In our society, some aspects of life are off-limits to commerce. We prohibit the selling of children and the buying of wives, juries, and kidneys. Tainted blood is an inevitable consequence of paying blood donors; even sophisticated laboratory tests cannot supplant the gift-giving relationship as a safeguard of the purity of blood. Like blood, health care is too precious, intimate, and corruptible to entrust to the market.The hospice movement in the United States is approximately 40 years old. During these past (...) four decades, the concept of holistic, multidisciplinary care for patients who are suffering from a terminal illness has evolved from a modest, grassroots constellation of primarily volunteer-run and community-governed endeavors to a multimillion dollar industry where the surviving nonprofits compete with for-profit providers, often publicly traded, managed by M.B.A.-trained executives, and governed by corporate boards. The relatively recent emergence of for-profit hospice reflects an increasing commercialization of health care in the United States, the potentially adverse impact of which has been well documented. (shrink)

While positive information in the context of clinical care can lead to placebo effects, negatively framed information can have negative or nocebo effects. Extant literature documents how doctor–patient encounters are fertile ground for suboptimal interactions leading to negative experiences for ethnoracial minority patients. In their _JME_ paper, Blease presents a critical perspective on the potential for patients’ access to their doctors’ clinical notes, ‘open notes’, to engender nocebo effects. 1 In this commentary, we affirm the central claim that nocebo effects (...) could emerge ‘via negative wording or framing of health information expressed by clinicians in documentation’. The advent of electronic health records (EHR) allowed patients the unprecedented opportunity to access personal clinical documentation, giving them a window into decision making around their health. This shift is undoubtedly complex, and thus warrants a more fulsome rendering of the unique challenges faced by ethnoracial minority patients. Herein, we highlight three... (shrink)

This article critically questions the commercialization of hospice care and the ethical concerns associated with the industry's movement toward “market-driven medicine” at the end of life. For example, the article examines issues raised by an influx of for-profit hospice providers whose business model appears at its core to have an ethical conflict of interest between shareholders doing well and terminal patients dying well. Yet, empirical data analyzing the experience of patients across the hospice industry are limited, and general claims that (...) end-of-life patient care is inferior among for-profit providers or even that their business practices are somehow unseemly when compared to nonprofit providers cannot be substantiated. In fact, non-profit providers are not immune to potentially conflicting concerns regarding financial viability (i.e., “no margin, no mission”). Given the limitations of existing empirical data and contrasting ideological commitments of for-profit versus non-profit providers, the questions raised by this article highlight important areas for reflection and further study. Policymakers and regulators are cautioned to keep ethical concerns in the fore as an increasingly commercialized hospice industry continues to emerge as a dominant component of the U.S. health care system. Both practitioners and researchers are encouraged to expand their efforts to better understand how business practices and commercial interests may compromise the death process of the patient and patient's family — a process premised upon a philosophy and ethical tradition that earlier generations of hospice providers and proponents established as a trusted, end-of-life alternative. (shrink)

Recent work in cognitive neuroscience on the child's Theory of Mind (ToM) has pursued the idea that the ability to metarepresent mental states depends on a domain-specific cognitive subystem implemented in specific neural circuitry: a Theory of Mind Module. We argue that the interaction of several domain-general mechanisms and lower-level domain-specific mechanisms accounts for the flexibility and sophistication of behavior, which has been taken to be evidence for a domain-specific ToM module. This finding is of more general interest since it (...) suggests a parsimonious cognitive architecture can account for apparent domain specificity. We argue for such an architecture in two stages. First, on conceptual grounds, contrasting the case of language with ToM, and second, by showing that recent evidence in the form of fMRI and lesion studies supports the more parsimonious hypothesis. 1. Theory of Mind, Metarepresentation, and Modularity2. Developmental Components of ToM3. The Analogy with Modularity of Language4. Dissociations without Modules5. The Evidence from Neuroscience6. Conclusion. (shrink)

This paper argues that independent auditors have lost sight of their obligation to be truly impartial, and have increasingly adopted an attitude of client advocacy. We argue that auditors have a professional obligation to go beyond merely passing judgment on whether client accounting methods are acceptable under GAAP, and to judge whether the principles adopted are the most appropriate under the circumstances. We then review recent evidence which suggests that auditors have abandoned this objective in favor of advocating client-preferred principles. (...) The results of a survey of public accountants employed by small CPA firms indicates that, in a scenario in which an auditor did not feel that the client's accounting treatment was the most appropriate under the circumstances but it was recognized as an acceptable alternative under GAAP, advocacy of the client-preferred approach is considered appropriate and is very likely to occur in practice. In less subtle cases (e.g., when the auditor did not feel that the client's treatment provided the best reflection of the economic substance of the underlying transactions), survey participants as a group were ambivalent regarding the appropriateness of client advocacy, and felt that subordination of judgment was likely to occur in practice. The results also indicate that engagement risk, or the risk that the firm will be harmed by aggressive behavior, affects judgments of both the appropriateness and likelihood of subordination of judgment. These findings suggest that auditors have adopted an ideology of client advocacy, within the constraints of engagement risk. (shrink)

Action research is increasingly used as a means for teachers to improve their instruction, yet for many the idea of doing "research" can be somewhat intimidating. _Using Action Research to Improve Instruction_ offers a comprehensive, easy-to-understand approach to action research in classroom settings. This engaging and accessible guide is grounded in sources of data readily available to teachers, such as classroom observations, student writing, surveys, interviews, and tests. Organized to mirror the action research process, the highly interactive format prompts readers (...) to discover a focus, create research questions, address design and methodology, collect information, conduct data analysis, communicate the results, and to generate evidence-based teaching strategies. Engaging in these decision-making processes builds the skills essential to action research and promotes a deeper understanding of teaching practice. Special Features Include: -An Interactive Text -Reflection Questions and Activity Prompts -A Sample Action Research Report -Numerous Examples and Practice Examples -Numbered Sections for Cross Referencing This original text is a must-read for teachers interested in how they can use their current knowledge of instruction and assessment to meaningfully engage in action research. (shrink)

PurposeTo use the power of knowledge acquisition and machine learning in the development of a collaborative computer classification system based on the features of age-related macular degeneration (AMD).MethodsA vocabulary was acquired from four AMD experts who examined 100 ophthalmoscopic images. The vocabulary was analyzed, hierarchically structured, and incorporated into a collaborative computer classification system called IDOCS. Using this system, three of the experts examined images from a second set of digital images compiled from more than 1000 patients with AMD. Images (...) were annotated, and features were identified and defined. Decision trees, a machine learning method, were trained on the data collected and used to extract patterns. Interrelationships between the data from the different clinicians were investigated.ResultsSix drusen classes in the structured vocabulary were largely sufficient to describe all the identified features. The decision trees classified the data with 76.86% to 88.5% accuracy and distilled patterns in the form of hierarchical trees composed of 5 to 15 nodes. Experts were largely consistent in their characterization of soft, and to a lesser extent, hard drusen, but diverge in definition of other drusen. Size and crystalline morphology were the main determinants of drusen type across all experts.ConclusionsMachine learning is a powerful tool for the characterization of disease phenotypes. The creation of a defined feature set for AMD will facilitate the development of an IDOCS-based classification system. (shrink)

The contributions in this volume map out how technologies are used and designed to plan, maintain, govern, demolish, and destroy the city. The chapters demonstrate how urban technologies shape, and are shaped, by fundamental concepts and principles such as citizenship, publicness, democracy, and nature. The many authors herein explore how to think of technologically mediated urban space as part of the human condition. The volume will thus contribute to the much-needed discussion on technology-enabled urban futures from the perspective of the (...) philosophy of technology. This perspective also contributes to the discussion and process of making cities ‘smart’ and just. This collection appeals to students, researchers, and professionals within the fields of philosophy of technology, urban planning, and engineering. (shrink)

This paper proposes that autonomous vehicles should be designed to reduce light pollution. In support of this specific proposal, a moral assessment of autonomous vehicles more comprehensive than the dilemmatic life-and-death questions of trolley problem-style situations is presented. The paper therefore consists of two interrelated arguments. The first is that autonomous vehicles are currently still a technology in development, and not one that has acquired its definitive shape, meaning the design of both the vehicles and the surrounding infrastructure is open-ended. (...) Design for values is utilized to articulate a path forward, by which engineering ethics should strive to incorporate values into a technology during its development phase. Second, it is argued that nighttime lighting—a critical supporting infrastructure—should be a prima facie consideration for autonomous vehicles during their development phase. It is shown that a reduction in light pollution, and more boldly a better balance of lighting and darkness, can be achieved via the design of future autonomous vehicles. Two case studies are examined through which autonomous vehicles may be designed for “driving in the dark.” Nighttime lighting issues are thus inserted into a broader ethics of autonomous vehicles, while simultaneously introducing questions of autonomous vehicles into debates about light pollution. (shrink)

Scholars who engage with texts that were written by George Herbert Mead (e.g., 1925e.g., 1926e.g., 1929e.g., 1932e.g., 1938) in the latter half of the 1920s are faced with the task of comprehending Mead’s interpretation of relativity theory and also understanding why relativity theory was considered by Mead to have such profound implications for his own philosophy. As several scholars of Mead’s work have explained (e.g., Joas 1997; Martin 2007; Rosenthal and Bourgeois 1991), Mead was a realist. Mead opposed psychophysical dualism (...) (Cook 1979) and both the behaviorist and the idealist implications that could follow from such a dualism. He wanted to explain human conduct in terms of the self-determination of human .. (shrink)

Les valeurs faisant sens pour le locuteur jouent un rôle central dans la justification des décisions. Le jugement de valeur est cependant suspect d'être prescriptif et inique. Sa réhabilitation est l'objet de cet ouvrage. On y démontre que rhétorique et rationalité axiologique sont indissociables.

Three experiments examined contributions of study phase awareness of word identity to subsequent word-identification priming by manipulating visual attention to words at study. In Experiment 1, word-identification priming was reduced for ignored relative to attended words, even though ignored words were identified sufficiently to produce negative priming in the study phase. Word-identification priming was also reduced after color naming relative to emotional valence rating (Experiment 2) or word reading (Experiment 3), even though an effect of emotional valence upon color naming (...) (Experiment 2) indicated that words were identified at study. Thus, word-identification priming was reduced even when word identification occurred at study. Word-identification priming may depend on awareness of word identity at the time of study. (shrink)

Evolutionary theories of human cognition should refer to specific times in the primate or hominid past. Though alternative accounts of tool manufacture from Wynn's are possible (e.g., frontal lobe function), Wynn demonstrates the power of archaeology to guide cognitive theories. Many cognitive abilities evolved not in the “Pleistocene hunter-gatherer” context, but earlier, in the context of other patterns of social organization and foraging.

Technology is no stranger to the city. Cities are planned, built, maintained, governed, demolished, and destroyed by technical means. Yet, the city has yet to receive much attention within the philosophy of technology. This volume addresses this gap, and in doing so contributes to the much-needed discussion on technology-enabled urban futures from the perspective of the philosophy of technology. In this introductory chapter, the larger volume is introduced by reflecting on the rationale and need for such a collection, sketching the (...) main themes analyzed throughout, and providing an overview of the contributions. (shrink)

Faut-il chercher un principe de la morale, quelque chose qui serait là, en nous, pour qu'elle puisse exister? La morale ne nous vient-elle pas aussi de l'extérieur, d'une contrainte sociale? Les protagonistes de la troisième partie de l'Alciphron s'engagent dans un vif débat sur cette question. Toutefois l'attention est détournée du « bien » vers le beau, objet du sens moral. L'exposé de cette thèse, les objections qui lui sont faites, sont le levier qui permet d'envisager la place de l'intérêt, (...) de nos sentiments de crainte et d'espoir, et de l'obéissance à la loi divine. L'enjeu, c'est la possibilité d'une morale autonome. Should one try and find some principle of ethics, i.e. something that would be herein, within us, so that it may be liable to exist? Do not ethics also come from outside, i.e. from a social constraint? The protagonists of Alciphron's third part start an acute debate on the topic. However attention is turned from the « good » towards the beautiful which is the object of the moral sense. This thesis and objections made to it are the lever enabling to grasp the part played by interest, by our feelings both of fear and of hope and by obedience to the divine law. What is at stake is the liability of autonomous ethics. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

Le champ de l’histoire naturelle, longtemps descriptif et classificatoire, connaît tout au long du xmf siècle, un ensemble de transformations dues au développement croissant d’un point de vue physiologique sur les êtres vivants. Si, dans un premier temps, les disciplines traditionnelles (botanique, zoologie) voient des aspects particuliers se développer en leur sein (physique végétale, anatomie et physiologie comparées), la question se pose peu à peu de l’émergence d’une sdence du vivant, dépassant le clivage traditionnel des trois règnes, consciente de l’unité (...) que représente le monde vivant par opposition au monde inorganique. L’apparition presque simultanée en Europe du terme biologie (Roze, Treviranus, Lamarck) ou de son substitut zoonomie (E. Darwin) ne constitue cependant qu’une naissance avortée, qui perturbe les classifications antérieures, sans aboutir immédiatement à la reconnaissance de la biologie comme discipline. L’objet de cet article est d’analyser les conditions conceptuelles qui permettent cette naissance, d’examiner les processus de redistribution des savoirs qu’elle entraîne et d’étudier les redéfinitions et les redécoupages qui s’opèrent dans les catégories utilisées dans les institutions académiques, les périodiques ou les dictionnaires. (shrink)

Public Health Science and practice expanded during the course of the 20th century. Initially focused on controlling infectious disease through basic public health programs regulating water, sanitation and food, by 1988 the Institute of Medicine broadly declared that “public health is what we, as a society, do collectively to. assure the conditions for people to be healthy.” Commensurate with this definition, public health practitioners and policymakers today work on ;in enormous range of issues. The 2002 policy agenda of the American (...) Public Health Association reflects positions on genomics’ role in public health; national health and safety standards for child care programs; sodium in Americans’ diets; the health and safety of emergency rescue workers; and war in Central Asia and the Persian Gulf. (shrink)

Public Health Science and practice expanded during the course of the 20th century. Initially focused on controlling infectious disease through basic public health programs regulating water, sanitation and food, by 1988 the Institute of Medicine broadly declared that “public health is what we, as a society, do collectively to. assure the conditions for people to be healthy.” Commensurate with this definition, public health practitioners and policymakers today work on ;in enormous range of issues. The 2002 policy agenda of the American (...) Public Health Association reflects positions on genomics’ role in public health; national health and safety standards for child care programs; sodium in Americans’ diets; the health and safety of emergency rescue workers; and war in Central Asia and the Persian Gulf. (shrink)