This paper does not mean to imply that it is only public controversy that can meaningfully affect political outcomes, or even that it is the most important factor. Rather, we have attempted to indicate that public controversy constitutes a forum on which political actorsact; on which they attempt to implicate each other and the public in terms of some preferred view of the controversy at hand. It is certainly the case that the formal structure of the government and power relationships (...) provides important constraints in terms of which controversy may take place. Yet within these constraints, actors can meaningfully construct various views of the structure of the controversy which differently construe the rights and obligations of participants. In this sense, the course of public controversy may in part be understood as a function of the language employed by these actors, both to the extent that particular expressions stand as documentary evidence of underlying discrepancies about the shape of the controversy and to the extent that the logic of certain speech-acts constrains the forms subsequent statements may take. (shrink)
I define serendipity as the art of making an unsought finding. And I propose an overview of my collection of serendipities, the largest yet assembled, chiefly in science and technology, but also in art, by giving a list of ‘serendipity patterns’. Although my list of ‘patterns’ is just a list and not a classification, it serves to introduce a new and possibly stimulating perspective on the old subject of serendipity. Knowledge of these ‘serendipity patterns’ might help in expecting also the (...) unexpected and in finding also the unsought. * I acknowledge A. D. de Groot, R. C. M. Noordam, B. P. van Heusden, T. Pinkster, C. J. van den Berg, T. A. F. Kuipers, A. Wegener Sleeswijk and my referee for their suggestions and I dedicate this article to T. A. van Kooten. Cases and studies of serendipidy are welcome. À propos: a travelling serendipity exhibition is available, also for ‘new democracies’: ‘Freedom of opportunity as developed by democracy is the best human reaction to divergent phenomena. We may, in fact, define ‘freedom’ as ‘the opportunity to profit from the unexpected.’ (Langmuir ). (shrink)
This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)
Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status of (...) the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed. (shrink)
In this article we review research in our laboratory on auditory hallucinations using behavioral and MRI measure. The review consists of both previously published and new data that for the fi rst time is presented together in a cohesive way. Auditory hallucinations are among the most common symptoms in schizophrenia, affecting more than 70% of the patients. We here advance the hypothesis that auditory hallucinations are internally generated speech perceptions that are lateralized to the left temporal lobe, in the peri-Sylvian (...) region. From this we predict that hallucinating patients should have problems identifying a simultaneously presented external speech sound, as measured through performance on the dichotic listening (DL) paradigm with consonant-vowel syllables, since this technique lateralizes the stimulus input. Across a series of behavioral experiments, we have shown that patients with schizophrenia who experience frequent auditory hallucinations fail to demonstrate an expected right ear advantage on the dichotic listening test. Absence of a right ear advantage is indicative of a functional defi cit in the left peri-Sylvian region. The results also revealed that patients with ongoing auditory hallucinations were more impaired than patients with previous hallucinations, and that a higher score on the hallucination item in a standard symptom rating scale (BPRS) correlated negatively with number of correct reports for the right ear stimulus. Moreover, we have found that schizophrenia patients fail to shift attention to the left ear stimulus, when explicitly instructed to focus on the right or left ear stimulus only, thus showing a defi cit in inhibition of attention and response-inhibition. The behavioral DL data are substantiated in two MR morphometry studies that revealed signifi cant reductions in grey matter density in the left peri-Sylvian region in hallucinating patients, and patients with reduced left temporal lobe grey matter density. Hallucinating patients also failed to show a right ear advantage in the dichotic listening test. Ongoing fMRI studies are focused on the underlying synaptic and molecular mechanisms by investigating the effects of the glutamate antagonist drug memantine on auditory perception and speech lateralization, and examination of temporal cortex-specifi c gene expression in the left peri-Sylvian region. (shrink)
This book explores the various views on language and its relation to philosophy in the Platonic tradition by examening the reception of Plato's Cratylus in antiquity in general, and the commentary of the Neoplatonist Proclus in particular.
Background: Thrombolytic drugs to treat an acute ischaemic stroke reduce the risk of death or major disability. The treatment is, however, also associated with an increased risk of potentially fatal intracranial bleeding. This confronts the patient with the dilemma of whether or not to take a risk of a serious side effect in order to increase the likelihood of a favourable outcome. Objective: To explore acute stroke patients’ perception of risk and willingness to accept risks associated with thrombolytic drug treatment. (...) Design: Eleven patients who had been informed about thrombolytic drug treatment and had been through the process of deciding whether or not to participate in a thrombolytic drug trial went through repeated qualitative, semistructured interviews. Results: Many patients showed a limited perception of the risks connected with thrombolytic drug treatment. Some perceived the risk as not relevant to them and were reluctant to accept that treatment could cause harm. Others seemed to be aware that treatment would mean exposure to risk. The patients’ willingness to take a risk also varied substantially. Several statements revealed ambiguity and confusion about being involved in a decision about treatment. The patients’ reasoning about risk was put into the context of their health-related experiences and life histories. Several patients wanted the doctor to be responsible for the decisions. Conclusion: Acute stroke patients’ difficulties in perceiving and processing information about risk may reduce their ability to be involved in clinical decisions where risks are involved. (shrink)
InWord and Object W. V. Quine argues that there is no uniquely correct way to assign referents to the terms of a language; any claim about the reference of a term is implicitly relative to a manual of translation. To Rudolf Carnap this must have seemed familiar. BeforeWord and Object was written Carnap had been saying the same thing inMeaning and Necessity: under the assumption of the method of the name-relation, any claim about the reference of a term is implicitly (...) relative to what Carnap calls a conception of the name-relation. Yet Carnap is often taken to be a victim of Quine's relativistic notion of reference. Drawing on Carnap's discussion of the name-relation inMeaning and Necessity, it is argued that Carnap's and Quine's views on reference are not so far apart as is usually perceived. (shrink)