The promises of precision medicine are often heralded in the medical and lay literature, but routine integration of genomics in clinical practice is still limited. While the “last mile” infrastructure to bring genomics to the bedside has been demonstrated in some healthcare settings, a number of challenges remain — both in the receptivity of today's health system and in its technical and educational readiness to respond to this evolution in care. To improve the impact of genomics on health and disease (...) management, we will need to integrate both new knowledge and new care processes into existing workflows. This change will be onerous and time-consuming, but hopefully valuable to the provision of high quality, economically feasible care worldwide. (shrink)

Most materialist responses to the zombie argument against materialism take either a “type-A” or “type-B” approach: they either deny the conceivability of zombies or accept their conceivability while denying their possibility. However, a “type-Q” materialist approach, inspired by Quinean suspicions about a priority and modal entailment, rejects the sharp line between empirical and conceptual truths needed for the traditional responses. In this paper, I develop a type-Q response to the zombie argument, one stressing the theory-laden nature of our conceivability and (...) possibility intuitions. I argue that our first-person access to the conscious mind systematically misleads us into thinking that the distinctive qualities of conscious experience—qualia—are nonfunctional. Qualia, I contend, are functional, even though they do not seem to be. To support my claim, I introduce the “meditations” of Rene Descartes’ zombie twin. This establishes the plausibility of an appearance/reality distinction for consciousness and it undermines various anti-materialist objections based on privileged first-person access. I conclude that the best overall theory posits an appearance/reality distinction for qualia, and this, for the type-Q materialist, is decisive. (shrink)

The debate between A-theory and B-theory in the philosophy of time is a persistent one. It is not always clear, however, what the terms of this debate are. A-theorists are often lumped with a miscellaneous collection of heterodox doctrines: the view that only the present exists, that time flows relentlessly, or that presentness is a property (Williams 1996); that time passes, tense is unanalysable, or that earlier than and later than are defined in terms of pastness, presentness, and futurity (Bigelow (...) 1991); or that events or facts (as opposed to language) are “tensed” (Mellor 1993). B-theorists then argue that the A-theory is incoherent, using variants on J.M.E. McTaggart’s argument for the unreality of time (McTaggart 1927, ch. 33). (shrink)

Many feminists (e.g. T. Bettcher and B. R. George) argue for a principle of first person authority (FPA) about gender, i.e. that we should (at least) not disavow people's gender self-categorisations. However, there is a feminist tradition resistant to FPA about gender, which I call "radical feminism”. Feminists in this tradition define gender-categories via biological sex, thus denying non-binary and trans self-identifications. Using a taxonomy by B. R. George, I begin to demystify the concept of gender. We are also able (...) to use the taxonomy to model various feminist approaches. It becomes easier to see how conceptualisations ofgender which allow for FPA often do not allow for understanding female subjugation as being rooted in reproductive biology. I put forward a conceptual scheme: radical FPA feminism. If we accept FPA, but also radical feminist concerns, radical FPA feminism is an attractive way of conceptualising gender. (shrink)

Cosmological arguments attempt to prove the existence of God by appeal to the necessity of a first cause. Schematically, a cosmological argument will thus appear as: (1) All contingent beings have a cause of existence. (2) There can be no infinite causal chains. (3) Therefore, there must be some non-contingent First Cause. Cosmological arguments come in two species, depending on their justification of the second premiss. Non-temporal cosmological arguments, such as those of Aristotle and Aquinas, view causation as requiring explanatory (...) or conceptual priority, and thus insist that there can be no infinite regresses in such priority. Temporal cosmological arguments, also called kalam cosmological arguments due to their historical roots in Islamic kalam philosophers such as Abu Yusuf Ya'qub b. Ishaq al-Kindi and Abu Ali al-Hussain ibn Sina, view causation as requiring temporal priority, and thus insist that there can be no infinite temporal regresses.1 The kalam cosmological argument thus requires some supporting argument showing the incoherence of an infinite temporal regress of causally related events. William Lane Craig, in "The Finitude of the Past and the Existence of God"2, attempts to provide such an argument: (4) An actual infinite cannot exist. (5) An infinite temporal regress of events is an actual infinite. (6) Therefore an infinite temporal regress of events cannot exist. (9) I will not be concerned here with the general status of cosmological arguments, kalam or otherwise, or with contesting Craig's assumption that an infinite past would (unlike an infinite future) constitute a problematic actual infinity. I am rather concerned with Craig's general working principle, embodied in (4) above, that actual infinities are impossible. Craig, of course, is not alone in denying the possibility of the actually infinite. Resistance to such infinities is at least as old as Aristotle (Physics 3.5.204b1 – 206a8), and, as Craig rightly points out, persists through much of modern (i.e., post-scholastic, pre-twentieth-century) philosophy.. (shrink)

The semantic puzzles posed by propositional attitude contexts have, since Frege, been understood primarily in terms of certain substitution puzzles. We will take as paradigmatic of such substitution puzzles cases in which two coreferential proper names cannot be intersubstituted salva veritate in the context of an attitude verb. Thus, for example, the following sentences differ in truth value: (1) Lois Lane believes Superman can fly. (2) Lois Lane believes Clark Kent can fly. despite the fact that "Superman" and "Clark Kent" (...) pick out the same individual.1 Equivalently, the following sentence may be true: (3) Lois Lane believes that Superman can fly, but that Clark Kent cannot fly. despite the coreferentiality of the names. (It will at times be convenient to appeal to this conjunctive attitude report in order to fix a single context of utterance.) Substitution failures such as these create a puzzle when conjoined with the assumptions (a) that attitude reports report a binary relation between an individual and some object of that individual's attitude and (b) that that object of the attitude is determined by the content of the complement sentence in the attitude report. If all of the terms in two complement sentences (e.g., "Superman can fly" and "Clark Kent can fly") have the same semantic content, then, prima facie, they ought to generate the same object of believe and, a fortiori, materially equivalent attitude reports. Frege, famously, attempts to defuse the puzzle by positing a semantic value of sense in addition to that of reference, and thereby distinguishing the semantic contents of the two complement sentences. (shrink)

You are presented with a choice between two envelopes. You know one envelope contains twice as much money as the other, but you don't know which contains more. You arbitrarily choose one envelope -- call it Envelope A -- but don't open it. Call the amount of money in that envelope X. Since your choice was arbitrary, the other envelope (Envelope B) is 50% likely to be the envelope with more and 50% likely to be the envelope with less. But, (...) strangely, that very fact might make Envelope B seem attractive: Wouldn't switching to Envelope B give you a 50% chance of doubling your money and a 50% chance of halving it? Since double or nothing is a fair bet, double or half is more than fair. Applying the standard expectation formula, you might calculate the expected value of switching to Envelope B as (.50)½X [50% chance it has less] + (.50)2X [50% chance it has more] = (1.25)X. So, it seems, you ought to switch to Envelope B: Your expected return -- your return on average, over the long run, if you did this many times -- would seem to be 25% more. But obviously that's absurd: A symmetrical calculation could persuade you to switch back to Envelope A. Hence the paradox. (shrink)

Drawing from the Boulding''s (1956) framework for general systems theory, the need to employ richer paradigm in the study of organizations (Pondy and Mitroff, 1979) is reiterated. It is argued that a better understanding of organizational ethical behavior is contingent upon viewing organizations as symbol processing systems of shared language and meanings. Further, it is proposed that organizations, like individuals, develop into collectivities of shared cognitions and rationale, over a period of time. The study adapts Kohlberg''s (1983) model of moral (...) development to examine if organizations can be viewed as passing through different stages of moral development depending on the type of moral reasoning employed to explain their behaviors in the face of ethical crises. Several cases raising questions about the ethics of corporate behavior were researched. An instrument entitled Organization Response Analysis was constructed using statements made by various spokespersons representing five of these organizations. The instrument was administered to 246 graduate and undergraduate students of business (N = 246). Results indicated a great degree of concurrence among respondents of differing genders, levels of education and work experience in determining the stages of moral development of organizations. Limitations of the current study and implications for future research and practice are discussed. (shrink)

In International Law and World Order, B. S. Chimni articulates an integrated Marxist approach to international law combining the insights of Marxism, socialist feminism and postcolonial theory. The book uses IMAIL to systematically and critically examine the most influential contemporary theories of international law including new, feminist, realist and policy-oriented approaches. In doing so, it discusses a range of themes relating to the history, structure and process of international law. The book also considers crucial world order issues and problems that (...) the international legal process has to contend with, including the welfare of weak groups and nations, the ecological crisis and the role of human rights. This extensively revised second edition provides an invaluable, in-depth and updated review of the key literature and scholarship within this field of study. It will be of particular interest to students and scholars of international law, international relations, international politics and global studies. (shrink)

This paper investigates a well-known case of simultaneous discovery in twentieth-century chemistry, the origins of the concept of hybridisation, in the light of Kuhn's insights. There has been no ambiguity as to who discovered this concept, when it was "rst in print, and how important it was. The full-#edged form of the concept was published in 1931 independently by two American scientists John C. Slater (1900}1976) and Linus Pauling (1901}1994), although both of them had made their ideas public earlier: Slater (...) at the American Physical Society meetings in 1930, and Pauling in the Proceedings of the National Academy of Sciences in 1928. Slater and Pauling both argued for the necessity of using an s orbital as well as three p orbitals in the carbon atom in order to explain carbon's four valences and the tetrahedral structure of methane. The metaphor &hybridisation' for denoting this mix of s and p orbitals was "rst used by Robert S. Mulliken and J. H. Van Vleck before gaining currency with the scienti"c community around 1935.2 The concept of hybridisation was indeed indispensable for extending the quantum-mechanical interpretation of the chemical bond as an electron pairing from diatomic molecules to polyatomic ones. To be sure, the emergence of hybridisation attests to scientists' growing interest in exploring the borderland between physics and chemistry, a trend that led to the creation of physical chemistry in the late nineteenth century and of chemical physics and quantum chemistry in the 1920s and 30s. Slater and Pauling themselves experienced and on many occasions talked about the fruitfulness of interdisciplinary research; and historians have legitimately illuminated their works by examining them in this broad context.3 Yet the careful analysis of their research notes and published papers reveals that Slater and Pauling were working in quite disparate disciplinary traditions, with di!erent approaches, for di!erent audiences, and towards di!erent goals. The aim of this paper is to explore their di!erent routes to a common destination*hybridisation*and thereby to explicate tensions existing between physics and chemistry amidst the institutional and conceptual overlapping of the two disciplines. (shrink)

As I had rejected en bloc references to Bacchanalia as indications of date, it was a mere chance which led me, after the above had left my hands, to look up Cas. 980 ‘ nunc Bacchae nullae ludunt,’ quoted in Schanz, R. Lit.3, p. 78. As this affords an excellent opportunity of testing my conclusions, perhaps a word or two will not be out of place.

Short’s assertion that Peirce lacked a cohesive philosophical system is critically examined, and the interconnectedness of Peirce’s 1884–1893 “cosmology” with other aspects of his work is explored, countering Short’s claims of its limited systematic relevance. Additionally, Short’s claim that Peirce “expanded empiricism empirically” is scrutinized, and his interpretation of Peirce’s account of perception is criticized. By contrasting Short’s anti-system reading, I highlight the importance of studying Peirce’s philosophy holistically.

This is a detailed commentary on Hume's first Inquiry. Flew argues, rightly, that it should not be treated simply as a weakened abridgement of part of the Treatise. He gives a great deal of the historical context in an interesting and helpful way, but he is primarily concerned to lay out and to assess Hume's arguments. Inevitably much of the book covers quite familiar ground, but in discussing Hume's arguments on miracles and on religion generally, Flew has a number of (...) new and suggestive points to make. The book as a whole will be useful for the student beginning the study of Hume, and Flew's criticisms, as well as his frequent review of other criticisms, should prove helpful to the advanced student. --J. B. S. (shrink)

Formal definitions of the following concepts of animal ecology are given: environment, niche, locality, local population, natural population, community, ecosystem. Five primitive (undefined) notions are used including "animal", "offspring" and "habitat", the latter in the sense of Charles Elton. The defining equations for the environment of one animal are first given, then niche (in the Elton sense) is formally defined in terms of the environment. The fifth primitve notion "habitat" is then introduced in order to define the remaining concepts.

In his two recent books on ontology, Universals: an Opinionated Introduction, and A World of States of Affairs, David Armstrong gives a new argument against nominalism. That argument seems, on the face of it, to be similar to another argument that he used much earlier against Rylean behaviourism: the Truthmaker Argument, stemming from a certain plausible premise, the Truthmaker Principle. Other authors have traced the history of the truthmaker principle, its appearance in the work of Aristotle [10], Bradley [16], and (...) even Husserl [15]. But that is not my task — in this paper I argue that Armstrong’s new argument is not logically analogous to the old, and, in particular, that it is quite possible to be a thoroughgoing nominalist, and hold a truthmaker principle. (shrink)

Medical confidentiality is a core concept of professionalism and should be an integral part of pregraduate and postgraduate medical education. The aim of our study was to define the factors influencing attitudes towards patient confidentiality in everyday situations in order to define the need for offering further education to various subgroups of physicians. All internists and general practitioners who were registered members of the association of physicians in Geneva or who were working in the department of internal medicine or in (...) the medical polyclinic of the University Hospital of Geneva in 2004 received a standardised questionnaire. Physicians were asked to indicate for seven vignettes whether a violation of confidentiality had occurred and whether the violation was not important, important or serious (scores 1–3; no violation = 0). 508 completed questionnaires were returned (participation rate 55%). Physicians who had worked in the hospital for more than 20 years identified violations of confidentiality more often than physicians with less hospital experience. Binary logistic regression showed that ethics education, total years of professional experience, being an internist, having a private practice, the length of working in private practice and gender were factors associated with correct identification of violations and their severity. However, each factor played a specific role only for single cases or a small number of situations (Cronbach α <0.6). Postgraduate education programs on confidentiality should be offered to a wide range of physicians and should address specific hypothetical situations in which there is a risk of avoidable breaches of confidentiality. (shrink)

Jewish law has a history stretching from the early period to the modern State of Israel, encompassing the Talmud, Geonic and later codifications, the Spanish Golden Age, medieval and modern responsa, the Holocaust and modern reforms. Fifteen distinct periods are separately studied in this volume, each one by a leading specialist, and the emphasis throughout is on the development of the institutions and sources of the law.

Machine learning algorithms may radically improve our ability to diagnose and treat disease. For moral, legal, and scientific reasons, it is essential that doctors and patients be able to understand and explain the predictions of these models. Scalable, customisable, and ethical solutions can be achieved by working together with relevant stakeholders, including patients, data scientists, and policy makers.

Objectives: To compare attitudes of medical and law students toward informing a cancer patient about diagnosis and prognosis and to examine whether differences are related to different convictions about benefit or harm of information.Setting and design: Anonymous questionnaires were distributed to convenience samples of students at the University of Geneva containing four vignettes describing a cancer patient who wishes, or alternatively, who does not wish to be told the truth.Participants: One hundred and twenty seven medical students and 168 law students.Main (...) outcome measures: Five point Likert scale of responses to the vignettes ranging from “certainly inform” to “certainly not inform” the patient.Results: All medical students and 96% of law students favoured information about the diagnosis of cancer if the patient requests it. Seventy four per cent of medical students and 82% of law students favoured informing a cancer patient about his or her prognosis . Thirty five per cent of law students and 11.7% of medical students favoured telling about the diagnosis and 25.6% of law students and 7% of medical students favoured telling about the prognosis even if the patient had clearly expressed his wish not to be informed. Law students indicated significantly more often than medical students reasons to do with the patient’s good, legal obligations, and the physician’s obligation to tell the truth, and significantly less often than medical students that their attitude had been determined predominantly by respect for the autonomous choice of the patient.Conclusion: Differences in attitudes according to the type of case and the type of studies were related to convictions about the benefit or harm to the patient caused by being given information. The self reported reasons of future physicians and future lawyers are helpful when considering means to achieve a better acceptance of patients’ right to know and not to know. (shrink)

In his account of probable reasoning, Poincaré used the concept, or at least the language, of conventions. In particular, he claimed that the prior probabilities essential for inverse probable reasoning are determined conventionally. This paper investigates, in the light of Poincaré's well known claim about the conventionality of metric geometry, what this could mean, and how it is related to other views about the determination of prior probabilities. Particular attention is paid to the similarities and differences between Poincaré's conventionalism as (...) it applies to probabilities and de Finetti's subjectivism. The aim of the paper is to suggest that in accounts of the development of ideas about probable reasoning, particularly those customarily described as Bayesian, Poincaré's discussion deserves more attention than it has so far received. (shrink)