Background: In prevalence studies of sexually transmitted infections (STIs), investigators often provide syndromic management for symptomatic participants, but may not provide specific treatment for asymptomatic individuals with positive laboratory test results due to the delays between sample collection and availability of results as well as logistical constraints in recontacting study participants. Methods: To characterize the extent of this issue, 80 prevalence studies from the World Health Organization’s Report on global sexually transmitted infection surveillance, 2018, were reviewed. Studies were classified as (...) to whether clinically relevant positive results were returned or if this was not specified. Results: More than half (56%) of the cited studies did not specify if participants were notified of clinically relevant positive STI test results. The percentages were similar for low- and middle-income country populations (57%) and high-income country populations (53%). Conclusions: The absence of documentation of the provision of test results raises the possibility that in some instances, results may not have been communicated, with potential negative effects for participants, their sexual partners, and newborns. From an ethical perspective, clinically relevant results should be returned to study participants and treating clinicians in a timely fashion to ensure appropriate management of identified infections. Study authors should document if they returned test results to study participants and report on numbers lost to follow-up. (shrink)

Er is de laatste decennia nogal wat te doen over de metafoor en haar functie. En vaak wordt daarbij verwezen naar een belangrijke tekst van de Griekse filosoof Aristoteles. Ik wil in het hierna volgende nagaan wat Aristoteles over de metafoor zegt. Ik begin met de hierboven bedoelde passage in haar verband zo letterlijk mogelijk te vertalen. Dan bezie ik verder wat Aristoteles met de metafoor die hij als voorbeeld gebruikt, doet en vervolgens bezien we wat Aristoteles verder over de (...) ‘overdracht’ zegt, en wat enkele geleerden zeggen over Aristoteles-en-de-metafoor. Tenslotte stel ik de vraag of, afgezien van Aristoteles, er reden is om te denken dat de metafoor een ‘cognitief extra’ heeft boven een mededeling in normale bewoordingen, en speciaal de wat soms genoemd wordt ‘levende’ metafoor. Ik zelf kan daar niet van overtuigd raken. (shrink)

Introduction While quizzing during informed consent for research to ensure understanding has become commonplace, it is unclear whether the quizzing itself is problematic for potential participants. In this study, we address this issue in a multinational HIV prevention research trial enrolling injection drug users in China and Thailand. Methods Enrolment procedures included an informed consent comprehension quiz. An informed consent survey followed. Results 525 participants completed the informed consent survey (Heng County, China=255, Xinjiang, China=229, Chiang Mai, Thailand=41). Mean age was (...) 33 and mean educational level was 8 yrs. While quizzing was felt to be a good way to determine if a person understands the nature of clinical trial participation (97%) and participants did not generally find the quiz to be problematic, minorities of respondents felt pressured (6%); anxious (5%); bored (5%); minded (5%); and did not find the questions easy (13%). In multivariate analysis, lower educational level was associated with not minding the quizzing (6–10 yrs vs 0–5 yrs: OR=0.27, p=0.03; more than 11 yrs vs 0–5 yrs: OR=0.18, p=0.03). There were also site differences (Heng County vs Xinjiang) in feeling anxious (OR=0.07; p=<0.01), not minding (OR=0.26; p=0.03), being bored (OR=0.25; p=0.01) and not finding the questions easy (OR=0.10; p=<0.01). Conclusions Quizzing during the informed consent process can be problematic for a minority of participants. These problems may be associated with the setting in which research takes place and educational level. Further research is needed to develop, test and implement alternative methods of ensuring comprehension of informed consent. Trial Registration clinicaltrials.gov number NCT00270257. (shrink)

Despite its current popularity, “emergence” is a concept with a venerable history and an elusive, ambiguous standing in contemporary evolutionary theory. This paper briefly recounts the history of the term and details some of its current usages. Not only are there radically varying interpretations about how to define emergence but “reductionist” and “holistic” theorists hold very different views about the issue of causation. However, these two seemingly polar positions are not irreconcilable. Reductionism, or detailed analysis of the parts and their (...) interactions, is essential for answering the “how” question in evolution—how does a complex living system work? But holism is equally necessary for answering the “why” question—why did a particular arrangement of parts evolve? In order to answer the “why” question, a broader, multi-leveled paradigm is required. The reductionist approach to explaining emergent complexity has entailed a search for underlying “laws of emergence.” In contrast, the “Synergism Hypothesis” focuses on the “economics”—the functional effects produced by emergent wholes and their selective consequences in evolutionary change. This paper also argues that emergent phenomena represent, in effect, a subset of a larger universe of cooperative, synergistic effects in the natural world. (shrink)

People can learn to perform new tasks very quickly by making use of lower‐level skills they have developed when learning previous tasks. Hoekstra, Martens, and Taatgen model this process, showing how a system trained on simple tasks (visual search and two working memory tasks) can then quickly learn to perform the attentional blink task, and it ends up making the same sorts of errors as people do.

Though pain scientists now understand pain to be a complex experience typically composed of sensation, emotion, cognition, and motivational responses, many philosophers maintain that pain is adequately characterized by one privileged aspect of this complexity. Philosophically dominant unitary accounts of pain as a sensation or perception are here evaluated by their ability to explain actual cases—and found wanting. Further, it is argued that no forthcoming unitary characterization of pain is likely to succeed. Instead, I contend that both the motivating intuitions (...) behind unitary accounts and the wide range of pain phenomena are best accommodated by a componential view of pain that does not privilege any single component as necessary or sufficient. (shrink)

Johannine ethics was a problematic topic for a long time and has only been an acceptable and fruitful area of research since 2012. To stimulate and guide future research, this article proposes a model of Johannine ethics that consists of five aspects: Graeco-Roman virtue ethics is the broad ethical context for Johannine ethics; family is the theological context for Johannine ethics; mimesis is central to Johannine ethics; moral reasoning is the cognitive route to ethics; Spirit and community empower ethical living. (...) The argument is that the Johannine writings present ethics as divine family education that has mimesis at its centre and is facilitated by moral reasoning and the Spirit as the moral force. An Appendix contains a list of publications on Johannine ethics between 2012 and 2022. (shrink)

Charles Sanders Peirce, the founder of pragmatism, is a hugely important and influential thinker in the history of American philosophy. His philosophical interests were broad and he made significant contributions in several different areas of thought. Moreover, his contributions are intimately connected and his philosophy designed to form a coherent and systematic whole. Contents: 1: Life and Work; Chapter 2: Logic; Chapter 3: The Doctrine of the Categories; Chapter 4: Semiotics; Chapter 5: Philosophy of Science; Chapter 6: Pragmatism but Not (...) Practicalism; Chapter 7: A Pragmatist Theory of Truth; Chapter 8: The Perpetual Fight against Nominalism; Chapter 9: The Impact of Darwin; Chapter 10: Mathematics; Chapter 11: Mind and Self; Chapter 12 (Conclusion): The Architectonic Philosopher; Bibliography; Notes; Index. (shrink)

The phenomenon of pain presents problems and puzzles for philosophers who want to understand its nature. Though pain might seem simple, there has been disagreement since Aristotle about whether pain is an emotion, sensation, perception, or disturbed state of the body. Despite advances in psychology, neuroscience, and medicine, pain is still poorly understood and multiple theories of pain abound. The Routledge Handbook of Philosophy of Pain is an outstanding reference source to the key topics, problems and debates in this exciting (...) and interdisciplinary subject and is the first collection of its kind. Comprising over thirty chapters by a team of international contributors the Handbook is divided into nine clear parts: Modelling pain in philosophy Modelling pain in neuroscience Modelling pain in psychology Pain in philosophy of mind Pain in epistemology Pain in philosophy of religion Pain in ethics Pain in medicine Pain in law. As well as fundamental topics in the philosophy of pain such as the nature, role, and value of pain, many other important topics are covered including the neurological pathways involved in pain processing, biopsychosocial and cognitive behavioural models of pain; chronic pain; pain and non-human animals; pain and knowledge; controlled substances for pain; pain and placebo effects; and pain and physician assisted suicide. The Routledge Handbook of Philosophy of Pain is essential reading for students and researchers in philosophy of mind, philosophy of psychology and ethics. It will also be very useful to researchers of pain from any field, especially those in psychology, medicine, and health studies. (shrink)

One way to reconstruct the miracle argument for scientific realism is to regard it as a statistical inference: since it is exceedingly unlikely that a false theory makes successful predictions, while it is rather likely that an approximately true theory is predictively successful, it is reasonable to infer that a predictively successful theory is at least approximately true. This reconstruction has led to the objection that the argument embodies a base rate fallacy: by focusing on successful theories one ignores the (...) vast number of false theories some of which will be successful by mere chance.In this paper, I shall argue that the cogency of this objection depends on the explanandum of the miracle argument. It is cogent if what is to be explained is the success of a particular theory. If, however, the explanandum of the argument is the distribution of successful predictions among competing theories, the situation is different. Since the distribution of accidentally successful predictions is independent of the base rate, it is possible to assess the base rate by comparing this distribution to the empirically found distribution of successful predictions among competing theories. (shrink)

In 2010, the Dutch Scientific Council for Governmental Policy called for an explicit and adequate intervention ethics for policy on international development cooperation. Yet, as appears from a careful reading of their report, the council’s own overall commitment to a modernist worldview hinders the fruitful development of such an intervention ethics. There is, however, a strand in their thinking that draws attention to the importance of practical knowledge. We argue specifically that an intervention ethics for development cooperation in agriculture should (...) start from this practical knowledge, which points to the inherent normativity of agricultural development cooperation. That is, agricultural development cooperation is a normative practice of which the inherent normativity consists in facilitating other practices in the agricultural domain. As such, agricultural development cooperation should respect the normativity inherent in those other practices. (shrink)

Traditional eliminativism is the view that a term should be eliminated from everyday speech due to failures of reference. Following Edouard Machery, we may distinguish this traditional eliminativism about a kind and its term from a scientific eliminativism according to which a term should be eliminated from scientific discourse due to a lack of referential utility. The distinction matters if any terms are rightly retained for daily life despite being rightly eliminated from scientific inquiry. In this article, I argue that (...) while scientific eliminativism for pain may be plausible, traditional eliminativism for pain is not. I discuss the pain eliminativisms offered by Daniel Dennett and Valerie Hardcastle and argue that both theorists, at best, provide support for scientific eliminativism for pain, but leave the folk-psychological notion of pain unscathed. One might, however, think that scientific eliminativism itself entails traditional eliminativism—for pain and any other kind and corresponding term. I argue that this is not the case. Scientific eliminativism for pain does not entail traditional eliminativism about anything. (shrink)

Chapter The Triumph of Reason; Anticipating the Bio- Technetronic Civilization I believe information technology is at the basis of a new age of civilization ...

In recent years, evolutionary theorists have come to recognize that the reductionist, individualist, gene-centered approach to evolution cannot sufficiently account for the emergence of complex biological systems over time. Peter A. Corning has been at the forefront of a new generation of complexity theorists who have been working to reshape the foundations of evolutionary theory. Well known for his Synergism Hypothesis—a theory of complexity in evolution that assigns a key causal role to various forms of functional synergy—Corning puts this theory (...) into a much broader framework in _Holistic Darwinism_, addressing many of the issues and concepts associated with the evolution of complex systems. Corning's paradigm embraces and integrates many related theoretical developments of recent years, from multilevel selection theory to niche construction theory, gene-culture coevolution theory, and theories of self-organization. Offering new approaches to thermodynamics, information theory, and economic analysis, Corning suggests how all of these domains can be brought firmly within what he characterizes as a post–neo-Darwinian evolutionary synthesis. (shrink)

Promiscuous realism is the thesis that there are many equally legitimate ways of classifying the world’s entities. Advocates of promiscuous realism are typically taken to hold the further the- sis, often undistinguished, that kind terms usefully deployed in scientific generalisations are no more natural than those deployed for any other purposes. Call this further thesis promiscuous nat- uralism. I here defend a version of promiscuous realism which denies promiscuous naturalism. To do so, I introduce the notion of a promiscuous kind: (...) a kind that is maximally usefully referenced in predictive and explanatory generalisations, none of which are scientific generalisations. I first defend the claim that pain is a promiscuous kind before extending these considerations to everyday mental kinds more generally. I draw on further reflections from both everyday life and contem- porary psychology to make credible the novel suggestion that our everyday theory of our minds is for the explanation and prediction of individuals. Combined with the complex idiosyncrasy of individual minds, this suggested aim of everyday theory gives us reason to think that promiscuity is prevalent among everyday mental kinds. (shrink)

Mimesis is a fundamental and pervasive human concept, but has attracted little attention from Johannine scholarship. This is unsurprising, since Johannine ethics, of which mimesis is a part, has only recently become a fruitful area of research. Bennema contends that scholars have not yet identified the centre of Johannine ethics, admittedly due to the fact that mimesis is not immediately evident in the Johannine text because the usual terminology for mimesis is missing. This volume is the first organized study on (...) the concept of mimesis in the Johannine literature. The aim of the study is to establish that mimesis is a genuine Johannine concept, to explain its particulars and to show that mimesis is integral to Johannine ethics. Bennema argues that Johannine mimesis is a cognitive, creative process that shapes the believer's identity and behaviour within the context of the divine family. Besides being instrumental in people's moral transformation, mimesis is also a vital mechanism for mediating the divine reality to people. (shrink)

In coarse-grained environments specialists are generally predicted to dominate. Empirically, however, coexistence with generalists is often observed. We present a simple, but previously unrecognized, mechanism for coexistence of a habitat generalist and a number of habitat specialist species. In our model all species have a metapopulation structure in a landscape consisting of patches of different habitat types, governed by local extinction and colonization. Each specialist is limited to its specific type of habitat. The generalist can use more types of habitat, (...) has a lower local competitive ability but can exploit patches left open by the specialists. Our modeling shows that coexistence is easily possible. The mechanism amounts to a colonization/competition trade-off at the landscape level, where the colonization advantage of the inferior competitor does not arise from a higher colonization rate but from its ability to use more types of habitat. Habitat availability has to be intermediate: when there are few patches of each habitat, only the generalist is able to maintain itself and when there are many patches, high propagule pressure of the specialists excludes the generalist. Habitat selection or temporal variations in relative habitat quality are not necessary for coexistence. Increased niche-width, colonization rate or local competitive ability of the generalist enhances its performance compared to the specialists. Various types of habitat degradation favour generalism. When able to use a broad range of habitats, generalists can generate so much propagule pressure that only a low level of local competitive ability is needed to globally exclude the specialists. Hence, in a reversal of the original problem, the question is why there are so many specialist metapopulations? (shrink)

This unique introduction fully engages and clearly explains pragmatism, an approach to knowledge and philosophy that rejects outmoded conceptions of objectivity while avoiding relativism and subjectivism. It follows pragmatism's focus on the process of inquiry rather than on abstract justifications meant to appease the skeptic. According to pragmatists, getting to know the world is a creative human enterprise, wherein we fashion our concepts in terms of how they affect us practically, including in future inquiry. This book fully illuminates that enterprise (...) and the resulting radical rethinking of basic philosophical conceptions like truth, reality, and reason. Author Cornelis de Waal helps the reader recognize, understand, and assess classical and current pragmatist contributions--from Charles S. Peirce to Cornel West--evaluate existing views from a pragmatist angle, formulate pragmatist critiques, and develop a pragmatist viewpoint on a specific issue. The book discusses: Classical pragmatists, including Peirce, James, Dewey, and Addams; Contemporary figures, including Rorty, Putnam, Haack, and West; Connections with other twentieth-century approaches, including phenomenology, critical theory, and logical positivism; Peirce's pragmatic maxim and its relation to James's will-to-believe; Applications to philosophy of law, feminism, and issues of race and racism. (shrink)

Meyer Cornelis Smit taught history and philosophy in the Free University at Amsterdam for a quarter century. Toward a Christian Conception of History presents the harvest of his scholarly output. The relation between God and history and the problems inherent in articulating that relation in a manner consistent with historic Christian belief and modern ideas of historical existence is the central theme of Smit's writing. Smit discusses the influence of one's world view on the practice and appreciation of history, (...) the significance of the question of the meaning of history as an answer to the a-historical-mindedness of our time, and the fundamental flaw of the modernist theory of knowledge and philosophy of science. (shrink)

We performed an EEG graph analysis on data from 31 typical readers and 24 dyslexics, recorded while they were engaged in an audiovisual task and during resting-state. The task simulates reading acquisition as participants learned new letter-sound mappings via feedback. EEG data was filtered for the delta, theta, alpha, and beta bands. We computed the Phase Lag Index to provide an estimate of the functional connectivity between all pairs of electrodes per band. Then, networks were constructed using a Minimum Spanning (...) Tree, a unique sub-graph connecting all nodes without loops, aimed at minimizing bias in between groups and conditions comparisons. Both groups showed a comparable accuracy increase during task blocks, indicating that they correctly learned the new associations. The EEG results revealed lower task-specific theta connectivity, and lower theta degree correlation over both rest and task recordings, indicating less network integration in dyslexics compared to typical readers. This pattern suggests a role of theta oscillations in dyslexia and may reflect differences in task engagement between the groups, although robust correlations between MST metrics and performance indices were lacking. (shrink)

Background: The classical symptom specificity hypothesis (Blatt, 1974) links obsessional symptoms to autonomous interpersonal behavior. Inconsistent findings from cross-sectional group studies on symptom specificity have previously been associated with several conceptual and methodological limitations intrinsic to nomothetic research. Previous empirical case research reported ambivalences between autonomous and dependent interpersonal behavior in obsessional pathology. Aim and Method: The present ‘theory-building’ case study specifically aims at further refinement of the classical symptom specificity hypothesis by testing specific operationalizations within an empirical single case (...) design. Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of a psychodynamic therapy. Interpersonal functioning is assessed by means of the Core Conflictual Relationship Theme method. The classical symptom specificity hypothesis is contrasted to an alternative hypothesis of interpersonal ambivalences as determinants of obsessional symptoms. Results: Close associations between obsessions and interpersonal dynamics are observed. Findings predominantly affirm the ambivalence hypothesis rather than the classical symptom specificity hypothesis. Psychodynamic interventions focusing on interpersonal conflicts are related to symptomatic changes. Conceptual and methodological considerations, limitations and future research indications are discussed. (shrink)

There have been many different ways of characterizing and describing the phenomenon of life over the years. One aspect that has not often been stressed is lifersquo;s emergent propertiesmdash;the synergies that are produced when many elements or parts combine to produce distinctive new ldquo;wholesrdquo;. Indeed, complex living systems represent a multi-leveled, multi-faceted hierarchy of synergistic effects that has evolved over several billion years. Some of the many examples of synergy at various levels of life are briefly described, and it is (...) emphasized that life is still creating itself and still exploring its potentialities. (shrink)

Although discussion of social pain has become popular among researchers in psychology and behavioural neuroscience, the philosophical community has yet to pay it any direct attention. Social pain is characterized as the emotional reaction to the perception of the loss or devaluation of desired relationships. These are argued to comprise a pain type and are explicitly intended to include the everyday sub-types grief, jealousy, heartbreak, rejection, and hurt feelings. Social pain is accordingly posited as a nested type of pain encompassing (...) multiple emotional sub-types. Call this the social pain posit. This article focuses on whether we should endorse the social pain posit and, in particular, whether social pain is pain. I present the four lines of evidence for the social pain posit that are currently offered in the literature and I argue that each provides only inadequate support, taken either individually or together. I close by considering the significance of the presented argument for philosophical theo.. (shrink)

This book presents a theoretical treatment of externalities, public goods, and club goods. The new edition updates and expands the discussion of externalities and their implications, coverage of asymmetric information, underlying game-theoretic formulations, and intuitive and graphical presentations. Aimed at well-prepared undergraduates and graduate students making a serious foray into this branch of economics, the analysis should also interest professional economists wishing to survey recent advances in the field. No other single source for the range of materials explored is currently (...) available. Topics investigated include Nash equilibrium, Lindahl equilibria, club theory, preference-revelation mechanism, Pigouvian taxes, the commons, Coase Theorem, and static and repeated games. The authors use mathematical techniques only as much as necessary to pursue the economic argument. They develop key principles of public economics that are useful for subfields such as public choice, labor economics, economic growth, international economics, environmental and natural resource economics, and industrial organization. (shrink)

This book employs contemporary philosophy, scientific research, and clinical reports to argue that pain, though real, is not an appropriate object of scientific generalisations or an appropriate target for medical intervention. Each pain experience is instead complex and idiosyncratic in a way which undermines scientific utility. In addition to contributing novel arguments and developing a novel position on the nature of pain, the book provides an interdisciplinary overview of dominant models of pain. The author lays the needed groundwork for improved (...) models and targeted treatments at a time when pain science, pain medicine, and philosophy are explicitly searching for both and failing to find them. The Complex Reality of Pain will be of interest to a broad range of researchers and students, including those working in philosophy of mind, philosophy of science, cognitive science, neuroscience, medicine, health, cognitive and behavioural psychology, and pain science. (shrink)

Superfluous People describes Hannah Arendt's political and philosophical views on Nazi totalitarianism and the Shoah. In her contemplation of evil, Arendt initially spoke of the Shoah as a "radical evil," a term used by Kant. However, unlike Kant, Arendt's radical evil cannot be explained by human motives. Many years later she changed her mind and spoke of "the banality of evil," characterized by an inability to think and judge. Superfluous People seriously considers the question of whether thinking and judging can (...) prevent evil. (shrink)

This paper describes a belief understanding system which, taking an interview-text as its input, builds a conceptual representation of a respondent's belief system concerning a given object. Central to the understanding process is the identification of the connections between the object and the believer's goals. A general scheme governing the inference-processes with respect to these object-goal relationships is presented. It is suggested that the implementation of BUS could proceed from Schank's et al Integrated Partial Parsing program. The system's behavior is (...) illustrated by examining the processing of a fragment of an interview-text. Some implications for the study of belief systems are discussed. (shrink)

Grief Worlds is a phenomenological exploration of grief experiences and what they may teach us about emotional experience and human experience more generally. Though explicitly and self-consciously...

This book explores the dynamics of the commentary and textbook traditions in Aristotelian natural philosophy under the headings of doctrine, method, and scientific and social status. It enquires what the evolution of the Aristotelian commentary tradition can tell us about the character of natural philosophy as a pedagogical tool, as a scientific enterprise, and as a background to modern scientific thought. In a unique attempt to cut old-fashioned historiographic divisions, it brings together scholars of ancient, medieval, Renaissance and seventeenth-century philosophy. (...) The book covers a remarkably broad range of topics: it starts with the first Greek commentators and ends with Leibniz. (shrink)

To adequately model mathematical arguments the analyst must be able to represent the mathematical objects under discussion and the relationships between them, as well as inferences drawn about these objects and relationships as the discourse unfolds. We introduce a framework with these properties, which has been used to analyse mathematical dialogues and expository texts. The framework can recover salient elements of discourse at, and within, the sentence level, as well as the way mathematical content connects to form larger argumentative structures. (...) We show how the framework might be used to support computational reasoning, and argue that it provides a more natural way to examine the process of proving theorems than do Lamport’s structured proofs. (shrink)

Proponents of “the affective appeal” :787–812, 2014; Zagzebski in Philos Phenomenol Res 66:104–124, 2003) argue that we can make progress in the longstanding debate about the nature of moral motivation by appealing to the affective dimension of affective episodes such as emotions, which allegedly play either a causal or constitutive role in moral judgements. Specifically, they claim that appealing to affect vindicates a version of Motivational Internalism—roughly, the view that there is a necessary connection between moral judgment and motivation—that is (...) both more empirically respectable and less theoretically controversial than non-affective versions. We here argue that the affective appeal fails: versions of Internalism which appeal to affect are neither more empirically supported, nor clearly less controversial, than versions of Internalism which make no such appeal. Although affect doubtless has an important role to play in explaining moral motivation, we are sceptical that establishing any such role advances the debate. (shrink)

In this article I trace some of the main tenets of the struggle between nominalism and realism as identified by John Deely in his Four ages of understanding. The aim is to assess Deely’s claim that the Age of Modernity was nominalist and that the coming age, the Age of Postmodernism — which he portrays as a renaissance of the late middle ages and as starting with Peirce — is realist. After a general overview of how Peirce interpreted the nominalist-realist (...) controversy, Deely gives special attention to Thomas Aquinas’s On being and essence and the realism it entails. A subsequent discussion of the Modern Period shows that the issue of nominalism and realism is very much tied up with di¤erent conceptions of the intellect. Deely credits the theory of evolution with bringing us a conception of the intellect that is closer to that of the Middle Ages and that opens the way for a truly realistic ‘‘fourth age’’ of the understanding. (shrink)

In the last two decades Information and Computer Technology has come to play an increasingly important role in medicine and health care. Many medical practitioners and scholars wonder: will e-health cause a paradigm shift in health care? To answer this question we provide a philosophical analysis of the concept of the 'paradigm shift' through the work of Michel Foucault, Thomas Kuhn and Larry Laudan. Their work offers key insights to a comprehensive understanding of major evolutions in medicine. Nowadays the long-standing (...) curative paradigm in medicine is facing important challenges due to an aging population, a significant increase in chronic diseases and the development of more expensive diagnostic tools and therapies. This promotes the evolution towards a new paradigm in medicine with an emphasis on preventive, predictive and personalized care. E-health constitutes an essential part of this new paradigm that seeks to solve the challenges presented by an aging population, skyrocketing costs and so forth. On the other hand the characteristics of e-health will be strongly determined by this new paradigm. 'Will e-health cause a paradigm shift in medicine?' might not be the right question to pose. Rather, we should ask how the underlying paradigm shift, from discovery and cure to prevention and prediction, acts as a facilitator to embrace ICT in health care. This analysis is of crucial importance in understanding the impact of digital health care applications and provides a necessary framework for the emerging, dynamic system of e-health. (shrink)

This article offers a new theory of suffering as significantly disrupted agency. In presenting it, I here make three significant contributions. First, I subject the leading account of suffering as undesired unpleasant experience (Brady, 2018) to its first dose of sustained scrutiny. Second and drawing on this discussion, I identify and liberate eight desiderata for any account of suffering. Third, I present the novel account of suffering as significantly disrupted agency and argue that it satisfies these desiderata. Moreover, I argue (...) that elaborating this proposal with a minimal model of agency allows us to capture both the suffering of a wide range of organisms and the complex dynamics of suffering as it is endured. I conclude by briefly highlighting some of the potential implications of the theory for further theoretical and practical inquiries. (shrink)