_The_ _Routledge Companion to Philosophy of Medicine _is a comprehensive guide to topics in the fields of epistemology and metaphysics of medicine. It examines traditional topics such as the concept of disease, causality in medicine, the epistemology of the randomized controlled trial, the biopsychosocial model, explanation, clinical judgment and phenomenology of medicine and emerging topics, such as philosophy of epidemiology, measuring harms, the concept of disability, nursing perspectives, race and gender, the metaphysics of Chinese medicine, and narrative medicine. Each of (...) the 48 chapters is written especially for this volume and with a student audience in mind. For pedagogy and clarity, each chapter contains an extended example illustrating the ideas discussed. This text is intended for use as a reference for students in courses in philosophy of medicine and philosophy of science, and pairs well with _The_ _Routledge Companion to Bioethics_ for use in medical humanities and social science courses. (shrink)

I argue that there can be no such thing as a borderline case of the predicate ‘phenomenally conscious’: for any given creature at any given time, it cannot be vague whether that creature is phenomenally conscious at that time. I first defend the Positive Characterization Thesis, which says that for any borderline case of any predicate there is a positive characterization of that case that can show any sufficiently competent speaker what makes it a borderline case. I then appeal to (...) the familiar claim that zombies are conceivable, and I argue that this claim entails that there can be no positive characterizations of borderline cases of ‘phenomenally conscious’. By the Positive Characterization Thesis, it follows that ‘phenomenally conscious’ can not have any borderline cases. (shrink)

In this paper I use philosophical accounts on the relationship between trust and knowledge in science to apprehend this relationship on the Web. I argue that trust and knowledge are fundamentally entangled in our epistemic practices. Yet despite this fundamental entanglement, we do not trust blindly. Instead we make use of knowledge to rationally place or withdraw trust. We use knowledge about the sources of epistemic content as well as general background knowledge to assess epistemic claims. Hence, although we may (...) have a default to trust, we remain and should remain epistemically vigilant; we look out and need to look out for signs of insincerity and dishonesty in our attempts to know. A fundamental requirement for such vigilance is transparency: in order to critically assess epistemic agents, content and processes, we need to be able to access and address them. On the Web, this request for transparency becomes particularly pressing if (a) trust is placed in unknown human epistemic agents and (b) if it is placed in non-human agents, such as algorithms. I give examples of the entanglement between knowledge and trust on the Web and draw conclusions about the forms of transparency needed in such systems to support epistemically vigilant behaviour, which empowers users to become responsible and accountable knowers. (shrink)

Analytic Philosophy, Volume 62, Issue 3, Page 201-222, September 2021.

This paper is a fresh attempt to articulate the role of a theory of truthmakers. We argue that truthmaker theory constitutes a cornerstone of good methodology in metaphysics, but that a conflation of truthmaker theory with the theory of truth has been responsible for certain excesses associated with truthmaker-based approaches in the recent literature. If truthmaker theory is not a component of a theory of truth, then truthmaker maximalism – the view that every truth has a truthmaker – loses its (...) primary motivation. More generally, if the task of truthmaker theory is not to provide a definition or account of truth in truthmaker terms, there is no pressing need for hard, a priori principles stating which truths have truthmakers and which do not. (shrink)

A major international consultancy firm identified ‘AI ethicist’ as an essential position for companies to successfully implement artificial intelligence (AI) at the start of 2019. It declares that AI ethicists are needed to help companies navigate the ethical and social issues raised by the use of AI. Top 5 AI hires companies need to succeed in 2019. The view that AI is beneficial but nonetheless potentially harmful to individuals and society is widely shared by the industry, academia, governments, and civil (...) society organizations. Accordingly and in order to realize its benefits while avoiding ethical pitfalls and harmful consequences, numerous initiatives have been established to a) examine the ethical, social, legal and political dimensions of AI and b) develop ethical guidelines and recommendations for design and implementation of AI. (shrink)

Recently, amid growing awareness that computer algorithms are not neutral tools but can cause harm by reproducing and amplifying bias, attempts to detect and prevent such biases have intensified. An approach that has received considerable attention in this regard is the Value Sensitive Design (VSD) methodology, which aims to contribute to both the critical analysis of (dis)values in existing technologies and the construction of novel technologies that account for specific desired values. This article provides a brief overview of the key (...) features of the Value Sensitive Design approach, examines its contributions to understanding and addressing issues around bias in computer systems, outlines the current debates on algorithmic bias and fairness in machine learning, and discusses how such debates could profit from VSD-derived insights and recommendations. Relating these debates on values in design and algorithmic bias to research on cognitive biases, we conclude by stressing our collective duty to not only detect and counter biases in software systems, but to also address and remedy their societal origins. (shrink)

Recently, there has been renewed interest in so-called evidence-based policy making. Enticed by the grand promises of Big Data, public officials seem increasingly inclined to experiment with more data-driven forms of governance. But while the rise of Big Data and related consequences has been a major issue of concern across different disciplines, attempts to develop a better understanding of the phenomenon's historical foundations have been rare. This short commentary addresses this gap by situating the current push for numerical evidence within (...) a broader socio-political context, demonstrating how the epistemological claims of Big Data science intersect with specific forms of trust, truth, and objectivity. We conclude by arguing that regulators' faith in numbers can be attributed to a distinct political culture, a representative democracy undermined by pervasive public distrust and uncertainty. (shrink)

In considering the debate about the meaning of ‘disease’, the positions are generally presented as falling into two categories: naturalist, e.g., Boorse, and normativist, e.g., Engelhardt and many others. This division is too coarse, and obscures much of what is going on in this debate. I therefore propose that accounts of the meaning of ‘disease’ be assessed according to Hare’s (1997) taxonomy of evaluative terms. Such an analysis will allow us to better understand both individual positions and their inter-relationships. Most (...) importantly, it will show that it is unlikely that there is a single unique disease-concept at issue. Rather, different authors are, for the most part, considering different concepts. (shrink)

Humans can recollect past events in details and/or know that an object, person, or place has been encountered before. During the last two decades, there has been intense debate about how recollection and familiarity are organized in the brain. Here, we propose an integrative memory model which describes the distributed and interactive neurocognitive architecture of representations and operations underlying recollection and familiarity. In this architecture, the subjective experience of recollection and familiarity arises from the interaction between core systems and an (...) attribution system. By integrating principles from current theoretical views about memory functioning, we provide a testable framework to refine the prediction of deficient versus preserved mechanisms in memory-impaired populations. The case of Alzheimer's disease is considered as an example because it entails progressive lesions starting with limited damage to core systems before invading step-by-step most parts of the model-related network. We suggest a chronological scheme of cognitive impairments along the course of AD, where the inaugurating deficit would relate early neurodegeneration of the perirhinal/anterolateral entorhinal cortex to impaired familiarity for items that need to be discriminated as viewpoint-invariant conjunctive entities. The integrative memory model can guide future neuropsychological and neuroimaging studies aiming to understand how such a network allows humans to remember past events, to project into the future, and possibly also to share experiences. (shrink)

Theodore Sider has recently produced an argument which he takes to show that three-dimensionalism is incompatible with the possibility of time travel. I wish to argue that there is indeed a problem for the three-dimensionalist who wishes to countenance time travel, but that Sider has misdiagnosed it. I show why his putative challenge fails, and furthermore that if it were to succeed this would be as problematic for a wide class of four-dimensionalist positions, including Sider’s own, as it would be (...) for three-dimensionalism. Finally, I present the problem that the possibility of time travel genuinely poses for the three-dimensionalist. (shrink)

Gaulin, McBurney, and Brakeman-Wartell (1997) found that college students reported both matrilateral and sex biases in the investment of aunts and uncles (aunts invested more than uncles). They interpreted the matrilateral bias as a consequence of paternity uncertainty. We replicated that study with Orthodox Jewish college students, selected because they come from a population we presume to have higher paternity certainty than the general population. The Orthodox sample also showed matrilateral and sex biases. Comparing the two data sets, the Orthodox (...) sample reported more investment, and slightly less matrilateral and sex biases, but the differences were not statistically significant. We did find an interaction between sex of relative and group membership, resulting from greater investment by Orthodox uncles. We interpret the results as reflecting the operation of a facultative investment mechanism whose upper limit is tuned to the maximum levels of paternity certainty found in ancestral environments. Lack of a difference in matrilateral bias between groups may result from levels of paternity certainty near to, or above, that maximum in both groups. (shrink)

Biobanks correspond to different situations: research and technological development, medical diagnosis or therapeutic activities. Their status is not clearly defined. We aimed to investigate human biobanking in Europe, particularly in relation to organisational, economic and ethical issues in various national contexts. Data from a survey in six EU countries were collected as part of a European Research Project examining human and non-human biobanking. A total of 147 institutions concerned with biobanking of human samples and data were investigated by questionnaires and (...) interviews. Most institutions surveyed belong to the public or private non-profit-making sectors, which have a key role in biobanking. This activity is increasing in all countries because few samples are discarded and genetic research is proliferating. Collections vary in size, many being small and only a few very large. Their purpose is often research, or research and healthcare, mostly in the context of disease studies. A specific budget is very rarely allocated to biobanking and costs are not often evaluated. Samples are usually provided free of charge and gifts and exchanges are the common rule. Good practice guidelines are generally followed and quality controls are performed but quality procedures are not always clearly explained. Associated data are usually computerised. Biobankers generally favour centralisation of data rather than of samples. Legal and ethical harmonisation within Europe is considered likely to facilitate international collaboration. We propose a series of recommendations and suggestions arising from the EUROGENBANK project. (shrink)

Trust is pervasive in our lives. Both our simplest actions--like buying a coffee, or crossing the street--as well as the functions of large collective institutions--like those of corporations and nation states--wouldn't be possible without it. Yet, only in the last several decades has trust started to receive focused attention from philosophers as a specific topic of investigation. The Routledge Handbook of Trust and Philosophybrings together XX never before published essays, accessible for both students and researchers, created to cover the most (...) salient topics in the various theories of trust. The Handbookis broken up into four sections: a first on basic foundational and conceptual issues; a second on when trust is warranted; a third on the epistemology of trust; and a fourth on trust and science and technology. Each section is preceded by a short introduction, and each chapter includes a bibliography and cross-references to other entries in the volume. (shrink)

The ontology of medicine—the question of whether disease entities are real or not—is an underdeveloped area of philosophical inquiry. This essay explains the primary question at issue in medical ontology, discusses why answering this question is important from both a philosophical and a practical perspective, and argues that the problem of medical ontology is unique, i.e., distinct, from the ontological problems raised by other sciences and therefore requires its own analysis.

What was the impact of Lavoisier's new elementary chemical analysis on the conception and practice of chemistry in the vegetable kingdom at the end of the eighteenth century? I examine how this elementary analysis relates both to more traditional plant analysis and to philosophical and mathematical concepts of analysis current in the Enlightenment. Thus I explore the relationship between algebra, Condillac's philosophy and Lavoisier's chemical system, as well as comparing Lavoisier's analytical approach to those of his predecessors, such as Baumé (...) and Bucquet. With reference to the aims of vegetable analysis, I show how the dominance of elementary analysis devalued a tradition that sought to isolate immediate principles , marginalizing the chemical practices of many doctors and pharmacists in the context of the new chemistry in France. (shrink)

The central hypothesis of the collaboration between Language and Computing (L&C) and the Institute for Formal Ontology and Medical Information Science (IFOMIS) is that the methodology and conceptual rigor of a philosophically inspired formal ontology greatly benefits application ontologies. To this end r®, L&C’s ontology, which is designed to integrate and reason across various external databases simultaneously, has been submitted to the conceptual demands of IFOMIS’s Basic Formal Ontology (BFO). With this project we aim to move beyond the level of (...) controlled vocabularies to yield an ontology with the ability to support reasoning applications. Our general procedure has been the implementation of a meta-ontological definition space in which the definitions of all the concepts and relations in LinKBase® are standardized in a framework of first-order logic. In this paper we describe how this standardization has already led to an improvement in the LinKBase® structure that allows for a greater degree of internal coherence than ever before possible. We then show the use of this philosophical standardization for the purpose of mapping external databases to one another, using LinKBase® as translation hub, with a greater degree of success than possible hitherto. We demonstrate how this offers a genuine advance over other application ontologies that have not submitted themselves to the demands of philosophical scrutiny. LinKBase® is one of the world’s largest applications-oriented medical domain ontologies, and BFO is one of the world’s first philosophically driven reference ontologies. The collaboration of the two thus initiates a new phase in the quest to solve the so-called “Tower of Babel”. (shrink)

Software application ontologies have the potential to become the keystone in state-of-the-art information management techniques. It is expected that these ontologies will support the sort of reasoning power required to navigate large and complex terminologies correctly and efficiently. Yet, there is one problem in particular that continues to stand in our way. As these terminological structures increase in size and complexity, and the drive to integrate them inevitably swells, it is clear that the level of consistency required for such navigation (...) will become correspondingly difficult to maintain. While descriptive semantic representations are certainly a necessary component to any adequate ontology-based system, so long as ontology engineers rely solely on semantic information, without a sound ontological theory informing their modeling decisions, this goal will surely remain out of reach. In this paper we describe how Language and Computing nv (L&C), along with The Institute for Formal Ontology and Medical Information Sciences (IFOMIS), are working towards developing and implementing just such a theory, combining the open software architecture of L&C’s LinkSuiteTM with the philosophical rigor of IFOMIS’s Basic Formal Ontology. In this way we aim to move beyond the more or less simple controlled vocabularies that have dominated the industry to date. (shrink)

Background: The regulation of muscle force is a vital aspect of sensorimotor control, requiring intricate neural processes. While neural activity associated with upper extremity force control has been documented, extrapolation to lower extremity force control is limited. Knowledge of how the brain regulates force control for knee extension and flexion may provide insights as to how pathology or intervention impacts central control of movement.Objectives: To develop and implement a neuroimaging-compatible force control paradigm for knee extension and flexion.Methods: A magnetic resonance (...) imaging safe load cell was used in a customized apparatus to quantify force during neuroimaging. Visual biofeedback and a target sinusoidal wave that fluctuated between 0 and 5 N was provided via an MRI-safe virtual reality display. Fifteen right leg dominant female participants completed a knee extension and flexion force matching paradigm during neuroimaging. The force-matching error was calculated based on the difference between the visual target and actual performance. Brain activation patterns were calculated and associated with force-matching error and the difference between quadriceps and hamstring force-matching tasks were evaluated with a mixed-effects model.Results: Knee extension and flexion force-matching tasks increased BOLD signal among cerebellar, sensorimotor, and visual-processing regions. Increased knee extension force-matching error was associated with greater right frontal cortex and left parietal cortex activity and reduced left lingual gyrus activity. Increased knee flexion force-matching error was associated with reduced left frontal and right parietal region activity. Knee flexion force control increased bilateral premotor, secondary somatosensory, and right anterior temporal activity relative to knee extension. The force-matching error was not statistically different between tasks.Conclusion: Lower extremity force control results in unique activation strategies depending on if engaging knee extension or flexion, with knee flexion requiring increased neural activity for the same level of force and no difference in relative error. These fMRI compatible force control paradigms allow precise behavioral quantification of motor performance concurrent with brain activity for lower extremity sensorimotor function and may serve as a method for future research to investigate how pathologies affect lower extremity neuromuscular function. (shrink)

Nach Kant bleibt alles Denken auf das einzelne Subjekt des Denkens und seine Möglichkeiten zurückbezogen. Simon beschreibt Kants Werk als ein System, das den eigenen Denkansatz als einen Besonderen neben anderen begreift. Auch wenn das Subjekt anderes Denken nicht immer von sich aus versteht, bezieht es jenes als "fremde Vernunft" in seine Weltorientierung ein und erkennt es an. Damit ergibt sich die Notwendigkeit des Findens einer Sprache, in der im Ausgang vom eigenen Vorverständnis anderen etwas so gesagt werden kann, dass (...) es auch ihnen "etwas" bedeutet und in diesem Sinne als wahr erscheint. Von hier aus verändert sich dann der Begriff der Bedeutung und die Sprache der Philosophie. (shrink)

This paper examines the role of ethics in research with potentialapplicability to chemical and biological warfare. It focuses uponbiological warfare research, and examines the ethical dilemmas faced bythose working with dual-use potential technologies. It discusses thenormative, legal and ethical prohibitions against participation inchemical and biological warfare programmes from a Western perspective.It examines the motivations of individuals participating in CBW researchand concludes with recommendations for increasing awareness aboutethical and normative prohibitions. An appendix lists the results of asurvey of ethical codes in (...) relevant scientific disciplines conducted viathe Internet. (shrink)

Rationale One's understanding of medical progress – what it is, how it is pursued and how it is assessed – may be deeply dependent on one's understanding of the metaphysics of medicine, and of diseases in particular. -/- Aims and Objectives In this paper I present a new account of the nature of diseases, neither realist nor constructivist, and describe what progress in medicine looks like if we understand diseases in this way. -/- Conclusions This new account, Constructive Realism, may (...) provide a better account of medicine than either realism or constructivism. (shrink)

The following analysis seeks to question Rousseau's assumptions concerning the desirability of an �education from things�. In particular, I will focus on the problematic relationship between, on one hand, the development of Emile's sense of freedom and independence, and on the other, his sense of moral autonomy. It is my contention that moral development necessarily entails both what Rousseau provides, namely a well-developed conception of individuality, and something that is sorely lacking in Rousseau's project. Turning to an analysis of the (...) preceptor's role in Emile's education, I will argue that it is precisely this type of connection and commitment to other human beings that Emile's education fails to foster. Ultimately, Emile emerges from his education prepared to deal with other humans on one level, but woefully lacking in other skills that are necessary for moral personhood. (shrink)

In this paper I propose a new theoretical framework to analyse socio?technical epistemic practices and systems on the Web and beyond, and apply it to the topic of web?based scientific publishing. This framework is informed by social epistemology, science and technology studies (STS) and feminist epistemology. Its core consists of a tripartite classification of socio?technical epistemic systems based on the mechanisms of closure they employ to terminate socio?epistemic processes in which multiple agents are involved. In particular I distinguish three mechanisms (...) of closure, integration, aggregation and selection, and argue that they correspond to three different types of epistemic sociality. Different systems can employ different mechanism of closure or combinations thereof. Yet each mechanism has its own epistemic merits, depends on specific social, technical and epistemic prerequisites, has different strengths and weaknesses, and is optimal for different epistemic tasks. The aim of my analysis is twofold. Distinguishing different modes of epistemic sociality is a way for me not only to put forward a more nuanced framework for analysing socio?epistemic practices, such as web?based scientific publishing and scholarly communication. It can also serve as the theoretical basis for improving them. (shrink)

Two German philosophers working during the Weimar Republic in Germany, between the two World Wars, produced seminal texts that continue to resonate almost a hundred years later. Franz Rosenzweig—a Jewish philosopher, and Martin Heidegger—a philosopher who at one time was studying to become a Catholic priest, each in their own, particular way include in their writings powerful philosophies of art that, if approached phenomenologically and ethically, provide keys to understanding their radically divergent trajectories, both biographically and for their philosophical heritage. (...) Simon provides a close reading of some of their essential texts—The Star of Redemption for Rosenzweig and Being and Time and The Origin of the Work of Art for Heidegger—in order to draw attention to how their philosophies of art can be understood to provide significant ethical directives. (shrink)

In the first Critique, Kant claims to refute Moses Mendelssohn’s argument for the immortality of the soul. But some commentators, following Bennett (1974), have identified an apparent problem in the exchange: Mendelssohn appears to have overlooked the possibility that the “leap” between existence and non-existence might be a boundary or limit point in a continuous series, and Kant appears not to have exploited the lacuna, but to have instead offered an irrelevant criticism. Here, we argue that even if these commentators (...) are correct, an argument against the leap-as-limit possibility is implicit in claims that Mendelssohn accepts. Moreover, Kant’s criticism of Mendelssohn adapts naturally into a response to this argument, though Mendelssohn endorses further claims which enable him to address this Kantian response. To illustrate the philosophical issues in play, we conclude by noting the affinity between the Mendelssohnian argument we develop and several prominent arguments in contemporary metaphysics: David Lewis’s argument from vagueness for unrestricted composition, Ted Sider’s argument from vagueness for perdurantism, and Peter Unger’s argument from the problem of the many for substance dualism. In short, we argue that the philosophical issues involved in the Mendelssohn-Kant exchange are much richer than previous commentators have believed, and that there is a Mendelssohnian argument for the immortality of the soul (or anyway, the permanence of simples) that does not suffer from any obvious flaw. (shrink)

No piece of the present conjuncture is more alarming than the explosive growth of the American prison population since the late 1970s. The prison has been a critical element of American government since the early 19th century, but the mentalities of rule and the technologies of power linked to the prison, have changed several times during that history. Building more prison cells, therefore, does not have the same constancy of meaning that building more tanks or more strategic bombers does. While (...) the prison has played a crucial role in construction of successful political orders since the American Revolution, its role at present is unprecedented. In the current era of the neo_liberal, neo_conservative, post_New Deal state, which we can call for shorthand, the "Carceral State," the prison has become the very meaning of sovereignty: a steel leviathan in which an increasingly hollowed out version of the state comes to rest with brutal force on selected parts of the population. (shrink)

This dissertation reassesses the chemical revolution that occurred in eighteenth-century France from the pharmacists' perspective. I use French pharmacy to place the event in historical context, understanding this revolution as constituted by more than simply a change in theory. The consolidation of a new scientific community of chemists, professing an importantly changed science of chemistry, is elucidated by examining the changing relationship between the communities of pharmacists and chemists across the eighteenth century. This entails an understanding of the chemical revolution (...) that takes into account social and institutional transformations as well as theoretical change, and hence incorporates the reforms brought about during and after the French Revolution. First, I examine the social rise of philosophical chemistry as a scientific pursuit increasingly independent of its practical applications, including pharmacy, and then relate this to the theoretical change brought about by Lavoisier and his oxygenic system of chemistry. Then, I consider the institutional reforms that placed Lavoisier's chemistry in French higher education. ;During the seventeenth century, chemistry was intimately entwined with pharmacy, and chemical manipulations were primarily intended to enhance the medicinal properties of a substance. An independent philosophical chemistry gained ground during the eighteenth century, and this development culminated in the work of Lavoisier who cast pharmacy out of his chemistry altogether. Fourcroy, one of Lavoisier's disciples, brought the new chemistry to the pharmacists in both his textbooks and his legislation. Under Napoleon, Fourcroy instituted a new system of education for pharmacists that placed a premium on formal scientific education. Fourcroy's successors, Vauquelin and Bouillon-Lagrange, taught the new chemistry to the elite pharmacists in the School of Pharmacy in Paris. These pharmacists also developed new analytical techniques that combined the aims of the new chemistry with traditional pharmaceutical extractive practices. The scientific pharmacist was created, who, although a respected member of the community of pharmacists, helped to define the new chemistry precisely by not being a true chemist. (shrink)

No piece of the present conjuncture is more alarming than the explosive growth of the American prison population since the late 1970s. The prison has been a critical element of American government since the early 19th century, but the mentalities of rule and the technologies of power linked to the prison, have changed several times during that history. Building more prison cells, therefore, does not have the same constancy of meaning that building more tanks or more strategic bombers does. While (...) the prison has played a crucial role in construction of successful political orders since the American Revolution, its role at present is unprecedented. In the current era of the neo_liberal, neo_conservative, post_New Deal state, which we can call for shorthand, the "Carceral State," the prison has become the very meaning of sovereignty: a steel leviathan in which an increasingly hollowed out version of the state comes to rest with brutal force on selected parts of the population. (shrink)

The collaboration of Language and Computing nv (L&C) and the Institute for Formal Ontology and Medical Information Science (IFOMIS) is guided by the hypothesis that quality constraints on ontologies for software ap-plication purposes closely parallel the constraints salient to the design of sound philosophical theories. The extent of this parallel has been poorly appreciated in the informatics community, and it turns out that importing the benefits of phi-losophical insight and methodology into application domains yields a variety of improvements. L&C’s LinKBase® (...) is one of the world’s largest medical domain ontologies. Its current primary use pertains to natural language processing ap-plications, but it also supports intelligent navigation through a range of struc-tured medical and bioinformatics information resources, such as SNOMED-CT, Swiss-Prot, and the Gene Ontology (GO). In this report we discuss how and why philosophical methods improve both the internal coherence of LinKBase®, and its capacity to serve as a translation hub, improving the interoperability of the ontologies through which it navigates. (shrink)