Chronologically ordered readings varying in length from a high of sixty-two pages from J. S. Mill to a low of twenty-two pages from Brentano, with most of the other eleven philosophers included having between thirty-five and forty-five pages each. Comte, Spencer, and Mach are mild surprises whose presence is explained over that of, say, Marx, by the editor's desire to emphasize epistemological, metaphysical, and methodological themes. The bibliographies accompanying the selections are "non-selective"; sometimes they appear positively random. The general (...) introduction is too brief to be of any real use but one can sympathize with the fact that the editor had to say something by way of introduction. In addition to the philosophers mentioned above, selections from Fichte, Hegel, Schopenhauer, Kierkegaard, Nietzsche, Peirce, Bradley, and Frege are included.—E. A. R. (shrink)

Bi-directional differences in social communication and behavior can contribute to poor interactions between autistic and non-autistic people, which in turn may reduce social opportunities for autistic adults and contribute to poor outcomes. Historically, interventions to improve social interaction in autism have focused on altering the behaviors of autistic people and have ignored the role of NA people. Recent efforts to improve autism understanding among NA adults via training have resulted in more favorable views toward autistic people, yet it remains unknown (...) whether these benefits extend to real-world interactions between autistic and NA people. The current study explores whether a brief autism acceptance training program can improve social interactions between autistic and NA adults. Thirty-nine NA males were randomly assigned to complete AAT or a no-training control condition, then participated in a 5-min unstructured conversation with an unfamiliar autistic male. Following the conversation, participants rated their perceptions of interaction quality, first impressions of their partner, and their interest in future interactions with their partner. In dyads where the NA individual completed AAT, both the autistic and NA person endorsed greater future interest in hanging out with their partner relative to dyads in which the NA adult did not complete AAT. However, other social interaction outcomes, including ratings of interaction quality and first impressions of autistic partners, largely did not differ between training and no-training conditions, and assessments of the interaction were largely unrelated for autistic and NA partners within dyads. Results also indicated that NA participants, but not autistic participants, demonstrated substantial correspondence between evaluations of their partner and the interaction, suggesting that autistic adults may place less weight on trait judgments when assessing the quality of an interaction. These findings suggest that the brief AAT for NA adults used in this study may increase mutual social interest in real-world interactions between NA and autistic adults, but more systematic changes are likely needed to bridge divides between these individuals. Future work with larger, more diverse samples is recommended to further explore whether interventions targeting NA adults are beneficial for improving autistic experiences within NA social environments. (shrink)

Chronologically ordered readings varying in length from a high of sixty-two pages from J. S. Mill to a low of twenty-two pages from Brentano, with most of the other eleven philosophers included having between thirty-five and forty-five pages each. Comte, Spencer, and Mach are mild surprises whose presence is explained over that of, say, Marx, by the editor's desire to emphasize epistemological, metaphysical, and methodological themes. The bibliographies accompanying the selections are "non-selective"; sometimes they appear positively random. The general (...) introduction is too brief to be of any real use but one can sympathize with the fact that the editor had to say something by way of introduction. In addition to the philosophers mentioned above, selections from Fichte, Hegel, Schopenhauer, Kierkegaard, Nietzsche, Peirce, Bradley, and Frege are included.—E. A. R. (shrink)

Translational ethics (TE) has been developed into a specific approach, which revolves around the argument that strategies for bridging the theory‐practice gap in bioethics must themselves be justified on ethical terms. This version of TE incorporates normative, empirical and foundational ethics research and continues to develop through application and in the face of new ethical challenges. Here, I explore the idea that the academic field of bioethics has not yet sufficiently analysed its own philosophical foundation for how it can, and (...) should, be practically relevant; neither has it comprehensively discussed the limitations on what impacts bioethicists should pursue. As a result, there has not been adequate training on how to suitably and appropriately impact real‐world practices. Moreover, bioethical perspectives are often competing with other strong interests, for example, economic and political, which may weaken their impact on policy‐making. The TE approach I propose can not only facilitate practical impacts of academic bioethics by being better informed by real‐world ethical issues but it also supports targeted and ethical justifications of the actual impact of academic work in real‐world contexts. In this paper, I clarify the premises for this TE approach, identify further challenges and sketch out potential solutions for the implementation of this methodological framework. (shrink)

The overall aim of this article is to discuss the organization of limit setting in healthcare in terms of legitimacy. We argue there is a strong ethical demand that such processes should be arranged to provide adversely affected people well-justified reasons to confer legitimacy to the processes despite favouring a different decision-making outcome. Two increasingly popular approaches, Accountability for Reasonableness (A4R) and Multi-Criteria Decision Analysis (MCDA), can both be applied to support legitimate decision-making processes. However, the role played by ‘fair-minded (...) people’ in the A4R framework can be shown to undermine an adequate conceptualization of legitimacy according to the ethical demand. We discuss and specify conditions enabling A4R to meet this ethical demand when being implemented in a real-world setting without having to renounce the aim of striving for ‘reasonableness’ and impartiality. The methodological approach MCDA describes how to arrange for transparent resource allocation. This approach does not encompass any normative guidance on how to shape limit settings in terms of ‘reasonableness’; it basically promotes ‘rational’ decisions. We discuss how this practical methodology can be integrated with the theoretical A4R framework to meet the ethical demand while at the same time promoting politically required impartiality of healthcare limit setting. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt to capture a comprehensive (...) overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

Political argument and institutions in the UnitedKingdom have frequently been represented as the products of ablend of nationalistic conservatism, liberal individualism andsocialism, in which consensus has been prized over ideology. This situation changed, as the standard story has it, with therise of Thatcherism in the late 1970s, and again with the arrivalof Tony Blair's ``New Labour'' pragmatism in the late 1990s. Solidarity as an element of political discourse makes itsappearance in the UK late in the day. It has been most (...) stronglylinked to the Third Way debate, as framed most influentially inthe work of Prof. Anthony Giddens.In this paper we review the history and pre-history of the debateon solidarity in the UK, focussing mostly on its implications forwelfare state reform. In particular we discuss the proposals forthe long-term care of the Elderly issued by the Royal Commissionon long-term care in 1999. In this context we critically examinethe idea that solidarity is a new concept in British politicalculture, and that it is a concept which has real political ``bite''in the project of welfare reform. We examine this through aconsideration of Giddens's attempted synthesis of politicalargument and social theory. (shrink)

Background: Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors’ decisions. Associations between physicians’ religious characteristics and their weighting of the criteria were also examined. Methods: Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association (...) masterfile. Physicians were asked how much weight should be given to the following: (1) the patient’s expressed wishes and values, (2) the physician’s own judgment about what is in the patient’s best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. Results: Response rate 51% (446/879). Half of physicians (55%) gave the patient’s expressed wishes and values “the highest possible weight”. In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient’s expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the “highest possible weight”, versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). Conclusions: Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians’ decisions as much as is often recommended in the ethics literature. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

This book of fifteen essays is presented in honor of one of the premier historians of medieval philosophy, Armand Maurer of the Pontifical Institute for Mediaeval Studies and the University of Toronto. The authors, internationally recognized scholars in the field of medieval philosophy and theology, are friends, colleagues, and students of Fr. Maurer. They are united in a common love of medieval thought and a common appreciation of philosophizing through the study of the history of philosophy. Their interests and methodologies, (...) however, are diverse, and cover a range from Justin Marytr, who died during the reign of Marcus Aurelius, to Bartholomew Mastrius, a contemporary of Descartes. “This is a volume that honors the memory of Armand Maurer not only by reviewing his own scholarly achievements but by advancing the state of scholarship on the subject that he loved, the philosophy of the middle ages. The range of topics covered here richly reflect the pluralism of medieval thought. Some of the essays gathered for this collection give a fresh look at important perennial themes like the nature of Christian philosophy and the real distinction between essence and existence. Others turn—as Maurer loved to do—to figures who are studied less often that help fill out our knowledge of this period and add to our sense of the contributions that study of medieval authors can make for contemporary philosophizing.” —Joseph W. Koterski, S.J., Fordham University “This lovely Festschrift for Armand Maurer contains fourteen essays by distinguished scholars on the tradition of medieval philosophy, from its ancient origins to seventeenth-century inheritors. Since many essays treat large-scale movements or fundamental issues, the volume will be useful to serious undergraduates and graduate students, as well as to scholars._ Laudemus_ indeed: from the editor’s moving tribute to Armand Maurer, through discussions of Avicenna and Thomas and Ockham, to Maurer’s closing recollections of his teachers, this volume is full of well-earned praise.” —Donald Morrison, Rice University. (shrink)

The computable Lipschitz reducibility was introduced by Downey, Hirschfeldt and LaForte under the name of strong weak truth-table reducibility [6]). This reducibility measures both the relative randomness and the relative computational power of real numbers. This paper proves that the computable Lipschitz degrees of computably enumerable sets are not dense. An immediate corollary is that the Solovay degrees of strongly c.e. reals are not dense. There are similarities to Barmpalias and Lewis’ proof that the identity bounded Turing degrees of (...) c.e. sets are not dense [2]), however the problem for the computable Lipschitz degrees is more complex. (shrink)

This is a translation of Carnap's early classic, Der Logische Aufbau der Welt and his less technical but also important article from the same period, Scheinprobleme in der Philosophie. It is no secret that Carnap abandoned the phenomenalism of the Aufbau for the physicalism of Logische Syntax der Sprache, but there is no doubt that the real message of the Aufbau—which is punctuated with the Messianic spirit of early logical positivism—is the program of "rational reconstruction" which becomes, on an inverted (...) reading and with the addition of a bias in favor of the universal descriptive and explanatory power of scientific discourse, the program of scientific reductionism. In this light, the continuities between the Aufbau and Carnap's later work completely dwarf in importance the discrepancies between these two periods of his creative output. The Aufbau remains an important book in its own right, and is not simply a detailed manifesto of a now defunct program; it is a pleasure to have it in English.—E. A. R. (shrink)

This volume is a revival and updating of the rationalism initiated by the Cartesian cogito. Even the four main divisions of the work give evidence of this: Perception, the Real World, Real Mind, and the Suprarational. The order of treatment is not identical in every respect with that of Descartes, but the four main themes are indubitably Cartesian. While the protagonist is Descartes, the antagonist to whom this volume is consciously addressed is the empiricist and the positivist. Professor Robinson seems (...) intent on convincing the contemporary positivist that science is primarily an affair of reason and secondarily one of experience. He enlists two formidable allies of Descartes to elucidate and solidify his position. One he finds in the same century as Descartes, the redoubtable Leibniz; the other he takes from the twentieth century, Bertrand Russell. The problem of perception is resolved by the joint solution of Leibniz and Russell, a solution which rejects a naive realism in favor of a metarealism. The singular attraction of this volume is the personal dedication and expertise which Professor Robinson brings to this subject. His exploration and defense of his rationalistic premise brings him to examine epistemic issues and paradoxes which have cast long shadows over the history of modern and contemporary philosophy in Western civilization. These are the issues with which the inheritors of the Cartesian cogito have been wrestling: Spinoza, Leibniz, Locke, Berkeley, Hume, and Kant. Another very attractive aspect of this volume is that whereas Professor Robinson’s thesis has its protagonist and antagonist, it does not explicitly address itself to these. They remain more in the background as the audience to whom the book is addressed. They are not called on explicitly to engage in the exposition. In this sense, the book is not presented as a professorial treatise with copious footnotes and an extensive bibliography. It is presented as a personal exposition engaging in the act of philosophizing within the letter and spirit of a rationalistic revival. In spite of this personal and personalized renewal of rationalism on the part of Professor Robinson, it should not be construed that the book is written either for the layman or by a layman. It is a methodical and technical exposition replete with the coinage of new terms befitting the spirit of a philosophy operating within the parameters of a self-enclosed and self-contained scientism. Professor Robinson presents his book as a viable alternative to the monopoly which the empiricist and positivist have exercised within the domain of the philosophy of science.—R.E.D. (shrink)

When the first r lower extreme order statistics of a sample of large size n, 1 < r < s < n, are observed, asymptotic predictive intervals of the future extreme order statistic with a rank s are constructed. The only assumption that we adopt is that the first failure time is attracted to the Weibull distribution. In addition, we suggest an efficient point estimator of its shape parameter and then a confidence interval is constructed for it. Moreover, new interesting (...) asymptotic properties of the distributions that belong to the minimum domain of attraction of the Weibull distribution are revealed. Furthermore, extensive simulation studies are conducted to demonstrate the efficiency of the proposed methods. Two real datasets are analyzed to illustrate and corroborate the obtained results. The main results concern large samples. (shrink)

Background In the context of limited health care budgets in countries where Neglected Tropical Diseases are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost-effectiveness analyses may lead to biased and insufficiently justified priorities. Objectives The objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi-criteria decision-making matrix, and (...) 3) discuss the conditions under which this decision-making procedure should be carried out in a real-world decision-making context. Methods This paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi-criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases. Discussion Our in vitro multi-criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil-transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision-making process and we stress the limitations of this study exercise. Conclusion By exploring how several criteria relevant to the multi-facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)

In response to widespread concern about illegal drug use and the associated risk of the spread of HIV/AIDS, a study was undertaken to examine whether it was, in principle, feasible to conduct a trial providing heroin to dependent users in a controlled manner. Such a trial involves real ethical issues which are examined in this paper. The general issues examined are: should a trial be an experiment or an exercise in public policy?; acts and omissions; countermobilization; termination of a trial, (...) and payment for drugs and for a trial. The specific issues examined are: selection of trial participants; privacy; issues for staff working on a trial; coupling the trial with other treatment, and issues for researchers. A number of alternative approaches to the various ethical issues are presented and discussed. (shrink)

The Metaphysical Club, a gathering of intellectuals in the 1870s associated with Harvard, is widely recognized as the crucible where pragmatism, America's distinctively original philosophy, was refined and proclaimed. Louis Menand's bestseller about the group was a dramatic publishing success. However, only three actual members - Oliver Wendell Holmes Jr., Charles S. Peirce, and William James - appear in this book, alongside other thinkers such as John Dewey who were never in the Club. The Real Metaphysical Club tells the full (...) story of how this influential group shifted the course of philosophy in America. In addition to pioneering pragmatism, the group explored radical empiricism and idealism, and formulated personalism and process philosophy, equally important developments. This volume contains thirty-seven important writings dating from 1870 to 1885 by the real members of the Metaphysical Club. The first section centers on pragmatism and science; the second part collects writings of the lawyers; and the third part covers idealist and personalist philosophers. Many of these writings have never been reprinted before, and nothing like this impressive collection has ever been attempted. A general introduction provides a narrative history, and the editors' three introductions to the volume's sections vividly bring to life the intense meetings, sustained debates, and pioneering thought from the Metaphysical Club. (shrink)

The Frauchiger–Renner Paradox is an extension of paradoxes based on the “Problem of Measurement,” such as Schrödinger’s Cat and Wigner’s Friend. All these paradoxes stem from assuming that quantum theory has only unitary physical dynamics, and the attendant ambiguity about what counts as a ‘measurement’—i.e., the inability to account for the observation of determinate measurement outcomes from within the theory itself. This paper discusses a basic inconsistency arising in the FR scenario at a much earlier point than the derived contradiction: (...) namely, the inconsistency inherent in treating an improper mixture as a proper, epistemic mixture. This is an illegitimate procedure that is nevertheless endemic if quantum theory is assumed to be always unitary. In contrast, under a non-unitary account of quantum state reduction yielding determinate outcomes, the use of a proper mixture for measurement results becomes legitimate, and this entire class of paradoxes cannot be mounted. The conclusion is that the real lesson of the FR paradox is that it is the unitary-only assumption that needs to be critically reassessed. (shrink)

This paperback edition of Dodds's standard edition of Plato's Gorgias is designed to meet the needs both of undergraduates and professional scholars. The text and apparatus criticus are based on a fresh survey of the evidence: two major manuscripts are here for the first time fully collated, and account has been taken both of new papyri and of the exceptionally rich indirect tradition. The text is supplemented by a full introduction giving details on the subject and structure of the dialogue, (...) its characters and intended historical setting, the real date of composition, and the background to Plato and Athens at the time of composition. The commentary, besides explaining Platonic usages and discussing textual points, aims to treat the historical, philosphical, and literary questions which arise from the text. (shrink)

R&D collaborations between industry, government, civil society, and research (also known as ‘quadruple helix collaborations’ (QHCs)) have recently gained attention from R&D theorists and practitioners. In aiming to come to grips with their complexity, past models have generally taken a stakeholder-analytical approach based on stakeholder types. Yet stakeholder types are difficult to operationalise. We therefore argue that a processual model is more suited for studying the interaction in QHCs because it eschews matters of titles and identities. We develop such a (...) model in which the QHC is represented as a process of generating four types of value: research value, market value, political value, and societal value. We then apply this processual model in analysing reallife cases of friction in QHCs. Friction is seen, not as an interpersonal clash, but as a discrepancy between two or more value-creation processes that compete for limited resources (some overperforming while others under-performing). (shrink)

While Dubourg and Baumard argue that predisposition toward exploration draws us to fictional environments, they fail to answer their titular question: “Why Imaginary Worlds?” Research in pretend play, psychological distancing, and theatre shows that being “imaginary” (i.e., any type of unreal, rather than only fantastically unreal) makes exploration of any fictional world profoundly different than that of real-life unfamiliar environments.

In lieu of an abstract, here is a brief excerpt of the content:Picking Up the Pieces of a Shattered Culture:Abandoning Sartre for AquinasR. E. HouserI expect to die in my bed, my successor will die in prison, and his successor will die a martyr in the public square. Then his successor will pick up the shards of a ruined society and slowly help rebuild civilization, as the Church has done so often in human history.—Francis Cardinal George (2010)Here I propose to (...) present a feature of the ethics of Thomas Aquinas, his ethical doctrine of virtue, concentrating on the four cardinal virtues—justice, prudence or good practical judgment, courage, and temperance. Plato first selected them as the four premier virtues, but they go back at least to Homer, for whom wily Odysseus exemplified prudence, warlike Achilles courage, old Nestor justice, Penelope and Telemachus, Odysseus' wife and son, temperance. And I offer them as central to living the morally good life required to "rebuild civilization" in an America that so fair and judicious a man as Cardinal George could call a "ruined society." To see the need for Thomas's solution, we must begin with the problem. Now, all societies depend upon the deep and fundamental ideas of the most important thinkers, prophets and sages, saints, and yes, even philosophers. Their ideas "trickle down" to influence regular folk, like you and me, those who whose hard work actually makes a society thrive, or die. And when those fundamental ideas change, the moral principles of those who embrace those ideas change, and consequently their actions change, and as a result the wider society in which they live changes, for better or worse. Such effects can now be felt across America [End Page 135] by all; but most of us are unaware of the primary intellectual agents of these changes, since they operate at the level of fundamental ideas, not politics or business or day-to-day life. And often their originators have died before the ideas reach full cultural force. So, ignorance of history makes it difficult to deal with present problems caused by those ideas.My first conclusion will be that a major cause of the current coarsening of our culture is the group of ideas of the French philosopher Jean Paul Sartre, even though most Americans have never heard of him, and most of those who recognize his name have not read his works carefully enough to see the connection. Why Sartre? In the honors program at my university, I had a bright young lady of Muslim heritage who had gone to a lycée, one of France's elite classical secondary schools. "Did you read the classics?" "Yes." Expecting Montaigne or Pascal, I asked, "Who?" Her answer: "Sartre." So let us begin with the theory and practice of Sartre and his long-time lover Simone Beauvoir, whose book The Second Sex was an intellectual spark for the women's liberation movement. Then we turn to some real-life examples of Sartrean influence on ourselves and American culture. Finally, for the best remedy for non-Christian and Christian alike, I recommend Aquinas's doctrine of virtue, when taken in its full scope.Sartre's Ethics of Absolute FreedomIn 1946, the year I was born, Sartre gave a lecture to a meeting of French librarians, which became his most popular book, Existentialism is a Humanism. There he laid out the core of his thought about God, humans, and their ethical behavior. Here I arrange his main ideas in an order that facilitates comparison with Aquinas, beginning with his view of human ontology and proceeding to its impact on the four cardinal virtues.Human OntologySartre turned his back on the traditional metaphysical view that every creature is an individual substance defined by a nature or essence it has in common with all other things of that type. In his "first principle of existentialism," Sartre skips over other animate things, plants and animals, and compares humans to inanimate objects:Let us consider... a book or a paper-cutter: here is an object made by an artisan whose inspiration came from a concept.... One cannot postulate a man who makes a paper-cutter but does not know what it is... (shrink)

This paperback edition of Dodds's standard edition of Plato's Gorgias is designed to meet the needs both of undergraduates and professional scholars. The text and apparatus criticus are based on a fresh survey of the evidence: two major manuscripts are here for the first time fully collated, and account has been taken both of new papyri and of the exceptionally rich indirect tradition. The text is supplemented by a full introduction giving details on the subject and structure of the dialogue, (...) its characters and intended historical setting, the real date of composition, and the background to Plato and Athens at the time of composition. The commentary, besides explaining Platonic usages and discussing textual points, aims to treat the historical, philosphical, and literary questions which arise from the text. (shrink)

This is a translation of II Motore Immobile (Metafisica, libro XII), Traduzione intégrale, introduzione e commento by Giovanni Reale (Editrice La Scuola, Brescia, 4th Ed. 1971)- The author offers a unitary reading of the famous twelfth book of Aristotle's Metaphysics. The book is intended for students who wish to read the text itself of Aristotle’s, so that the introduction and commentary to the text and the summaries of the entire Metaphysics as well as the twelfth book gives the student ample (...) material to read the text intelligently. The work is aware of the current state of Aristotelian studies but does not intrude them into the commentary, because they should be reserved for more specialized work which the author has completed. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by the (...) patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured. (shrink)

Informed decision-making (IDM) is considered an important ethical and legal requirement for population-based screening. Governments offering such screening have a duty to enable invitees to make informed decisions regarding participation. Various views exist on how to define and measure IDM in different screening programmes. In this paper we first address the question which components should be part of IDM in the context of cancer screening. Departing from two diverging interpretations of the value of autonomy—as a right and as an ideal—we (...) describe how this value is operationalized in the practice of informed consent in medicine and translate this to IDM in population-based cancer screening. Next, we specify components of IDM, which is voluntariness and the requirements of disclosure and understanding. We argue that whereas disclosure should contain all information considered relevant in order to enable authentic IDM, understanding of basic information is sufficient for a valid IDM. In the second part of the paper we apply the capability approach in order to argue for the responsibility of the government to warrant equal and real opportunities for invitees for IDM. We argue that additional conditions beyond mere provision of information are needed in order to do so. (shrink)

Pragmatic comparative effectiveness randomized controlled trials evaluate the effectiveness of one interventions under real-world clinical conditions. The results of ceRCTs are often directly generalizable to everyday clinical practice, providing information critical to decision-making by patients, clinicians, and healthcare policymakers. The PRECIS-2 framework identifies nine domains that serve to score a trial on a continuum between very explanatory to very pragmatic. According to the framework, pragmatic trials may have one or more of the following features: there are fewer eligibility criteria for (...) participants, in an... (shrink)

Insight has been investigated under the assumption that participants solve insight problems with insight processes and/or experiences. A recent trend has involved presenting participants with the solution and analysing the resultant experience as if insight has taken place. We examined self-reports of the aha experience, a defining aspect of insight, before and after feedback, along with additional affective components of insight (e.g., pleasure, surprise, impasse). Classic insight problems, compound remote associates, and non-insight problems were randomly interleaved and presented to participants. (...) Solution feedback increased ratings of aha experience in both insight and non-insight problems, with this result being driven by responses to solutions that were initially incorrectly generated. Ratings of aha for correctly generated solutions decreased after the correct solution was presented. These findings have implications for insight research paradigms as well as informing teaching methods. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

R&D collaborations between industry, government, civil society, and research ) have recently gained attention from R&D theorists and practitioners. In aiming to come to grips with their complexity, past models have generally taken a stakeholder-analytical approach based on stakeholder types. Yet stakeholder types are difficult to operationalise. We therefore argue that a processual model is more suited for studying the interaction in QHCs because it eschews matters of titles and identities. We develop such a model in which the QHC is (...) represented as a process of generating four types of value: research value, market value, political value, and societal value. We then apply this processual model in analysing real-life cases of friction in QHCs. Friction is seen, not as an interpersonal clash, but as a discrepancy between two or more value-creation processes that compete for limited resources. (shrink)

Despite its effectiveness, limited research has examined the provision of telemental health and how practices may vary according to treatment paradigm. We surveyed 276 community mental health providers registered with a commercial telemedicine platform. Most providers reported primarily offering TMH services to adults with anxiety, depression, and trauma-and stressor-related disorders in individual therapy formats. Approximately 82% of TMH providers reported endorsing the use of Cognitive Behavioral Therapy in their remote practice. The most commonly used in-session and between-session exercises included coping (...) and emotion regulation, problem solving, mindfulness, interpersonal skills, relaxation, and modifying and addressing core beliefs. CBT TMH providers had a higher odds of using in-session and homework exercises and assigning them through postal mail, email or fax methods, as compared to non-CBT TMH providers. TMH providers, regardless of treatment paradigm, felt that assigning homework was neither easy nor difficult and they believed their patients were somewhat-to-moderately compliant to their assigned exercises. CBT TMH providers also collected clinical information from their patients more often than non-CBT TMH providers. They reported being less satisfied with their method, which was identified most often as paper-based surveys and forms. Overall, TMH providers employ evidence-based treatments to their patients remotely, with CBT TMH providers most likely to do so. Findings highlight the need for innovative solutions to improve how TMH providers that endorse following the CBT treatment paradigm remotely assign homework and collect clinical data to increase their satisfaction via telemedicine. (shrink)

Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Our review identified four (...) major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)

The work presented here investigates the process by which one group of individuals solves the problem of detecting deceptions created by other agents. A field experiment was conducted in which twenty‐four auditors (partners in international public accounting firms) were asked to review four cases describing real companies that, unknown to the auditors, had perpetrated financial frauds. While many of the auditors failed to detect the manipulations in the cases, a small number of auditors were consistently successful. Since the detection of (...) frauds occurs infrequently in the work of a given auditor, we explain success by the application of powerful heuristics gained from experience with deceptions in everyday life. These heuristics implement a variation of Dennett's intentional stance strategy, which is based on interpreting detected inconsistencies in the light of the Deceiver's (i.e., management's) goals and possible actions. We explain failure to detect deception by means of perturbations (bugs) in the domain knowledge of accounting needed to apply these heuristics to the specific context of financial statement fraud. We test our theory by showing that a computational model of fraud detection that employs the proposed heuristics successfully detects frauds in the cases given to the auditors. We then modify the model by introducing perturbations based on the errors made by each of the auditors in the four cases. The resulting models account for 84 of the 96 observations (i.e., 24 auditors × four cases) in our data. (shrink)

The work presented here investigates the process by which one group of individuals solves the problem of detecting deceptions created by other agents. A field experiment was conducted in which twenty-four auditors (partners in international public accounting firms) were asked to review four cases describing real companies that, unknown to the auditors, had perpetrated financial frauds. While many of the auditors failed to detect the manipulations in the cases, a small number of auditors were consistently successful. Since the detection of (...) frauds occurs infrequently in the work of a given auditor, we explain success by the application of powerful heuristics gained from experience with deceptions in everyday life. These heuristics implement a variation of Dennett's intentional stance strategy, which is based on interpreting detected inconsistencies in the light of the Deceiver's (i.e., management's) goals and possible actions. We explain failure to detect deception by means of perturbations (bugs) in the domain knowledge of accounting needed to apply these heuristics to the specific context of financial statement fraud. We test our theory by showing that a computational model of fraud detection that employs the proposed heuristics successfully detects frauds in the cases given to the auditors. We then modify the model by introducing perturbations based on the errors made by each of the auditors in the four cases. The resulting models account for 84 of the 96 observations (i.e., 24 auditors × four cases) in our data. (shrink)

Participants in clinical research sometimes view participation as therapy or exaggerate potential benefits, especially in phase I or phase II trials. We conducted this study to discover what methods might improve cancer patients’ understanding of early-phase clinical trials. We randomly assigned 130 cancer patients from three U.S. medical centers who were considering enrollment in a phase I or phase II cancer trial to receive either a multimedia intervention or a National Cancer Institute pamphlet explaining the trial and its purpose. Intervention (...) participants were 32 times more likely to believe that the trial’s purpose was to examine safety and 60 % less likely to believe they would experience long-term benefit or cure. There was no difference in enrollment decision. However, while patients’ understanding of the trial’s purpose improved and expectations of long-term benefit diminished, half the respondents still believed they would experience long-term benefit or cure from participation. Therefore, we conclude that multimedia interventions such as this one may help oncologists to explain the risks and benefits of early-phase cancer trials in a way that patients can more easily understand, helping them to make more informed decisions about participation. But further research into other factors that influence patients’ beliefs about the outcome of enrollment is needed, both to modify the interventions and to determine how malleable patient beliefs are. (shrink)

Social cognition, social skill, and social motivation have been extensively researched and characterized as atypical in autistic people, with the assumption that each mechanistically contributes to the broader social interaction difficulties that diagnostically define the condition. Despite this assumption, research has not directly assessed whether or how these three social domains contribute to actual real-world social interaction outcomes for autistic people. The current study administered standardized measures of social cognition, social skill, and social motivation to 67 autistic and 58 non-autistic (...) adults and assessed whether performance on these measures, both individually and relationally between dyadic partners, predicted outcomes for autistic and NA adults interacting with unfamiliar autistic and NA partners in a 5 minute unstructured “get to know you” conversation. Consistent with previous research, autistic adults scored lower than NA adults on the three social domains and were evaluated less favorably by their conversation partners. However, links between autistic adults' performance on the three social domains and their social interaction outcomes were minimal and, contrary to prediction, only the social abilities of NA adults predicted some interaction outcomes within mixed diagnostic dyads. Collectively, results suggest that reduced performance by autistic adults on standardized measures of social cognition, social skill, and social motivation do not correspond in clear and predictable ways with their real-world social interaction outcomes. They also highlight the need for the development and validation of more ecological assessments of autistic social abilities and the consideration of relational dynamics, not just individual characteristics, when assessing social disability in autism. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

Persons registered to vote in Seattle, Washington for the November, 1986 general election and a September, 1987 primary election were randomly assigned to treatments in two telephoneconducted experiments that sought to increase voter tumout. The experiments applied and extended a "self-prophecy” technique, in which respondents are asked simply to predict whether or not they will perform a target action. In the present studies, voting registrants were asked to predict whether or not they would vote in an election that was less (...) than 48 hours away. This technique, which previously increased turnout in a small study done during the 1984 U.S. Presidential election, was again effective among moderate prior-turnout voters in the second of the present much larger experiments. The failure of the effect in Experiment 1 was plausibly a ceiling effect due to very high turnout for a U.S. Senate contest in the 1986 election. Successful applications of the self· prophecy technique are facilitated by social desirability of the target action (which leads subjects to predict that they will perform it). However, social desirability of the target behavior is not a sufficient condition for the effect, as indicated by an unexpected nonoccurrence of the effect among low prior-tumout voters in Experiment 2. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect (delayed response due to interference) elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

All of our information about the world is derived from the function of our senses, and thus they are the principal source of all our knowledge. This was recognized explicitly by early Greek philosophers, remained an important point of discussion for nineteenth‐century philosophers, and continues to be a key issue for present‐day philosophers, psychologists, and neuroscientists. It is a key issue in cognitive science because, by initiating the processes that store and evaluate information, sensory information transmission can be considered a (...) cognitive initiator. In a very real sense, who we are and how we see the world are the result of the experiences that are mediated by our sensory systems. These are some of the reasons why the study of sensory systems has occupied such a prominent place in modern cognitive neuroscience. (shrink)

The COVID-19 outbreak has simultaneously increased the need for mental health services and decreased their availability. Brief online self-help interventions that can be completed in a single session could be especially helpful in improving access to care during the crisis. However, little is known about the uptake, acceptability, and perceived utility of these interventions outside of clinical trials in which participants are compensated. Here, we describe the development, deployment, acceptability ratings, and pre–post effects of a single-session intervention, the Common Elements (...) Toolbox, adapted for the COVID-19 crisis to support graduate and professional students. Participants, who were not compensated, were randomly assigned to two of three modules: behavioral activation, cognitive restructuring, and gratitude. Over 1 week, 263 individuals began and 189 individuals completed the intervention. Participants reported that the intervention modules were acceptable, helpful, engaging, applicable to their lives, and could help them manage COVID-related challenges. Participants reported pre- to post-program improvements in secondary control and in the perceived negative impact of the COVID-19 crisis on their quality of life. On average, differences in their perceived ability to handle lifestyle changes resulting from the pandemic were positive, but small and at the level of a non-significant trend. Our results highlight the acceptability and utility of an online intervention for supporting individuals through the COVID-19 crisis. (shrink)

Background: A growing literature has raised—skeptically—the question of whether cutting-edge scientific research can identify and address broader ethical and policy considerations in real time. In genomics, the question is: Can ELSI contribute to genomics in real time, or will it be relegated to its historical role of after-the-fact outsider critique? We address this question against the background of a genomic screening project where we participated as embedded, real-time ELSI researchers and observers, from its initial design through its conclusion.Methods: As part (...) of the ELSI study design, the project included an ongoing reflexive ethnography in which the authors studied the process of its design and implementation. The authors were true participant observers, serving as members of various task-oriented groups while recording meetings and other events for ongoing qualitative analysis. We also conducted and analyzed interviews of multiple participants at the conclusion of the project.Results: Our real-time ELSI initiative had a mixed record of successes and challenges. If we define success as ELSI researchers having had an opportunity to participate fully in the project and to make the ELSI perspective heard, then our assessment is largely positive. If, however, we define successes as instances where real-time ELSI contributions changed the direction of the genomic or public health aspects of the GeneScreen project or, after careful deliberation, confirmed the appropriateness of the status quo, then we can identify only a few examples. While we had a seat at the table, we were, for the most part, tolerated guests.Conclusions: We conclude that there are significant barriers to real-time ELSI influence. The difficulty does not reside in any intended exclusion of an ELSI perspective, but in factors endemic to genomic research, including knowledge disparities, epistemological biases, and the pressures of time and money. (shrink)