This is the third draft of a paper that aims to clarify the apparent contradictions in the views presented in certain standards and other specifications of health informatics systems, contradictions which come to light when the latter are evaluated from the perspective of realist philosophy. One of the origins of this document was Klein’s discussion paper of 2005-07-02 entitled “Conceptology vs Reality” and the responses from Smith, as well as the several hours of discussions during the 2005 MIE meeting (...) in Geneva. (shrink)

This process is the transformation of the self, even to the extent that we no longer recognize ourselves although, oddly, something in us will then recognize our ‘new’ self as being what we really are, or at least what we started out to be. Then, in a way, we are like the seedling of some wonderful tree which has been overtaken by a parasitic plant until very little of the original tree is recognizable – it may have become dwarfed, hollowed (...) out or even killed by the parasite, which is our egoic mask. With meticulous pruning and therapy, the tree can be uncovered and possibly healed, but then it will be a test of the tree’s original nature and soil to see whether it will endure and grow straight and tall, with roots that will hold against adversity. For this purpose, I have assembled twelve steps to describe the transformational process (consider it coincidental that the alcoholic recovery program also has twelve steps but there is, inevitably, some correspondence between the two systems). Although I describe these steps here as if they were a progression, you’ll find that they really work in parallel or in stages wherein first one line will seem emphasized, and then another at a different point in your evolution. These steps induce a gradual change in our psychic shape (the way that we fit with each other and with our circumstances), and also they are an alchemic progression, in that each prepares our neurochemical apparatus to attune to the next stage more readily. (shrink)

The author proposes a field as a new sub-branch of psychology, called Esoteric Psychology. This would be a sub-branch of Cognitive Psychology. The author claims that even the newest forms of psychology are not able to investigate special or higher states of consciousness, due to being too externally oriented; that is, standing outside of the subjective space of the subject. The author cites a wealth of information and guidance which has come down to us from ancient times, and which is (...) practiced in the forms of shamanism, certain religions, martial arts and yoga; he claims that these can be organized and used to deliberately attain the desired states and, in these states, the scholar-practitioner will be able to study, understand and assist in new therapies and larger ideas than otherwise. The aspiration is that the subconscious and unconscious minds could be better understood and accessed, and also legendary features of the mind could be apprehended, such as miracles and the supernatural. The author claims that, in so doing, ‘reality’ could be transformed and the general consciousness of society could be uplifted. (shrink)

American teachings use the idea of shields to describe how we meet, receive and respond to the world, and I have found some equivalencies in Eastern teachings, as well. I’ll tell you about a few that I’ve learned, and then we’ll expand those ideas to embrace the core ideas of this book.

Even though there are many views on consciousness theory in the pertinent literature, there remains a need for a unifying framework for specifying the features of specific states of consciousness. In order to know what kinds of experiences conscious states have in common, researchers need to elicit testimony that is more direct and finer-grained than has been previously available. This dissertation endeavors to fill a gap in current research by addressing concepts and methods for making requisite distinctions and illuminates the (...) question of whether specific states of consciousness can be reliably and validly distinguished from each other. In order to do this, 41 individuals were invited to be interviewed. The interview was designed as a conversational-type synthesis of 5 well-known questionnaires pertinent to states of consciousness, but without their explicit and implicit assumptions; that is, the volunteers’ responses would not conform to predetermined questions. Encoding their responses allowed me to develop a model that helped to answer the research question (“Are there identifiable features that can reliably and validly distinguish among states of consciousness thought to be distinct from each other?”) by formulating a model in which any given conscious state can be catalogued in terms of its component factors (background, resistances, setting, induction, tradition, energies, and breakthrough events). The results of this study provide much-needed insights into people’s internal experiences of their various states, thus forming a basis for improved treatments and analyses. Better understanding of these states can be an impetus for social change by allowing for more incisive analyses and treatments, as well as fostering improved interpersonal communications. (shrink)

Juxtaposing two dates in human evolution poses a mystery. Anatomically modern people (with our bodies, brains, and genes) apparently first appear in Africa 100,000 years ago. Yet there is no evidence of them behaving like us — no evidence of modern human culture — until 50,000 years ago. For the first 50,000 years of our existence we were archaeologically indistinct from Neanderthal or erectus. Then everything quickly changed, forever. Why this gap? What were we waiting for? Klein, a leading (...) American paleoanthropologist, denies that these facts are complete. There had to be more biological evolution, right up to the moment people started behaving like modern humans, which he attributes to a relatively recent genetic mutation. Yet it is biologically possible that "the dawn of culture" is not a biological event at all. It could be a cascade of consequences following the delayed expression of what Steven Jay Gould calls an evolutionary spandrel, a coincidental side-consequence of evolved structures, not directly shaped by natural selection. Modern culture would have been potential from the biological beginning, but waited on an expression it took time and circumstance to discover. (shrink)

What is W. V. O. Quine’s relationship to classical pragmatism? Although he resists the comparison to William James in particular, commentators have seen an affinity between his “web of belief” model of theory confirmation and James’s claim that our beliefs form a “stock” that faces new experience as a corporate body. I argue that the similarity is only superficial. James thinks our web of beliefs should be responsive not just to perceptual but also to emotional experiences in some cases; Quine (...) denies this. I motivate James’s controversial view by appealing to an episode in the history of medicine when a researcher self-experimented by swallowing a vial of bacteria that at the time had not been studied in much detail. The researcher’s commitment to his own as-yet untested hypothesis was based in part on emotional considerations. Finally, I argue that Quine’s insistence that emotions can never be relevant to adjusting our web of belief reflects a tacit holdover of one of logical positivism’s crucially anti-pragmatist commitments—that philosophy of science should focus exclusively on the context of justification, not the context of discovery. James’s emphasis on discovery as a (perhaps the) crucial locus for epistemological inquiry is characteristic of pragmatism in general. Since Quinean epistemology is always an epistemology of justification, he is not happily viewed as a member of the pragmatist tradition. (shrink)

Barry Schein proposes combining a second-order treatment of plurals with DonaldDavidson's suggestion that there are positions for reference to events in ordinary predicates inorder to account for several of the more puzzling features of ...

Family members can provide crucial support to individuals participating in clinical trials. In research on the “newest frontier” of Deep Brain Stimulation (DBS)—the use of DBS for psychiatric conditions—family member support is frequently listed as a criterion for trial enrollment. Despite the significance of family members, qualitative ethics research on DBS for psychiatric conditions has focused almost exclusively on the perspectives and experiences of DBS recipients. This qualitative study is one of the first to include both DBS recipients and their (...) family members as interview participants. Using dyadic thematic analysis—an approach that takes both the individuals and the relationship as units of analyses—this study analyzes the complex ways in which family relationships can affect DBS trial participation, and how DBS trial participation in turn influences family relationships. Based on these findings, we propose ways to improve study designs to better take family relationships into account, and better support family members in taking on the complex, essential roles that they play in DBS trials for psychiatric conditions. (shrink)

We comment on the collection of papers inspired by our book Why Machines Will Never Rule the World published in volume 12 (5+6) of the journal Cosmos+Taxis. We summarize the arguments made by the contributors about what we say in the book, and then show where we disagree.

A Sceptical Theory of Scientific Inquiry: Problems and Their Progress presents a distinctive re-interpretation of Popper's 'critical rationalism', displaying the kind of spirit found at the L.S.E. before Popper's retirement. It offers an alternative to interpretations of critical rationalism which have emphasised the significance of research programmes or metaphysics (Lakatos; Nicholas Maxwell), and is closer to the approach of Jagdish Hattiangadi. Briskman gives priority to methodological argument rather than logical formalisms, and takes further his own work on creativity. In addition (...) to offering an important contribution to the understanding of critical rationalism, the book contains interesting engagements with Michael Polanyi and the Meno Paradox. This volume also contains an introduction by the editor, which situates Briskman's work in the history of the interpretation of 'critical rationalism'. (shrink)

We use normative reasons in a bewildering variety of different ways. And yet, as many recent theorists have shown, one can discern systematic distinctions underlying this complexity. This paper is a contribution to this project of constructive normative metaphysics. We aim to bring a black sheep back into the flock: the balancing model of weighing reasons. This model is threatened by a variety of cases in which distinct reasons overlap, in the sense that they do not contribute separate weight for (...) or against an option. Our response is to distinguish between derivative reasons and load-bearing reasons, only the latter of which contribute non-overlapping weight to an option. This distinction is close at hand for analyses of reasons in terms of the promotion of significant outcomes. But we also develop an account of this distinction for fundamentalist theories of normative reasons. (shrink)

Invasive neurotechnologies are a frequent subject of discussion in neuroethics. Technologies, like deep brain stimulation and implantable brain-computer interfaces, are thought to hold significant promise for human health and well-being, but they also raise important ethical questions about autonomy, safety, stigma, privacy, and agency, among others. The terms ‘invasive’ and ‘invasiveness’ are commonly applied to these and other neurotechnologies, yet the concept of invasiveness itself is rarely defined or delimited. Some have suggested that invasiveness may have multiple meanings – physical, (...) emotional, or lifestyle – and that confusion about how people use the terms may lead to harm, especially for users of invasive devices. It is uncertain if debates in neuroethics contribute to this confusion. To investigate this, we conducted a study of how the term ‘invasiveness’ is used in neuroethics. We found that neuroethicists almost always use ‘invasiveness’ to refer to the physical features of interventions, and rarely to refer to other senses of invasiveness. We also found that referencing invasiveness does not determine which ethical issues are prioritized for a given type of neurotechnology. Overall, this study affirms the importance of understanding the meaning and use of the concept of invasiveness in ethical discussion of neurotechnology while also suggesting the need for further work in the area and consideration for rethinking what forms of technology we consider to be invasive. (shrink)

A argumentação desenvolvida no presente artigo se propõe a defender a interpretação austera do construtivismo em Kant das objeções a ela levantadas por Jeremy Schwartz (2017) em seu artigo _Was Kant a ‘Kantian Constructivist’?_. Tendo isso em vista, primeiramente, procede-se à reconstrução da interpretação de Schwartz para a distinção analítico-sintética na esfera prática a partir da caracterização por contradição e à indicação de objeções para sua aceitação. Na sequência, apresenta-se a caracterização de analiticidade por continência e como esta pode ser (...) transposta para o caso dos imperativos sem resultar em conflitos com a interpretação austera do construtivismo. Por fim, delineiam-se considerações quanto à formalidade dos princípios constitutivos da razão prática e seu escopo, chegando à conclusão de que não se pode estabelecer uma identidade entre construtivismo austero e logicismo prático. (shrink)

This book investigates several dimensions of the concept of cosmopolitanism since Kant. The first of these dimensions is a world vision that considers the construction of a 'cosmopolitan self' as a question of justice. The second is the idea that a local political-legal order is fully democratic only if it respects the environment and the human rights of all people of the world, regardless of their citizenship. The third dimension concerns the practice of crossborder associations between individuals, institutionalized or not (...) (cosmopolitics, as Balibar called it). The fourth considers individuals as subjects of international law, as in the case of individual petitions concerning human rights through the European Court of Human Rights and individual responsibility in international criminal law. Finally, the fifth dimension is a form of ecological consciousness based on the relationship between the self and the cosmos, which would imply a profound revision of modern anthropocentric concepts."--Publisher. (shrink)

The view of nature we adopt in the natural attitude is determined by common sense, without which we could not survive. Classical physics is modelled on this common-sense view of nature, and uses mathematics to formalise our natural understanding of the causes and effects we observe in time and space when we select subsystems of nature for modelling. But in modern physics, we do not go beyond the realm of common sense by augmenting our knowledge of what is going on (...) in nature. Rather, we have measurements that we do not understand, so we know nothing about the ontology of what we measure. We help ourselves by using entities from mathematics, which we fully understand ontologically. But we have no ontology of the reality of modern physics; we have only what we can assert mathematically. In this paper, we describe the ontology of classical and modern physics against this background and show how it relates to the ontology of common sense and of mathematics. (shrink)

The first book to focus on the intersection of Western philosophy and the Asian martial arts, _Striking Beauty_ comparatively studies the historical and philosophical traditions of martial arts practice and their ethical value in the modern world. Expanding Western philosophy's global outlook, the book forces a theoretical reckoning with the concerns of Chinese philosophy and the aesthetic and technical dimensions of martial arts practice. _Striking Beauty_ explains the relationship between Asian martial arts and the Chinese philosophical traditions of Confucianism, Buddhism, (...) and Daoism, in addition to Sunzi's _Art of War_. It connects martial arts practice to the Western concepts of mind-body dualism and materialism, sports aesthetics, and the ethics of violence. The work ameliorates Western philosophy's hostility toward the body, emphasizing the pleasure of watching and engaging in martial arts, along with their beauty and the ethical problem of their violence. (shrink)

This chapter contextualizes the book and summarizes its subsequent chapters.

Governments standardly deploy a distinction between goods and services in assessing economic health and tracking national income statistics, of which medical goods and services carry significant importance. In what follows we draw on Basic Formal Ontology (BFO) to introduce a third kind of entity called patterns, which help capture the various ways in which goods and services are intertwined and help also to show how many services generate a new kind of non-goods-related products. Patterns are an overlooked yet essential features (...) of many economic sectors including medicine. Studying patterns offers new insights into various components of economic analysis, including outcomes-oriented evaluations of medical services and the value of human capital in the medical sphere. (shrink)

Knowledge and Civilization advances detailed criticism of philosophy's usual approach to knowledge and describes a redirection, away from textbook problems of epistemology, toward an ecological philosophy of technology and civilization. Rejecting theories that confine knowledge to language or discourse, Allen situates knowledge in the greater field of artifacts, technical performance, and human evolution. His wide ranging considerations draw on ideas from evolutionary biology, archaeology, anthropology, and the history of cities, art, and technology.

Some defenders of so-called `artificial intelligence' believe that machines can understand language. In particular, Søgaard has argued in his "Understanding models understanding language" (2022) for a thesis of this sort. His idea is that (1) where there is semantics there is also understanding and (2) machines are not only capable of what he calls `inferential semantics', but even that they can (with the help of inputs from sensors) `learn' referential semantics. We show that he goes wrong because he pays insufficient (...) attention to the difference between language as used by humans and the sequences of inert symbols which arise when language is stored on hard drives or in books in libraries. (shrink)

This paper considers two questions. First, what is the scope of the Equal Weight View? Is it the case that meeting halfway is the uniquely rational method of belief-revision in all cases of known peer disagreement? The answer is no. It is sometimes rational to maintain your own opinion in the face of peer disagreement. But this leaves open the possibility that the Equal Weight View is indeed sometimes the uniquely rational method of belief revision. Precisely what is the skeptical (...) import of this fact; is it the case that some form of skepticism triumphs in such cases? The answer to this question is also no. As it turns out, the situations in which it is most plausible that the Equal Weight view is a rational requirement are the ones in which meeting halfway with a disagreeing peer brings you closer to, and not farther from, knowledge. I argue for these theses in a novel way; by looking at the comparative reliability of belief- invariance and meeting halfway using measures of reliability for degrees of belief, and by drawing normative conclusions from such results. The conclusions here can have the effect of reframing the entire debate in the epistemology of disagreement. (shrink)

One famous scene in The Wolf of Wall Street (2013) is the dialogue between the young Jordan Belfort (Leonardo DiCaprio) and the expert trader Mark Hanna (Matthew McConaughey). Hanna is complaining that the stock market is unpredictable; it’s “fugazi … it’s fairy dust. It doesn’t exist. It’s never landed. It is not matter. It’s not on the element chart. It’s not real”. But the fact that something is unpredictable and non-physical does not imply that it does not exist. On the (...) other hand, its unpredictability, non-physicality, and the fact that the stock market trend is largely determined by investors’ beliefs, do make its nature difficult to grasp. -/- This special issue of Rivista di Estetica aims to explore the financial sector from an ontological point of view. While the ontology of money has been extensively studied, few scholars have focused on the stock market and, more generally, on those entities belonging to the investment landscape. Matters are made more complicated by the fact that the financial sector is characterized by an ever-increasing use of digital technology, including software elements that trade in the market themselves. We believe that a careful study of this phenomenon may help us better to understand the role of artificial agents in the social world. (shrink)

This paper is an attempt to identify and to suggest reasons to reject those assumptions about the nature and scope of perceptual knowledge that appear to make an unacceptable scepticism the only strictly defensible answer to the philosophical problem of knowledge of the world in general. The suggestion is that our knowing things about the world around us by perception can be satisfactorily explained only if we can be understood to sometimes perceive that such‐and‐such is so, where what we perceive (...) to be so is the very state of the world that we thereby know to be so. This is not proposed as a better answer to the philosophical problem, but as a way of seeing how that problem as traditionally understood could not really present a threat to anyone who can think about the world at all. (shrink)

Acceptance of Humean Supervenience and thereductive Humean analyses that entail it leadsto a litany of inadequately explained conflictswith our intuitions regarding laws andpossibilities. However, the non-reductiveHumeanism developed here, on which law claimsare understood as normative rather than factstating, can accommodate those intuitions. Rational constraints on such norms provide aset of consistency relations that ground asemantics formulated in terms offactual-normative worlds, solving theFrege-Geach problem of construing unassertedcontexts. This set of factual-normative worldsincludes exactly the intuitive sets ofnomologically possible worlds associated witheach possible (...) set of laws. The extension ofthe semantics to counterfactual and subjunctiveconditionals is sketched. Potential objectionsinvolving subjectivity, mind-dependence, andnon-factuality are discussed. (shrink)

Although most business-owning families (BOFs) that operate large family firms practice community social engagement both in private via family foundations and in the business domain via community corporate social responsibility (CSR) programs, the relationship between their activities in the two domains remains unclear. Prior literature speculates that BOFs will deprioritize firms’ community CSR when they have family foundations as more efficient vehicles to achieve socioemotional wealth (SEW), which would imply that such BOFs are less ethical in operating their firms. We (...) contrast these speculations by enriching the socioemotional wealth (SEW) approach with instrumental stakeholder theory and cue consistency arguments and theorize that BOFs seek to ensure consistency between their activities in the two domains. Using data from 2008 to 2018 on the 95 largest US public family firms whose BOFs also operate private foundations, we show a positive relationship between family foundation giving and firm community CSR activity. Furthermore, we provide evidence for the boundary conditions of this relationship, showing that it is weaker for firms that do not share the family’s name and stronger for those firms with family leaders who also lead their families’ foundations. (shrink)

In this paper I argue that Kant’s political and juridical philosophy justifies a type of normative legal positivism that implies specific notions of law and legal freedom which determine and restrict the sphere of action of judges and jurists. Finally, I defend that, according to Kant’s practical philosophy, the normative connection between justice and law is not supposed to be carried out at the juridical level, as a meta-juridical theory, but at the political one, making it a meta-political theory.

We present some ideas on logical process descriptions, using relations from the DIO (Drug Interaction Ontology) as examples and explaining how these relations can be naturally decomposed in terms of more basic structured logical process descriptions using terms from linear logic. In our view, the process descriptions are able to clarify the usual relational descriptions of DIO. In particular, we discuss the use of logical process descriptions in proving linear logical theorems. Among the types of reasoning supported by DIO one (...) can distinguish both (1) basic reasoning about general structures in reality and (2) the domain-specific reasoning of experts. We here propose a clarification of this important distinction between (realist) reasoning on the basis of an ontology and rule-based inferences on the basis of an expert’s view. (shrink)

Transcript of an Interview on the podcast: Irreverend: Faith and Current Affairs.

Dr. Elisabeth Kübler-Ross is credited as one of the first clinicians to formalize recommendations for working with patients with advanced medical illnesses. In her seminal book, On Death and Dying,...

Agent-based modeling has become a common and well-established tool in the social sciences and certain of the humanities. Here, we aim to provide an overview of the different modeling approaches in current use. Our discussion unfolds in two parts: we first classify different aspects of the model-building process and identify a number of characteristics shared by most agent-based models in the humanities and social sciences; then we map relevant differences between the various modeling approaches. We classify these into different dimensions (...) including the type of target systems addressed, the intended modeling goals, and the models’ degree of abstraction. Along the way, we provide reference to related debates in contemporary philosophy of science. (shrink)

The clinical relationship has been underexplored in dementia care. This is in part due to the way that the clinical relationship has been articulated and understood in bioethics. Robert Veatch’s social contract model is representative of a standard view of the clinical relationship in bioethics. But dementia presents formidable challenges to the standard clinical relationship, including ambiguity about when the clinical relationship begins, how it weathers changes in narrative identity of patients with dementia, and how the intimate involvement of family (...) fits alongside a paradigmatically dyadic relationship. Drawing on work in recent feminist theory, a critique is offered of the standard clinical relationship in bioethics as underwritten by an individualistic conception of autonomy. An alternative view of the clinical relationship in dementia, one that embraces a relational account of autonomy, is put forward. (shrink)

This book examines Bertrand Russell’s complicated relationships to the women around him, and to feminism more generally. The essays in this volume offer scholarly reassessments of these relationships and their import for the history of feminism and of analytic philosophy. Russell is a founder of analytic philosophy. He has also been called a feminist due to his public, decades-long advocacy for women’s rights and equality of the sexes. But his private behavior towards wives and sexual partners, and his apparently dismissive (...) (occasionally public) responses to some women philosophers, raises the question of what sort of feminist (or chauvinist) Russell actually was. Focusing on women in Russell’s circle of acquaintance, including feminist activists and his philosophical interlocutors, this book casts new light on a timeless thinker’s feminism and the women who played critical roles in the making of analytic philosophy. (shrink)

Pain is undertreated in the American health-care system at all levels: physician offices, hospitals, long-term care facilities. The result is needless suffering for patients, complications that cause further injury or death, and added costs in treatment overall. The health-care system's failure to respond to patient pain needs corrective action. Excuses for such shortcomings are simply not acceptable any longer.Physicians have long been accused of poor pain management for their patient. The term “opiophobia” has been coined to describe this remarkable clinical (...) aversion to the proper use of opioids to control pain. If the professional mandate of the health-care professional is to relieve suffering, then physicians are falling far short of their obligations by accepting myths about the use of opioids in the face of evidence to the contrary. (shrink)

Ernst Mach's atomistic theory of sensation faces problems in doing justice to our ability to perceive and remember complex phenomena such as melodies and shapes. Christian von Ehrenfels attempted to solve these problems with his theory of "Gestalt qualities", which he sees as entities depending one-sidedly on the corresponding simple objects of sensation. We explore the theory of dependence relations advanced by Ehrenfels and show how it relates to the views on the objects of perception advanced by Husserl and by (...) the Gestalt psychologists. (shrink)

This is the opening chapter to The Philosophy of Creativity: New Essays. It argues that since creativity is such a significant aspect of the human experience, and since it raises a wealth of philosophical questions, it deserves much more attention than it currently receives in philosophy. It also argues for the fruitfulness of interdisciplinary exchange, integrating philosophical insights with research in experimental psychology. Providing an overview of the field and of the subsequent essays in the volume, this chapter surveys issues (...) such as the definition of creativity, the role of consciousness in the creative process, the role of the audience in the creation of art, the emergence of creativity through childhood pretense, whether great works of literature give us insight into human nature, whether a computer program can really be creative, whether creativity is a virtue, the difference between creativity in science and art, and whether creativity can be taught—both in general and within philosophy itself. (shrink)

The forms and specific situations of the government of men by one another in a given society are multiple; they are superimposed, they cross, impose their own limits, sometimes cancel one another out, sometimes reinforce one another. According to a commonplace in the critical discussion of Foucault's later work, he is supposed to have decided to take up Nietzsche's interpretation of power as Wille zur Macht, ‘will to power.’ For instance, Habermas believes he has criticized Foucault when he says, ‘Nietzsche’s (...) authority, from which this [Foucault’s] utterly unsociological concept of power is borrowed, is not enough to justify its systematic usage.’ Charles Taylor finds in Nietzsche ‘a doctrine which Foucault seems to have made his own,’ viz., that ‘there is no order of human life, or way we are, or human nature, that one can appeal to in order to judge or evaluate between ways of life. (shrink)

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task of ensuring that the right sorts of information gets to the right sorts of people remains. We argue that the many efforts underway to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations. This in turn requires that the management of information and knowledge within healthcare (...) organizations be combined with models of resources and processes of patient care that are based on a general ontology of social interaction. The Health Level 7 (HL7) is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. HL7 has advanced a widely used messaging standard that enables healthcare applications to exchange clinical and administrative data in digital form. HL7 focuses on the interface requirements of the entire healthcare system and not exclusively on the requirements of one area of healthcare such as pharmacy, medical devices, imaging or insurance transactions. This has inspired the development of a powerful abstract model of patient care called the Reference Information Model (RIM). The present paper begins with an overview of the core classes of the HL7 (Version 3) RIM and a brief discussion of its “actcentered” view of healthcare. Central to this account is what is called the life cycle of events. A clinical action may progress from defined, through planned and ordered, to executed. These modalities of an action are represented as the mood of the act. We then outline the basis of an ontology of organizations, starting from the theory of speech Acts, and apply this ontology to the HL7 RIM. Special attention is given to the sorts of preconditions that must be satisfied for the successful performance of a speech act and to the sorts of entities to which speech acts give rise (e.g. obligations, claims, commitments, etc.). Finally we draw conclusions for the efficient communication and management of medical information and knowledge within and between healthcare organizations, paying special attention to the role that medical documents play in such organizations. (shrink)