Risk prediction in emergency medicine (EM) holds unique challenges due to issues surrounding urgency, blurry research-practise distinctions, and the high-pressure environment in emergency departments (ED). Artificial intelligence (AI) risk prediction tools have been developed with the aim of streamlining triaging processes and mitigating perennial issues affecting EDs globally, such as overcrowding and delays. The implementation of these tools is complicated by the potential risks associated with over-triage and under-triage, untraceable false positives, as well as the potential for the biases of (...) healthcare professionals toward technology leading to the incorrect usage of such tools. This paper explores risk surrounding these issues in an analysis of a case study involving a machine learning triage tool called the Score for Emergency Risk Prediction (SERP) in Singapore. This tool is used for estimating mortality risk in presentation at the ED. After two successful retrospective studies demonstrating SERP’s strong predictive accuracy, researchers decided that the pre-implementation randomised controlled trial (RCT) would not be feasible due to how the tool interacts with clinical judgement, complicating the blinded arm of the trial. This led them to consider other methods of testing SERP’s real-world capabilities, such as ongoing-evaluation type studies. We discuss the outcomes of a risk–benefit analysis to argue that the proposed implementation strategy is ethically appropriate and aligns with improvement-focused and systemic approaches to implementation, especially the learning health systems framework (LHS) to ensure safety, efficacy, and ongoing learning. (shrink)

This article presents a mutual critique of the analytic and phenomenological theory of action. The first perspective focuses on the standard approach introduced by G.E.M. Anscombe. According to Anscombe, actions are events that are intentional under a description. Consequently, the distinction between action and mere behavior depends on the linguistic description of behavior. However, this perspective fails to address the possible transitions between behavior and action. One way to fill this gap is by investigating the specific form of intentionality belonging (...) to striving or tendency. Such an investigation can complement the standard theory of action by illuminating the realm in which volitional and intentional actions are formed. In this regard, it is instructive to examine A. Pfänder’s and E. Husserl’s philosophy of striving and willing. Pfänder’s _Phenomenology of Willing_ (1900) and the essay _Motives and Motivation_ (1911) reflect on the genesis of volition from striving. Both texts view willing as a particular form of striving that may, but does not have to, lead to action. Similarly, Husserl aims to retrace the pre-voluntary roots of willing, but unlike Pfänder, he considers willing and action to be necessarily connected. The second perspective focuses on what analytic philosophy contributes to philosophical action theory: the recognition of language’s constitutive role in determining actions. This is evident not only in terms of how we describe actions (Anscombe), but also in how we ascribe willing, intending, and acting to one another in communicative contexts (H.L.A. Hart). Therefore, a phenomenological investigation of action should be complemented by linguistic analysis. This idea is already outlined in rudiments by Husserl and particularly by Pfänder. (shrink)

Kant's philosophy of arithmetic / by Charles Parsons -- Visual geometry / by James Hopkins -- The proof-structure of Kant's transcendental deduction / by Dieter Henrich -- Imagination and perception / by P.F. Strawson -- Kant's categories and their schematism / by Lauchlan Chipman -- Transcendental arguments / by Barry Stroud -- Strawson on transcendental idealism / by H.E. Matthews -- Self-knowledge / by W.H. Walsh -- The age and size of the world / by Jonathan Bennett.

This collection of previously unpublished essays addresses a number of issues arising out of philosophical controversies over the possibility of genuine moral dilemmas. Issues addressed include the form of a moral dilemma; the paradoxes a moral dilemma is said to entail; the question of whether a moral dilemma must exhibit inconsistency; the role of intractable circumstances in occasioning moral dilemmas; and the plausibility of supposing that there might be rational ways of addressing moral dilemmas in practice. The contributors, writing from (...) a number of widely differing points of view, include Simon Blackburn, Ruth Barcan Marcus, Alan Donagan, Terrance McConnell, Walter Sinnott-Armstrong, Mary Mothersill, Norman Dahl, David Brink, Peter Railton, Thomas E. Hill, Jr., Christopher Gowans, and H.E. Mason. (shrink)

I argue, first, that the deprived individuals whose predicaments Nussbaum cites as examples of "adaptive preference" do not in fact prefer the conditions of their lives to what we should regard as more desirable alternatives, indeed that we believe they are badly off precisely because they are not living the lives they would prefer to live if they had other options and were aware of them. Secondly, I argue that even where individuals in deprived circumstances acquire tastes for conditions that (...) we regard as bad, they are typically better off having their acquired preferences satisfied. If they are badly off it is because they cannot get what we and they, would regard as more desirable alternatives. Preference utilitarianism explains why individuals in such circumstances are badly off whether they have adapted to their deprived circumstances or not. Even if they prefer the conditions of their lives to all other available alternatives, most would prefer alternatives that are not available to them which would, on the preferentist account, make them better off. And that, on the preferentist account, is the basis for a radical critique of unjust institutions that limit people's options and prevent them from getting what they want. (shrink)

Preferentism is the doctrine that "in deciding what is good and what is bad for a given individual, the ultimate criterion can only be his own wants and his own preferences." If preferentism is true then it would seem to follow that modifying a person's preferences so that they are satisfied by what is on offer should be as good as improving the circumstances of her life to satisfy her preferences. Our intuitive response to stories of life-adjustment through brainwashing, psychosurgery (...) and the like suggests otherwise. I sketch a broadly preferentist account drawing upon Sen's (non-preferentist) capability approach that resists such putative counterexamples. (shrink)

A certain familiar but “deep” joke, which might be called “The Tattletale’s Paradox,” embodies a logical confusion that figures crucially in some discussions of substantive philosophical issues. “I can’t tell you the secret,” it runs, “because if I did it wouldn’t be a secret.” It is easy enough to detect the trick involved here: to tell a secret is not to make known a piece of information that is a secret at the time that it is revealed, but rather to (...) tell a story which was a secret but ceases to be one in the telling. The air of paradox arises insofar as we confuse the two claims. (shrink)

Rabgūzī’s Stories of the Prophets , written in Khwarezmian Turkish contains an account of the life of the biblical prophets and of the Prophet Muḥammed.

This book identifies the physical, emotional, and psychological adjustments many boys have been forced to navigate alone during their most vulnerable, formative years and provides adjustments that adults must make to assist them in these transitions.

Ideologues of the American Dream doctrine assume that state intervention aimed at providing social safety nets for citizens and reducing economic inequality, restricts freedom and undermines individual opportunity. This assumption is the result of empirical misinformation and, more fundamentally, a conceptual mistake. Robust empirical data indicate that economic equality, far from stifling initiative or undermining opportunity, is conducive to social mobility.