Miranda Fricker’s influential concept of epistemic injustice has recently seen application to many areas of interest, with an increasing body of healthcare research using the concept of epistemic injustice in order to develop both general frameworks and accounts of specific medical conditions and patient groups. This paper illuminates tensions that arise between taking steps to protect against committing epistemic injustice in healthcare, and taking steps to understand the complexity of one’s predicament and treat it accordingly. Work on epistemic injustice is (...) therefore at risk of obfuscating legitimate and potentially fruitful inquiry. This paper uses Chronic Fatigue Syndrome/Myalgic Encephalomyelitis as a case study, but I suggest that the key problems identified could apply to other cases within healthcare, such as those classed as Medically Unexplained Illnesses, Functional Neurological Disorders and Psychiatric Disorders. Future work on epistemic injustice in healthcare must recognise and attend to this tension to protect against unsatisfactory attempts to correct epistemic injustice. (shrink)

ABSTRACT Current attempts to understand unusually high rates of psychiatric illness in complex, chronic illnesses can be guilty of operating within an explanatory framework whereby there are two options. Either (a) that the psychiatric predicaments are secondary to the bodily condition, and (b) that they are primary. In this paper, I draw upon philosophical work on affect, contemporary empirical work, and qualitative first-person patient data to illustrate a much messier reality. I argue that affective experience is generally more complex in (...) such conditions, and that a variety of pre- and post-morbid causal factors dynamically interact such that the resultant psychiatric predicaments do not permit to classification as strictly primary or secondary to the bodily condition. Affective scaffolding, in my view, provides an apt theoretical framework for capturing this nuance. (shrink)

This paper points to a more expansive conception of grief by arguing that the losses of illness can be genuine objects of grief. I argue for this by illuminating underappreciated structural features of typical grief — that is, grief over a bereavement — which are shared but under-recognized. I offer a common chronic illness, chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), as a striking case study. I then use this analysis to highlight some clinical challenges that arise should this claim receive uptake (...) in clinical practice. Extant literature on CFS/ME tells us that rates of comorbid depression are atypically high. If one accepts that people with CFS/ ME can grieve over losses associated with the condition, and that grief can be easily mistaken for depression in this context, this might suggest that rates of comorbid depression are inflated. I show, however, that the challenge of distinguishing between healthy and pathological grief arises in its place, and is just as tricky to solve. (shrink)

Various claims have been made concerning the role of narrative in grief. In this paper, we emphasize the need for a discerning approach, which acknowledges that narratives of different kinds relate to grief in different ways. We focus specifically on the positive contributions that narrative can make to sustaining, restoring and revising a sense of who one is. We argue that, although it is right to suggest that narratives provide structure and coherence, they also play a complementary role in disrupting (...) established structure and opening up new possibilities. We add that both of these roles point to the importance of interpersonal, social and cultural factors in shaping the trajectory of grief. We conclude by briefly considering the implications for distinguishing between typical and pathological forms of grief. (shrink)

Objective Standards of care regarding obstetric management of life-threatening anomalies are not defined. It is hypothesised that physicians' management of these pregnancies is variable and influenced by demographic factors. Design A questionnaire was mailed to members of the Society of Maternal–Fetal Medicine with valid US addresses assessing obstetric management of both ‘uniformly lethal’ (eg, anencephaly, renal agenesis) and ‘uniformly severe, commonly lethal’ (eg, trisomy 13 and 18) anomalies. Respondents were asked to answer as if not limited by state/institutional restrictions. Fisher's (...) exact or χ2 tests were used as appropriate and correction made for multiple comparisons in analyses that were not prespecified. Results The response rate was 36% (732/2038). Nearly 100% of respondents discuss termination for both uniformly and commonly lethal anomalies. In continuing pregnancies, with patient request for obstetric non-intervention 99% of providers would comply for either uniformly or commonly lethal anomalies. The majority ‘encourage’ such management, but some were non-directive or discouraged this management. In continuing pregnancies, with patient request for full obstetric intervention the majority of respondents was willing to comply for both uniformly (71%) and commonly (82%) lethal anomalies. While most practitioners ‘discouraged’ full intervention, some were non-directive or encouraged this management. Demographics and severity of anomaly influenced counselling. Conclusion Discrepancies exist regarding the management of life-threatening fetal anomalies. Patients may be offered different options based on practitioner demographics. The majority of physicians comply with patient wishes. Differences were noted when comparing the management of lethal with that of severe commonly lethal anomalies, suggesting that practitioners make a distinction when counselling patients. (shrink)

ABSTRACTThis article addresses the question of whether certain experiences that originate in causes other than bereavement are properly termed ‘grief’. To do so, we focus on widespread experiences of grief that have been reported during the Covid-19 pandemic. We consider two potential objections to a more permissive use of the term: grief is, by definition, a response to a death; grief is subject to certain norms that apply only to the case of bereavement. Having shown that these objections are unconvincing, (...) we sketch a positive case for a conception of grief that is not specific to bereavement, by noting some features that grief following bereavement shares with other experiences of loss. (shrink)

Eleanor Byrne and Martin McQuillan _Deconstructing Disney_ London: Pluto Press, 1999 ISBN 0 7453 1456 2 (hbk) 209 pp.

The theory of mental models and its computer implementations have led to crucial experiments showing that no standard logic—the sentential calculus and all logics that include it—can underlie human reasoning. The theory replaces the logical concept of validity (the conclusion is true in all cases in which the premises are true) with necessity (conclusions describe no more than possibilities to which the premises refer). Many inferences are both necessary and valid. But experiments show that individuals make necessary inferences that are (...) invalid, e.g., Few people ate steak or sole; therefore, few people ate steak. Other crucial experiments show that individuals reject inferences that are not necessary but valid, e.g., He had the anesthetic or felt pain, but not both; therefore, he had the anesthetic or felt pain, or both. Nothing in logic can justify the rejection of a valid inference: a denial of its conclusion is inconsistent with its premises, and inconsistencies yield valid inferences of any conclusions whatsoever including the one denied. So inconsistencies are catastrophic in logic. In contrast, the model theory treats all inferences as defeasible (nonmonotonic), and inconsistencies have the null model, which yields only the null model in conjunction with any other premises. So inconsistences are local. Which allows truth values in natural languages to be much richer than those that occur in the semantics of standard logics; and individuals verify assertions on the basis of both facts and possibilities that did not occur. (shrink)

As algorithms have become ubiquitous in consequential domains, societal concerns about the potential for discriminatory outcomes have prompted urgent calls to address algorithmic bias. In response, a rich literature across computer science, law, and ethics is rapidly proliferating to advance approaches to designing fair algorithms. Yet computer scientists, legal scholars, and ethicists are often not speaking the same language when using the term ‘bias.’ Debates concerning whether society can or should tackle the problem of algorithmic bias are hampered by conflations (...) of various understandings of bias, ranging from neutral deviations from a standard to morally problematic instances of injustice due to prejudice, discrimination, and disparate treatment. This terminological confusion impedes efforts to address clear cases of discrimination. -/- In this paper, we examine the promises and challenges of different approaches to disambiguating bias and designing for justice. While both approaches aid in understanding and addressing clear algorithmic harms, we argue that they also risk being leveraged in ways that ultimately deflect accountability from those building and deploying these systems. Applying this analysis to recent examples of generative AI, our argument highlights unseen dangers in current methods of evaluating algorithmic bias and points to ways to redirect approaches to addressing bias in generative AI at its early stages in ways that can more robustly meet the demands of justice. (shrink)

In this position paper, we introduce a new epistemic lens for analyzing algorithmic harm. We argue that the epistemic lens we propose herein has two key contributions to help reframe and address some of the assumptions underlying inquiries into algorithmic fairness. First, we argue that using the framework of epistemic injustice helps to identify the root causes of harms currently framed as instances of representational harm. We suggest that the epistemic lens offers a theoretical foundation for expanding approaches to algorithmic (...) fairness in order to address a wider range of harms not recognized by existing technical or legal definitions. Second, we argue that the epistemic lens helps to identify the epistemic goals of inquiries into algorithmic fairness. There are two distinct contexts within which we examine algorithmic harm: at times, we seek to understand and describe the world as it is, and, at other times, we seek to build a more just future. The epistemic lens can serve to direct our attention to the epistemic frameworks that shape our interpretations of the world as it is and the ways we envision possible futures. Clarity with respect to which epistemic context is relevant in a given inquiry can further help inform choices among the different ways of measuring and addressing algorithmic harms. We introduce this framework with the goal of initiating new research directions bridging philosophical, legal, and technical approaches to understanding and mitigating algorithmic harms. (shrink)

Fractal patterns offer one way to represent the rough complexity of the natural world. Whilst they dominate many of our visual experiences in nature, little large-scale perceptual research has been done to explore how we respond aesthetically to these patterns. Previous research (Taylor et al., 2011) suggests that the fractal patterns with mid-range fractal dimensions have universal aesthetic appeal. Perceptual and aesthetic responses to visual complexity have been more varied with findings suggesting both linear (Forsythe et al., 2011) and curvilinear (...) (Berlyne, 1970) relationships. Individual differences have been found to account for many of the differences we see in aesthetic responses but some, such as culture, have received little attention within the fractal and complexity research fields. This 2-study paper aims to test preference responses to fractal dimension and visual complexity, using a large cohort (N=443) of participants from around the world to allow universality claims to be tested. It explores the extent to which age, culture and gender can predict our preferences for fractally complex patterns. Following exploratory analysis that found strong correlations between fractal dimension and visual complexity, a series of linear mixed-effect models were implemented to explore if each of the individual variables could predict preference. The first tested a linear complexity model (likelihood of selecting the more complex image from the pair of images) and the second a mid-range fractal dimension model (likelihood of selecting an image within mid-range). Results show that individual differences can reliably predict preferences for complexity across culture, gender and age. However, in fitting with current findings the mid-range models show greater consistency in preference not mediated by gender, age or culture. This paper supports the established theory that the mid-range fractal patterns appear to be a universal construct underlying preference but also highlights the fragility of universal claims by demonstrating individual differences in preference for the interrelated concept of visual complexity. This highlights a current stalemate in the field of empirical aesthetics. (shrink)

Most clinical ethics committees (CECs) have lay members. Why are they there, how are they chosen, and what do they do? Can their presence make health professionals less prone to jargon and hospital politicking, and can the lay members ever hope to represent the broad sweep of patients when many of them are white, middle class females? As hospital managers embrace CECs and even boast about them, will their informality be lost, with consequent exposure of professional and lay members to (...) public scrutiny and criticism? Will brave, open discussion be stifled, and the purpose of the committees ultimately be lost? (shrink)

Edited by a team of four leading philosophers, The Norton Introduction to Philosophy introduces students to contemporary perspectives on major philosophical issues and questions. This text features an impressive array of readings, including 25 specially-commissioned essays by prominent philosophers. A student-friendly presentation, a handy format, and a low price make The Norton Introduction to Philosophy as accessible and affordable as it is up-to-date.

Business Ethics, the Environment &Responsibility, EarlyView.

Character strengths profiles in the specific setting of medical professionals are widely unchartered territory. This paper focused on an overview of character strengths profiles of medical professionals (medical students and physicians) based on literature research and available empirical data illustrating their impact on well-being and work engagement. A literature research was conducted and the majority of peer-reviewed considered articles dealt with theoretical or conceptually driven ‘virtues’ associated with medical specialties or questions of ethics in patient care (e.g., professionalism, or what (...) makes a good physician). The virtues of compassion, courage, altruism, and benevolence were described most often. Only a limited number of papers addressed character strengths of medical students or physicians according to the VIA-classification. Those articles showed that the VIA-character strengthsfairness, honesty,kindness, andteamworkwere considered most often by respondents to be particularly important for the medical profession. Available cross-sectional (time span: six years) and longitudinal (time span: three years) data regarding VIA-character strengths profiles of medical professionals were analyzed (N= 584 medical students, 274 physicians). These profiles were quite homogenous among both groups. The character strengthsfairness,honesty,judgment,kindness, andlovehad the highest means in both samples. Noteworthy differences appeared when comparing medical specialties, in particular concerning general surgeons and psychiatrists, with the former reporting clearly higher levels of e.g.,honesty(d= 1.02) orprudence(d= 1.19). Long-term results revealed significant positive effects of character strengths on well-being and work engagement (e.g.,perseveranceon physicians’ work engagement) but also significant negative effects (e.g.,appreciation of beauty and excellenceon students’ well-being). Further,hopewas significantly associated both positively with physicians’ well-being and negatively with students’ work engagement, possibly indicating specific issues concerning medical education or hospital working conditions. According to the modern-day physician’s pledge, medical professionals should pay attention to their own well-being and health. Therefore, promoting self-awareness and character building among medical professionals could be a beneficial strategy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Meditations on the Letter A:The Hand as Nexus Between Music and LanguageEleanor V. StubleyThe image is that of a little girl. She stands alone, center-stage, her lips moving quietly as she rehearses the letters of the alphabet so that her forthcoming performance will be fresh and perfect. Her name is called. She takes a deep breath and begins, haltingly, doh,... doh, ray,... doh, ray, me,.... Her tongue catches at (...) the beginning of each sound as if it were a new found delight, but it is the sequence, the linear progression that is the focus of her concentration. And slowly, her recitation begins to take on its own rhythmic fluidity, each sound's name becoming stronger and more confident than the one before. Then just as quickly as it began, it is over, and she stands tall in the glory of the final doh's resonance, proud in her belief that having mastered the letters of the alphabet, she has at long last discovered the key to unlocking music's deepest and darkest mysteries.The alphabet—I begin its story with the hand behind the hieroglyphic markings of our ancient ancestors, the hand that discovered in the tracings of its own aimless movements across the sand a capacity to replicate the arc of the moon, the flowering branches of a shrub. It was a hand pre-occupied with the visual, its scratchings serving to extend the communicative power of its own reach by calling forth the image of a thing not immediately present. Meaning, as such, was typically a matter of a one-to-one correspondence inferred on the basis of shape and form, with concepts such as speed and light portrayed by animals and natural objects that one would associate with each (for instance, a running cougar, a stylized sun). But as language and the art of storytelling evolved, the emergence of concepts lacking precise visual associations required the development of a variety of phonetic strategies that, often working through pictographic puns (that is, belief, bee+leaf), used the visual to invoke the sound of the human voice.1 The effect, David Abrams suggests, was that of magic, the word having seemingly been "drawn" from the silence of thin air.2 And, like all tricks, the hand disappeared behind the magic. Where initially voice and hand had worked as extensions of one another, the voice serving to bring people together,3 the hand pointing to that which was voiced, the word as name now sounded alone.The story continues with the artistry of the storyteller. It was the artistry of a rhapsodist, one who used the voice to spin a tale of a "remembered present" from [End Page 42] the remnants of the hand's scratchings that had withstood the ravages of time.4 I say "remembered present" because the voice was valued for its expressive qualities and worked in and through a battery of memorized melodic embellishments that allowed it to stitch one image to the next on the basis of the storyteller's own experience and knowledge.5 It was a voice, consequently, that worked in the moment, a voice that drew energy and inspiration not only from the hand's scratchings but also from those that had gathered to listen. The first alphabets did little to change the dynamics of the event, they being nothing more than crudely assembled compilations of idiosyncratic phonograms (that is, z = buzzing bee) designed to define the possibilities of language as a vocabulary of names.6 Etched into bark, tree, stone, and parchment, however, they came to have a longevity that allowed the sounding codes they represented to be carried "word of mouth" from place to place. Where the spoken word had once been both fleeting and fluid, gone before it was fully sounded, it now had a repeatability that served to fix both its spellings and its meanings. And it was not long before the spinning of a tale had become a matter of second sight, the work of an extraordinary memory able to "recall" that which the storyteller had not been present to hear.7The gift worked through a self-conscious awareness of oneself as... (shrink)

Feminist Buddhology is a burgeoning area of study, with many scholar-practitioners examining the interaction between Buddhism and feminist theory. Here I examine the contributions made by Buddhist Feminists and argue that, in general, Feminist Buddhology runs the serious risk of being ‘apologist’. I contrast the discrimination against women evident in Buddhist traditions with the claims of Buddhist Feminists that ‘Buddhism is feminism’ and ‘feminism is Buddhism’. In order to do so I provide a brief history or the position of women (...) in Buddhism, an overview of Feminist Buddhology and lastly the beginnings of an alternate perspective from which we may interweave Buddhism and feminism, without an underlying apologist perspective. (shrink)

In the USA, there are missed opportunities to diagnose hepatitis C virus in pregnancy because screening is currently risk-stratified and thus primarily limited to individuals who disclose history of injection drug use or sexually transmitted infection risks. Over the past decade, the opioid epidemic has dramatically increased incidence of HCV and a feasible, well-tolerated cure was introduced. Considering these developments, recent evidence suggests universal HCV screening in pregnancy would be cost-effective and several professional organisations have called for updated national policy. (...) Historically, universal screening has been financially disincentivised on the healthcare system level, particularly since new diagnoses may generate an obligation to provide expensive treatments to a population largely reliant on public health resources. Here, we provide ethical arguments supporting universal HCV screening in pregnancy grounded in obligations to respect for persons, beneficence and justice. First, universal prenatal HCV screening respects pregnant women as persons by promoting their long-term health outside of pregnancy. Additionally, universal screening would optimise health outcomes within current treatment guidelines and may support research on treatment during pregnancy. Finally, universal screening would avoid potential harms of risk-stratifying pregnant women by highly stigmatised substance use and sexual behaviours. (shrink)

This article engages, from the point of view of the higher education department and practitioner, with the realities, and explores the rhetoric, of the `research—teaching nexus' with reference to the role of research and research skills, in the context of the student experience in higher education. The ultimate questions are: How serious should we be about responding to this rhetoric? Would it mean significantly changing the way we currently do things? Who decides such questions? What control do practitioners have? In (...) so doing, the article focuses on examples of `the student as researcher' as an educational goal relating to employ-ability, the Extended Project that will result from 14—19 curriculum reform and the undergraduate dissertation. It also provides rule-of-thumb definitions for the technical language that is evolving in this area. (shrink)

Beyond Man offers models, methods, and new directions for the still nascent, long overdue conversation between philosophical studies of religion and critical studies of race and coloniality. The interdisciplinary contributors approach this work through philosophical, theological, historical, and aesthetic lenses. Euro-descended Christianity has historically defined itself by its Others while paradoxically claiming to represent and speak to humanity in its totality. The essays in Beyond Man disrupt the normative categories of religion and philosophy by rearranging presumptions about what constitutes philosophy (...) of religion. (shrink)

Even babies have an implicit appreciation of the relationship between realistic pictures and the objects that they depict, but a mature understanding of pictures involves an explicit appreciation of how pictures work. Adults appreciate that pictures are public representations that can communicate information to other people, and that some pictures are better at doing this than others. We explore the foundations of this understanding in young children. In three experiments, using yes/no and forced-choice questions, we find that 3- and 4-year (...) olds understand that other people benefit from pictures that contain greater perceptual detail and that the more realistic the picture, the better it is as a symbolic vehicle. (shrink)

In amblyopia, abnormal visual experience during development leads to an enduring loss of visual acuity in adulthood. Physiological studies in animal models suggest that intracortical GABAergic inhibition may mediate visual deficits in amblyopia. To better understand the relationship between visual cortical γ-aminobutyric acid (GABA) and perceptual suppression in persons with amblyopia (PWA), we employed magnetic resonance spectroscopy (MRS) to quantify GABA levels in both PWA and normally-sighted persons (NSP). In the same individuals, we obtained psychophysical measures of perceptual suppression for (...) a variety of ocular configurations. In PWA, we found a robust negative correlation between the depth of amblyopia (the difference in visual acuity between the amblyopic and non-amblyopic eyes) and GABA concentration that was specific to visual cortex and was not observed in a sensorimotor cortical control region. Moreover, lower levels of visual cortical GABA were associated with weaker perceptual suppression of the fellow eye by the amblyopic eye and stronger suppression of the amblyopic eye by the fellow eye. Taken together, our findings provide evidence that intracortical GABAergic inhibition is an important component of the pathology of human amblyopia and suggest possible therapeutic interventions to restore vision in the amblyopic eye through enhancement of visual cortical GABAergic signaling in PWA. (shrink)

A lively and engaging study of Roman culture and Latin literature as reflected in the system of address, based on a corpus of 15,441 addresses from literary and non-literary sources. A valuable resource for Latin teachers and active users of the language; the text will be enjoyed even by those with no prior knowledge of Latin.

The well-being of children and young people has been affected by the COVID-19 pandemic. The shift to online education disrupted daily rhythms, transformed learning opportunities, and redefined social connections with peers and teachers. We here present a qualitative content analysis of responses to open-ended questions in a large-scale survey of teachers and students in Romania. We explore how their well-being has been impacted by online education through overflow effects of the sudden move to online classes; identity work at the individual (...) and group levels; and Students’ and teachers’ presentations of self in the online environment, with a focus on problematic aspects of webcam use. The results indicate that both students and teachers experienced ambivalence and diverse changes in well-being, generated by the flexibility, burdens, and disruptions of school-from-home. The identities associated with the roles of teacher and student have been challenged and opened for re-negotiation. Novel patterns have emerged in teachers’ and Students’ identity work. Failure or success at the presentation of self in online situations is relevant for the emotional valence of learning encounters, impacting well-being. Online classes have brought about new ways to control one’s presentation of self while also eliminating previous tactics and resources. The controversy regarding webcams has captured this duality: for some, the home remained a backstage that could not be safely exposed; for others, the home became a convenient front stage for school. Well-being was affected by the success of individual and collective performances, and by student-teacher asymmetries. Overall, our study of online learning indicates powerful yet variable influences on subjective well-being, which are related to overflow effects, identity work, and presentation of self. (shrink)

Neste artigo, tratamos de três tópicos básicos para o entendimento de uma noção de razão, a saber, relação de consequência, relação de ordem e sistema formal. A partir de uma caracterização de sistema formal, definimos as duas relações mencionadas. Destacamos uma inter-relação entre consequência e ordem. Então, apresentamos outros sistemas formais que consideram especificamente um conceito de implicação, dado pelas álgebras implicativas e pela lógica implicativa. Esta lógica implicativa, que tem como modelo as álgebras implicativas, apresenta apenas um operador, o (...) de implicação; e este conceito de implicação, mais uma vez, remete para as noções de consequência e ordem. Por fim, a partir da caracterização de consequência que está no texto, introduzimos um modelo algébrico para esta lógica implicativa. (shrink)

El objetivo de este estudio es analizar el impacto de la metodología activa ABP en la adquisición de conocimientos de música en secundaria, además de conocer las valoraciones que los alumnos participantes hacen de su proceso de aprendizaje. Se utilizó un diseño cuantitativo, exploratorio y descriptivo en el que participaron 21 alumnos y dos docentes. Los resultados indican que existe una mejora significativa de los resultados de aprendizaje de los estudiantes, aunque la valoración que hacen los alumnos del ABP no (...) coincide plenamente con tales resultados. Esta discrepancia dará lugar al rediseño de la metodología en futuras intervenciones. (shrink)

Cet article a déjà paru dans Techniques & Culture en ligne, 48-49 | 2007 Résumé : L'œuvre d'André Leroi-Gourhan est traversée par une anthropologie du rythme. Celle-ci ne part pas d'une socialité constituée, de rythmes dits « sociaux », mais inscrit au contraire l'analyse de la rythmicité dans une approche de l'homme comme être vivant, comme totalité indivise. Elle pose en des termes renouvelés le problème classique du groupement des hommes et des liens entre l'individu et son milieu. Avec la (...) question - Anthropologie. (shrink)

Why did the Greeks of the Roman period make such extensive use of the vocative kurie, when Greeks of earlier periods had been content with only one vocative meaning ¿master¿, despota? This study, based primarily on a comprehensive search of documentary papyri but also making extensive use of literary evidence (particularly that of the Septuagint and New Testament), traces the development of both terms from the classical period to the seventh century ad. It concludes that kurie was created to provide (...) a translation for Latin domine, and that domine, which has often been considered a translation of kurie, had a Roman origin. In addition, both kurie and domine were from their beginnings much less deferential than is traditionally supposed, so that neither term underwent the process of ¿weakening¿ which converted English ¿master¿ into ¿Mr¿. despota, which was originally far more deferential than the other two terms, did undergo some weakening, but not (until a very late period) as much as is usually supposed. These findings in turn imply that Imperial politeness has been somewhat misunderstood and suggest that the Greeks of the first few centuries ad were much less servile in their language than is traditionally assumed. (shrink)