In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Review of: A History of Sociological Research Methods in America, 1920-1960, by Jennifer Platt. -/- One might expect a history of research methods in sociology during the 40 years this book examines to deal with such questions as the conceptual preconditions for the statistical techniques employed during the period, the changes in statistical practice, the failure of the effort to measure attitudes in a dramatically more precise way, the failure of the many hopes and expectations of methodologists, for (...) the creation of a true science, and so forth. Some of these issues do peep out from the text now and then. But Platt's central concern is quite different. Despite the title, the book is not concerned with the development of techniques. It is instead a highly polemical attack on various previous writers and certain conventional historical opinions about this period. (shrink)

In the philosophical literature on mental states, the paradigmatic examples of mental states are beliefs, desires, intentions, and phenomenal states such as being in pain. The corresponding list in the psychological literature on mental state attribution includes one further member: the state of knowledge. This article examines the reasons why developmental, comparative and social psychologists have classified knowledge as a mental state, while most recent philosophers--with the notable exception of Timothy Williamson-- have not. The disagreement is traced back to a (...) difference in how each side understands the relationship between the concepts of knowledge and belief, concepts which are understood in both disciplines to be closely linked. Psychologists and philosophers other than Williamson have generally have disagreed about which of the pair is prior and which is derivative. The rival claims of priority are examined both in the light of philosophical arguments by Williamson and others, and in the light of empirical work on mental state attribution. (shrink)

Many epistemologists use intuitive responses to particular cases as evidence for their theories. Recently, experimental philosophers have challenged the evidential value of intuitions, suggesting that our responses to particular cases are unstable, inconsistent with the responses of the untrained, and swayed by factors such as ethnicity and gender. This paper presents evidence that neither gender nor ethnicity influence epistemic intuitions, and that the standard responses to Gettier cases and the like are widely shared. It argues that epistemic intuitions are produced (...) by the natural ‘mindreading’ capacity that underpins ordinary attributions of belief and knowledge in everyday social interaction. Although this capacity is fallible, its weaknesses are similar to the weaknesses of natural capacities such as sensory perception. Experimentalists who do not wish to be skeptical about ordinary empirical methods have no good reason to be skeptical about epistemic intuitions. (shrink)

Intuitively, there is a difference between knowledge and mere belief. Contemporary philosophical work on the nature of this difference has focused on scenarios known as “Gettier cases.” Designed as counterexamples to the classical theory that knowledge is justified true belief, these cases feature agents who arrive at true beliefs in ways which seem reasonable or justified, while nevertheless seeming to lack knowledge. Prior empirical investigation of these cases has raised questions about whether lay people generally share philosophers’ intuitions about these (...) cases, or whether lay intuitions vary depending on individual factors (e.g. ethnicity) or factors related to specific types of Gettier cases (e.g. cases that include apparent evidence). We report an experiment on lay attributions of knowledge and justification for a wide range of Gettier Cases and for a related class of controversial cases known as Skeptical Pressure cases, which are also thought by philosophers to elicit intuitive denials of knowledge. Although participants rated true beliefs in Gettier and Skeptical Pressure cases as being justified, they were significantly less likely to attribute knowledge for these cases than for matched true belief cases. This pattern of response was consistent across different variations of Gettier cases and did not vary by ethnicity or gender, although attributions of justification were found to be positively related to measures of empathy. These findings therefore suggest that across demographic groups, laypeople share similar epistemic concepts with philosophers, recognizing a difference between knowledge and justified true belief. (shrink)

Do we apply higher epistemic standards to subjects with high stakes? This paper argues that we expect different outward behavior from high-stakes subjects—for example, we expect them to collect more evidence than their low-stakes counterparts—but not because of any change in epistemic standards. Rather, we naturally expect subjects in any condition to think in a roughly adaptive manner, balancing the expected costs of additional evidence collection against the expected value of gains in accuracy. The paper reviews a body of empirical (...) work on the automatic regulation of cognitive effort in response to stakes, and argues that we naturally see high- and low-stakes subjects as experiencing different levels of ‘epistemic anxiety’, and anticipate different levels of cognitive effort from them for this reason. If unresolved epistemic anxiety always bars an ascription of knowledge, then we can explain our responses to cases involving shifting stakes without positing any variation in the standards of intuitive knowledge ascription. (shrink)

Why do our intuitive knowledge ascriptions shift when a subject's practical interests are mentioned? Many efforts to answer this question have focused on empirical linguistic evidence for context sensitivity in knowledge claims, but the empirical psychology of belief formation and attribution also merits attention. The present paper examines a major psychological factor (called ?need-for-closure?) relevant to ascriptions involving practical interests. Need-for-closure plays an important role in determining whether one has a settled belief; it also influences the accuracy of one's cognition. (...) Given these effects, it is a mistake to assume that high- and low-stakes subjects provided with the same initial evidence are perceived to enjoy belief formation that is the same as far as truth-conducive factors are concerned. This mistaken assumption has underpinned contextualist and interest-relative invariantist treatments of cases in which contrasting knowledge ascriptions are elicited by descriptions of subjects with the same initial information and different stakes. The paper argues that intellectualist invariantism can easily accommodate such cases. (shrink)

Once symbolized by a burning armchair, experimental philosophy has in recent years shifted away from its original hostility to traditional methods. Starting with a brief historical review of the experimentalist challenge to traditional philosophical practice, this chapter looks at research undercutting that challenge, and at ways in which experimental work has evolved to complement and strengthen traditional approaches to philosophical questions.

Skepticism about the epistemic value of intuition in theoretical and philosophical inquiry has recently been bolstered by empirical research suggesting that people’s concrete-case intuitions are vulnerable to irrational biases (e.g., the order effect). What is more, skeptics argue that we have no way to ‘‘calibrate” our intuitions against these biases and no way of anticipating intuitional instability. This paper challenges the skeptical position, introducing data from two studies that suggest not only that people’s concrete-case intuitions are often stable, but also (...) that people have introspective awareness of this stability, providing a promising means by which to assess the epistemic value of our intuitions. (shrink)

Harman’s lottery paradox, generalized by Vogel to a number of other cases, involves a curious pattern of intuitive knowledge ascriptions: certain propositions seem easier to know than various higher-probability propositions that are recognized to follow from them. For example, it seems easier to judge that someone knows his car is now on Avenue A, where he parked it an hour ago, than to judge that he knows that it is not the case that his car has been stolen and driven (...) away in the last hour. Contextualists have taken this pattern of intuitions as evidence that ‘knows’ does not always denote the same relationship; subject-sensitive invariantists have taken this pattern of intuitions as evidence that non-traditional factors such as practical interests figure in knowledge; still others have argued that the Harman Vogel pattern gives us a reason to abandon the principle that knowledge is closed under known entailment. This paper argues that there is a psychological explanation of the strange pattern of intuitions, grounded in the manner in which we shift between an automatic or heuristic mode of judgment and a controlled or systematic mode. Understanding the psychology behind the pattern of intuitions enables us to see that the pattern gives us no reason to abandon traditional intellectualist invariantism. The psychological account of the paradox also yields new resources for clarifying and defending the single premise closure principle for knowledge ascriptions. (shrink)

Recent scholarship (Goodwin & Darley, 2008) on the meta-ethical debate between objectivism and relativism has found people to be mixed: they are objectivists about some issues, but relativists about others. The studies discussed here sought to explore this further. Study 1 explored whether giving people the ability to identify moral issues for themselves would reveal them to be more globally objectivist. Study 2 explored people's meta-ethical commitments more deeply, asking them to provide verbal explanations for their judgments. This revealed that (...) while people think they are relativists, this may not always be the case. The explanations people gave were sometimes rated by outside (blind) coders as being objective, even when given a relativist response. Nonetheless, people remained meta-ethical pluralists. Why this might be is discussed. (shrink)

Do epistemic intuitions tell us anything about knowledge? Stich has argued that we respond to cases according to our contingent cultural programming, and not in a manner that tends to reveal anything significant about knowledge itself. I’ve argued that a cross-culturally universal capacity for mindreading produces the intuitive sense that the subject of a case has or lacks knowledge. This paper responds to Stich’s charge that mindreading is cross-culturally varied in a way that will strip epistemic intuitions of their evidential (...) value. I argue that existing work on cross-cultural variation in mindreading favors my position over Stich’s. (shrink)

The paper proposes a minimal definition of dreaming in terms of immersive spatiotemporal hallucination (ISTH) occurring in sleep or during sleep–wake transitions and under the assumption of reportability. I take these conditions to be both necessary and sufficient for dreaming to arise. While empirical research results may, in the future, allow for an extension of the concept of dreaming beyond sleep and possibly even independently of reportability, ISTH is part of any possible extension of this definition and thus is a (...) constitutive condition of dreaming. I also argue that the proposed ISTH model of dreaming, in conjunction with considerations on the epistemic relationship between dreaming and dream reports, raises important questions about the extent to which dreams typically involve a detailed body representation—an assumption that plays an important role in philosophical work on dreaming. As a commonly accepted definition of dreaming is lacking in current dream research, the ISTH model, which integrates conceptual analysis and epistemological considerations with results from empirical research, is an important contribution to this field. By linking dreaming to felt presence, full-body illusions, and autoscopic phenomena such as out-of-body experiences in wakefulness and in the hypnagogic state, the ISTH model of dreaming also helps integrate dream research, both theoretically and experimentally, with the study of other altered states of consciousness involving hallucinations. It makes straightforward and investigable predictions by claiming that all of these experiences have amodal spatiotemporal hallucinations as their common denominator. Finally, it is theoretically relevant for the philosophical discussion on minimal phenomenal selfhood. (shrink)

In this paper I will argue that this entire dialectic is somewhat misguided. The mental states which are generally assumed to fall under the category of ‘intuition’ likely comprise a highly heterogeneous group; from the point of view of psychology or of neuroscience, in fact, ‘intuitions’ appear to be generated by several fundamentally different sorts of mental processes. If this is correct, then the term ‘intuition’ may simply carve things too broadly. I will argue that it is a mistake to (...) focus on the ‘reliability of intuition’; empirical evidence suggests that the reliability of one type of intuition may tell us next to nothing about the reliability of other types. Rather than debating the evidential status of intuition as a whole, philosophers interested in methodology would do well to focus their investigations much more narrowly. (shrink)

To what extent should we trust our natural instincts about knowledge? The question has special urgency for epistemologists who want to draw evidential support for their theories from certain intuitive epistemic assessments while discounting others as misleading. This paper focuses on the viability of endorsing the legitimacy of Gettier intuitions while resisting the intuitive pull of skepticism – a combination of moves that most mainstream epistemologists find appealing. Awkwardly enough, the “good” Gettier intuitions and the “bad” skeptical intuitions seem to (...) be equally strong. This chapter argues that it is not a coincidence that these two types of intuition register with equal force: they are generated by a common mechanism. However, the input to this mechanism is interestingly different in the two types of case, and different in a way that can support the mainstream view that Gettier cases tell us something about knowledge where skeptical intuitions involve systematic error. (shrink)

Do laypeople and philosophers differ in their attributions of knowledge? Starmans and Friedman maintain that laypeople differ from philosophers in taking ‘authentic evidence’ Gettier cases to be cases of knowledge. Their reply helpfully clarifies the distinction between ‘authentic evidence’ and ‘apparent evidence’. Using their sharpened presentation of this distinction, we contend that the argument of our original paper still stands.

Many are reluctant to accept primitive modality into their fundamental picture of the world. The worry often traces to this thought: we shouldn't adopt any more primitive - that is, unexplained - notions than we need in order to explain all the features of the world, and primitive modal notions are not needed. I examine one prominent rival to modal primitivism, combinatorialism, and show that in order to account for all the modal features of the world the combinatorialist must adopt (...) two additional primitive notions. My own modal primitivist view takes as primitive the notion of incompatibility between properties or relations. I show how the non-modal notions that the combinatorialist must adopt as primitive may be analyzed using my notion. The upshot is that with respect to the number of primitive notions, my modal primitivist theory comes out ahead. (shrink)

Abstract: Recent experimental research on the 'Knobe effect' suggests, somewhat surprisingly, that there is a bi-directional relation between attributions of intentional action and evaluative considerations. We defend a novel account of this phenomenon that exploits two factors: (i) an intuitive asymmetry in judgments of responsibility (e.g. praise/blame) and (ii) the fact that intentionality commonly connects the evaluative status of actions to the responsibility of actors. We present the results of several new studies that provide empirical evidence in support of this (...) account while disconfirming various currently prominent alternative accounts. We end by discussing some implications of this account for folk psychology. (shrink)

Action is not always guided by conscious deliberation; in many circumstances, we act intuitively rather than reflectively. Tamar Gendler (2014) contends that because intuitively guided action can lead us away from our reflective commitments, it limits the power of knowledge to guide action. While I agree that intuition can diverge from reflection, I argue that this divergence does not constitute a restriction on the power of knowledge. After explaining my view of the contrast between intuitive and reflective thinking, this paper (...) argues against the conclusions Gendler draws from empirical work on implicit bias. (shrink)

Questions regarding the nature of moral judgment loom large in moral philosophy. Perhaps the most basic of these questions asks how, exactly, moral judgments and moral rules are to be defined; what features distinguish them from other sorts of rules and judgments? A related question concerns the extent to which emotion and reason guide moral judgment. Are moral judgments made mainly on the basis of reason, or are they primarily the products of emotion? As an example of the former view, (...) Kant held all moral requirements to be derived from a principle of rationality (the categorical imperative). As an example of the latter, Hume famously claimed that reason is “the slave of the passions” and that moral judgments stem from the moral emotions. When addressing these issues, philosophers have largely relied on the traditional tools of philosophical analysis, along with introspection, anecdotal evidence and armchair speculation. In recent years, however, a rich body experimental psychology has emerged which, in the view of a growing number of philosophers, casts important new light on these venerable questions. Our aim, in this chapter, is to illustrate how empirical methods can help move traditional philosophical debates forward in interesting and important ways. Since space does not permit an exhaustive survey of the relevant experimental work, we will focus on a few of the most compelling examples. (shrink)

Previous research suggests a higher perceived risk associated with a risky behavior predicts a lower likelihood of involvement in that behavior; however, this relationship can vary based on personality characteristics such as impulsivity and behavioral activation. During the COVID-19 pandemic, individuals began to re-evaluate the level of risk associated with everyday behaviors. But what about risks associated with “typical” risk-taking behaviors? In the present study, 248 undergraduate student participants completed measures of impulsivity, behavioral activation and inhibition, propensity to take risks, (...) numeracy, and perceptions of and involvement in both risk-taking behavior and health promoting behavior. Our study revealed that higher behavioral inhibition and greater propensity to take risks predicted greater likelihood of involvement in COVID-19-related risk behaviors, even after accounting for perceived risks and benefits of the behavior. Greater likelihood of involvement in social risk behaviors was predicted by greater numeracy and risk-taking propensity. Identifying as male, a greater propensity to take risks, and greater impulsivity predicted increased health/safety risk behaviors. Younger age, lower risk-taking propensity, and lower impulsivity were associated with a greater likelihood of donating blood. For the likelihood of registering to become an organ donor, increasing risk perception, both before and during the pandemic, was associated with greater likelihood of registering, but greater risk-taking propensity was associated with a decreased likelihood of organ donation registration. For flu vaccination, a greater propensity to take risks was associated with a greater likelihood of flu vaccination during the 2020–2021 flu season. Both cognitive and personality factors can predict involvement in risk-taking and health-promotion behaviors, warranting their continued examination. (shrink)

One of the ethical issues that has been raised recently regarding emerging neurotherapies is that people will be coerced explicitly or implicitly in the workplace or in schools to take cognitive enhancing drugs. This article builds on this discussion by showing how the law may pressure people to adopt emerging neurotherapies. It focuses on a range of private law doctrines that, unlike the criminal law, do not come up very often in neuroethical discussions. Three doctrines—the doctrine of mitigation, the standard (...) of care in negligence, and child custody determinations in family law—are addressed to show how the law may pressure people to consent to treatment by offering a choice between accepting medical treatment and suffering a legal disadvantage. The doctrines considered in this article apply indirect pressure to submit to treatment, unlike court-ordered medical treatment, which applies direct pressure and is not addressed here. The outcome of this discussion is to show that there is a greater range of social pressures that may encourage the uptake of novel neurotherapies than one might initially think. Once treatments that were developed and offered with therapeutic benefits in mind become available, their existence gives rise to unintended legal consequences. This certainly does not mean we should cease developing new therapies that may be of tremendous benefit to patients, but it does raise some questions for physicians and for legal policy-makers. How should physicians, who are required by medical ethical principles to obtain valid consent to treatment, react to a patient’s reluctant consent that is driven by legal pressure? From the legal policy perspective, are our legal doctrines satisfactory or should they be changed because, for example, they unduly promote the collective interest over individual freedom to reject medical treatment or because they channel us toward economically efficient treatments to the detriment of more costly but potentially superior approaches of dealing with behavioural problems? (shrink)

Internalists have criticised reliabilism for overlooking the importance of the subject's point of view in the generation of knowledge. This paper argues that there is a troubling ambiguity in the intuitive examples that internalists have used to make their case, and on either way of resolving this ambiguity, reliabilism is untouched. However, the argument used to defend reliabilism against the internalist cases could also be used to defend a more radical form of externalism in epistemology.

Several recent articles on the concept of intentional action center on experimental findings suggesting that intentionality ascription can be affected by moral factors. I argue that the explanation for these phenomena lies in the workings of a tacit moral judgment mechanism, capable under certain circumstances of altering normal intentionality ascriptions. This view contrasts with that of Knobe ([2006]), who argues that the findings show that the concept of intentional action invokes evaluative notions. I discuss and reject possible objections to the (...) moral mechanism view, and offer arguments supporting the model over Knobe's account on grounds of simplicity and plausibility. (shrink)

State prescription drug monitoring programs (PDMPs) use proprietary, predictive software platforms that deploy algorithms to determine whether a patient is at risk for drug misuse, drug diversion, doctor shopping, or substance use disorder (SUD). Clinical overreliance on PDMP algorithm‐generated information and risk scores motivates clinicians to refuse to treat—or to inappropriately treat—vulnerable people based on actual, perceived, or past SUDs, chronic pain conditions, or other disabilities. This essay provides a framework for challenging PDMP algorithmic discrimination as disability discrimination under federal (...) antidiscrimination laws, including a new proposed rule interpreting section 1557 of the Affordable Care Act. (shrink)

Research on the use of propranolol as a pharmacological memory dampening treatment for post-traumatic stress disorder is continuing and justifies a second look at the legal and ethical issues raised in the past. We summarize the general ethical and legal issues raised in the literature so far, and we select two for in-depth reconsideration. We address the concern that a traumatized witness may be less effective in a prosecution emerging from the traumatic event after memory dampening treatment. We analyze this (...) issue in relation to sexual assault, where the suggestion that corroborating evidence may remedy any memory defects is less likely to be helpful. We also consider the clinical ethical question about a physician's obligation to discuss potential legal consequences of memory dampening treatment. We conclude that this latter question reflects a general problem related to novel medical treatments where the broader socio-legal consequences may be poorly understood, and suggest that issues of this sort could usefully be addressed through the promulgation of practice guidelines. (shrink)

We investigated how two cues to contrast—beat gesture and contrastive pitch accenting—affect comprehenders' cognitive load during processing of spoken referring expressions. In two visual‐world experiments, we orthogonally manipulated the presence of these cues and their felicity, or fit, with the local (sentence‐level) referential context in critical referring expressions while comprehenders' task‐evoked pupillary responses (TEPRs) were examined. In Experiment 1, beat gesture and contrastive accenting always matched the referential context of filler referring expressions and were therefore relatively felicitous on the global (...) (experiment) level, whereas in Experiment 2, beat gesture and contrastive accenting never fit the referential context of filler referring expressions and were therefore infelicitous on the global level. The results revealed that both beat gesture and contrastive accenting increased comprehenders' cognitive load. For beat gesture, this increase in cognitive load was driven by both local and global infelicity. For contrastive accenting, this increase in cognitive load was unaffected when cues were globally felicitous but exacerbated when cues were globally infelicitous. Together, these results suggest that comprehenders' cognitive resources are taxed by processing infelicitous use of beat gesture and contrastive accenting to convey contrast on both the local and global levels. (shrink)

In this paper, we address the different ways in which dream research can contribute to interdisciplinary consciousness research. As a second global state of consciousness aside from wakefulness, dreaming is an important contrast condition for theories of waking consciousness. However, programmatic suggestions for integrating dreaming into broader theories of consciousness, for instance by regarding dreams as a model system of standard or pathological wake states, have not yielded straightforward results. We review existing proposals for using dreaming as a model system, (...) taking into account concerns about the concept of modeling and the adequacy and practical feasibility of dreaming as a model system. We conclude that existing modeling approaches are premature and rely on controversial background assumptions. Instead, we suggest that contrastive analysis of dreaming and wakefulness presents a more promising strategy for integrating dreaming into a broader research context and solving many of the problems involved in the modeling approach. (shrink)

According to current definitions of civil disobedience, drawn from the work of John Rawls and Carl Cohen, eco-saboteurs are not civil disobedients because their disobedience is not a form of address and/or does not appeal to the public's sense of justice or human welfare. But this definition also excludes disobedience by a wide range of groups, from labor activists to hunt saboteurs, either because they are obstructionist or because they address moral concerns other than justice or the public weal. However (...) earlier definitions of civil disobedience were not so narrow. I review the development of the current definition and the circumstances of its acceptance. I argue that the circumstances which help to explain the attractiveness of the Rawls/Cohen formulations in the 1970s are no longer applicable and that the question of civil disobedience should be revisited. I suggest a wider definition according to which at least some types of eco-sabotage would be civil disobedience. (shrink)

'This book not only revises the interpretation of Dewey's ethics but also has relevance to recent discussions about the possibility of naturalistic, ...

Drawing from ethnographic research in the Research Triangle of North Carolina and Williamsburg, Virginia, the authors build on Anzaldúa's conceptualization of “borderlands” to analyze how borders of social membership are constructed and enforced in “el Nuevo South.” Our gender analysis reveals that intersecting structural conditions—the labor market, the organization of public space, and the institutional organization of health care and other public services—combine with gendered processes in the home and family to regulate women's participation in community life. Enforcers of borders (...) include institutional actors, mostly women, in social services and clinics who occupy institutional locations that enable them to define who is entitled to public goods and to categorize migrants as undeserving “others.” We reveal how a particularly configured matrix of domination transcends the spheres of home, work, and community to constrain women migrants' physical and economic mobility and personal autonomy and to inhibit their participation in their societies of reception. (shrink)

In the Essay Concerning Human Understanding, Locke insists that all knowledge consists in perception of the agreement or disagreement of ideas. However, he also insists that knowledge extends to outer reality, claiming that perception yields ‘sensitive knowledge’ of the existence of outer objects. Some scholars have argued that Locke did not really mean to restrict knowledge to perceptions of relations within the realm of ideas; others have argued that sensitive knowledge is not strictly speaking a form of knowledge for Locke. (...) This chapter argues that Locke’s conception of sensitive knowledge is in fact compatible with his official definition of knowledge, and discusses his treatment of the problem of skepticism, both in the Essay and in the correspondence with Stillingfleet. (shrink)

Skepticism about the epistemic value of intuition in theoretical and philosophical inquiry fueled by the empirical discovery of irrational bias (e.g., the order effect) in people's judgments has recently been challenged by research suggesting that people can introspectively track intuitional instability. The two studies reported here build upon this, the first by demonstrating that people are able to introspectively track instability that was experimentally induced by introducing conflicting expert opinion about certain cases, and the second by demonstrating that it was (...) the presence of instability?not merely the presence of conflicting information?that resulted in changes in the relevant attitudinal states (i.e., confidence and belief strength). The paper closes with the suggestion that perhaps the best explanation for these (and other) findings may be that intuitional instability is not actually ?intuitional.? (shrink)

Mammals have an XX:XY system of chromosomal sex determination in which a small heterochromatic Y controls male development. The Y contains the testis determining factor SRY, as well as several genes important in spermatogenesis. Comparative studies show that the Y was once homologous with the X, but has been progressively degraded, and now consists largely of repeated sequences as well as degraded copies of X linked genes. The small original X and Y have been enlarged by cycles of autosomal addition (...) to one partner, recombination onto the other and continuing attrition of the compound Y. This addition–attrition hypothesis predicts that the pseudoautosomal region of the human X is merely the last relic of the latest addition. Genes (including SRY) on the conserved or added region of the Y evolved functions in male sex determination and differentiation distinct from the general functions of their X‐linked partners. Although the gonadogenesis pathway is highly conserved in vertebrates, its control has probably changed radically and rapidly in vertebrate – even mammalian – evolution. (shrink)

Introduction -- Elucidating complexity theories -- Complexity in the natural sciences -- Complexity in social theory -- Towards transdisciplinarity -- Complexity in philosophy: complexification and the limits to knowledge -- Complexity in ethics -- Earth in the anthropocene -- Complexity and climate change -- American dreams, ecological nightmares and new visions -- Complexity and sustainability: wicked problems, gordian knots and synergistic solutions -- Conclusion.

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)