Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...) ethical vignettes.The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles.This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings. (shrink)

It is being increasingly recognized that the Saussurean dictum of “the arbitrariness of the linguistic sign” is in conflict with the pervasiveness of the phenomenon commonly known as “sound symbolism”. After first presenting a historical overview of the debate, however, we conclude that both positions have been exaggerated, and that an adequate explanation of sound symbolism is still lacking. How can there, for example, be (perceived) similarity between expressionsand contents across different sensory modalities? We offer an answer, based on the (...) Peircian notion of iconic ground, and G. Sonesson’s distinction betweenprimary and secondary iconicity. Furthermore, we describe an experimental study, in a paradigm first pioneered by W. Kohler, and recently popularized by V.Ramachandran, in which we varied vowels and consonants in fictive word-forms, and conclude that both types of sounds play a role in perceiving an iconic ground between the word-forms and visual figures. The combination of historical conceptual analysis, semiotic explication and psychological experimentationpresented in this article is characteristic of the emerging paradigm of cognitive semiotics. (shrink)

BackgroundAn editorial expression of concern (EEoC) is issued by editors or publishers to draw attention to potential problems in a publication, without itself constituting a retraction or correction.MethodsWe searched PubMed, PubMed Central (PMC), and Google Scholar to identify EEoCs issued for publications in PubMed and PMC up to 22 August 2016. We also searched the archives of the Retraction Watch blog, some journal and publisher websites, and studies of EEoCs. In addition, we searched for retractions of EEoCs and affected articles (...) in PubMed up to 8 December 2016. We analyzed overall historical trends, as well as reported reasons and subsequent editorial actions related to EEoCs issued between August 2014 and August 2016.ResultsAfter screening 5076 records, we identified 230 EEoCs that affect 300 publications indexed in PubMed, the earliest issued in 1985. Half of the primary EEoCs were issued between 2014 and 2016 (52%). We found evidence of some EEoCs that had been removed by the publisher without leaving a record, and some were not submitted for PubMed or PMC indexing. A minority of publications affected by EEoCs had been retracted by early December 2016 (25%). For the subset of 92 EEoCs issued between August 2014 and August 2016, affecting 99 publications, the rate of retraction was similar (29%). The majority of EEoCs were issued because of concerns with validity of data, methods, or interpretation of the publication (68%), and 31% of cases remained open. Issues with images were raised in 40% of affected publications. Ongoing monitoring after the study identified another 17 EEoCs to year’s end in 2016, increasing the number of EEoCs to 247 and publications in PubMed known to be affected by EEoCs to 320 at the end of 2016.ConclusionsEEoCs have been rare publishing events in the biomedical literature, but their use has been increasing. Most have not led to retractions, and many remain unresolved. Lack of prominence and inconsistencies in management of EEoCs reduce the ability of these notices to alert the scientific community to potentially serious problems in publications. EEoCs will be made identifiable in PubMed in 2017. (shrink)

A topic ignored in mainstream scientific inquiry for decades, wisdom is beginning to return to the place of reverence that it held in ancient schools of intellectual study. A Handbook of Wisdom, first published in 2005, explores wisdom's promise for helping scholars and lay people to understand the apex of human thought and behavior. At a time when poor choices are being made by notably intelligent and powerful individuals, this book presents analysis and review on a form of reasoning and (...) decision-making that is not only productive and prudent, but also serves a beneficial purpose for society. A Handbook of Wisdom is a collection of chapters from some of the most prominent scholars in the field of wisdom research. Written from multiple perspectives, including psychology, philosophy, and religion, this book gives the reader an in-depth understanding of wisdom's past, present, and possible future direction within literature, science, and society. (shrink)

Political apologies are commonly imagined as gestures of finality and closure: capstone moments that summate public knowledge. One manifestation of these assumptions is the position that apologies should be timed to come only after appropriate investigation into the wrongdoing has been completed. This article takes a different view, for two reasons. First, even apologies that seem based on robust knowledge can come to seem incomplete or inadequate in the light of subsequent learning and knowledge. Second, because apologies are complexly embedded (...) in longer-term processes of activism and response, they can contribute to their own unravelling by encouraging further consideration and inquiry. We develop these arguments by considering two Canadian cases that illustrate these dynamics: apologies that addressed, respectively, the wartime internment of Japanese Canadians and the policy of forcing Indigenous children to attend residential schools. (shrink)

We defend a fitting-attitude theory of the funny against a set of potential objections. Ultimately, we endorse a version of FA theory that treats reasons for amusement as non-compelling, metaphysically non-conditional, and alterable by social features of the joke telling context. We find that this version of FA theory is well-suited to accommodate our ordinary practices of telling and being amused by jokes, and helpfully bears on the related faultless disagreement dispute.

Human kinship systems play a central role in social organization, as anthropologists have long demonstrated. Much less is known about how cultural schemas of relatedness are transmitted across generations. How do children learn kinship concepts? To what extent is learning affected by known cross-cultural variation in how humans classify kin? This review draws on research in developmental psychology, linguistics, and anthropology to present our current understanding of the social and cognitive foundations of kinship categorization. Amid growing interest in kinship in (...) the cognitive sciences, the paper aims to stimulate new research on the ontogeny of kinship categorization, a rich domain for studying the nexus of language, culture, and cognition. We introduce an interdisciplinary research toolkit to help streamline future research in this area. (shrink)

Every day we make choices, but our degree of investment in them differs, both in terms of pre-verbal experience and verbal justification. In an earlier experimental study, participants were asked to pick the more attractive one among two human faces, and among two abstract figures, and later to provide verbal motivations for these choices. They did not know that in some of the cases their choices were manipulated. Against claims about our unreliability as conscious agents, the study found that in (...) about half the cases the manipulations were detected. In the present study, we investigated whether varying degrees of choice investment could be an explanatory factor for such findings. We analysed the verbal justifications of the participants along a set of semantic categories, based on theoretical ideas from phenomenology and cognitive linguistics, and formulated a matrix of eleven markers of choice investment. We predicted a greater degree of investment when motivating choices of faces than figures, manipulated than actual choices, and detected than non-detected manipulations. These predictions were confirmed, but with various strength. This allows us to argue for both consilience and differences between pre-verbal choice investment and the corresponding verbal motivations of the choices made, and thus for conscious awareness of choice making. (shrink)

We suggest that the accounts offered by the target articles could be strengthened by acknowledging the role of group selection and cultural niche construction in shaping the evolutionary trajectory of human music. We argue that group level traits and highly variable cultural niches can explain the diversity of human song, but the target articles' accounts are insufficient to explain such diversity.

Few other social technologies and institutions are more consequential to human societies than money. Yet money remains a deeply perplexing phenomenon. On the one hand, it is a pan-human system of valuation, but on the other, it is conventional and variable in its uses. While it is controversial if money instantiates a fully-fledged sign system, it is rife with semiotic capacities. To present an illuminating analysis of money is thus a test case for the Motivation & Sedimentation Model (MSM) of (...) meaning making, with roots in the phenomenology of Husserl and Merleau-Ponty. Using MSM, we analyze two origin accounts of money: the commodity money account evidenced in archaic and classical Greek coinage, and the credit money account exemplified by early findings in Mesopotamia. Both accounts focus on the interactions between the three levels of MSM: the pre-signitive Embodied, the cultural Sedimented, and the interactional Situated levels of meaning and propose different series of “loops” to account for the genesis of money. Despite key differences in the two origins, both imply semiotic processes operating according to motivated, and hence non-arbitrary, conventions developing within institutional formations that ultimately influenc present-day concepts of money. (shrink)

Jordan's book is an inspiring and uplifting exploration of the power of hope. Drawing on philosophy, science, and literature, Jordan argues that hope is a fundamental human need that can sustain us during life's darkest moments. This book is a testament to the resilience of the human spirit and a call to embrace hope as a guiding principle in our lives. This work has been selected by scholars as being culturally important, and is part of the knowledge base (...) of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In recent work, W. Matthews Grant challenges the common assumption that if humans have libertarian free will, and the moral responsibility it affords, then it is impossible for God to cause what humans freely do. He does this by offering a “non-competitivist” model that he calls the “Dual Sources” account of divine and human causation. Although we find Grant’s Dual Sources model to be the most compelling of models on offer for non-competitivism, we argue that it fails to circumvent a (...) theological version of Peter van Inwagen’s direct argument for incompatibilism. In the paper, we motivate and deploy a theological take on the direct argument, and we contend that this theological rendition of the direct argument effectively dismantles Grant’s Dual Sources account of non-competitivism. (shrink)

By using religion to get at the core concepts of Michel Foucault's thinking, this book offers a strong alternative to the way that the philosopher's work is read across the humanities. Foucault was famously interested in Christianity as both the rival to ancient ethics and the parent of modern discipline and was always alert to the hypocrisy and the violence in churches. Yet many readers have ignored how central religion is to his thought, particularly with regard to human bodies and (...) how they are shaped. The point is not to turn Foucault into some sort of believer or to extract from him a fixed thesis about religion as such. Rather, it is to see how Foucault engages religious _rhetoric_ page after page—even when religion is not his main topic. When readers follow his allusions, they can see why he finds in religion not only an object of critique, but a perennial provocation to think about how speech works on bodies—and how bodies resist. Arguing that Foucault conducts experiments in writing to frustrate academic expectations about history and theory, Mark Jordan gives equal weight to the performative and theatrical aspects of Foucault's writing or lecturing. How does Foucault stage possibilities of self-transformation? How are his books or lectures akin to the rituals and liturgies that he dissects in them? _Convulsing Bodies_ follows its own game of hide-and-seek with the agents of totalizing systems and gives us a Foucault who plays with his audiences as he plays for them—or teaches them. (shrink)

A reflexão tem como objetivo identificar aspectos de um pensamento educacional no conjunto das obras, em Nietzsche, como uma perspectiva de autotransformação. Defende a tese de que a perspectiva educacional do filósofo é crítica e se apresenta como uma antieducação, na medida em que se contrapõe ao modelo educativo tradicional. Tendo como procedimento metodológico a pesquisa bibliográfica, recorreu-se à seleção de textos e obras que abordaram a temática da Educação nas três fases do pensamento de Nietzsche. Na primeira fase, consideram-se (...) os textos: “Sobre o futuro dos nossos estabelecimentos de ensino” e a “Terceira Consideração extemporânea: Schopenhauer como educador”. Neles, identificam-se aspectos de um projeto educativo em devir na filosofia de Nietzsche, voltado à renovação da cultura alemã daquela época. Já na segunda fase, trata-se da ruptura com a filosofia de Schopenhauer, e com a música de Richard Wagner como aspectos fundamentais de um projeto educacional que passou a inaugurar a “Escola da Suspeita” na obra Humano, demasiado humano, que leva Nietzsche a pensar na ciência como um contraponto à forma metafísica de entender o mundo. Ele dá preferência às coisas demasiadamente humanas, ou seja, pensa na Educação como libertação, na perspectiva do espírito livre. Em decorrência do pensamento educacional de Nietzsche, em sua terceira fase na obra Assim falou Zaratustra, identificam-se quatro aspectos da antieducação traduzidos como: o ensino da solidão; o ensino da elevação; o ensino da grande razão; e o ensino da afirmação. Conclui-se que tais aspectos constituem um quadro interpretativo, os quais articulam as lições filosófico-existenciais de uma Pedagogia Crítica na Educação, contrária à tradição ocidental que construiu, em seus processos educativos, uma cultura da gregariedade e da negação da vida. (shrink)

In their recent article, Brummett and Muaygil reject Bishop et al.’s framing of the debate over standardization in clinical ethics consultation (CEC) “as one between pro-credentialing procedural and anti-credentialing phenomenological,” claiming that this framing “amounts to a false dichotomy between two extreme approaches to CEC.” Instead of accepting proceduralism and phenomenology as a binary, Brummett and Muaygil propose that these two views should be seen as the extreme ends of a spectrum upon which CEC should be done. However, as evidenced (...) by several inconsistencies within their article, they have failed to fully appreciate the concern animating Bishop et al.’s proposal. Additionally, because of this failure, they do not seem to realize that credentialing ethicists for CEC will only create different problems in Saudi Arabia even as it possibly solves some of the current problems they identify. In this commentary, we highlight and clarify Brummet and Muaygil’s five misunderstandings of Bishop et al. This leads us to conclude that while they claim to be advocating a middle way between proceduralism and phenomenology, in fact they would like for us to standardize another proceduralism, albeit one that incorporates some of the “qualitative” values of American bioethics. (shrink)

In this paper, we present and defend a modest anti-realist conception of aesthetic properties – e.g. being unified, moving, delicate, tragic, etc – in order to motivate a contextualist semantic view about aesthetic judgments. We argue that aesthetic properties are plausibly seen as viewpoint-dependent even though our epistemic access to the presence of aesthetic properties is decidedly more complicated than other, less controversial instances of viewpoint-dependent properties. On the basis of our anti-realist conception, we argue, utilizing the Kaplanian distinction between (...) character and content within a possible worlds semantic theory, that the contents expressed in aesthetic thought and language are sensitive to certain contextual features of a particular thinker’s or speaker’s situation. Finally, we address a number of formidable objections to our view, objections concerning certain context-sensitivity diagnostics, and sho... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Fitness, Fatness, and Aesthetic Judgments of the Female Body:What the AMA Decision to Medicalize Obesity means for other Non–Normal Female BodiesSara R. Jordan“I’ll be happy to refer you to our dietician to get you on a program to help you get your weight under control before it becomes a problem”.As my new physician spun around out of the examination room door, my head spun faster. I had heard (...) the phrase “get your weight under control” twice that morning, but the contexts in which the phrase was uttered could not have been more different.At 7:30 a.m., my fitness trainer was imploring me to get my weights under control as I struggled under a bar, laden with slightly less than my body weight, to do a final set of front squats. At 11:15 a.m., my new general practitioner was imploring me to get my weight under control, by which he meant to learn how to reduce my body mass index (BMI) to match the chart prominently displayed on his office wall. The exhortation to get my weight under control meant such radically different things in these two contexts that it was difficult to comprehend the meaning of the phrase.I am 5’4” and 158 pounds. This gives me a BMI of 27.3, which means that I am considered overweight; right in the middle of the category of overweight. Or, according to the definition of the BMI found on the calculator pinned to the National Heart Lung and Blood Institutes (NHLBI) webpage, I am over fat. If the BMI is, “a measure of body fat based on height and weight that applies to adult men and women” then I carry a health–threatening percentage of body fat. If my fitness trainer, with his 12 point skin–fold caliper test is correct, my body fat percentage of 17% is within the limits expected of female (non–endurance) athletes. In terms of health, then, I am a paradox: according to one standard, I am healthy and fit, according to another, I am unhealthy and fat.As this new physician picked apart my weight, suggesting I should lose between 15 and 20 pounds to bring myself to “full health”, I found myself quite annoyed. He was a small, rail thin, man with greying hair, tired eyes, unpressed khakis, and a beaten pair of black–ish grey “Crocs” on his feet. He looked disheveled and as if he had not seen the inside of a weights room in his life. As I listened to him address my history, current vitals, and how being overweight in my 30s could lead to being [End Page 101] “fat and 40”, I looked him over and made a snap judgment of “I could bench (press) you [right out this window]”. While I was angry with his delivery, I tried to remind myself that he was an overworked physician in a multi–lingual office, trying to operate under a new paradigm in healthcare policy, practice, and diagnostic categories. Specifically, prompted by the medicalization of the condition of obesity by the American Medical Association, my physician was reflecting the professional wisdom that I suffer from a condition needing preventive treatment. He was trying to be a good practitioner to recommend preventive treatment, but to me, he was being a terrible physician.The AMA Declares Obesity a DiseaseThe declaration by the American Medical Association in 2013 that the condition of being obese is one that requires medical treatment is one that I, on the face of it, support. By inviting the medicalization of the condition, the AMA opens the door for individuals who wage a deeply personal battle with their weight to find support in their physicians’ offices and from their insurance companies. Yet, the blunt tools that are used to assess these conditions raise my ire, emotionally and intellectually.Intellectually, the use of the BMI calculator for snap diagnosis of all individuals makes easy sense. It is an easily comprehended tool and, for a normally distributed population, such a simple tool is an excellent choice. But, it stands to treat outliers like me poorly. Outliers, such as particularly fit... (shrink)

Being a patient and living a life -- Clinical space and traits of healing -- False starts and frequent failures -- Three journeys : A.'Ibuprofen and love', B. 'Staying tuned up', C. 'We all want the same things' -- Being a patient : the moral field -- Rethinking healthcare ethics : the patient's moral authority.

Are demands for equality motivated by envy? Nietzsche, Freud, Hayek, and Nozick all thought so. Call this the Envy Objection. For egalitarians, the Envy Objection is meant to sting. Many egalitarians have tried to evade the Envy Objection.. But should egalitarians be worried about envy? In this paper, I argue that egalitarians should stop worrying and learn to love envy. I argue that the persistent unwillingness to embrace the Envy Objection is rooted in a common misunderstanding of the nature of (...) the charge, what it reveals, and what can be said in response to it. I develop what Bernard Williams might call a vindicatory genealogy of envy, thereby allowing us to see that envy, rather than undermining egalitarian intuitions, can in fact play a distinct justificatory role (when it is fitting), which undermines the Envy Objection. (shrink)

We discuss four interconnected issues that we believe have hindered investigations into how language may affect thinking. These have had a tendency to reappear in the debate concerning linguistic relativity over the past decades, despite numerous empirical findings. The first is the claim that it is impossible to disentangle language from thought, making the question concerning “influence” pointless. The second is the argument that it is impossible to disentangle language from culture in general, and from social interaction in particular, so (...) it is impossible to attribute any differences in the thought patterns of the members of different cultures to language per se. The third issue is the objection that methodological and empirical problems defeat all but the most trivial version of the thesis of linguistic influence: that language gives new factual information. The fourth is the assumption that since language can potentially influence thought from “not at all” to “completely,” the possible forms of linguistic influence can be placed on a cline, and competing theories can be seen as debating the actual position on this cline. We analyze these claims and show that the first three do not constitute in-principle objections against the validity of the project of investigating linguistic influence on thought, and that the last one is not the best way to frame the empirical challenges at hand. While we do not argue for any specific theory or mechanism for linguistic influence on thought, our discussion and the reviewed literature show that such influence is clearly possible, and hence in need of further investigations. (shrink)

Money plays a powerful role in modern medicine, both in terms of how health services are organized and delivered and increasingly in how physicians understand themselves and their work. The phrase “the hegemony of money” is intended to capture that power.

1. Sexual Brains and Body Politics 2. Hormones and Hardwiring 3. Making Sense of Brain Organization Studies 4. Thirteen Ways of Looking at Brain Organization 5. Working Backward from “Distinct‘ Groups 6. Masculine and Feminine Sexuality 7. Sexual Orienteering 8. Sex-Typed Interests 9. Taking Context Seriously 10. Trading Essence for Potential.

When our nearest and dearest experience medical crises, we may need to step into caregiving roles. But in doing so, we may find that our new caregiving relationship is actually in tension with the loving relationship that motivated us towards care. What we owe and are entitled to as friends, spouses, and family members, can be different from what we owe and are entitled to as caregivers. For this reason, caregiving carries with it the risk of a type of moral (...) distress that I call “role conflict distress.” Rather than view role conflict distress as a sign that we are falling short, I suggest that it actually speaks to the commitment that we have to the loving relationship that grounds our duty of care. (shrink)

It is commonplace to point out that Alfred Kinsey's taxonomic work on gall wasps provided a methodology for his studies of human sexual behavior. It is equally commonplace to point out that, when researching and presenting his sexual studies, Kinsey's professedly neutral scientific data were constrained by a social agenda. What I have done in this paper is to join these two claims and demonstrate, with particular reference to Kinsey's Sexual Behavior in the Human Male, how his zoology helped guide (...) Kinsey to a naturalistic ethics that, despite contrasts to, shared certain parallel logical failures with the traditional ethics of his critics. (shrink)

Strawson (1994) and Peacocke (1992) introduced thought experiments that show that it seems intuitive that there is, in some way, an experiential character to mental events of understanding. Some (e.g., Siewert 1998, 2011; Pitt 2004) try to explain these intuitions by saying that just as we have, say, headache experiences and visual experiences of blueness, so too we have experiences of understanding. Others (e.g., Prinz 2006, 2011; Tye 1996) propose that these intuitions can be explained without positing experiences of understanding. (...) Call this the debate between Realism and Anti-Realism about experiences of understanding. This paper aims to advance that debate in two ways. In the first half, I develop more precise characterizations of what Realists and Anti-Realists propose. In the second half, I distinguish the four most plausible versions of Anti-Realism and argue that Realism better explains the target intuition than any of them does. (shrink)

Wittgenstein's insistence in his later philosophy that explanation comes to an end in the explication of what it is to follow a rule provides a locus for the awakening of wonder, analogous to the mystical awe referred to in the "Tractatus". While Wittgenstein did not explore this analogy, it provides a point of entry into the examination of the relevance of his work to religious concerns. Every regular practice is built on capacities of reaction, uptake, and response which are the (...) endpoints of explanation, whose sheer givenness in their relation to our physical and social environment can bring on amazement. This wonder at the end of explanation has been explored -- from quite a different perspective -- by Stephen Gould, whose conclusions complement Wittgenstein's own. (shrink)