BackgroundAlthough the number of reporting guidelines has grown rapidly, few have gone through an updating process. The STARD statement (Standards for Reporting Diagnostic Accuracy), published in 2003 to help improve the transparency and completeness of reporting of diagnostic accuracy studies, was recently updated in a systematic way. Here, we describe the steps taken and a justification for the changes made.ResultsA 4-member Project Team coordinated the updating process; a 14-member Steering Committee was regularly solicited by the Project Team when making critical (...) decisions. First, a review of the literature was performed to identify topics and items potentially relevant to the STARD updating process. After this, the 85 members of the STARD Group were invited to participate in two online surveys to identify items that needed to be modified, removed from, or added to the STARD checklist. Based on the results of the literature review process, 33 items were presented to the STARD Group in the online survey: 25 original items and 8 new items; 73 STARD Group members (86 %) completed the first survey, and 79 STARD Group members (93 %) completed the second survey.Then, an in-person consensus meeting was organized among the members of the Project Team and Steering Committee to develop a consensual draft version of STARD 2015. This version was piloted in three rounds among a total of 32 expert and non-expert users. Piloting mostly led to rewording of items. After this, the update was finalized. The updated STARD 2015 list now consists of 30 items. Compared to the previous version of STARD, three original items were each converted into two new items, four original items were incorporated into other items, and seven new items were added.ConclusionsAfter a systematic updating process, STARD 2015 provides an updated list of 30 essential items for reporting diagnostic accuracy studies. (shrink)

Legislation for dementia care needs to be continually rethought, if the rights of older persons and other persons with dementia are to be addressed properly. We propose a theoretical framework for understanding vulnerability and dependency, which enables us to problematize the currently prevailing legal conception of adults as always able — irrespective of health or age — to act autonomously in their everyday lives. Such an approach gives rise to difficult dilemmas when persons with dementia are forced to make decisions (...) on their own about basic living conditions, such as housing and care, without decision-making support. In Sweden, for example, such matters are frequently left to the person him- or herself to decide, often without any assistance from social workers, and with family members serving as caregivers of last resort.Using vulnerability theory as the framework for our discussion, we argue that policymakers should not apply a group-oriented approach (based on factors like age, legal status, or mental capacity) to persons suffering from dementia. The needs of such individuals are as complex and varied as they themselves are. We discuss our findings from an interdisciplinary (law/social work) research project in which we examine the dilemma that social workers face when they are required, under the terms of the Swedish Social Services Act, to determine whether persons with dementia are to be granted support.We argue further that a cross-disciplinary approach — in which vulnerability theory furnishes the framework — opens up for new ways of understanding and developing social welfare law and practice. This, we believe, can help us better address the rights, interests, and needs of people with dementia, of their families, and of professionals in the social welfare system. Finally, many of the problems faced by ageing societies in general can be understood on the basis of such an approach. (shrink)

Virtue ethics has emerged as a distinct field within moral theory - whether as an alternative account of right action or as a conception of normativity which departs entirely from the obligatoriness of morality - and has proved itself invaluable to many aspects of contemporary applied ethics. Virtue ethics now flourishes in philosophy, sociology and theology and its applications extend to law, politics and bioethics. 'The handbook of virtue ethics' brings together leading international scholars to provide an overview of the (...) field. Each chapter summarizes and assesses the most important work on a particular topic and sets this work in the context of historical developments. Taking a global approach by embracing a variety of major cultural traditions along with the Western, the handbook maps the emergence of virtue ethics and provides a framework for future developments. (shrink)

This book presents the deterministic view of quantum mechanics developed by Nobel Laureate Gerard 't Hooft. Dissatisfied with the uncomfortable gaps in the way conventional quantum mechanics meshes with the classical world, 't Hooft has revived the old hidden variable ideas, but now in a much more systematic way than usual. In this, quantum mechanics is viewed as a tool rather than a theory. The book presents examples of models that are classical in essence, but can be analysed (...) by the use of quantum techniques, and argues that even the Standard Model, together with gravitational interactions, might be viewed as a quantum mechanical approach to analysing a system that could be classical at its core. He shows how this approach, even though it is based on hidden variables, can be plausibly reconciled with Bell's theorem, and how the usual objections voiced against the idea of 'superdeterminism' can be overcome, at least in principle. This framework elegantly explains - and automatically cures - the problems of the wave function collapse and the measurement problem. Even the existence of an "arrow of time" can perhaps be explained in a more elegant way than usual. As well as reviewing the author's earlier work in the field, the book also contains many new observations and calculations. It provides stimulating reading for all physicists working on the foundations of quantum theory. (shrink)

It is frequently said that pain is incommunicable and even that it destroys language . This paper offers a phenomenological account of pain and then explores and critiques this view. It suggests not only that pain is communicable to an adequate degree for clinical purposes, but also that it is itself a form of communication through which the person in pain appeals to the empathy and ethical goodness of the clinician. To explain this latter idea and its ethical implications, reference (...) is made to the writings of Emmanuel Levinas. (shrink)

Superstring theory is an extension of conventional quantum field theory that allows for stringlike and branelike material objects besides pointlike particles. The basic foundations on which the theory is built are amazingly shaky, and, equally amazingly, it seems to be this lack of solid foundations to which the theory owes its strength. We emphasize that such a situation is legitimate only in the development phases of a new doctrine. Eventually, a more solidly founded structure must be sought.Although it is advertised (...) as a “candidate theory of quantum gravity”, we claim that string theory may not be exactly that. Rather, just like quantum field theory itself, it is a general mathematical framework for a class of theories. Its major flaw could be that it still embraces a Copenhagen view on the relation between quantum mechanics and reality, while any “theory of everything”, that is, a theory for the entire cosmos, should do better than that. (shrink)

This paper examines how Descartes’ philosophy was presented and discussed in articles and reviews published in Mind from 1900 to 1947, a period in which this most prestigious British philosophical journal was edited by George F. Stout (until 1920) and then by George E. Moore (from 1921 to 1947). The survey deals with various aspects of the reception of Cartesian philosophy in the journal: articles devoted to several topics of Cartesian thought, critical notices and reviews of the secondary literature, discussions (...) of twentieth-century English translations of Cartesian works. In line with the theoretical character of Mind, most of the interpreters discussed Cartesian philosophy with the aim either of checking its internal consistency or of proving how the Cartesian system might be rendered consistent with its own premises. In this respect, all the themes revolving around the problem of the Cartesian circle attracted the attention of commentators, and the intuitionist foundation of Cartesian theory was analyzed. Descartes’ metaphysics and natural philosophy were often evaluated from the perspective of contemporary philosophical debates, while their original historical context was neglected. Of particular relevance were issues like the mind-body problem, discussed at the beginning of the century in relation to developments in psychology, and the question of the existence of the external world, which was examined from various standpoints, metaphysically, epistemologically and from the point of view of linguistic analysis. Interest in Descartes was shown by many authors from major philosophers (such as Ward, Schiller, Taylor, Broad, Ryle) to lesser known scholars whose profiles and contributions are outlined. Through the angle of the Cartesian presence a sketch emerges of the rich and variegated philosophical scene of British culture in the first half of the twentieth century. (shrink)

Fast moving classical variables can generate quantum mechanical behavior. We demonstrate how this can happen in a model. The key point is that in classically evolving systems one can still define a conserved quantum energy. For the fast variables, the energy levels are far separated, such that one may assume these variables to stay in their ground state. This forces them to be entangled, so that, consequently, the slow variables are entangled as well. The fast variables could be the vacuum (...) fluctuations caused by unknown super heavy particles. The emerging quantum effects in the light particles are expressed by a Hamiltonian that can have almost any form. The entire system is ontological, and yet allows one to generate interference effects in computer models. This seemed to lead to an inexplicable paradox, which is now resolved: exactly what happens in our models if we run a quantum interference experiment in a classical computer is explained. The restriction that very fast variables stay predominantly in their ground state appears to be due to smearing of the physical states in the time direction, preventing their direct detection. Discussions are added of the emergence of quantum mechanics, and the ontology of an EPR/Bell Gedanken experiment. (shrink)

Methods developed in a previous paper are employed to define an exact correspondence between the states of a deterministic cellular automaton in 1+1 dimensions and those of a bosonic quantum field theory. The result may be used to argue that quantum field theories may be much closer related to deterministic automata than what is usually thought possible.

Conventional particle theories such as the Standard Model have a number of freely adjustable coupling constants and mass parameters, depending on the symmetry algebra of the local gauge group and the representations chosen for the spinor and scalar fields. There seems to be no physical principle to determine these parameters as long as they stay within certain domains dictated by the renormalization group. Here however, reasons are given to demand that, when gravity is coupled to the system, local conformal invariance (...) should be a spontaneously broken exact symmetry. The argument has to do with the requirement that black holes obey a complementarity principle relating ingoing observers to outside observers, or equivalently, initial states to final states. This condition fixes all parameters, including masses and the cosmological constant. We suspect that only examples can be found where these are all of order one in Planck units, but the values depend on the algebra chosen. This paper combines findings reported in two previous preprints (G. ’t Hooft in arXiv:1009.0669 [gr-qc], 2010; arXiv:1011.0061 [gr-qc], 2010) and puts these in a clearer perspective by shifting the emphasis towards the implications for particle models. (shrink)

It is the thesis of the authors that the caring ethic and moral state of being of nurses ideally suffuses their professional caring and is thus implicit in their ethical decision making. Socratic dialogue is a technique that allows such moral attitudes to be made explicit. This article describes a Socratic dialogue conducted with nurses on the topic: 'What is love in nursing?' The conclusions drawn were based on the belief that the current western-style health care system restricts the practice (...) of nursing in such a way as to limit professional caring and loving possibilities. Nurses who love in the practice of caring go beyond the role definition of the duty of care; they are people who are prepared to think differently about their practice as professionals, and are identified as competent risk takers committed to the betterment of the other. From this dialogue, 'love in nursing' was understood as the willingness and commitment of the nurse to want the good of the other before the self, without reciprocity. (shrink)

Most attempts at obtaining theories that unify quantum mechanics with general relativity require violation of locality and/or causality to some degree. Here, we suggest that these problems actually are very deep and fundamental; hence they may require reconsideration of both quantum mechanics and general relativity at a very fundamental level. An approach called ‘deterministic quantisation’ is sketched.

Standard canonical quantum mechanics makes much use of operators whose spectra cover the set of real numbers, such as the coordinates of space, or the values of the momenta. Discrete quantum mechanics uses only strictly discrete operators. We show how one can transform systems with pairs of integer-valued, commuting operators $P_i$ and $Q_i$ , to systems with real-valued canonical coordinates $q_i$ and their associated momentum operators $p_i$ . The discrete system could be entirely deterministic while the corresponding (p, q) system (...) could still be typically quantum mechanical. (shrink)

This is a review of Gillian Brock’s new book, Global justice: a cosmopolitan account (Oxford: Oxford University Press, 2009) which sets out the central theses of the book and then offers a critical appraisal of its central arguments. My specific concern is that Brock gives an insufficiently robust account of human rights with which to define the nature of global justice and thereby leaves cosmopolitanism too vulnerable to the normative pull of local and traditional moral conceptions that fall short of (...) the universalism that cosmopolitans should be able to embrace. Keywords: cosmopolitanism; human rights; global justice; Rawls; humanitarian intervention; global governance; liberal nationalism; democracy; equality; immigration (Published: 4 December 2009) Citation: Ethics & Global Politics, Vol. 2, No. 4, 2009, pp. 369–382. DOI: 10.3402/egp.v2i4.2107. (shrink)

In the last chapter of Ethics and the Limits of Philosophy , Bernard Williams brings to a conclusion a sustained attack on the pretensions of moral theory by arguing against the allegedly objective reality of moral obligation. It had been a theme of the book that, while there can be answers to the questions of how one should live and order one's social relationships—answers which, in a given culture, go to make up its ethics —there is no place for a (...) morality or a moral theory which would claim to give externally binding answers to such questions. We will be explaining the notion of an ‘externally binding answer’ later in this paper, but for the moment we can take such an answer to be one that applies to people irrespective of their beliefs or desires. Williams considers Kant to have been the main proponent of the notion of morality in this sense, with the latter's stress on obligation as central to the institution of morality. (shrink)

Hawking particles emitted by a black hole are usually found to have thermal spectra, if not exactly, then by a very good approximation. Here, we argue differently. It was discovered that spherical partial waves of in-going and out-going matter can be described by unitary evolution operators independently, which allows for studies of space-time properties that were not possible before. Unitarity dictates space-time, as seen by a distant observer, to be topologically non-trivial. Consequently, Hawking particles are only locally thermal, but globally (...) not: we explain why Hawking particles emerging from one hemisphere of a black hole must be 100 % entangled with the Hawking particles emerging from the other hemisphere. This produces exclusively pure quantum states evolving in a unitary manner, and removes the interior region for the outside observer, while it still completely agrees locally with the laws of general relativity. Unitarity is a starting point; no other assumptions are made. Region I and the diametrically opposite region II of the Penrose diagram represent antipodal points in a PT or CPT relation, as was suggested before. On the horizon itself, antipodal points are identified. A candidate instanton is proposed to describe the formation and evaporation of virtual black holes of the type described here. (shrink)

In Berkeley’s writings the topic of light is discussed in two different ways, within a theory of perception and within a metaphysics of nature of a Platonic stamp. In his first work, the original Essay for a New Theory of Vision, light and colours are regarded as condition and object of vision; they are examined as contents of visual perception distinct from tangible perception. Light will be dealt with in a completely different manner in Berkeley’s last work, Siris, in which (...) a spiritualistic reading of the natural world is superimposed on modern science in general and on Newtonian physics in particular. In Siris, light is the instrument by which the causal activity of divine Intellect orders and permeates the natural world. A detailed analysis of the topic of light in the two aforementioned contexts shows inconsistencies and strained interpretations which derive from the apologetic use of the theory of vision in Berkeley’s early immaterialism and from the multi-layered and confused speculations of his late Siris. On the whole, Berkeley conceives light within the idealistic frame inherited from Platonic metaphysics of light; however, the specific themes examined in the Essay for a New Theory of Vision and in Siris derive from acquisitions of modern science, and are recast within a spiritualistic interpretation which intended both to neutralize scientific ideas through their phenomenistic reading and to exploit them for apologetic ends. (shrink)

This paper is a theoretical and empirical investigation into whether persons in subordinate social contexts possess agency and if they do, how do we recognise and recover their agency given the oppressive conditions of their lives. It aims to achieve this through forging closer links between the philosophical arguments and the ethnographic evidence of women's agency. Through such an exercise, this paper hopes to bridge the existing gap between feminist theoretical interventions and feminist politics as well as to increase ‘sociological (...) awareness’ within feminist philosophical arguments. In order to think about women's agency in oppressive social contexts, the paper evaluates the suitability of existing theoretical frameworks for examining, describing and capturing the autonomy of persons and concludes that a new and a more complex thinking is required to facilitate thinking about human agency within oppressive transcultural contexts. The social context of subordination, the exhibition of agency within and oppressive context and the application of the new theoretical framework is illustrated in an extensive empirical study of the contact with modernity and its accompanying ideas of autonomy and individual rights of rural women belonging to two districts in Rajasthan, North western India. (shrink)

Book Information Integrity and the Fragile Self. By Damian Cox, Marguerite La Caze and Michael P. Levine. Ashgate. Aldershot. 2003. Pp. 168. Hardback, £45.00. Paperback, £17.99.

Matter interacting classically with gravity in 3+1 dimensions usually gives rise to a continuum of degrees of freedom, so that, in any attempt to quantize the theory, ultraviolet divergences are nearly inevitable. Here, we investigate matter of a form that only displays a finite number of degrees of freedom in compact sections of space-time. In finite domains, one has only exact, analytic solutions. This is achieved by limiting ourselves to straight pieces of string, surrounded by locally flat sections of space-time. (...) Globally, however, the model is not finite, because solutions tend to generate infinite fractals. The model is not (yet) quantized, but could serve as an interesting setting for analytical approaches to classical general relativity, as well as a possible stepping stone for quantum models. Details of its properties are explained, but some problems remain unsolved, such as a complete description of the most violent interactions, which can become quite complex. (shrink)

In light of the structural role of computational technology in the expansion of modern global finance, this essay investigates the ontology of contemporary markets starting from a reformulation of liquidity—one of the tenets of financial trading. Focusing on the nexus between financial and algorithmic flows, the paper complements contemporary philosophies of the market with insights into recent theories of computation, emphasizing the functional role of contingency, both for market trading and algorithmic processes. Considering the increasing adoption of advanced computational methods (...) in automated trading strategies, this article argues that the event of price is the direct manifestation of the incomputability at the heart of market exchange. In doing so, it questions the ontological assumptions of “flow” and “fluidity” underpinning traditional conceptions of liquidity and challenges the notion of rationality in market behavior. Ultimately, the paper gestures toward some of the social and political consequences of this reformulation. (shrink)

After presenting a broad overview of the history of virtue ethics, this work explores virtues in the context of contemporary moral theory to analyse how many intractable moral dilemmas might be overcome by responsible, virtuous agents.

In the standard formalism of quantum gravity, black holes appear to form statistical distributions of quantum states. Now, however, we can present a theory that yields pure quantum states. It shows how particles entering a black hole can generate firewalls, which however can be removed, replacing them by the ‘footprints’ they produce in the out-going particles. This procedure can preserve the quantum information stored inside and around the black hole. We then focus on a subtle but unavoidable modification of the (...) topology of the Schwarzschild metric: antipodal identification of points on the horizon. If it is true that vacuum fluctuations include virtual black holes, then the structure of space-time is radically different from what is usually thought. (shrink)

A promising strategy for better understanding space and time at the Planck scale, is outlined and further pursued. It is explained in detail, how black hole unitarity demands the existence of transformations that can remove firewalls. This must then be combined with a continuity condition on the horizon, with antipodal identification as an inevitable consequence. The antipodal identification comes with a \ inversion. We claim to have arrived at ‘new physics’, but rather than string theory, our ‘new physics’ concerns new (...) constraints on the topology and the boundary conditions of general coordinate transformations. The resulting theory is conceptually quite non trivial, and more analysis is needed. A strong entanglement between Hawking particles at opposite sides of the black hole is suspected, but questions remain. A few misconceptions concerning black holes, originating from older investigations, are discussed. (shrink)

The argument of this article is framed by a debate between the principle of humanity and the principle of justice. Whereas the principle of humanity requires us to care about others and to want to help them meet their vital needs, and so to be partial towards those others, the principle of justice requires us to consider their needs without the intrusion of our subjective interests or emotions so that we can act with impartiality. I argue that a deep form (...) of caring lies behind both approaches and so unites them. In the course of the argument, I reject Michael Slote’s sentimentalist form of an ethics of care, and expound Thomas Nagel’s moral theory, which seems to lie at the opposite end of a spectrum ranging from moral sentiments to impersonal objectivity. Nevertheless, Nagel’s theory of normative realism provides unexpected support for the thesis that a deep and subjective form of caring lies at the base of even our most objective moral reasons. (shrink)

Taking as its starting point a recent statement of the Goals of Medicine published by the Hastings Centre, this paper argues against the dualistic distinction between pain and suffering. It uses an Aristotelian conception of the person to suggest that malady, pain, and disablement are objective forms of suffering not dependent upon any state of consciousness of the victim. As a result, medicine effectively relieves suffering when it cures malady and relieves pain. There is no medical mission to confront the (...) spiritual condition of the patient. (shrink)