treat PD, but the usage were conditioned and specific terms were demanded. Informed consent from both donors were required and delicacy and sensitivity when working with embryos were needed.ConclusionsIt was perceived better to use surplus embryos to treat PD increase is than to discard them, also among those who perceived the embryo as “a potential life.” The participants raised several conditions under usage for treatment should be allowed. Even if the embryos otherwise are going to be discarded, usage requires informed consent from the donating couples. (shrink)

In this introduction to the edited volume, we briefly describe some of the current challenges faced by public mental health initiatives, at both the national and global level. We also include several general remarks on interdisciplinary methodology in public mental health ethics, followed by short descriptions of the chapters included in the volume.

Five-year-old children categorized as skilled versus unskilled counters were given verbal estimation and number word comprehension tasks with numerosities 20 – 120. Skilled counters showed a linear relation between number words and nonsymbolic numerosities. Unskilled counters showed the same linear relation for smaller numbers to which they could count, but not for larger number words. Further tasks indicated that unskilled counters failed even to correctly order large number words differing by a 2 : 1 ratio, whereas they performed well on (...) this task with smaller numbers, and performed well on a nonsymbolic ordering task with the same numerosities. These findings provide evidence that large, approximate numerosity representations become linked to number words around the time that children learn to count to those words reliably. (shrink)