In the exploratory study reported here, we tested the efficacy of an intervention designed to train teenagers with Möbius syndrome (MS) to increase the use of alternative communication strategies (e.g., gestures) to compensate for their lack of facial expressivity. Specifically, we expected the intervention to increase the level of rapport experienced in social interactions by our participants. In addition, we aimed to identify the mechanisms responsible for any such increase in rapport. In the study, five teenagers with MS interacted with (...) three naïve participants without MS before the intervention, and with three different naïve participants without MS after the intervention. Rapport was assessed by self-report and by behavioral coders who rated videos of the interactions. Individual non-verbal behavior was assessed via behavioral coders, whereas verbal behavior was automatically extracted from the sound files. Alignment was assessed using cross recurrence quantification analysis and mixed-effects models. The results showed that observer-coded rapport was greater after the intervention, whereas self-reported rapport did not change significantly. Observer-coded gesture and expressivity increased in participants with and without MS, whereas overall linguistic alignment decreased. Fidgeting and repetitiveness of verbal behavior also decreased in both groups. In sum, the intervention may impact non-verbal and verbal behavior in participants with and without MS, increasing rapport as well as overall gesturing, while decreasing alignment. (shrink)

Disturbed identity is one of the defining characteristics of Borderline Personality Disorder manifested in a broad spectrum of dysfunctions related to the self, including disturbances in meaning-generating self-narratives. Autobiographical memories are memories of personal events that provide crucial building-blocks in our construction of a life-story, self-concept, and a meaning-generating narrative identity. The cultural life script represents culturally shared expectations as to the order and timing of life events in a prototypical life course within a given culture. It is used to (...) organize one’s autobiographical memories. Here, 17 BPD-patients, 14 OCD-patients, and 23 non-clinical controls generated three important autobiographical memories and their conceptions of the cultural life script. BPD-patients reported substantially more negative memories, fewer of their memories were of prototypical life script events, their memory narratives were less coherent and more disoriented, and the overall typicality of their life scripts was lower as compared with the other two groups. (shrink)

In the generative tradition, the language faculty has been shrinking—perhaps to include only the mechanism of recursion. This paper argues that even this view of the language faculty is too expansive. We first argue that a language faculty is difficult to reconcile with evolutionary considerations. We then focus on recursion as a detailed case study, arguing that our ability to process recursive structure does not rely on recursion as a property of the grammar, but instead emerges gradually by piggybacking on (...) domain-general sequence learning abilities. Evidence from genetics, comparative work on non-human primates, and cognitive neuroscience suggests that humans have evolved complex sequence learning skills, which were subsequently pressed into service to accommodate language. Constraints on sequence learning therefore have played an important role in shaping the cultural evolution of linguistic structure, including our limited abilities for processing recursive structure. Finally, we re-evaluate some of the key considerations that have often been taken to require the postulation of a language faculty. (shrink)

Indigenous peoples are disproportionally vulnerable to climate change. At the same time, they possess valuable knowledge for fair and sustainable climate adaptation planning and policymaking. Yet Indigenous peoples and knowledges are often excluded from or underrepresented within adaptation plans and policies. In this paper we ask whether the concept of epistemic injustice can be applied to the context of climate adaptation and the underrepresentation of Indigenous knowledges within adaptation policies and strategies. In recent years, the concept of epistemic injustice has (...) gained prominence, indicating that someone has been unfairly discriminated against in their capacity as a knower. We argue that many climate adaptation policies are epistemically unjust towards Indigenous peoples because of the underrepresentation of Indigenous knowledges by showing how the case of Indigenous knowledges in climate adaptation planning and policy satisfies five conditions of epistemic injustice. We further consider what challenges there are to integrating local and Indigenous knowledges within development in general, and climate adaptation strategies in particular and how these can be addressed. Whether the lack of Indigenous knowledges in climate adaptation policies constitutes an epistemic injustice matters because an injustice denotes an unfair advantage to one group – whether by design or default – that ought to be remedied and redressed. (shrink)

Many philosophers and medical scientists assume thatdisease categories or entities used to classify concrete cases ofdisease, are often defined by disease mechanisms or causalprocesses. Others suggest that diseases should always be definedin this manner. This paper discusses these standpoints criticallyand concludes that they are untenable, not only when `diseasemechanism' refers to an objective mechanism, but also when`mechanism' refers to a pragmatically demarcated part of thetotal ``objective'' causal structure of diseases. As an alternativeto principles that use the concept of disease mechanism (...) oranalogous concepts, a pragmatic approach is suggested anddescribed. This approach has been suggested before, but inproblematic or inadequate versions. This paper proposes a versioncompiled of two ``pragmatic principles'' and shows that they aremuch more adequate than the principle of disease mechanism. Withreference to a case study of a still ongoing internationaldiscussion of various candidates for a classification system formalignant lymphomas, including REAL (Revised European–AmericanClassification of Lymphoid Neoplasms) in which the concept ofdisease mechanism or analogous concepts plays a very small part,it is shown just how pivotal these two pragmatic principles canbe in actual discussions of definitions of diseases. Finally, itis pointed out that with regard to modern philosophy of languageit may, at least in some cases, be problematic to distinguishbetween the two pragmatic principles as they stand. (shrink)

In this paper I offer a normative account of development expertise. Although extending expertise beyond the traditional development experts to include local stakeholders, this normative account aims to delimit legitimate forms of expertise. I label this normative view third wave development expertise. Third wave expertise is distinguished from both the technocratic and the social constructivist views of development expertise. In particular, I discuss the notions of contributory and interactional expertise. Contributory expertise denotes the extent to which a group of agents (...) possesses knowledge which can make a significant contribution to development decision-making, while interactional expertise denotes the extent to which they are able to communicate this knowledge meaningfully. While local stakeholders may possess contributory expertise in matters of their own development, they may lack interactional expertise to communicate this knowledge. Resolving this issue, I argue, requires a mediator who can interact with and between external experts and local stakeholders. (shrink)

It is widely assumed that human learning and the structure of human languages are intimately related. This relationship is frequently suggested to derive from a language-specific biological endowment, which encodes universal, but communicatively arbitrary, principles of language structure (a Universal Grammar or UG). How might such a UG have evolved? We argue that UG could not have arisen either by biological adaptation or non-adaptationist genetic processes, resulting in a logical problem of language evolution. Specifically, as the processes of language change (...) are much more rapid than processes of genetic change, language constitutes a both over time and across different human populations, and, hence, cannot provide a stable environment to which language genes could have adapted. We conclude that a biologically determined UG is not evolutionarily viable. Instead, the original motivation for UG arises because language has been shaped to fit the human brain, rather than vice versa. Following Darwin, we view language itself as a complex and interdependent which evolves under selectional pressures from human learning and processing mechanisms. That is, languages themselves are shaped by severe selectional pressure from each generation of language users and learners. This suggests that apparently arbitrary aspects of linguistic structure may result from general learning and processing biases deriving from the structure of thought processes, perceptuo-motor factors, cognitive limitations, and pragmatics. (shrink)

In a recent article, [Sergent, C. & Dehaene, S. . Is consciousness a gradual phenomenon? Evidence for an all-or-none bifurcation during the attentional blink, Psychological Science, 15, 720–729] claim to give experimental support to the thesis that there is a clear transition between conscious and unconscious perception. This idea is opposed to theoretical arguments that we should think of conscious perception as a continuum of clarity, with e.g., fringe conscious states [Mangan, B. . Sensation’s ghost—the non-sensory “fringe” of consciousness, Psyche, (...) 7, 18]. In the experimental study described in this article, we find support for this opposite notion that we should have a parsimonious account of conscious perception. Our reported finding relates to the hypothesis that there is more than one perceptual threshold [Merikle, P.M., Smilek, D. & Eastwood, J.D. . Perception without awareness: perspectives from cognitive psychology, Cognition, 79, 115–134], but goes further to argue that there are different “levels” of conscious perception. (shrink)

Dienes and Seth (2010) conclude that confidence ratings and post-decision wagering are two comparable and recommendable measures of conscious experience. In a recently submitted paper, we have however found that both methods are problematic and seem less suited to measure consciousness than a direct introspective measure. Here, we discuss the methodology and conclusions put forward by Dienes and Seth, and why we think the two experiments end up with so different recommendations.

Memory is fleeting. New material rapidly obliterates previous material. How, then, can the brain deal successfully with the continual deluge of linguistic input? We argue that, to deal with this “Now-or-Never” bottleneck, the brain must compress and recode linguistic input as rapidly as possible. This observation has strong implications for the nature of language processing: (1) the language system must “eagerly” recode and compress linguistic input; (2) as the bottleneck recurs at each new representational level, the language system must build (...) a multilevel linguistic representation; and (3) the language system must deploy all available information predictively to ensure that local linguistic ambiguities are dealt with “Right-First-Time”; once the original input is lost, there is no way for the language system to recover. This is “Chunk-and-Pass” processing. Similarly, language learning must also occur in the here and now, which implies that language acquisition is learning to process, rather than inducing, a grammar. Moreover, this perspective provides a cognitive foundation for grammaticalization and other aspects of language change. Chunk-and-Pass processing also helps explain a variety of core properties of language, including its multilevel representational structure and duality of patterning. This approach promises to create a direct relationship between psycholinguistics and linguistic theory. More generally, we outline a framework within which to integrate often disconnected inquiries into language processing, language acquisition, and language change and evolution. (shrink)

This paper makes two main claims: first, that the need to protect health professionals' moral integrity is what grounds the right to conscientious objection in health care; and second, that for a given claim of conscientious objection to be acceptable to society, a certain set of criteria should be fulfilled. The importance of moral integrity for individuals and society, including its special role in health care, is advocated. Criteria for evaluating the acceptability of claims to conscientious objection are outlined. The (...) precise content of the criteria is dictated by the two main interests that are at stake in the dilemma of conscientious objection: the patient's interests and the health professional's moral integrity. Alternative criteria proposed by other authors are challenged. The bold claim is made that conscientious objection should be recognised by society as acceptable whenever the five main criteria of the proposed set are met. (shrink)

In this article, I critically assess Hélène Landemore's new model of Open Democracy, asking whether it requires of citizens to blindly defer to the decisions of the mini-public. To address this question, I, first, discuss three institutional mechanisms in Open Democracy, all of which can be read to grant citizens democratic control. I argue that neither the capacity to authorize the selection mechanism (random sortition), nor the lottocratic conception of political equality, nor the self-selection mechanisms of Landemore's model deliver the (...) form of control that would insulate Open Democracy from the charge of blind deference. I then discuss the direct democracy mechanisms that Landemore incorporates into her model. Although these devices grant citizens control and, by extension, offer the resources for repudiating the charge of blind deference, they also, I argue, subvert the logic of Landemore's lottocratic model, rendering Open Democracy predictably unstable. Given the deliberative asymmetries between the mini-public and the citizenry, a high frequency of bottom-up challenges is to be expected that would throw the whole system into jeopardy. Thus, the challenge for lottocrats is to show how democratic control can be achieved in a lottocratic system without undermining the benefits of the legislature by lot. (shrink)

Morten Frederiksen explores Carl Gustav Jung's elusive notion of synchronicity from a transrational perspective and relates synchronicity to the transpersonality of the "All-One". This is done by expanding the content and meaning of Wolfgang Dietrich's layers of Elicitive Conflict Mapping (ECM) through re-relating them to Ken Wilber's model of the structures of consciousness; with synchronicity as the literal connecting principle. The result, then, is an expanded notion of the transrational peace philosophy which includes Wilber's model of stages shorn of (...) its evolutionary slant and fathoms synchronicity in its theoretical outlook and practical application. Contents A Transrational Approach to Peace Studies through processing the Topic of Synchronicity Jungian Psychology and his Concept of Synchronicity Transrational Peace Philosophy and Consciousness Development Seven different Structures of Consciousness Consequences of Synchronicity for a transrational-oriented Peace Philosophy and Practice Target Groups Lecturers and Students of Psychology, Peace Students and Conflict Transformation Researchers Practitioners in the Field of Elicitive Conflict Transformation About the Author Morten Frederiksen is a Peace Researcher from the MA Program in Peace, Security, Development and International Conflict Transformation at the University of Innsbruck, Austria, and Coordinator of the Danish Development Aid Agency "U-landsforeningen Svalerne". (shrink)

In this review article, Christiansen provides a historical perspective on the two research traditions, implicit learning and statistical learning, thus nicely setting the scene for this special issue of Topics in Cognitive Science. In this “tale of two literatures”, he first traces the history of both literatures before sketching a framework that provides a basis for understanding implicit learning and statistical learning as a unified phenomenon.

The article analyses the role and moral force of consent in BDSM (Sado-masochistic and related practice). The view defended accepts consent as a key feature in sexual morality, and explains in detail the relation between consent and autonomy. In brief, it is argued that consent as a genuine extension of personal autonomy both justifies and draws limits to justifiable BDSM-practices: autonomy-undermining practices cannot be justified by appealing to autonomy. The paper discusses in detail the necessary conditions for consent with an (...) emphasis on relevant pitfalls in the context of BDSM and moves to an analysis of the prevalent “official” morality of the BDSM-community, expressed in the slogan “safe, sane, and consensual.” Finally, it draws attention to an un-discussed parallel between sexual morality and the concept of exit-rights as it is known from political philosophy. (shrink)

Journal of Social Philosophy, EarlyView.

Recent works on the concept of dignity have opened up the otherwise quite deadlocked debate about assisted death (AD). Rather than just reinforcing already fixed positions, it seems to me that these conceptions of dignity make room for a moderate and normatively richer position on the moral permissibility of AD. I do not think that we have seen the full potential of the said conceptions and interpretations. I try in this article to contribute my part. First, I briefly recapitulate some (...) of the paradoxical ways in which dignity is typically invoked in the debate and try to clear up some of the obvious confusions. Then, I go on to explore a particular Kantian line of thought in some recent works on dignity and AD that seems to pave the way for a moderate position with a more principled foundation than the usual compromise positions. (shrink)

Blindsight is classically defined as residual visual capacity, e.g., to detect and identify visual stimuli, in the total absence of perceptual awareness following lesions to V1. However, whereas most experiments have investigated what blindsight patients can and cannot do, the literature contains several, often contradictory, remarks about remaining visual experience. This review examines closer these remarks as well as experiments that directly approach the nature of possibly spared visual experiences in blindsight.

In the attempt to construct a scientific approach to consciousness, it has been proposed that transcendental phenomenology or phenomenological psychology be introduced into the framework of cognitive neuroscience. In this article, the consequences of such an approach in terms of basic assumptions, methods for the collection of data, and evaluation of the collected data are discussed. Especially, the proposed notions of mutual constraint and the second perso are discussed. It is concluded that even though naturalising of phenomenology might not prove (...) impossible, the projec has not yet found a coherent basic ground. (shrink)

BackgroundSurveys on attitudes towards assisted dying play an important role in informing public debate, policy and legislation. Unfortunately, surveys are often designed with insufficient attention to framing effects; that is, effects on the respondents’ stated attitudes caused by question wording and context. The purpose of this study was to demonstrate and measure such framing effects. MethodsSurvey experiment in which an eight-question survey on attitudes towards assisted dying was distributed to Norwegian citizens through a web-based panel. Two variations of question wording (...) as well as two variations of question order were employed. Respondents were randomized to receive one of four questionnaire versions. ResultsThree thousand and fifty responses were received. There were moderate to large question wording and question order effects. A majority of Norwegian citizens favour the legalization of assisted dying for patients with terminal or chronic disease. ConclusionsStakeholders in the assisted dying debate need to acknowledge potential framing effects, and accordingly should interpret survey results with caution. The same holds for researchers who conduct attitude surveys in the field of bioethics. (shrink)

PurposeAs interest in technology ethics is increasing, so is the interest in bringing schools of ethics from non-Western philosophical traditions to the field, particularly when it comes to information and communication technology. In light of this development and recent publications that result from it, this paper aims to present responds critically to recent work on Confucian virtue ethics (CVE) and technology.Design/methodology/approachFour critiques are presented as theoretical challenges to CVE in technology, claiming that current literature insufficiently addresses: overall applicability, collective ethics (...) issues, epistemic overconfidence within technology corporations and amplification of epistemic overconfidence by the implementation of CVE. These challenges make use of general CVE literature and work on technology critique, political philosophy, epistemology and business ethics.FindingsImplementing CVE in technology may yield some benefits, but these may be outweighed by other outcomes, include strengthening hierarchies, widening inequities, increasing, rather than limiting, predictive activity, personal data collection, misinformation, privacy violations and challenges to the democratic process.Originality/valueThough not directly advocating against CVE, the paper reveals hitherto unidentified and serious issues that should be addressed before CVE are used to inform ethics guidelines or regulatory policies. It also serves as a foundation for further inquiry into how Eastern philosophy more broadly can inform technology ethics in the West. (shrink)

'Behavioral Methods in Consciousness Research' is the first book of its kind, providing an overview of methods and approaches for studying consciousness. The chapters are written by leading researchers and experts who describe the methods they actually use in their own studies, along with their pitfalls, problems, and difficulties.

How may clinical ethics committees inspire ethical reflection among healthcare professionals? How may they deal with organizational ethics issues? In recent years, Norwegian CECs have attempted different activites that stretch or go beyond the standard trio of education, consultation, and policy work. We studied the novel activities of Norwegian CECs by examining annual reports and interviewing CEC members. Through qualitative analysis we identified nine categories of novel CEC activities, which we describe by way of examples. In light of the findings, (...) we argue that some novel working methods may be well suited to promote ethical reflection among clinicians, and that the CEC may be a suitable venue for discussing issues of organizational ethics. (shrink)

BackgroundCase consultation performed by clinical ethics committees (CECs) is a complex activity which should be evaluated. Several evaluation studies have reported stakeholder satisfaction in single institutions. The present study was conducted nationwide and compares clinicians’ evaluations on a range of aspects with the CEC’s own evaluation.MethodsProspective questionnaire study involving case consultations at 19 Norwegian CECs for 1 year, where consultations were evaluated by CECs and clinicians who had participated.ResultsEvaluations of 64 case consultations were received. Cases were complex with multiple ethical (...) problems intertwined. Clinicians rated the average CEC consult highly, being both satisfied with the process and perceiving it to be useful across a number of aspects. CEC evaluations corresponded well with those of clinicians in a large majority of cases. Having next of kin/patients present was experienced as predominantly positive, though practised by only half of the CECs. The educational function of the consult was evaluated more positively when the CEC used a systematic deliberation method.ConclusionsCEC case consultation was found to be a useful service. The study is also a favourable evaluation of the Norwegian CEC system, implying that it is feasible to implement well-functioning CECs on a large scale. There are good reasons to involve the stakeholders in the consultations as a main rule. (shrink)

The ability to convey our thoughts using an infinite number of linguistic expressions is one of the hallmarks of human language. Understanding the nature of the psychological mechanisms and representations that give rise to this unique productivity is a fundamental goal for the cognitive sciences. A long-standing hypothesis is that single words and rules form the basic building blocks of linguistic productivity, with multiword sequences being treated as units only in peripheral cases such as idioms. The new millennium, however, has (...) seen a shift toward construing multiword linguistic units not as linguistic rarities, but as important building blocks for language acquisition and processing. This shift—which originated within theoretical approaches that emphasize language learning and use—has far-reaching implications for theories of language representation, processing, and acquisition. Incorporating multiword units as integral building blocks blurs the distinction between grammar and lexicon; calls for models of production and comprehension that can accommodate and give rise to the effect of multiword information on processing; and highlights the importance of such units to learning. In this special topic, we bring together cutting-edge work on multiword sequences in theoretical linguistics, first-language acquisition, psycholinguistics, computational modeling, and second-language learning to present a comprehensive overview of the prominence and importance of such units in language, their possible role in explaining differences between first- and second-language learning, and the challenges the combined findings pose for theories of language. (shrink)

Controversies arise over abortion, assisted dying and conscientious objection in healthcare. The purpose of the study was to examine the relationship between attitudes towards these bioethical dilemmas, and secularity and religiosity. Data were drawn from a 2017 web-based survey of a representative sample of 1615 Norwegian adults. Latent moderated structural equations modelling was used to develop a model of the relationship between attitudes. The resulting model indicates that support for abortion rights is associated with pro-secular attitudes and is a main (...) “driver” for support for assisted dying and opposition to conscientious objection. This finding should be regarded as a hypothesis which ought to be tested in other populations. If the relationship is robust and reproduced elsewhere, there are important consequences for CO advocates who would then have an interest in disentangling the debate about CO from abortion; and for health systems who ought to consider carefully how a sound policy on CO can safeguard both patient trust in the services and the moral integrity of professionals. It is suggested that if religiosity wanes and pro-secular and pro-abortion attitudes become more widespread, support for CO might decline, putting into question whether present policies of toleration of conscientious refusals will remain acceptable to the majority. (shrink)

Although most theorists of healthcare rationing argue that rationing, including rationing that takes place in the physician–patient relationship is unavoidable, some health professionals strongly disagree. In a recent essay, Vegard Bruun Wyller argues that bedside rationing is immoral and thoroughly at odds with a sound view of the physician–patient relationship. We take Wyller to be an articulate exponent of the reluctance to participate in rationing found among some clinicians. Our essay attempts to refute the five crucial premises of his argument (...) yet build on his genuine insights. In our analysis, Wyller’s critique of bedside rationing is instructive both for harbouring some very common misconceptions that must be exposed and refuted, but also for offering important words of caution. In particular, bedside rationing must be performed in ways that do not harm the physician–patient relationship. Read irenically, Wyller’s critique is a reminder of what must not be lost in our painful endeavour to update the ethics of medicine to encompass the unavoidability of rationing. (shrink)

ABSTRACTStories pervade sport. In elite spectator sport, stories play out in packed stadiums while being broadcast simultaneously to immense TV audiences. These stories, which present controversial...

Two of the Scandinavian countries, Sweden and Finland have recently joined the European Communities. Together with a third Scandinavian country, Denmark, which joined the Communities two decades ago it seems likely that Scandinavian views and attitudes will make a great impact on the future work of the European Communities — including the on-going harmonisation in the field of corporate social responsibility.This article provides an examination of the Scandinavian view on the five best known models for achieving corporate social responsibility and (...) it shows the likely impact of the admittance of the Scandinavian countries on the future work in the European Communities with regard to corporate social responsibility. (shrink)

As is the case with other concepts about mental affairs, the concept of introspection has many different interpretations. Some seem to consider introspecting a perceptive act and others see it as a thinking activity . For the present purpose, we will claim it as a common understanding in all such theories that introspection presupposes consciousness . States of consciousness, broadly discussed in the philosophical and empirical literature as first order states of consciousness, are states in which a subject is aware (...) of some or other object, thought, or feeling. Introspective states, however, are states in which a subject directs his or her attention towards their own conscious state. According to this understanding which we claim is a widespread one introspection can exist only in conscious subjects, and, furthermore, it is by way of introspection that a subject can learn about having this or that experience. To avoid misunderstandings, we wish to underline that the claim is not that experiencing as such is dependent upon such acts of introspection. On the contrary, we believe that a subject can have all kinds of intero- and exteroceptive experiences, directing attention towards the represented object . It is only when the subject directs attention not towards the object as such but towards the very state of being conscious of the object that he or she is introspective. (shrink)

Arguably, emotion is always valenced—either pleasant or unpleasant—and dependent on the pleasure system. This system serves adaptive evolutionary functions; relying on separable wanting, liking, and learning neural mechanisms mediated by mesocorticolimbic networks driving pleasure cycles with appetitive, consummatory, and satiation phases. Liking is generated in a small set of discrete hedonic hotspots and coldspots, while wanting is linked to dopamine and to larger distributed brain networks. Breakdown of the pleasure system can lead to anhedonia and other features of affective disorders. (...) Eudaimonia and well-being are difficult to study empirically, yet whole-brain computational models could offer novel insights potentially linking eudaimonia to optimal metastability in the pleasure system. (shrink)

In a recent paper, Brogaard presents counter-arguments to the conclusions of an experiment with blindsight subject GR. She argues that contrary to the apparent findings that GR’s preserved visual abilities relate to degraded visual experiences, she is in fact fully unconscious of the stimuli she correctly identifies. In this paper, we present arguments and evidence why Brogaard’s argument does not succeed in its purpose. We suggest that not only is relevant empirical evidence in opposition to Brogaard’s argument, her argument misconstrues (...) necessary criteria to decide whether a conscious experience is visual or not visual. (shrink)

The importance of developmental agendas -- A capability framework for development goals -- A Republican account of local authority in development -- Third wave development expertise -- Selecting capabilities for a development agenda -- Methods for the selection of capabilities and functionings -- An inclusive framework for setting development agendas.

Despite the commonly held view that confessing to doping is morally right, few former elite athletes who have doped confess to doping. In this paper, I ask whether elite athletes who have d...

Several authors within psychology, neuroscience and philosophy take for granted that standard empirical research techniques are applicable when studying consciousness. In this article, it is discussed whether one of the key methods in cognitive neuroscience – the contrastive analysis – suffers from any serious confounding when applied to the field of consciousness studies; that is to say, if there are any systematic difficulties when studying consciousness with this method that make the results untrustworthy. Through an analysis of theoretical arguments in (...) favour of using contrastive analysis, combined with analyses of empirical findings, I conclude by arguing for three factors that currently are confounding of research using contrastive analysis. These are (1) unconscious processes, (2) introspective reports, and (3) attention. (shrink)

Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns. Descriptions of activities involving priority setting in annual reports from Norwegian CECs were studied and categorized through qualitative content analysis. Three hundred thirty-nine reports from 38 CECs were studied. (...) We found 78 activities where resource use or priority setting were explicitly highlighted as main topics. Of these, 29 were seminars or other educational activities, 21 were deliberations on individual patient cases, whereas 28 were discussions of principled or general cases. Individual patient cases concerned various distributional dilemmas where values were at stake. Six main topics and seven roles for the CEC were identified. CECs handle issues concerning the introduction of new costly drugs, extraordinarily costly established treatment, the application of priority setting criteria, resource use for vulnerable groups, resource constraints compromising practice, and futility of care. The CEC can act as an analyst, advisor, moderator, disseminator, facilitator, watch dog, and guardian of values and laws. In order to fulfil their responsibilities in handling priority setting cases, CECs need knowledge of both the ethics and the institutionalized systems of priority setting. There is potential for developing this aspect of the CECs’ work further. The Norwegian CECs are involved in priority setting decisions where they can play multiple constructive roles. In particular, they advise and raise awareness of ethical aspects in resource allocations; bridge clinical practice with higher-level decisions; and promote fair resource allocation and stakeholder rights and interests. (shrink)

Background Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns. Method Descriptions of activities involving priority setting in annual reports from Norwegian CECs were studied and categorized through qualitative content analysis. Results Three hundred thirty-nine reports from 38 (...) CECs were studied. We found 78 activities where resource use or priority setting were explicitly highlighted as main topics. Of these, 29 were seminars or other educational activities, 21 were deliberations on individual patient cases, whereas 28 were discussions of principled or general cases. Individual patient cases concerned various distributional dilemmas where values were at stake. Six main topics and seven roles for the CEC were identified. CECs handle issues concerning the introduction of new costly drugs, extraordinarily costly established treatment, the application of priority setting criteria, resource use for vulnerable groups, resource constraints compromising practice, and futility of care. The CEC can act as an analyst, advisor, moderator, disseminator, facilitator, watch dog, and guardian of values and laws. Discussion In order to fulfil their responsibilities in handling priority setting cases, CECs need knowledge of both the ethics and the institutionalized systems of priority setting. There is potential for developing this aspect of the CECs’ work further. Conclusions The Norwegian CECs are involved in priority setting decisions where they can play multiple constructive roles. In particular, they advise and raise awareness of ethical aspects in resource allocations; bridge clinical practice with higher-level decisions; and promote fair resource allocation and stakeholder rights and interests. (shrink)