While taking Charles Chihara's metaphysics course as a graduate student at U.C. Berkeley, I wrote an advice columnist to ask about the puzzle at the center of the course. Marilyn Vos Savant writes a weekly column for Parade Magazine , which is included in the Sunday editions of many newspapers. She claims to be listed in the Guinness Book of World Records for "highest IQ".
In reference to the different approaches in philosophy(of medicine) of the nature of (medical) technology,this article introduces the topic of this specialissue of Theoretical Medicine and Bioethics, that is,the way the different forms of medical technologyfunction in everyday medical practice. The authorselaborate on the active role technology plays inshaping our views on disease, illness, and the body,whence in shaping our world.
Background and aim With the increasing interest in lifestyle, health and consequences of unhealthy lifestyles for the healthcare system, a new kind of solidarity is gaining importance: lifestyle solidarity. While it might not seem fair to let other people pay for the costs arising from an unhealthy lifestyle, it does not seem fair either to punish people for their lifestyle. However, it is not clear how solidarity is assessed by people, when considering disease risks or lifestyle risks. The aim of (...) this study was to investigate the degree of solidarity with lifestyle as well as with other factors that are related to health outcomes—for example, old age—and the relation between this degree of solidarity and various characteristics. Methods This cross-sectional study is part of the Dutch longitudinal SMILE study. Data on the degree of solidarity with different lifestyles and old age, and the relation between the degree of solidarity and various demographic and other variables were obtained in a questionnaire survey. Results Solidarity with smokers and overweight people was moderate, as was solidarity with older people. Respondents were ambivalent about athletes. Respondents who were younger, male and highly educated, and those with a healthy lifestyle, a small social network, high quality of life and an internal locus of control, showed low solidarity. Conclusions Solidarity with an unhealthy lifestyle and old age is moderate and the degree of solidarity varies among the different subgroups. (shrink)
Do undergraduate students perceive that it is more acceptable to ‹cheat’ using information technology (IT) than it is to cheat without the use of IT? Do business discipline-related majors cheat more than non-business discipline-related majors? Do undergraduate students perceive it to be more acceptable for them personally to cheat than for others to cheat? Questionnaires were administered to undergraduate students at five geographical academic locations in the spring, 2006 and fall 2006 and spring, 2007. A total of 708 usable questionnaires (...) were returned including 532 from students majoring in business-related disciplines and 139 from students majoring in non-business related disciplines (37 were undecided). It appears that in terms of intellectual property violations, undergraduate students in general find cheating using IT more acceptable than cheating without the use of IT. It also appears that undergraduate students perceive that it is relatively more acceptable for them to personally cheat when using IT than for others to cheat when using IT, although this is reversed when IT is not involved. No significant differences on these issues were found between undergraduate students having business discipline-related majors and those having non-business discipline-related majors. (shrink)
Background: Spirometry for early detection of chronic obstructive pulmonary disease (COPD) and smoking cessation is criticised because of the potential negative effects of labelling with disease. Aim: To assess the effects of opinions of smokers with mild to moderate COPD on the effectiveness of spirometry for smoking cessation, the justification of early detection of airflow limitation in smokers and the impact of confrontation with COPD. Design: Qualitative study with data from a randomised controlled trial. Setting: General population of Dutch and (...) Belgian Limburg. Methods: Semistructured ethical exit interviews were conducted with 205 smokers who were motivated to quit smoking and had no prior diagnosis of COPD but were detected with airflows limitation by means of spirometry. They received either (1) counselling, including labelling with COPD, plus with nortriptyline for smoking cessation, (2) counselling excluding labelling with COPD, plus nortriptyline for smoking cessation or (3) care as usual for smoking cessation by the general practitioner, without labelling with COPD. Results: Of the participants, 177 (86%) agreed or completely agreed that it is justified to measure lung function in heavy smokers. These participants argued that measuring lung function raises consciousness of the negative effects of smoking, helps to prevent disease or increases motivation to stop smoking. Most of the 18 participants who disagreed argued that routinely measuring lung function in smokers would interfere with freedom of choice. Conclusions: Labelling with disease is probably a less important issue in the discussion about the pros and cons of early detection of COPD. (shrink)
It is important and urgent to question therelationship between evidence-based medicineand power shifts in health care systems.Although definitions of EBM are phrased as ascientific approach to medicine, EBM is anormative concept: it aims to improve medicineand health care. Both proponents and opponentsuse a normative concept. More particularly,they provide particular views on positions,responsibilities, possibilities, norms andrelationships between professionals, patientgroups, governments and other parties in healthcare and society. From this perspective, wewant to analyse the role of EBM in modernwestern societies. By using (...) citizenshiptheory, we will argue that the role of EBM isnot fixed but depends on the relation betweenstate and society. We will first analyse thefundamental change in western societies duringthe past decades, from modern to post-modernsocieties. Then, we will elaborate a fourfoldmodel of possible relationships between stateand society, and discuss the issue of how EBM mayfit in, by giving some examples of the practiceof EBM in different European countries. On thisbasis, we conclude to consider EBM as a publicforum where proponents and opponents of EBMdiscuss diverse and possibly conflicting waysof changing medicine, health care, and healthpolicy. This requires the incorporation of theperspective of citizens and their socialnetworks, professionals with practical andtacit knowledge, and diverse public views onwhat is regarded as `a good life'. Inasmuch asEBM is expected to be practically relevant, itought to be tied to rather than separated fromthe normative world of emancipated patients anddiverse health care practices. Proponents andopponents of EBM should be prepared to defendthe normative claims and power effects that areinherently tied to any presentation ofevidence. (shrink)
Design research programs attempt to bring together the properties of available materials and the demands derived from intended applications. The logic of problem states and state transitions in such programs, including assessment criteria and heuristic principles, is described in settheoretic terms, starting with a naive model comprising an intended profile and the operational profile of a prototype. In a first concretization the useful distinction between structural and functional properties is built into the model. In two further concretizations the inclusion of (...) potential applications is motivated and described for the case of drug research as well as the inclusion of potential realizations for the case of complex products. Next, another line of concretization of the naive model, the incorporation of potentially relevant properties, is sketched. Then the partial analogy between product- and truth-approximation is indicated. We conclude with some remarks about the usefulness of our models for products reaching the market in comparison to the the so-called social construction of technology approach. (shrink)
The question of whether old age should or should not play a role in medical decision-making for the elderly patient is regularly debated in ethics and medicine. In this paper we investigate exactly how age influences the decision-making process. To explore the normative argumentation in the decisions regarding an elderly patient we make use of the argumentation model advanced by Toulmin. By expanding the model in order to identify normative components in the argumentation process it is possible to analyse the (...) way that age-related value judgements influence the medical decision-making process. We apply the model to practice descriptions made by medical students after they had attended consultations and meetings in medical practice during their clinical training. Our results show the pervasive character of age-related value judgements. They influence the physician’s decision in several ways and at several points in the decision-making process. Such explicit value judgements were not exclusively used for arguments against further diagnosis or treatment of older patients. We found no systematic “ageist” pattern in the clinical decisions by physicians. Since age plays such an important, yet hidden role in the medical decision-making process, we make a plea for revealing such normative argumentation in order to gain transparency and accountability in this process. An explicit deliberative approach will make the medical decision-making process more transparent and improve the physician–patient relationship, creating confidence and trust, which are at the heart of medical practice. (shrink)
Next SectionEvidence based medicine is rightly at the core of current medicine. If patients and society put trust in medical professional competency, and on the basis of that competency delegate all kinds of responsibilities to the medical profession, medical professionals had better make sure their competency is state of the art medical science. What goes for the ethics of clinical trials goes for the ethics of medicine as a whole: anything that is scientifically doubtful is, other things being equal, ethically (...) unacceptable. This particularly applies to so called orphaned fields of medicine, those areas where medical research is weak and diverse, where financial incentives are lacking, and where the evidence regarding the aetiology and treatment of disease is much less clear than in laboratory and hospital based medicine. Examples of such orphaned fields are physiotherapy, psychotherapy, medical psychology, and occupational health, which investigate complex syndromes such as RSI, whiplash, chronic low back pain, and chronic fatigue syndrome. It appears that the primary ethical problem in this context is the lack of attention to the orphaned fields. Although we agree that this issue deserves more attention as a matter of potential injustice, we want to argue that, in order to do justice to the interplay of heterogeneous factors that is so typical of the orphaned fields, other ethical models than justice are required. We propose the coordination model as a window through which to view the important ethical issues which relate to the communication and interaction of scientists, health care workers, and patients. (shrink)
A. Vos (1993). Buridan on Contingency and Free Will. In Egbert P. Bos & H. A. Krop (eds.), John Buridan, a Master of Arts: Some Aspects of His Philosophy: Acts of the Second Symposium Organized by the Dutch Society for Medieval Philosophy Medium Aevum on the Occasion of its 15th Anniversary, Leiden-Amsterdam (Vrije Universiteit), 20-21 June, 19. Ingenium Publishers.score: 30.0
The proposed federal regulation oforganic agriculture in the United States raisesquestions both about the nature and character oforganic farming, as well as its relation to theagro-food system at large. The regulatory process hasengendered a public debate about conventional andalternative approaches to agricultural production,which in turn raises issues of environmental politicsand society-nature relations. An analysis oftranscripts from public hearings, organic farmingmovement literature, and interviews with organicpractitioners and advocates reveals the broaderecological, social, and political ramifications. Inexamining the proposed federal rule and its (...) criticalopposition, we encounter two different worldviews; twoconflicting visions of agriculture, rural life, andnature itself. Whether this is a fundamental impasse,or a controversy that can be fruitfully resolved,remains an open question. But organic farming hasarrived at a critical juncture, both fraught withperil, and full of opportunity. The enormous publicresponse to this issue indicates the renewed potentialon the part of civil society to participate ingrassroots environmental social movements in supportof alternative agriculture. (shrink)
This essay serves as both a response and embellishment of Marilyn Frye's now classic essay "Oppression." It is meant to pick up where this essay left off and to make connections between oppression, as Frye defines it, and the privileges that result from institutional structures. This essay tries to clarify one meaning of privilege that is lost in philosophical discussions of injustice. I develop a distinction between unearned privileges and earned advantages. Clarifying the meaning of privilege as unearned structural (...) advantage makes visible the role white privilege plays in maintaining complex systems of domination such as racism, sexism, heterosexism and classism. Using a critical reading of both Frye (1983) and Young's (1990) accounts of oppression as a springboard, I develop a definition of privilege as a particular class of unearned advantages. -/- I distinguish my account of privilege from standard legal and philosophical definitions of privilege. The general distinction I make between privileges and advantages rests on three interrelated claims: (a) that benefits granted by privilege are always unearned and conferred systemically to members of dominant social groups; (b) that privileges granted to members of dominant groups solely on the basis of their membership in these groups is never justifiable; and, (c) that privileges have an unconditional value that can be explained not only in terms of immunities, but also in terms of additional benefits. (shrink)
Summary In the second half of the eighteenth century, the Prussian State supported savants who combined learned inquiry into nature with technical work. Members of the physical and mathematical classes of the Royal Prussian Academy of Sciences were involved in State projects such as surveying for the construction of canals, chemical analysis of Silesian iron, production of porcelain and of beet sugar. Some of these men were truly ?hybrid? experts living both in the worlds of State-directed manufacture and academic natural (...) inquiry. Among these savant experts there was a particular sub-group that is at the centre of this paper: mining officials who were also recognized as mineralogists, geologists and chemists. The paper describes and analyses the training and the varied technical and scientific activities of these ?savant officials?. At the centre of attention are the travels of inspection of the mineralogist and mining official Carl Abraham Gerhard (1738?1821) in the late 1760s. I argue that Gerhard's travels of inspection were at the same time geological travels and that savant officials like Gerhard made a significant contribution to the fledgling science of geology. (shrink)
Excerpt: Ernst von Glasersfeld has succeeded in finding a viable fit between the man and the scientist and in embodying a Haltung (attitude) that represents constructivism. He was prepared to get involved with a "different way of thinking" and to deal with a matter that is often "demanding and uncomfortable" for those affected. Ernst von Glasersfeld, in an interview with me on questions of constructivism and school.
Extreme conditions like savantism, autism or synaesthesia, which have a neurological 2AH, UK basis, challenge the idea that other minds are similar to our own. In this paper we report a single case study of a man in whom all three of these conditions co-occur. We suggest, on the basis of this single case, that when savantism and synaesthesia co- occur, it is worthwhile testing for an undiagnosed Autism Spectrum Condition (ASC). This is because savantism has an established association with (...) ASC, and the combination of ASC with synaesthesia may increase the likelihood of savantism. The implications of these conditions for philosophy of mind are introduced. (shrink)
In her paper ‘An Awkward Relationship: the Case of Feminism and Anthropology’, Marilyn Strathern argues that feminist research cannot produce a paradigm shift in social anthropology. I present an argument for thinking that, on the relevant understanding of paradigm shift, it is possible for this to happen. I then object to Strathern’s arguments against the possibility.
This paper contains an overview of the essays contained in the Mind and morals anthology plus a critical discussion of certain themes raised in many of these essays concerning the bearing of recent work in cognitive science on the traditional project of moral theory. Specifically, I argue for the following claims: (1) authors like Virginia Held, who appear to be antagonistic toward the methodological naturalism of Owen Flanagan, Andy Clark, Paul Churchland, and others, are really in fundamental agreement with the (...) naturalists (at least once the naturalist view is suitably clarified); (2) the prototype theory of moral concepts that is inspired by recent work in cognitive science does not necessarily jeopardize the aim of systematization characteristic of traditional moral theory; (3) nor does it threaten certain widely accepted views about moral rationality that is part of traditional moral theorizing. Moreover, I speculate that (4) recent work in cognitive science can be expected to play a corroborative role in the justification of theories in ethics, but we should probably not expect this work to yield new insights and directions in ethics. Finally, (5) Fodor's recent critique of cognitive science makes clear the perils of methodological ethical naturalism. (shrink)