This book is a synthesis of more than three decades of research into the concept of time and its semiotic nature. If traditional philosophy – and philosophy of time should be no exception – in the shadow of advancing biology can be said to have reached an impasse, one important reason for this, in harmony with Wittgenstein’s vision, appears to have been its lack of appropriate tools for explicating language. The present theory of time proceeds, accordingly, from the exploration of (...) temporal expressions in language as an evolutionary fact. It derives in a hypothetical, coherent feedback process of hierarchically ordered distinctions the semantics of time from its biologically dictated perceptual and cognitive-pragmatic origins. The corresponding abductive-regulative model is anchored in the assumption of biological rhythmization as the very foundation of perception and mental/physical action. Understood to originate in space and spatial perspective, time reveals itself as an instrument for temporal perspective on motion (events and situations) in a process of analysis, i.e., discontinuation of chaos made divisible and continuous by the rhythmical screen. Whereas traditional philosophy of time paid attention almost exclusively to the temporal category of tense, the biopragmatic model sees strong evidence in the perspectival nature of time for ascribing the decisive, and probably universal, role in temporal analysis to the linguistic category of aspect. Aspect may, according to the present findings, be assumed to partake already of change-of-state and cause-effect analysis without which man’s adaptation to new situations – and precondition for survival – would be inconceivable. The proposed model of space/time cognition, inspired by Hegelian dialectics, Heidegger-Gadamer’s hermeneutic circle and Peircean logic, makes Kantian a priori superfluous and liberates time from its enigmatic appearance. For the first time in temporal studies it thus appears possible to derive hypothetically linguistic expressions of time all the way from pretemporal, homogeneous continuity effected by biological rhythmization, via pretemporal metonymic (Gestalt), chunk-wise partitioning – as a general precondition for the perception and, based on primary metaphorization, the cognition of things, space and motion – to temporal analysis/discontinuation proper, primarily by aspectual perspective, and the subsequent synthesized, heterogeneous continuity of temporally ordered events. The conception of time, so disastrous for modern temporal logic, i.e., as moving object assigned extension, divisible continuity (‛linearity’) and direction, can be shown to have emerged as a result of secondary metaphorization. (shrink)

BackgroundMachine learning-based clinical decision support systems (ML_CDSS) are increasingly employed in various sectors of health care aiming at supporting clinicians’ practice by matching the characteristics of individual patients with a computerised clinical knowledge base. Some studies even indicate that ML_CDSS may surpass physicians’ competencies regarding specific isolated tasks. From an ethical perspective, however, the usage of ML_CDSS in medical practice touches on a range of fundamental normative issues. This article aims to add to the ethical discussion by using professionalisation theory (...) as an analytical lens for investigating how medical action at the micro level and the physician–patient relationship might be affected by the employment of ML_CDSS.Main textProfessionalisation theory, as a distinct sociological framework, provides an elaborated account of what constitutes client-related professional action, such as medical action, at its core and why it is more than pure expertise-based action. Professionalisation theory is introduced by presenting five general structural features of professionalised medical practice: (i) the patient has a concern; (ii) the physician deals with the patient’s concern; (iii) s/he gives assistance without patronising; (iv) s/he regards the patient in a holistic manner without building up a private relationship; and (v) s/he applies her/his general expertise to the particularities of the individual case. Each of these five key aspects are then analysed regarding the usage of ML_CDSS, thereby integrating the perspectives of professionalisation theory and medical ethics.ConclusionsUsing ML_CDSS in medical practice requires the physician to pay special attention to those facts of the individual case that cannot be comprehensively considered by ML_CDSS, for example, the patient’s personality, life situation or cultural background. Moreover, the more routinized the use of ML_CDSS becomes in clinical practice, the more that physicians need to focus on the patient’s concern and strengthen patient autonomy, for instance, by adequately integrating digital decision support in shared decision-making. (shrink)

Over the course of the 20th century the sex differential in life expectancy at birth in the industrialized countries has widened considerably in favour of women. Starting in the early 1970s, the beginning of a reversal in the long-term pattern of this differential has been noted in some high-income countries. This study documents a sustained pattern of narrowing of this measure into the later part of the 1990s for six of the populations that comprise the G7 countries: Canada, France, Germany, (...) Italy, England and Wales (as representative of the United Kingdom) and USA. For Japan, a persistence of widening sex differences in survival is noted. The sex differences in life expectancy are decomposed over roughly three decades (early 1970s to late 1990s) from the point of view of four major cause-of-death categories: circulatory diseases, cancers, accidents/violence/suicide, and (residual) causes. In the six countries where the sex gap has narrowed, this has resulted primarily from reduced sex differences in circulatory disease mortality, and secondarily from reduced differences in male and female death rates due to accidents, violence and suicide combined. In some of the countries sex differentials in cancer mortality have been converging lately, and this has also contributed to a narrowing of the difference in life expectancy. In Japan, males have been less successful in reducing their survival disadvantage in relation to Japanese women with regard to circulatory disease and cancer; and in the case of accidents/violence/suicide, male death rates increased during the 1990s. These trends explain the divergent pattern of the sex difference in life expectation in Japan as compared with the other G7 nations. (shrink)

ABSTRACTSolving a conflict between two response options in an interference task has been found to increase control in a subsequent conflict situation. The present research examined whether such conflict adaptation persists in the presence of distractors that have motivational relevance and are therefore competing for attentional resources. In an adjusted flanker task, motivational distractors were presented together with the current trial while the previous trial never included any distractor. Accumulated evidence across three studies showed that motivational distractors reduced the conflict (...) adaptation effect. This was found irrespective of the location at which the distractor occurred, and independent of its valence. Study 3 and a merged data analysis ruled out low-level alternative explanations. In line with a dual competition account (P... (shrink)

Arthur O. Lovejoy conceived of the history of ideas as an interdisciplinary study, encompassing a variety of fields, including literary history, comparative literature, the history of folklore and ethnography, the history of language and the history of religious beliefs. This volume gathers together some of the most significant articles concerning the theory and practice of intellectual history, by Lovejoy himself and other scholars. Contributors: DONALD R. KELLEY, ARTHUR O. LOVEJOY, FREDERICK J. TEGGART, LEO SPITZER, THEODORE SPENCER, ABRAHAM EDEL, PAUL O. (...) KRISTELLER, PHILIP P. WIENER, JOSEPH A. MAZZEO, LEONARD KRIEGER, DANIEL J. WILSON, EDWARD P. MAHONEY, FRANCIS OAKLEY,JOHANN HUIZINGA, JOSEPH KATZ, CALVIN G. RAND, NILS B. KVASTAD, LESTER G. CROCKER and PATRICK H. HUTTON. (shrink)

Illusions of personal authorship can arise when causation for an event is ambiguous, but people mentally represent an anticipated outcome and then observe a corresponding match in reality. When people do not maintain such high-level outcome representations and focus instead on low-level behavioral representations of concrete actions, illusions of personal authorship can be reduced. One condition that yields specific action plans and thereby moves focus from high-level outcomes to low-level actions is the generation of counterfactual thoughts. Hence, in the present (...) research we tested whether thinking counterfactually can reduce illusory authorship. In line with predictions, generating behavior-regulating counterfactuals reduced susceptibility to the illusion . Importantly, this only occurred when people expected to re-encounter the situation to which the counterfactuals applied . These findings extend existing research on the boundary conditions of illusory experiences of personal authorship and might hint at a relationship between the illusion and behavior regulation. (shrink)

We discuss a recent approach to investigating cognitive control, which has the potential to deal with some of the challenges inherent in this endeavour. In a model-based approach, the researcher defines a formal, computational model that performs the task at hand and whose performance matches that of a research participant. The internal variables in such a model might then be taken as proxies for latent variables computed in the brain. We discuss the potential advantages of such an approach for the (...) study of the neural underpinnings of cognitive control and its pitfalls, and we make explicit the assumptions underlying the interpretation of data obtained using this approach. (shrink)

ABSTRACT In this survey we have investigated the experiences and attitudes of Danish physicians regarding end‐of life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non‐resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made (...) and found acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self‐determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death. (shrink)

In this survey we have investigated the experiences and attitudes of Danish physicians regarding end-of-life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non-resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made and found (...) acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self-determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death. (shrink)

Impairments in executive functioning are prevalent in chronic pain conditions, with cognitive inflexibility being the most frequently reported. The current randomized, cross-over trial, piloted a computerized cognitive training program based on Relational Frame Theory, targeting improvement in cognitive flexibility. At baseline, 73 chronic pain patients completed testing on pre-selected outcomes of executive functioning, alongside IQ measures. When tested three times over the course of 5 months, there was a drop-out rate of 40% at the third time point, leaving 44 patients (...) who had data at all time points. The results showed that there was a substantial learning effect from the MINDFLEX training and a substantial time-dependent improvement on the primary outcomes of increased flexibility, but that this could not be tied to active training. In conclusion, this small study indicated a learning effect as well as improvement on primary outcomes. Based on the current results, a larger trial with improved feasibility of training is warranted. (shrink)

It is suggested that the Harm Principle can be viewedas the moral basis on which genetically modified (GM) food iscurrently regulated. It is then argued (a) that the concept ofharm cannot be specified in such a manner as to render the HarmPrinciple a plausible political principle, so this principlecannot be used to justify existing regulation; and (b) that evenif the Harm Principle were a plausible political principle, itcould not be used alone in the regulation of GM food, since itdoes not (...) express a concern for the expected benefits of suchfood. (shrink)

Interessen for og fascinationen af middelalderen er for tiden så stor, at Umberto Eco i Slagmark nr. 5 ligefrem kan opstille ti forskellige "middelaldre", der rumsterer i den bølge, som ikke mindst hans egen "Rosens navn" er en vigtig del af.

The chapter presents Bergson’s conception of philosophy as a way of life, as a thinking that seeks to make contact with the creativity of life as a whole. This endeavor to alter our vision of the world, and ultimately, our action and sense of being in the world, seeks to operate a “conversion of attention.” For Bergson, such a conversion is tied in with what he calls the “true empiricism” that allows us to experience and think change as that which (...) makes up living reality as a whole. Bergson conceptualizes this move beyond the human in terms of sympathy, a term employed both descriptively, to develop the notion of a sympathetic whole of life in which philosophy as a way of life resituates the self, and prescriptively, as urging us to overcome our estrangement from “the ocean of life” to which we owe our existence. This effort of sympathy takes the form of a spiritual exercise. Not limited to mere contemplation of the world, it transforms the manner in which we perceive the reality of duration and thus opens the path for a different way of living. (shrink)

This book provides a worthwhile and challenging introduction to scientific and moral issues in germline gene therapy. It contains two parts, dealing with scientific and moral issues respectively. In the first, scientific part, a chapter on what the alternatives to germline therapy are is helpful, especially in pointing out that many of the goals one might want to achieve by using germline therapy may be achieved, at a slighter risk, by using non-genetic technologies such as selective embryo implantation and selective (...) abortion. However, the authors argue that germline therapy may be an option in certain cases in which these alternatives are not viable (page 72). In the second part of the book, moral and political issues in germline therapy are discussed, such as the distinction between therapy and enhancement, potential benefits and harms, rights and responsibilities, justice, our concept of humanness, and public policy issues. The …. (shrink)

A key question for evidence-based medicine is how best to model the way in which EBM should‘[integrate] individual clinical expertise and the best external evidence’. We argue that the formulations and models available in the literature today are modest variations on a common theme and face very similar problems when it comes to risk analysis, which is here understood as a decision procedure comprising a factual assessment of risk, the risk assessment, and the decision what to do based on this (...) assessment, the risk management. Both the early and updated models of evidence-based clinical decisions presented in the writings of Haynes, Devereaux and Guyatt assume that EBM consists of, among other things, evidence from clinical research together with information about patients’ values and clinical expertise. On this A-view, EBM describes all that goes on in a specific justifiable medical decision. There is, however, an alternative interpretation of EBM, the B-view, in which EBM describes just one component of the decision situation and in which, together with other types of evidence, EBM leads to a justifiable clincial decision but does not describe the decision itself. This B-view is inspired by a 100-years older version of EBM, a Swedish standard requiring medical decision-making, professional risk-taking and practice to be in accordance with‘science and proven experience’. In the paper, we outline how the Swedish concept leads to an improved understanding of the way in which scientific evidence and clinical experience can and cannot be integrated in light of EBM. How scientific evidence and clinical experience is integrated influences both the way we do risk assessment and risk management. In addition, the paper sketches the as yet unexplored historical background to VBE and EBM. (shrink)

A key question for evidence-based medicine is how best to model the way in which EBM should “[integrate] individual clinical expertise and the best external evidence”. We argue that the formulations and models available in the literature today are modest variations on a common theme and face very similar problems. For example, both the early and updated models of evidence-based clinical decisions presented in Haynes, Devereaux and Guyatt assume that EBM consists of, among other things, evidence from clinical research and (...) clinical expertise. On this A-view, EBM describes all that goes on in a specific justifiable medical decision. There is, however, an alternative interpretation of EBM, the B-view, in which EBM describes just one component of the decision situation and in which, together with other types of evidence, EBM leads to a justifiable clincial decision but does not describe the decision itself. This B-view is inspired by a 100-years older version of EBM, a Swedish standard requiring medical decision-making and practice to be in accordance with ‘science and proven experience’. In the paper we outline how the Swedish concept leads to an improved understanding of the way in which scientific evidence and clinical experience can and cannot be integrated in light of EBM. In addition the paper sketches the as yet unexplored historical background to EBM. (shrink)

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants (...) with a history of depression, currently in remission (N= 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N= 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse. (shrink)

Proceedings of the seminar organized by Centre of Advanced Study in Sanskrit, University of Pune in 2007.