BackgroundElectronic patient record (EPR) technology is a key enabler for improvements to healthcare service and management. To ensure these improvements and the means to achieve them are socially and ethically desirable, careful consideration of the ethical implications of EPRs is indicated. The purpose of this scoping review was to map the literature related to the ethics of EPR technology. The literature review was conducted to catalogue the prevalent ethical terms, to describe the associated ethical challenges and opportunities, and to identify (...) the actors involved. By doing so, it aimed to support the future development of ethics guidance in the EPR domain.MethodsTo identify journal articles debating the ethics of EPRs, Scopus, Web of Science, and PubMed academic databases were queried and yielded 123 eligible articles. The following inclusion criteria were applied: articles need to be in the English language; present normative arguments and not solely empirical research; include an abstract for software analysis; and discuss EPR technology.ResultsThe medical specialty, type of information captured and stored in EPRs, their use and functionality varied widely across the included articles. Ethical terms extracted were categorised into clusters ‘privacy’, ‘autonomy’, ‘risk/benefit’, ‘human relationships’, and ‘responsibility’. The literature shows that EPR-related ethical concerns can have both positive and negative implications, and that a wide variety of actors with rights and/or responsibilities regarding the safe and ethical adoption of the technology are involved.ConclusionsWhile there is considerable consensus in the literature regarding EPR-related ethical principles, some of the associated challenges and opportunities remain underdiscussed. For example, much of the debate is presented in a manner more in keeping with a traditional model of healthcare and fails to take account of the multidimensional ensemble of factors at play in the EPR era and the consequent need to redefine/modify ethical norms to align with a digitally-enabled health service. Similarly, the academic discussion focuses predominantly on bioethical values. However, approaches from digital ethics may also be helpful to identify and deliberate about current and emerging EPR-related ethical concerns. (shrink)

:Long-term patient outcomes after severe brain injury are highly variable, and reliable prognostic indicators are urgently needed to guide treatment decisions. Functional neuroimaging is a highly sensitive method of uncovering covert cognition and awareness in patients with prolonged disorders of consciousness, and there has been increased interest in using it as a research tool in acutely brain injured patients. When covert awareness is detected in a research context, this may impact surrogate decisionmaking—including decisions about life-sustaining treatment—even though the prognostic value (...) of covert consciousness is currently unknown. This paper provides guidance to clinicians and families in incorporating individual research results of unknown prognostic value into surrogate decisionmaking, focusing on three potential issues: Surrogate decisionmakers may misinterpret results; Results may create false hope about the prospects of recovery; There may be disagreement about the meaningfulness or relevance of results, and appropriateness of continued care. (shrink)

BackgroundThis manuscript presents a framework to guide the identification and assessment of ethical opportunities and challenges associated with electronic patient records (EPR). The framework is intended to support designers, software engineers, health service managers, and end-users to realise a responsible, robust and reliable EPR-enabled healthcare system that delivers safe, quality assured, value conscious care.MethodsDevelopment of the EPR applied ethics framework was preceded by a scoping review which mapped the literature related to the ethics of EPR technology. The underlying assumption behind (...) the framework presented in this manuscript is that ethical values can inform all stages of the EPR-lifecycle from design, through development, implementation, and practical application.ResultsThe framework is divided into two parts: context and core functions. The first part ‘context’ entails clarifying: the purpose(s) within which the EPR exists or will exist; the interested parties and their relationships; and the regulatory, codes of professional conduct and organisational policy frame of reference. Understanding the context is required before addressing the second part of the framework which focuses on EPR ‘core functions’ of data collection, data access, and digitally-enabled healthcare.ConclusionsThe primary objective of the EPR Applied Ethics Framework is to help identify and create value and benefits rather than to merely prevent risks. It should therefore be used to steer an EPR project to success rather than be seen as a set of inhibitory rules. The framework is adaptable to a wide range of EPR categories and can cater for new and evolving EPR-enabled healthcare priorities. It is therefore an iterative tool that should be revisited as new EPR-related state-of-affairs, capabilities or activities emerge. (shrink)

At present, the science of consciousness is structured around the search for the neural correlates of consciousness. One of the alleged advantages of the NCCs framework is its metaphysical neutrality—the fact that it begs no contested questions with respect to debates about the fundamental nature of consciousness. Here, we argue that even if the NCC framework is metaphysically neutral, it is structurally committed, for it presupposes a certain model—what we call the Lite-Brite model—of consciousness. This, we argue, represents a serious (...) liability for the NCC framework for the plausibility of the Lite-Brite model is very much an open question, and the science of consciousness would be better served by a framework that does not presuppose it. Drawing on interventionist ideas in the philosophy of science, we suggest that the Difference-Maker framework can provide just such an alternative. Instead of searching for the neural correlates of consciousness, we ought to be searching for the difference makers of consciousness. We detail how a shift to searching DMCs will change both the practice of consciousness science and the interpretation of existing results. (shrink)

Unlike the overall framework of Ernest Nagel's work on reduction, his theory of intertheoretic connection still has life in it. It handles aptly cases where reduction requires complex representation of a target domain. Abandoning his formulation as too liberal was a mistake. Arguments that it is too liberal at best touch only Nagel's deductivist theory of explanation, not his condition of connectability. Taking this condition seriously gives a powerful view of reduction, but one which requires us to index explanatory power (...) to sciences as they are formulated at particular times. While we may thereby reduce more than philosophers have supposed, we must abandon hope (as Nagel did) of saying anything useful about reductionism. (shrink)

In recent years there has been a resurgence of interest in the work of Emmanuel Levinas, widely recognized as one of the most important yet difficult philosophers of the 20th century. In this much-needed introduction, Davis unpacks the concepts at the centre of Levinas's thought - alterity, the Other, the Face, infinity - concepts which have previously presented readers with major problems of interpretation. Davis traces the development of Levinas's thought over six decades, describing the context in which he worked, (...) and the impact of his writings. He argues that Levinas's work remains tied to the ontological tradition with which he wants to break, and demonstrates how his later writing tries to overcome this dependency by its increasingly disruptive, sometimes opaque, textual practice. He discusses Levinas's theological writings and his relationship to Judaism, as well as the reception of his work by contemporary thinkers, arguing that the influence of his work has led to a growing interest in ethical issues among poststructuralist and postmodernist thinkers in recent years. Comprehensive and clearly written, this book will be essential reading for students and researchers in continental philosophy, French studies, literary theory and theology. (shrink)

Being whipped, getting a deep-tissue massage, eating hot chili peppers, running marathons, and getting tattooed are all painful. Sometimes they are also pleasant—or so many people claim. Masochistic pleasure consists in finding such experiences pleasant in addition to, and because of, the pain. Masochistic pleasure presents a philosophical puzzle. Pains hurt, they feel bad, and are aversive. Pleasures do the opposite. Thus many assume that the idea of a pleasant pain is downright unintelligible. I disagree. I claim that cases of (...) pleasant pains are more common than many philosophers suppose, and that they have no essential connection to either sex or psychopathology. I review several attempts to account for masochism that preserve the intuition that nothing can be both pleasant and painful at once. These account for some, but not all, cases of masochism. The stubborn remainder, I argue, are sensations that are genuinely pleasant and painful at once. I give an account of how that might be, focusing on boundary-pushing aspects of masochistic pleasure that have been largely overlooked in the literature. I show how, properly understood, pain and pleasure can coexist—and also why it is very rare for them to actually do so. (shrink)

Presents a self-contained introduction to logic suitable for majors and nonmajors, and can be covered entirely in a one-semester course. Natural deduction systems of sentential logic and of first-order logic, truth tables, and the basic ideas of model theory are presented without superfluous discussion.

Some realistic models of neural spiking take into account spike timing, yet the practical relevance of spike timing is often unclear. In Eugene Izhikevich’s model, timing plays a crucial role by al...

Milton Friedman's article, The Social Responsibility of Business Is To Increase Its Profits, owes its appeal to the rhetorical devices of simplicity, authority, and finality. More careful consideration reveals oversimplification and ambiguity that conceals empirical errors and logical fallacies. It is false that business does, or would, operate exclusively in economic terms, that managers concentrate obsessively on profitability, and that ethics can be marginalized. These errors reflect basic contradictions: an apolitical political base, altruistic agents of selfishness, and good deriving from (...) greed. (shrink)

With an eye on how post-colonial novels by authors Chinua Achebe and Ngugi Wa Thiong’o address aesthetic and environmental problems that preceded the Modern period, the intent of this essay is to emphasize how their fiction connects readers with a pre-industrial, premodern, and, strangely enough, radically new ways of thinking about books and the living world beyond them. To this end, the essay looks at this non-western literature through the lens of ecologist Aldo Leopold’s land-based ideas regarding epistemology, ethics, and (...) ecology. (shrink)

In this paper, I describe grounds for dissatisfaction with certain aspects of the sciences of animal cognition and argue that a turn toward mathematical modeling of animal cognition is warranted. I consider some objections to this call and argue that the implications of such a turn are not as drastic for ordinary, commonsense understanding of animal minds as they might seem.

Codes of ethics and conduct have become common in UK organisations. This paper explores how such codes are understood and responded to by those whom the codes seek to influence. The study is an interpretative one, based on interview material, in which a dialectical pattern is seen in employees’ reactions to codes. Initial contradictions are found in codes of ethics and in codes of conduct . These tensions create perceptions of a two‐tier system in organisations in which core employees are (...) subject to codes of ethics that are loosely applied, but non‐core staff are subject to codes of conduct that are strictly applied. However, even core staff are aware of a dialectical contradiction in their position. They believe that loyalty to the organisation is the price they pay for being allowed freedom of integrity by their organisations, but that the price they have to pay for showing integrity may be breaking faith with their organisations. This chiasmus of integrity and loyalty represents a difficulty for the project of improving standards of corporate citizenship. The use of this trope and other rhetorical figures to exemplify processes of understanding and interpretation in organisations is discussed. (shrink)

Final Report on Phase 1 of the New Zealand Law Foundation’s Artificial Intelligence and Law in New Zealand Project.

This paper considers the prospects for objectivity in reasoning strategies in response to empirical studies that apparently show systematic culture‐based differences in patterns of reasoning. I argue that there is at least one modest class of exceptions to the claim that there are alternative, equally warranted standards of good reasoning: the class that entails the solution of certain well‐structured problems which, suitably chosen, are common, or touchstone, to the sorts of culturally different viewpoints discussed. There is evidence that some cognitive (...) tasks are seen in much the same way across cultures, not least by virtue of the common run of experiences with the world of material objects in early childhood by creatures with similar cognitive endowments. These tasks thus present as similarly structured sets of claims that have similar priority: what is framed, and what is bracketed, or held constant in the background, is shown to be naturally common across cultures. As a consequence, a normative view of reasoning and, by implication, critical thinking can be defended. While this might be a modest sense of objectivity, the high level of intercultural articulation that is able to occur among people of different backgrounds suggests that it provides cognitive scaffolding for a lot of other reasoning tasks as well. (shrink)

Department of Political Studies, Queen's University, 99 University Avenue, Kingston, Ontario, Canada, K7L 3N6. Email: farrelly{at}queensu.ca ' + u + '@' + d + ' '//--> Abstract Should we invest more public funding in basic aging research that could lead to medical interventions that permit us to safely and effectively retard human aging? In this paper I make the case for answering in the affirmative. I examine, and critique, what I call the Fairness Objection to making aging research a greater (...) priority than it currently is. The Fairness Objection presumes that support for aging research is limited to a simplistic utilitarian justification. That is, a mode of justification that is aggregative and permits imposing high costs on a few so that small benefits could be enjoyed by numerous recipients. I develop two arguments to refute the Fairness Objection. The Fairness Objection mischaracterizes the utilitarian argument for retarding human aging. It does so by invoking the fallacious conceptual distinction between "saving lives" and "extending lives", as well as making a number of mistaken assumptions concerning the likely benefits of retarding human aging. Secondly, I argue that the case for tackling aging can be made on contractualist , in addition to utilitarian, grounds. Because the harms of senescence are "morally relevant" to the harms of disease, contractualists can permit aggregation within lives. And thus no one could reasonably reject, I contend, a principle that makes the aspiration to tackle human aging more of a priority than it currently is. CiteULike Connotea Del.icio.us What's this? (shrink)

I argue that computationalism is compatible with a plausible supervenience thesis about conscious states. The most plausible way of making it compatible, however, involves abandoning counterfactual conditions on implementation.

This deep presence of Foucault’s influence across contemporary theoretical landscapes signals a need for self-reflectiveness that has largely (though not entirely) been missing in contemporary uses of Foucault. While scholarship in a Foucauldian vein is obviously alive and well, scholarship on Foucauldian methodology is not. This paper develops a distinction between two methodological features of Foucault’s work that deserve to be disentangled: I parse the methods (e.g., genealogy, archaeology) and concepts (e.g., discipline, biopower) featured in Foucault’s texts. Following this, I (...) use the terms of this distinction to develop a detailed survey of two quite different contemporary uses of Foucault. My two test cases for comparison are the works of Giorgio Agamben and Ian Hacking, two contemporary theorists who demonstrate a productive engagement with central features of Foucault’s work. (shrink)

This paper considers the prospects for objectivity in reasoning strategies in response to empirical studies that apparently show systematic culture‐based differences in patterns of reasoning. I argue that there is at least one modest class of exceptions to the claim that there are alternative, equally warranted standards of good reasoning: the class that entails the solution of certain well‐structured problems which, suitably chosen, are common, or touchstone, to the sorts of culturally different viewpoints discussed. There is evidence that some cognitive (...) tasks are seen in much the same way across cultures, not least by virtue of the common run of experiences with the world of material objects in early childhood by creatures with similar cognitive endowments. These tasks thus present as similarly structured sets of claims that have similar priority: what is framed, and what is bracketed, or held constant in the background, is shown to be naturally common across cultures. As a consequence, a normative view of reasoning and, by implication, critical thinking can be defended. While this might be a modest sense of objectivity, the high level of intercultural articulation that is able to occur among people of different backgrounds suggests that it provides cognitive scaffolding for a lot of other reasoning tasks as well. (shrink)

Inquiry into the history of practices in the manner of Foucault's philosophical genealogy requires that we distinguish between practical action, on the one hand, and mere behavior, on the other. The need for this distinction may help explicate an aspect of Foucault's philosophical genealogy that might otherwise appear misplaced, namely his attention to rationalities and its attendant conceptual material. This article shows how a genealogical attention to practice goes hand in hand with an attention to the role of the conceptual (...) within our practices. This is done by first drawing on considerations furnished by a Wittgensteinean branch in analytic philosophy recently developed by Robert Brandom. With an account of conceptual normativity and reflexivity in hand, the article turns second to a crucial site of conceptual self-transformation by drawing on work from a particular Foucauldian lineage developed in the work of Arnold Davidson. Davidson's work helps us understand the crucial status of concepts of persons for any historical inquiry into practices. (shrink)

Pains are subject to obvious, well-documented, and striking top-down influences. This is in stark contrast to visual perception, where the debate over cognitive penetrability tends to revolve around fairly subtle experimental effects. Several authors have recently taken up the question of whether top-down effects on pain count as cognitive penetrability, and what that might show us about traditional debates. I review some of the known mechanisms for top-down modulation of pain, and suggest that it reveals an issue with a relatively (...) neglected part of the cognitive penetrability literature. Much of the debate inherits Pylyshyn’s stark contrast between transducers and cognition proper. His distinction grew out of his running fight with Gibson, and is far too strong to be defensible. I suggest that we might therefore view top-down influences on pain as a species of transducer calibration. This provides a novel but principled way to distinguish between several varieties of top-down effect according to their architectural features. (shrink)

The transport of molecules across the nuclear envelope plays a central role in the metabolism of the cell. Significant advances hi three major areas highlight the limits of our current knowledge and point to the prospect of exciting future developments. Firstly, findings that ions and small proteins do not diffuse freely into the nucleus call into question the current views of nuclear envelope permeability. Secondly, indications that nuclear protein import can be regulated in conjunction with the cell cycle and development (...) have been confirmed by the clear demonstration of regulated nuclear entry of specific transcription factors and morphogens. Thirdly, identification and characterisation of candidate receptor proteins indicates that the recognition of the nuclear targeting sequence occurs in the cytoplasm, suggesting that a different recognition event occurs at the nuclear pore. (shrink)

Pruss uses an example of Lester Dubins to argue against the claim that appealing to hyperreal-valued probabilities saves probabilistic regularity from the objection that in continuum outcome-spaces and with standard probability functions all save countably many possibilities must be assigned probability 0. Dubins’s example seems to show that merely finitely additive standard probability functions allow reasoning to a foregone conclusion, and Pruss argues that hyperreal-valued probability functions are vulnerable to the same charge. However, Pruss’s argument relies on the rule of (...) conditionalisation, but I show that in examples like Dubins’s involving nonconglomerable probabilities, conditionalisation is self-defeating. (shrink)

The book includes engaging discussions of all of the areas central to aesthetics: aesthetic experience, representation, expression, the definition and ontology of art, evaluation, interpretation, truth, and morality. As well as providing a solid grounding in the seminal theories of Plato, Immanuel Kant, and Benedetto Croce, it presents the ideas of contemporary analytic thinkers, such as Ludwig Wittgenstein and Nelson Goodman, and the iconoclastic views of continental theorists, such as Roland Barthes and Jacques Derrida. Concerned throughout with enhancing the reader's (...) response to art, Colin Lyas brings his theoretical discussions to life with a wealth of topical examples of human creativity that are familiar to young people: Bowie as well as Beethoven, Warhol as well as Whistler. With comprehensive, up-to-date guides to further reading, Aesthetics is an invaluable introduction for students taking philosophy of art courses and essential reading for anyone who wishes to be informed and inspired to think about and experience art in a new way. (shrink)

Barresi & Moore (B&M) provide a useful tool for the comparative study of social cognition that could, however, be improved by more subtle analysis of first person information about intentional relations. Knowledge of misrepresentation also needs to be better handled within the theory. I urge skepticism about B&M's sweeping phylogenetic claims.