This is a case study of a program to address professionalism at the Universidad de la República in Uruguay. We describe a five-year ongoing international collaboration. Relevant characteristics of the context, the program components, activities, and results were analyzed. The expected outcomes were to introduce standards of professional practices in the curricula of medical students and residents and the implementation of a program that might lead to a significant change in the culture of medicine in the University. Traditional didactics, interactive (...) theater, and professional development workshops, issues such as teamwork and communication, professional behavior, and the culture of medicine, and physician wellness were addressed. A total of 359 faculty members, general practitioners, stakeholders, and other healthcare professionals participated in the intervention. The process led to specific achievements including new content in the curricula, the use of educational innovations to address issues of professionalism, a growing institutional culture of accountability, and the establishment of new rules and regulations. The strategies and interventions followed in the case of Uruguay can serve as a model to other developing countries to promote physician professionalism, wellness, and joy. (shrink)

Informed consent is the single most important concept for understanding decision-making capacity. There is a steady pull in the clinical world to transform capacity into a technical concept that can be tested objectively, usually by calling for a psychiatric consult. This is a classic example of medicalization. In this article I argue that is a mistake, not just unnecessary but wrong, and explain how to normalize capacity assessment.Returning the locus of capacity assessment to the attending, the primary care doctor, and (...) even to ethics consultation in today's environment will require a substantial effort to undo a strong but illusory impression of capacity assessment. Hospital attorneys as well as clinical ethicists with a sophisticated understanding of health law can be in the vanguard of this reorientation. (shrink)

Based on evidence from press articles covering 39 corporate fraud cases that went public during the period 1992-2005, the objective of this article is to examine the role of managers' behavior in the commitment of the fraud. This study integrates the fraud triangle (FT) and the theory of planned behavior (TPB) to gain a better understanding of fraud cases. The results of the analysis suggest that personality traits appear to be a major fraud-risk factor. The analysis was further validated through (...) a quantitative analysis of keywords which confirmed that keywords associated with the attitudes/rationalizations component of the integrated theory were predominately found in fraud firms as opposed to a sample of control firms. The results of the study suggest that auditors should evaluate the ethics of management through the components of the TPB: the assessment of attitude, subjective norms, perceived behavioral control and moral obligation. Therefore, it is potentially important that the professional standards that are related to fraud detection strengthen the emphasis on managers' behavior that may be associated with unethical behavior. (shrink)

We consider how cue-reading, sensory-manipulation, and signaling games may initially evolve from ritualized decisions and how more complex games may evolve from simpler games by polymerization, template transfer, and modular composition. Modular composition is a process that combines simpler games into more complex games. Template transfer, a process by which a game is appropriated to a context other than the one in which it initially evolved, is one mechanism for modular composition. And polymerization is a particularly salient example of modular (...) composition where simpler games evolve to form more complex chains. We also consider how the evolution of new capacities by modular composition may be more efficient than evolving those capacities from basic decisions. (shrink)

David Lewis (1969) introduced sender-receiver games as a way of investigating how meaningful language might evolve from initially random signals. In this report I investigate the conditions under which Lewis signaling games evolve to perfect signaling systems under various learning dynamics. While the 2-state/2- term Lewis signaling game with basic urn learning always approaches a signaling system, I will show that with more than two states suboptimal pooling equilibria can evolve. Inhomogeneous state distributions increase the likelihood of pooling equilibria, but (...) learning strategies with negative reinforcement or certain sorts of mutation can decrease the likelihood of, and even eliminate, pooling equilibria. Both Moran and APR learning strategies (Bereby-Meyer and Erev 1998) are shown to promote successful convergence to signaling systems. A model is presented that illustrates how a language that codes state-act pairs in an order-based grammar might evolve in the context of a Lewis signaling game. The terms, grammar, and the corresponding partitions of the state space co-evolve to generate a language whose structure appears to reflect canonical natural kinds. The evolution of these apparent natural kinds, however, is entirely in service of the rewards that accompany successful distinctions between the sender and receiver. Any metaphysics grounded on the structure of a natural language that evolved in this way would track arbitrary, but pragmatically useful distinctions. (shrink)

In _Foucault Beyond Foucault_ Jeffrey Nealon argues that critics have too hastily abandoned Foucault's mid-career reflections on power, and offers a revisionist reading of the philosopher's middle and later works. Retracing power's "intensification" in Foucault, Nealon argues that forms of political power remain central to Foucault's concerns. He allows us to reread Foucault's own conceptual itinerary and, more importantly, to think about how we might respond to the mutations of power that have taken place since the philosopher's death in (...) 1984. In this, the book stages an overdue encounter between Foucault and post-Marxist economic history. (shrink)

This article considers how a generalized signalling game may self-assemble as the saliences of the agents evolve by reinforcement on those sources of information that in fact lead to successful action. On the present account, generalized signalling games self-assemble even as the agents co-evolve meaningful representations and successful dispositions for using those representations. We will see how reinforcement on successful information sources also provides a mechanism whereby simpler games might compose to form more complex games. Along the way, I consider (...) how an old game might be appropriated to a new context by reinforcement on successful associations between old and new saliences. (shrink)

In order to judge whether a theory is empirically adequate one must have epistemic access to reliable records of past measurement results that can be compared against the predictions of the theory. Some formulations of quantum mechanics fail to satisfy this condition. The standard theory without the collapse postulate is an example. Bell's reading of Everett's relative-state formulation is another. Furthermore, there are formulations of quantum mechanics that only satisfy this condition for a special class of observers, formulations whose empirical (...) adequacy could only be judged by an observer who records her measurement results in a special way. Bohm's theory is an example. It is possible to formulate hidden-variable theories that do not suffer from such a restriction, but these encounter other problems. (shrink)

Fifteen years ago I was the ethicist involved in a case of a 20-year-old woman who had a stroke, and who was discovered in the emergency room to be 16 weeks pregnant on the same day she was declare...

Given Hugh Everett III's understanding of the proper cognitive status of physical theories, his relative-state formulation of pure wave mechanics arguably qualifies as an empirically acceptable physical theory. The argument turns on the precise nature of the relationship that Everett requires between the empirical substructure of an empirically faithful physical theory and experience. On this view, Everett provides a weak resolution to both the determinate record and the probability problems encountered by pure wave mechanics, and does so in a way (...) that avoids unnecessary metaphysical complications. Taking Everett's goal to be showing the empirical faithfulness of the relative-state formulation agrees well with his characterization of his project as one of seeking a model for observation in the correlation structure described by pure wave mechanics and seeking a measure of typicality over this empirical substructure that covaries with our empirically warranted expectations. 1 Pure Wave Mechanics and Relative States2 Everett and Frank3 Everett on the Nature of Physical Theories4 Conditions for Empirical Faithfulness5 The Empirical Faithfulness of Pure Wave Mechanics6 Conclusion. (shrink)

Insofar as empirical inquiry involves the coevolution of descriptive language and theoretical commitments, a satisfactory model of empirical knowledge should describe the coordinated evolution of both language and theory. But since we do not know what conceptual resources we might need to express our future theories or to provide our best future faithful descriptions of the world, we do not now know even what the space of future descriptive options might be. One strategy for addressing this shifting-resource problem is to (...) track the predictive and linguistic dispositions of inquirers rather than to track their theories and conceptual resources directly. Sender-predictor games, a variant of Skyrms–Lewis sender-receiver games, provide very simple models for the coordinated coevolution of predictive and linguistic dispositions. Such models explain how it is possible for predictive and descriptive dispositions of inquirers to coevolve, term-wise incommensurable, but nevertheless descriptively faithful languages, to sequentially evolve, and a sort of underdetermination to occur where inquirers might satisfy their descriptive and predictive aims by revising their linguistic dispositions, their theoretical dispositions, or both. Such models also provide an elementary characterization of what it might mean for descriptions of the world to be faithful and hence for empirical inquiry to be successful. In doing so they provide a relatively weak, but perfectly clear, endogenous account of epistemic norms. (shrink)

The present paper shows how one might model Everettian quantum mechanics using hyperfinitely many worlds. A hyperfinite model allows one to consider idealized measurements of observables with continuous-valued spectra where different outcomes are associated with possibly infinitesimal probabilities. One can also prove hyperfinite formulations of Everett’s limiting relative-frequency and randomness properties, theorems he considered central to his formulation of quantum mechanics. Finally, this model provides an intuitive framework in which to consider no-collapse formulations of quantum mechanics more generally.

Grafting the Marxian idea that private property is coercive onto the liberal imperative of individual liberty, this new thesis from one of America's foremost intellectuals conceives a revised definition of justice that recognizes the harm inflicted by capitalism's hidden coercive structures. Maps a new frontier in moral philosophy and political theory Distills a new concept of justice that recognizes the iniquities of capitalism Synthesis of elements of Marxism and Liberalism will interest readers in both camps Direct and jargon-free style opens (...) these complex ideas to a wide readership. (shrink)

"This book introduces Gottfried Wilhelm Leibniz's Principle of Optimality and argues that it plays a central role his physics and philosophy, with profound implications for both. Each chapter begins with an introduction to one of Leibniz's ground-breaking studies in natural philosophy, paying special attention to the role of optimal form in those investigations. Each chapter then goes on to explore the philosophical implications of optimal form for Leibniz's broader philosophical system. Individual chapters include discussions of Leibniz's understanding of teleology, the (...) nature of bodies, laws of nature, and free will. The final chapter explores the legacy of Leibniz's physics in light of his work on optimal form"--. (shrink)

On the face of it, this is a very simple case. But in fact it has at least two different dilemmas that make it exceedingly difficult. For that reason, I find it almost a paradigm for clinical ethic...

In this paper I argue that the hoary theological doctrine of divine concurrence poses no deep threat to Leibniz’s views on theodicy and creaturely activity even as those views have been traditionally understood. The first three sections examine respectively Leibniz’s views on creation, conservation and concurrence, with an eye towards showing their sys­tematic compatibility with Leibniz’s theodicy and metaphysics. The fourth section takes up remaining worries arising from the bridging principle that conservation is a continued or continuous creation, and argues (...) that they can be allayed once two readings of the prin­ciple are distinguished. What emerges from the discussion as a whole is, I hope, a clearer picture of Leibniz’s views on the nature of monadic causation, his understanding of the relationship between divine and creaturely activity, and his position with respect to later medieval and early modern debates over secondary causation. (shrink)

We consider two ways one might use algorithmic randomness to characterize a probabilistic law. The first is a generative chance* law. Such laws involve a nonstandard notion of chance. The second is a probabilistic* constraining law. Such laws impose relative frequency and randomness constraints that every physically possible world must satisfy. While each notion has virtues, we argue that the latter has advantages over the former. It supports a unified governing account of non-Humean laws and provides independently motivated solutions to (...) issues in the Humean best-system account. On both notions, we have a much tighter connection between probabilistic laws and their corresponding sets of possible worlds. Certain histories permitted by traditional probabilistic laws are ruled out as physically impossible. As a result, such laws avoid one variety of empirical underdetermination, but the approach reveals other varieties of underdetermination that are typically overlooked. (shrink)

There is good reason to suppose that our best physical theories are false: In addition to its own internal problems, the standard formulation of quantum mechanics is logically incompatible with special relativity. I will also argue that we have no concrete idea what it means to claim that these theories are approximately true.

The Allegiance of Thomas Hobbes offers a new interpretation of Thomas Hobbes's response to the English Revolution. By focusing on his religious thought, it debunks the standard view of him as a royalist, and recovers his sympathies with the religious projects of the 1640s and 1650s. This reinterpretation culminates with an exploration of Hobbes's surprising sympathies with Oliver Cromwell and his supporters. By placing Thomas Hobbes within fresh contexts, Professor Collins offers a new angle of vision on the religious significance (...) of the English Revolution itself. (shrink)

We tell a story where an agent who chooses in such a way as to make the greatest possible profit on each of an infinite series of transactions ends up worse off than an agent who chooses in such a way as to make the least possible profit on each transaction. That is, contrary to what one might suppose, it is not necessarily rational always to choose the option that yields the greatest possible profit on each transaction.

Sleep spindles are frequently studied for their relationship with state and trait cognitive variables, and they are thought to play an important role in sleep-related memory consolidation. Due to their frequent occurrence in NREM sleep, the detection of sleep spindles is only feasible using automatic algorithms, of which a large number is available. We compared subject averages of the spindle parameters computed by a fixed frequency (11-13 Hz for slow spindles, 13-15 Hz for fast spindles) automatic detection algorithm and the (...) individual adjustment method (IAM), which uses individual frequency bands for sleep spindle detection. Fast spindle duration and amplitude are strongly correlated in the two algorithms, but there is little overlap in fast spindle density and slow spindle parameters in general. The agreement between fixed and manually determined sleep spindle frequencies is limited, especially in case of slow spindles. This is the most likely reason for the poor agreement between the two detection methods in case of slow spindle parameters. Our results suggest that while various algorithms may reliably detect fast spindles, a more sophisticated algorithm primed to individual spindle frequencies is necessary for the detection of slow spindles as well as individual variations in the number of spindles in general. (shrink)

This paper is concerned with how a simple metalanguage might coevolve with a simple descriptive base language in the context of interacting Skyrms–Lewis signaling games Lewis. We will first consider a metagame that evolves to track the successful and unsuccessful use of a coevolving base language, then we will consider a metagame that evolves a truth predicate for expressions in a coevolving base language. We will see how a metagame that tracks truth provides an endogenous way to break the symmetry (...) between indicative and imperative interpretations of the base language. Finally, we will consider how composite signaling games provide a way to characterize alternative pragmatic notions of truth. (shrink)

This essay offers an alternative account of Leibniz’s views on substance and fundamental ontology. The proposal is driven by three main ideas. First, that Leibniz’s treatment should be understood against the backdrop of a traditional dispute over the paradigmatic nature substance as well as his own overarching conciliatory ambitions. Second, that Leibniz’s metaphysics is intended to support his conciliatory view that both traditional views of substance are tenable in at least their positive and philosophical respects. Third, that the relationship between (...) immaterial substances, corporeal substances, and ordinary bodies in Leibniz’s metaphysics is best understood as one of “material” constitution. The interpretation as a whole thus suggests that Leibniz needn’t be read as offering either an exclusive defense of corporeal substance realism, nor of immaterial substance idealism, nor as being deeply torn (at a time or over time) between two such views. He may instead be seen as offering a carefully presented, consistent, and sophisticated conciliatory account of substance. (shrink)

David Hume’s skeptical solution to the problem of induction was grounded in his belief that we learn by means of custom. We consider here how a form of reinforcement learning like custom may allow an agent to learn how to learn in other ways as well. Specifically, an agent may learn by simple reinforcement to adopt new forms of learning that work better than simple reinforcement in the context of specific tasks. We will consider how such a bootstrapping process may (...) lead to a system that includes trial-and-error forms of learning like win-stay/lose-shift, probe and adjust, and simple reinforcement itself together with higher-rationality inferential tools. (shrink)

Jeffrey A. Bell here presents a finely constructed survey of the contemporary continental philosophers, focusing on how they have dealt with the problem of difference.

This article defends what I call the atmospheric claim about trust: at least one form of trust manifests itself in human life in a manner that is like an atmosphere (generalized, ambient, and diffuse). I also provide a provisional defense of the claim that trust is a necessary condition for the thriving of something that matters to us. I offer a phenomenological sketch of existential trust. Existential trust is a primordial and atmospheric (generalized, ambient, and diffuse) manifestation of trust that (...) constitutes a fundamental way of being in relationship with the world as a whole such that one feels supportively upheld, vulnerably open, orientationally attuned, and demanded in relation to this world, with the overall effect of feeling at home in it. (shrink)

In "Moral Realism and the Foundations of Ethics", David Brink defendsexternalist moral realism against Mackie's sceptical arguments, whichpresuppose some kind of internalism. But Brink confuses the issues by failing to distinguish different kinds of internalism. What he calls conceptual internalism may be false, but Mackie can retreat to sociological internalism, which holds that most people believe moral requirements to be capable of motivating action regardless of pre-existing desires. Brink does not challenge that thesis, which isall that Mackie's sceptical arguments necessarily (...) presuppose. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Nietzsche's Immoralism: Politics as First Philosophy by Donovan Miyasaki, and: Politics after Morality: Toward a Nietzschean Left by Donovan MiyasakiJeffrey ChurchDonovan Miyasaki, Nietzsche's Immoralism: Politics as First Philosophy Cham: Palgrave Macmillan, 2022. xv + 292 pp. isbn: 978-3-031-11358-1. Cloth, $54.99.Donovan Miyasaki, Politics after Morality: Toward a Nietzschean Left Cham: Palgrave Macmillan, 2022. xv + 330 pp. isbn: 978-3-031-12227-9. Cloth, $54.99.Without a doubt, Nietzsche's political philosophy is one of (...) the most elusive and ambiguous features of his corpus. How else can we explain the dizzying, even contradictory, variety of interpretations of Nietzsche's politics? Some read him as anti-political or a liberal skeptical of state power. For others, he is an aristocratic radical, obsessed with using state power to entrench a new class of Übermenschen. For still others, his thought is most compatible with democracy, as his defenses of perspectivism and agonism are best realized within a democratic political system. Finally, some other scholars throw up their hands and say that Nietzsche's political thought is incoherent.In this two-volume work, Donovan Miyasaki enters this fray with a distinctive defense of the democratic Nietzsche. Two features distinguish his view from others. First, it provides a novel grounding of Nietzschean democracy—what Miyasaki calls Nietzsche's "metapolitics." This grounding is examined in the first volume, Nietzsche's Immoralism (hereafter NI). Second, it offers the most radical political vision of a left Nietzschean form of Nietzschean socialism. For Miyasaki, socialism follows from Nietzsche's fundamental commitments, rather than the aristocratic radicalism that Miyasaki sees Nietzsche inferring—wrongly—from his own commitments. [End Page 97] This extrapolation from Nietzsche's "metapolitics" is undertaken in the second volume, Politics after Morality (hereafter PM). I discuss each of these contributions in turn. In general, I found Miyasaki's work to be clear, perceptive, and bold in their interpretations. That said, with a book that critiques so much of the Nietzsche scholarship and offers such a radical take on Nietzsche's politics, I have some potential objections to raise.Nietzsche's MetapoliticsOther interpreters of a left Nietzsche ground their reading on what they take to be Nietzsche's radical epistemological views: either his perspectivism or his anti-essentialism. This was a popular approach for the postmodern and agonistic readings. By contrast, Miyasaki grounds Nietzschean democracy in a completely different way, on his metaphysics, particularly his determinism and "hard incompatibilism" (NI 25). On Miyasaki's view, Nietzsche denies that freedom and determinism are compatible and hence also that any kind of moral responsibility or moral agency is possible. This is the meaning of Nietzsche's "immoralism." For Miyasaki, Nietzsche's alternative ideal is to engender a particular feeling, namely, the love of this determinism or amor fati.This thesis of hard incompatibilism leads Miyasaki to some sweeping critiques of scholarship on Nietzsche's ethics. Against the many recent interpreters who develop a Nietzschean view of freedom, Miyasaki argues that freedom is impossible in a deterministic world. Against the perfectionist and constitutivist interpreters of Nietzsche's ethics, Miyasaki argues that ethics requires the freedom to improve or fail, and such freedom is impossible. At the same time, Miyasaki admits that Nietzsche at times appeals to and even defends freedom. Yet he explains that what Nietzsche is after in these passages is not freedom, but only the "feeling" of freedom (NI 49). Miyasaki is driven to some strained interpretive moves, such as when he argues that higher individuals' feeling of freedom is enhanced precisely to the degree to which they have abandoned the "illusion of freedom" (NI 49). How can I have the feeling of something I have come to see as an illusion?It is true that Nietzsche critiques the traditional metaphysical notion of the freedom of the will on the basis of his naturalism and determinism. Yet in recent years, scholars have argued that Nietzsche defends a novel conception of freedom that is compatible with determinism, akin to what we find in Spinoza. On this view, freedom is defined in terms of agency rather [End Page 98] than a power or faculty of choice. A free agent is... (shrink)

The present paper shows how one might model Everettian quantum mechanics using hyperfinitely many worlds. A hyperfinite model allows one to consider idealized measurements of observables with continuous-valued spectra where different outcomes are associated with possibly infinitesimal probabilities. One can also prove hyperfinite formulations of Everett’s limiting relative-frequency and randomness properties, theorems he considered central to his formulation of quantum mechanics. Finally, this model provides an intuitive framework in which to consider no-collapse formulations of quantum mechanics more generally.

In the Philosophy of Nature, Hegel describes at length and in detail the particular workings of animal digestion and excretion, referring to the empirical research of his day (Berzelius, Spallanzani, Traviranus). By becoming engaged in the scientific disputes and insights of the time—regarding, for example, the mechanical versus chemical nature of digestion, immediate digestive assimilation and the chemical composition of feces—Hegel arrives at the novel idea that what the animal excretes as superfluous is its own particular entanglement with inorganic otherness. (...) The animal’s subsequent feeling of triumph and satisfaction constitutes the affirmation of individual purposiveness, a form of immediate ideality that Hegel presents as animal subjectivity. (shrink)

ABSTRACTIn 1929 Ernst Cassirer and Martin Heidegger participated in a momentous debate in Davos, Switzerland, which is widely held to have marked an important division in twentieth‐century European thought. Peter E. Gordon's recent book, Continental Divide: Heidegger, Cassirer, Davos, centers on this debate between these two philosophical adversaries. In his book Gordon examines the background of the debate, the issues that distinguished the respective positions of Cassirer and Heidegger, and the legacy of the debate for later decades. Throughout the work, (...) Gordon concisely portrays the source of disagreement between the two adversaries in terms of a difference between Cassirer's philosophy of spontaneity and Heidegger's philosophy of receptivity, or of “thrownness” , into a situation that finite human beings can never hope to master. Although it recognizes that this work provides an important contribution to our understanding of the Davos debate and to twentieth‐century European thought, this review essay subjects Gordon's manner of interpreting the distinction between Cassirer and Heidegger to critical scrutiny. Its purpose is to examine the possibility that important aspects of the debate, which do not conform to the grid imposed by Gordon's interpretation, might have been set aside in the context of his analysis. (shrink)

The second of Nietzsche's UM, "On the Uses and Disadvantage of History for Life", is one of his most celebrated and influential works, profoundly shaping the work of Continental theorists such as Martin Heidegger, Michel Foucault, and Paul de Man. For all the immense attention paid to this little text, philosophers and scholars have focused mainly on Nietzsche's reflections on culture, overlooking the text's epistemological concerns. Jensen's commentary rectifies this omission and succeeds admirably not only in analyzing the often cryptic (...) and meandering arguments of the text, but also in contextualizing it in nineteenth-century debates about objectivity and teleology in history.In the first chapter, Jensen... (shrink)