Background:A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population.Research aim:To identify challenges in implementing the ‘Let Me Decide’ advance care planning programme in long-term-care.Research design:This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families.Participants and research context:long-term-care residents in two nursing homes and one community hospital.Ethical considerations:The local research ethics committee granted ethical approval.Findings:Following implementation, over (...) 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training.Discussion:The challenges encountered were largely concerned with preserving resident’s autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources.Conclusions:Although it may be too late for many long-term-care residents to complete their own advance care directive, the ‘ Let Me Decide’ programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice. (shrink)

Objectives - To explore the wvay ethical principles develop during a medical education course for three groups of medical students - in their first year, at the beginning of their penultimate (fifth) year and towards the end of their final (sixth) year. Design - Survey questionnaire administered to medical students in their first, fifth and final (sixth) year. Setting - A large medical school in Queensland, Australia. Survey sample - Approximately half the students in each of three years (first, fifth (...) and sixth) provided data on a voluntary basis, a total of 385 students. Results - At the point of entry, minor differences were found between medical students and first year law and psychology students. More striking were differences between male and female medical students, suggesting early socialization had a substantial impact here. Conclusions - Results indicate that substantial changes in attitude have developed by the beginning of fifth year with little change thereafter. Gender difference persisted. Some difference in ethical attitudes were found when groups of different ethnic backgrounds were compared. The impact of a move to a graduate medical course, which gives high priority to ethics within a professional development domain, can now be evaluated. (shrink)

There has been considerable debate in the literature about the relative merits of information processing versus dynamical approaches to understanding cognitive processes. In this article, we explore the relationship between these two styles of explanation using a model agent evolved to solve a relational categorization task. Specifically, we separately analyze the operation of this agent using the mathematical tools of information theory and dynamical systems theory. Information-theoretic analysis reveals how task-relevant information flows through the system to be combined into a (...) categorization decision. Dynamical analysis reveals the key geometrical and temporal interrelationships underlying the categorization decision. Finally, we propose a framework for directly relating these two different styles of explanation and discuss the possible implications of our analysis for some of the ongoing debates in cognitive science. (shrink)

A new methodology for developing theories of action has recently emerged which provides means for formally evaluating the correctness of such theories. Yet, for a theory of action to qualify as a solution to the frame problem, not only does it need to produce correct inferences, but moreover, it needs to derive these inferences from a concise representation of the domain at hand. The new methodology however offers no means for assessing conciseness. Such a formal account of conciseness is developed (...) in this paper. Combined with the existing criterion for correctness, our account of conciseness offers a framework where proposed solutions to the frame problem can be formally evaluated. (shrink)

Children in foster care are considered a “vulnerable population” in clinical care and research, with good reason. These children face multiple medical, psychological, and social risks that obligate the child welfare and healthcare systems to protect them from further harms. An unintended consequence of the “vulnerable population” designation for children in foster care is that it may impose barriers on tracking and studying their health that creates gaps in knowledge that are key to their receipt of medical care and good (...) outcomes. These gaps in knowledge have implications for justice, beneficence, and maleficence and serve to undermine “protection” of this population. Here we review the challenges of research regarding children in foster care, particularly medically complex children, and offer specific recommendations to include children in foster care in medical research. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

The return of genetic research results after death in the pediatric setting comes with unique complexities. Researchers must determine which results and through which processes results are returned. This paper discusses the experience over 15 years in pediatric cancer genetics research of returning research results after the death of a child and proposes a preventive ethics approach to protocol development in order to improve the quality of return of results in pediatric genomic settings.

This book is a systematic reconstruction of Heidegger's account of time and temporality in Being and Time. The author locates Heidegger in a tradition of 'temporal idealism' with its sources in Plotinus, Leibniz, and Kant. For Heidegger, time can only be explained in terms of 'originary temporality', a concept integral to his ontology. Blattner sets out not only the foundations of Heidegger's ontology, but also his phenomenology of the experience of time. Focusing on a neglected but central aspect of Being (...) and Time, this book will be of considerable interest to all students of Heidegger both inside and outside philosophy. (shrink)

Two rotational bands have been identified and characterized in the proton-magic N = Z + 1 nucleus Ni-57. These bands complete the systematics of well-and superdeformed rotational bands in the light nickel isotopes starting from doubly magic Ni-56 to Ni-60. High-spin states in Ni-57 have been produced in the fusion-evaporation reaction Si-28(S-32, 2p1n)Ni-57 and studied with the gamma-ray detection array GAMMASPHERE operated in conjunction with detectors for evaporated light charged particles and neutrons. The features of the rotational bands in Ni-57 (...) are compared to those of neighbouring isotopes and interpreted by means of configuration-dependent cranked Nilsson-Strutinsky calculations. The two observed high-spin bands are considered signature partners and assigned to configurations with one 1g(9/2) proton and one 1g(9/2) neutron, resulting in an unambiguous understanding of the energetically favoured signature alpha = -1/2 band but a somewhat less satisfactory description of the signature alpha = +1/2 band. (shrink)

In Natural Ethical Facts William Casebeer argues that we can articulate a fully naturalized ethical theory using concepts from evolutionary biology and cognitive science, and that we can study moral cognition just as we study other forms of cognition. His goal is to show that we have "softly fixed" human natures, that these natures are evolved, and that our lives go well or badly depending on how we satisfy the functional demands of these natures. Natural Ethical Facts is a (...) comprehensive examination of what a plausible moral science would look like.Casebeer begins by discussing the nature of ethics and the possible relationship between science and ethics. He then addresses David Hume's naturalistic fallacy and G. E. Moore's open-question argument, drawing on the work of John Dewey and W. V. O. Quine. He then proposes a functional account of ethics, offering corresponding biological and moral descriptions. Discussing in detail the neural correlates of moral cognition, he argues that neural networks can be used to model ethical function. He then discusses the impact his views of moral epistemology and ontology will have on traditional ethical theory and moral education, concluding that there is room for other moral theories as long as they take into consideration the functional aspect of ethics; the pragmatic neo-Aristotelian virtue theory he proposes thus serves as a moral "big tent." Finally, he addresses objections to ethical naturalism that may arise, and calls for a reconciliation of the sciences and the humanities. "Living well," Casebeer writes, "depends upon reweaving our ethical theories into the warp and woof of our scientific heritage, attending to the myriad consequences such a project will have for the way we live our lives and the manner in which we structure our collective moral institutions.". (shrink)

The philosophy of cognitive science has recently become one of the most exciting and fastest growing domains of philosophical inquiry and analysis. Until the early 1980s, nearly all of the models developed treated cognitive processes -- like problem solving, language comprehension, memory, and higher visual processing -- as rule-governed symbol manipulation. However, this situation has changed dramatically over the last half dozen years. In that period there has been an enormous shift of attention toward connectionist models of cognition that are (...) inspired by the network-like architecture of the brain. Because of their unique architecture and style of processing, connectionist systems are generally regarded as radically different from the more traditional symbol manipulation models. This collection was designed to provide philosophers who have been working in the area of cognitive science with a forum for expressing their views on these recent developments. Because the symbol-manipulating paradigm has been so important to the work of contemporary philosophers, many have watched the emergence of connectionism with considerable interest. The contributors take very different stands toward connectionism, but all agree that the potential exists for a radical shift in the way many philosophers think of various aspects of cognition. Exploring this potential and other philosophical dimensions of connectionist research is the aim of this volume. (shrink)

In Natural Ethical Facts William Casebeer argues that we can articulate a fully naturalized ethical theory using concepts from evolutionary biology and cognitive science, and that we can study moral cognition just as we study other forms of cognition. His goal is to show that we have "softly fixed" human natures, that these natures are evolved, and that our lives go well or badly depending on how we satisfy the functional demands of these natures. Natural Ethical Facts is a (...) comprehensive examination of what a plausible moral science would look like.Casebeer begins by discussing the nature of ethics and the possible relationship between science and ethics. He then addresses David Hume's naturalistic fallacy and G. E. Moore's open-question argument, drawing on the work of John Dewey and W. V. O. Quine. He then proposes a functional account of ethics, offering corresponding biological and moral descriptions. Discussing in detail the neural correlates of moral cognition, he argues that neural networks can be used to model ethical function. He then discusses the impact his views of moral epistemology and ontology will have on traditional ethical theory and moral education, concluding that there is room for other moral theories as long as they take into consideration the functional aspect of ethics; the pragmatic neo-Aristotelian virtue theory he proposes thus serves as a moral "big tent." Finally, he addresses objections to ethical naturalism that may arise, and calls for a reconciliation of the sciences and the humanities. "Living well," Casebeer writes, "depends upon reweaving our ethical theories into the warp and woof of our scientific heritage, attending to the myriad consequences such a project will have for the way we live our lives and the manner in which we structure our collective moral institutions.". (shrink)

Philosophers have rightly condemned lookism—that is, discrimination in favor of attractive people or against unattractive people—in education, the justice system, the workplace and elsewhere. Surprisingly, however, the almost universal preference for attractive romantic and sexual partners has rarely received serious ethical scrutiny. On its face, it’s unclear whether this is a form of discrimination we should reject or tolerate. I consider arguments for both views. On the one hand, a strong case can be made that preferring attractive partners is bad. (...) The idea is that choosing partners based on looks seems essentially similar to other objectionable forms of discrimination. (In particular, the preference for attractive partners is arguably both unfair and harmful to a significant degree.) One can try to resist this conclusion in several ways. I consider three possible replies. The first has to do with the possibility of controlling our partner preferences. The second pertains to attractiveness and “good genes”. The last attempts to link certain aspects of attractiveness to a prospective partner’s personality and values. I argue that the first two replies fail conclusively, while the third only amounts to a limited defense of a particular kind of attractiveness preference. So the idea that we should often avoid preferring attractive partners is compelling. (shrink)

Merleau-Ponty spent the summer of 1960 in the small French village of Le Tholonet writing Eye and Mind. His choice of location was no accident. Le Tholonet was the physical and emotional epicenter of Paul Cezanne’s late painting, the ultimate proving ground of his relentless quest to reveal the truth of landscape in art.It makes perfect sense that Merleau-Ponty wrote Eye and Mind in Le Tholonet. The essay is a philosophical meditation on vision and painting. But it also is a (...) meditation on place, in the deeply saturated sense that encompasses the landscape, its natural and human history, and the history of the painter who brought this part of Provence to universal visibility in his art. Le Tholonet is the terroir of Eye and Mind, the site and soil of this final, extraordinary expression of Merleau-Ponty’s thinking. Merleau-Ponty passa l’été 1960 dans le petit village français de Le Tholonet en écrivant L’OEil et l’Esprit. Le choix de ce lieu n’est pas accidentel. Le Tholonet était l’épicentre physique et émotionnel de la dernière peinture de Paul Cézanne, le terrain d’essai final de sa quête incessante pour arriver à révéler la vérité du paysage dans l’art. C’est tout à fait sensé que Merleau-Ponty ait écrit L’OEil et l’Esprit à Le Tholonet. L’essai est une méditation philosophique sur la vision et sur la peinture. Mais c’est aussi une méditation sur le lieu, sur le sens profondément saturé qui entoure le paysage, sur son histoire naturelle et humaine, et sur l’histoire du peintre qui porta, par son art, ce coin de la Provence à la visibilité universelle. On pourrait alors dire que Le Tholonet est le terroir de L’OEil et l’Esprit, le site et le sol de cette expression finale et extraordinaire de la réflexion de Merleau-Ponty. Merleau-Ponty trascorse l’estate del 1960 nel piccolo villaggio francese di Le Tholonet, dedicandosi alla scrittura de L’occhio e lo spirito. La scelta di questo luogo non fu casuale. Le Tholonet fu infatti l’epicentro fisico ed emotivo della pittura dell’ultimo Cézanne, il campo di prova finale del suo tentativo instancabile di rivelare la verità del paesaggio nell’arte. È del tutto coerente che Merleau-Ponty abbia scritto L’occhio e lo spirito a Le Tholonet. Il saggio costituisce una riflessione filosofica sulla visione e sulla pittura, ma rappresenta anche una meditazione sul senso di un luogo, secondo un’accezione densa che comprende il paesaggio, la sua storia naturale e umana, e la storia del pittore che attraverso la sua arte ha portato questa parte della Provenza a una visibilità universale. Le Tholonet è il terroir de L’occhio e lo spirito, il sito che ospita e il terreno che nutre quest’ultima straordinaria espressione del pensiero di Merleau-Ponty. (shrink)

We discuss potential biorisks from large language models (LLMs). AI assistants based on LLMs such as ChatGPT have been shown to significantly reduce barriers to entry for actors wishing to synthesize dangerous, potentially novel pathogens and chemical weapons. The harms from deploying such bioagents could be further magnified by AI-assisted misinformation. We endorse several policy responses to these dangers, including prerelease evaluations of biomedical AIs by subject-matter experts, enhanced surveillance and lab screening procedures, restrictions on AI training data, and access (...) controls on biomedical AI. We conclude with a suggestion about future research directions in bioethics. (shrink)

According to a widespread view in metaphysics and philosophy of science, all explanations involve relations of ontic dependence between the items appearing in the explanandum and the items appearing in the explanans. I argue that a family of mathematical cases, which I call “viewing-as explanations”, are incompatible with the Dependence Thesis. These cases, I claim, feature genuine explanations that aren’t supported by ontic dependence relations. Hence the thesis isn’t true in general. The first part of the paper defends this claim (...) and discusses its significance. The second part of the paper considers whether viewing-as explanations occur in the empirical sciences, focusing on the case of so-called fictional models. It’s sometimes suggested that fictional models can be explanatory even though they fail to represent actual worldly dependence relations. Whether or not such models explain, I suggest, depends on whether we think scientific explanations necessarily give information relevant to intervention and control. Finally, I argue that counterfactual approaches to explanation also have trouble accommodating viewing-as cases. (shrink)

The problem of truth in fiction concerns how to tell whether a given proposition is true in a given fiction. Thus far, the nearly universal consensus has been that some propositions are ‘implicitly true’ in some fictions: such propositions are not expressed by any explicit statements in the relevant work, but are nevertheless held to be true in those works on the basis of some other set of criteria. I call this family of views ‘implicitism’. I argue that implicitism faces (...) serious problems, whereas the opposite view is much more plausible than has previously been thought. After mounting a limited defence of explicitism, I explore a difficult problem for the view and discuss some possible responses. (shrink)

Much recent work on mathematical explanation has presupposed that the phenomenon involves explanatory proofs in an essential way. I argue that this view, ‘proof chauvinism’, is false. I then look in some detail at the explanation of the solvability of polynomial equations provided by Galois theory, which has often been thought to revolve around an explanatory proof. The article concludes with some general worries about the effects of chauvinism on the theory of mathematical explanation. 1Introduction 2Why I Am Not a (...) Proof Chauvinist 2.1Proof chauvinism and mathematical practice 2.2Proof chauvinism and philosophy 3An Example: Galois Theory and Explanatory Proof 4Conclusion. (shrink)

Philosophers of science since Nagel have been interested in the links between intertheoretic reduction and explanation, understanding and other forms of epistemic progress. Although intertheoretic reduction is widely agreed to occur in pure mathematics as well as empirical science, the relationship between reduction and explanation in the mathematical setting has rarely been investigated in a similarly serious way. This paper examines an important particular case: the reduction of arithmetic to set theory. I claim that the reduction is unexplanatory. In defense (...) of this claim, I offer evidence from mathematical practice, and I respond to contrary suggestions due to Steinhart, Maddy, Kitcher and Quine. I then show how, even if set-theoretic reductions are generally not explanatory, set theory can nevertheless serve as a legitimate foundation for mathematics. Finally, some implications of my thesis for philosophy of mathematics and philosophy of science are discussed. In particular, I suggest that some reductions in mathematics are probably explanatory, and I propose that differing standards of theory acceptance might account for the apparent lack of unexplanatory reductions in the empirical sciences. (shrink)

This chapter contains sections titled: Introduction Did the Universe Begin to Exist? Everything That Begins to Exist Has a Cause The Cause of the Universe Properties of the First Cause Objections Conclusion References.

Mathematicians distinguish between proofs that explain their results and those that merely prove. This paper explores the nature of explanatory proofs, their role in mathematical practice, and some of the reasons why philosophers should care about them. Among the questions addressed are the following: what kinds of proofs are generally explanatory (or not)? What makes a proof explanatory? Do all mathematical explanations involve proof in an essential way? Are there really such things as explanatory proofs, and if so, how do (...) they relate to the sorts of explanation encountered in philosophy of science and metaphysics? (shrink)

Readers will gain insight in speaking truth in love, learn to avoid manipulating others, and realize the freedom of saying 'no.'"--Provided by publisher.