Over 35 years ago, Meltzoff and Moore (1977) published their famous article ‘Imitation of facial and manual gestures by human neonates’. Their central conclusion, that neonates can imitate, was and continues to be controversial. Here we focus on an often neglected aspect of this debate, namely on neonatal spontaneous behaviors themselves. We present a case study of a paradigmatic orofacial ‘gesture’, namely tongue protrusion and retraction (TP/R). Against the background of new research on mammalian aerodigestive development, we ask: How does (...) the human aerodigestive system develop and what role does TP/R play in the neonate’s emerging system of aerodigestion? We show that mammalian aerodigestion develops in two phases: (1) from the onset of isolated orofacial movements in utero to the post-natal mastery of suckling at 4 months after birth, and; (2) thereafter, from preparation to the mastery of mastication and deglutition of solid foods. Like other orofacial stereotypies, TP/R emerges in the first phase and vanishes prior to the second. Based upon recent advances in activity-driven early neural development, we suggest a sequence of three developmental events in which TP/R might participate: the acquisition of tongue control, the integration of the central pattern generator for TP/R with other aerodigestive CPGs, and the formation of connections within the cortical maps of S1 and M1. If correct, orofacial stereotypies are crucial to the maturation of aerodigestion in the neonatal period but also unlikely to co-occur with imitative behavior. (shrink)

Built-in decision thresholds for AI diagnostics are ethically problematic, as patients may differ in their attitudes about the risk of false-positive and false-negative results, which will require that clinicians assess patient values.

Exceptionalism is the view that one group is better than other groups and, by virtue of its alleged superiority, is not subject to the same constraints. Here we identify national exceptionalism in the responses made by political leaders in the United States and the United Kingdom to the covid-19 pandemic in early 2020. First, we observe that responses appealed to national values and national character and were marked by a denial of the severity of the situation. Second, we suggest an (...) analogy between national exceptionalism and unrealistic optimism, i.e., people’s tendency to make rosier predictions about their future than is warranted by the evidence due to illusions of superiority and control. Finally, we argue that, at the national level, exceptionalism gave rise to an assumption of invulnerability that made for slow responses to the pandemic, and at the individual level, it served as a justification of people’s failures to adopt safety behaviors. (shrink)

The development of the philosophy of science in the twentieth century has created a framework where issues concerning funding dynamics can be easily accommodated. It combines the historical-philosophical approach of Thomas Kuhn. The University of Chicago Press, Chicago, [1962] ) with the sociological approach of Robert K. Merton The sociology of science. Theoretical and empirical investigations. The University of Chicago Press, Chicago, pp 267–278, [1942] ), linking the ‘exact’ sciences to economy and politics. Out of this came a new domain, (...) namely the study of scientific practices : Science as practice and culture. The University of Chicago Press, Chicago, 1992). Given this broad theoretical framework, we will specify by looking at the case of STEM education and its variant Science, Technology, Engineering and Mathematics with Art education as an example par excellence. Without going into the technical details of the financial support of the projects, we prefer to open a philosophical debate on the way how policies on academic subjects influence a whole society and the personal life of both researchers and people/pupils involved in education. (shrink)

Healthcare organizations and workers are under pressure to produce increasingly complete and accurate data for multiple data-intensive endeavors. However, little research has examined the emerging occupations arising to carry out the data work necessary to produce “improved” data sets, or the specific work activities of these emerging data occupations. We describe the work of Clinical Documentation Integrity Specialists, an emerging occupation that focuses on improving clinical documentation to produce more detailed and accurate administrative datasets crucial for evolving data-intensive forms of (...) healthcare accountability, management, and research. Using ethnographic methods, we describe the core of CDIS’ work as a translation practice in which the language, interests, and concerns of clinicians and clinical documentation are translated via real-time “nudging” and ongoing education of clinicians into the language, interests, and concerns of medical coders, structured administrative datasets, and the various stakeholders of these datasets. Further, we show how the institutional context of CDIS’ work shapes the occupational virtues that guide CDIS’ translation practice, including financial reimbursement, quality measures, clinical accuracy, and protecting clinician’s time. Despite the existence of these multiple virtues, financial reimbursement is the most prominent virtue guiding CDIS’ limited attention. Thus, overall clinical documentation is “improved” in specific, partial ways. This research provides one of the first studies of the emergent data work occupations arising in the wake of digitization and big data opportunities, and shows how local data settings shape large scale data in specific ways and thus may influence outcomes of analyses based on such data. (shrink)

Some authors argue that the ethics of medical care and the ethics of research differ, and that it is a mistake to conflate the two. They propose “that medical research and medical treatment are two distinct forms of activities, governed by different ethical principles.” This raises the question of whether physicians who are also clinical investigators may separate their role as physician from that of researcher when they are involved in clinical trials, thereby avoiding the obligations required in the physician-patient (...) relationship. Miller and Brody suggest that medical training is to blame for what they believe is the physicians’ tendency to confound the obligations of research and practice. “Physician-investigators, after all, went to medical school” they explain. They believe that considering research with patients outside the ethical framework of the physician-patient relationship may be “difficult and threatening” to physicians who have “psychological needs” to consider the ethical obligations flowing from their relationship with their patients. (shrink)

Advances in medicine depend not only on the generation of information but also on its dissemination. Clinically relevant data must be transmitted to the practitioners who will use it. Health care professionals in North America are aware of their ethical and legal obligations to inform patients adequately concerning interventions and treatments so that they may make informed choices about medical care. This obligation has been well described and defined by the courts and in the literature of medicine, ethics, and law. (...) But do investigators and others who are responsible for disseminating information have any obligation to divulge adequately the results of clinical trials to practitioners so that the latter might offer the choice of appropriate care to their patients? Can incomplete disclosure of trial outcomes result in harm to patients? If this is the case, what possible avenues are available to avoid such harm? (shrink)

This article reviews four areas of pediatric research in which we have identified questionable levels of allowable risk, exceeding those foreseen by the Commission. They are the following: the categorization of increasingly risky interventions as minimal risk in a variety of protocols; the increasing number of applications for federal panel review of research not otherwise approvable because of higher projected risk levels; research on asymptomatic at risk children; and the inclusion of children and adolescents in placebo-controlled trials for participants of (...) all ages without performing subgroup analysis. While embracing the imperative to include children in research is an encouraging step towards providing the pediatric population with effective medical care and finally eradicating the therapeutic orphan, we must ensure that this research does not become overly permissive. (shrink)

This article reviews the phenomena of disordered discourse often manifested in schizophrenia. It argues that the Structure Building Framework, a model of the general cognitive processes and mechanisms underlying discourse, can be used to account for these phenomena. According to the Structure Building Framework, the goal of comprehension is to build coherent mental representations or structures. Building a mental structure involves several component subprocesses: laying a foundation, mapping relevant information onto that foundation, and shifting to initiate a new substructure. Building (...) a mental structure also involves at least two general cognitive mechanisms: enhancement of relevant activation and suppression of irrelevant or inappropriate activation. We suggest that schizophrenics who exhibit verbose disordered discourse have inefficient suppression mechanisms, are impaired in laying a foundation, and tend to shift too often. We also speculate that schizophrenics who exhibit impoverished disordered discourse have inefficient enhancement mechanisms and are impaired with the cognitive process of mapping. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Rita Gross as Teacher, Mentor, FriendKathleen M. ErndlI have been asked to speak about the work of Rita Gross from the point of view of someone who was once her student. Not only was I her student, I was one of her very first students. She was my first teacher of religious studies during my first semester of college in the first semester of her first full-time academic position. (...) The year was 1971; the place was New College, a small, alternative liberal arts college in Sarasota, Florida. As the eldest child in the second generation of a working-class immigrant family, I was the first person in my family to pursue higher education. While none of my grandparents had completed high school, both of my parents were high school graduates and my father had risen to a professional level as an engineer through on-the-job training and his own diligence, so my attending college was perhaps the next logical step in achieving the "American dream." However, my choice of college was a bit unusual.New College, as might be expected by its name (though I later discovered was named after a college at Oxford), was new and relatively unknown, lacking a football team and an engineering school, which my parents, with their limited knowledge of higher education, considered essential. But by this time I was somewhat of an educational radical, having been influenced by Angela Davis and Paolo Freire.1 A local newspaper article of the time described New College students as "rich, radical, and hedonistic" (I can only attest to ever having been one of the above). The Underground Guide to the College of Your Choice2 described New College as a place where students taught the classes and where "chicks suffer from underwear famine." While this was somewhat of an overstatement, it was the kind of place where students initiated courses, were largely free from required courses, conducted unusual independent research, came to class barefoot, and sat on the floor. In any case, as the first in my working-class immigrant family to attend college and as an idealist who had chafed against a system that I felt, to paraphrase Henry David Thoreau, allowed schooling to interfere with education, I was excited to be in any college and especially in one with a reputation for experimental modes of learning.When I went to meet my assigned faculty advisor to figure out my schedule and negotiate a "contract" of study, I was told that I had been reassigned to a new faculty member who was "young and full of energy." This, of course, was Rita Gross. Asian religious and cultural traditions place a strong significance on the first meeting with [End Page 57] one's teacher. To be honest, I do not remember much about our first meeting, but I can say in retrospect that it was life changing. After meeting with her, I decided to take her course, Indian Religions I, as well as courses in philosophy, literature, and constitutional law. On my first day of college, my initial plan had been to major in philosophy, with a focus on legal philosophy, with the eventual goal of law school and practicing constitutional, civil rights, or public interest law. But my experience in that Indian Religions I course changed that plan forever. I subsequently took Indian Religions II, then Indian Religious III, and by that time I was hooked. I took several other courses with Rita, including East Asian Religions and a tutorial on Primal Religions. In January of my second year, at Rita's encouragement, I went to Sri Lanka on a study program, doing a project under Rita's direction on lay Buddhist practices. By the time I returned to New College for my third and final year, Rita had already left for the University of Wisconsin-Eau Claire, but that was not the end of our association. We have stayed in contact for almost forty years now, meeting at the AAR, visiting each other's homes, and talking about each other's work and lives. I have hosted lectures or workshops by Rita at all three institutions where I have taught. I... (shrink)

Under certain circumstances the act of apologizing has moral import. It requires a commitment to truth, adherence to moral standards, and a willingness to acknowledge and regret one's own moral failures. In this paper I examine the moral import of apologizing within the U.S. legal system and as a response to historical acts of injustice. In both of these contexts apologies are expressed in a public forum, which adds an interesting dynamic to their moral significance. Within the legal system the (...) judge, representing the interests of the community, may use apologizing to directly address the harm done to victims, as an indicator of recidivism on the part of offenders, and to help create an atmosphere of respect for law in the community at large. Different moral aspects of apologizing come to the fore in the context of historical acts of injustice. Interesting philosophical questions arise, e.g. the legitimacy of moral judgments across time and culture and the very possibility of group action. And skepticism is commonly expressed about the value of such apologies: aren't they empty words that provide no real benefit to victims or the descendants of victims? Aren't they irrelevant to the future? I identify what I hope are convincing reasons to believe that historical apologies can in fact have considerable moral value and a significant impact on the future. (shrink)

A popular approach to defining fictive utterance says that, necessarily, it is intended to produce imagining. I shall argue that this is not falsified by the fact that some fictive utterances are intended to be believed, or are non-accidentally true. That this is so becomes apparent given a proper understanding of the relation of what one imagines to one's belief set. In light of this understanding, I shall then argue that being intended to produce imagining is sufficient for fictive utterance (...) as well. (shrink)

I am extremely grateful to all commentators for such patient, generous, and stimulating contributions. What follows are some thoughts to enrich the conversation, but these are by no means intended to be definitive answers to the worries they have raised.

As philosophers of mind we seem to hold in common no very clear view about the relevance that work in psychology or the neurosciences may or may not have to our own favourite questions—even if we call the subject ‘philosophical psychology’. For example, in the literature we find articles on pain some of which do, some of which don't, rely more or less heavily on, for example, the work of Melzack and Wall; the puzzle cases used so extensively in discussions (...) of personal identity are drawn sometimes from the pleasant exercise of scientific fantasy, at times from surprising reports of scientific fact; and there are those who deny, as well as those who affirm, the importance of the discovery of rapid-eye-movement sleep to the philosophical treatment of dreaming. A general account of the relation between scientific, and philosophical, psychology is long overdue and of the first importance. Here I shall limit myself to just one area where the two seem to connect, discussing one type of neuropsychological research and its relevance to questions in the philosophy of mind and the philosophy of psychology. (shrink)

COVID-19 is a highly contagious infection with no proven treatment. Approximately 2.5% of patients need mechanical ventilation while their body fights the infection.1 Once COVID-19 patients reach the point of critical illness where ventilation is necessary, they tend to deteriorate quickly. During the pandemic, patients with other conditions may also present at the hospital needing emergency ventilation. But ventilation of a COVID-19 patient can last for 2–3 weeks. Accordingly, if all ventilators are in use, there will not be time for (...) patients to ‘queue up’ to wait for those who arrived earlier to recover. Those who need a ventilator will die if they do not receive access to one quickly. Many nations now face the prospect that they failed to prepare appropriately for this foreseen risk of pandemic (another issue worthy of legal analysis) and that their populations will need far more ventilators than the health service can supply. For many weeks, the UK has been anticipating a surge of COVID-19 infections that could leave patients queuing in hospitals for ICU care. Luckily, social distancing has ‘flattened the curve’ and this problem might not arise. There is still a degree of risk, however, and other countries will not be so lucky. At some point, during this pandemic or the next, all countries will need to answer hard questions about whether and when scarce ICU resources (such as ventilators, beds and staff) should be either withheld or withdrawn from certain groups of patients solely for the purpose of providing them to others. Attempts to answer these questions can be found in a wide range of ICU triage protocols and ethical guidance documents, many of which embrace the foundational principle of ‘save the most lives’. Unfortunately, this worthwhile goal has generated many suggestions that could violate the law. This article identifies …. (shrink)

Scientists depend on complex computational systems that are often ineliminably opaque, to the detriment of our ability to give scientific explanations and detect artifacts. Some philosophers have s...

The concept of a relational self has been prominent in feminism, communitarianism, narrative self theories, and social network theories, and has been important to theorizing about practical dimensions of selfhood. However, it has been largely ignored in traditional philosophical theories of personal identity, which have been dominated by psychological and animal theories of the self. This book offers a systematic treatment of the notion of the self as constituted by social, cultural, political, and biological relations. The author's account incorporates practical (...) concerns and addresses how a relational self has agency, autonomy, responsibility, and continuity through time in the face of change and impairments. This cumulative network model of the self incorporates concepts from work in the American pragmatist and naturalist tradition. The ultimate aim of the book is to bridge traditions that are often disconnected from one another--feminism, personal identity theory, and pragmatism--to develop a unified theory of the self. (shrink)

This article examines the complaint that arbitrary algorithmic decisions wrong those whom they affect. It makes three contributions. First, it provides an analysis of what arbitrariness means in this context. Second, it argues that arbitrariness is not of moral concern except when special circumstances apply. However, when the same algorithm or different algorithms based on the same data are used in multiple contexts, a person may be arbitrarily excluded from a broad range of opportunities. The third contribution is to explain (...) why this systemic exclusion is of moral concern and to offer a solution to address it. (shrink)

In the first half of this book, I offer a theory of fictional content or, as it is sometimes known, ‘fictional truth’.The theory of fictional content I argue for is ‘extreme intentionalism’. The basic idea – very roughly, in ways which are made precise in the book - is that the fictional content of a particular text is equivalent to exactly what the author of the text intended the reader to imagine. The second half of the book is concerned with (...) showing how extreme intentionalism and the lessons learnt from it can illuminate cognate questions in the philosophy of fiction and imagination. For instance, I argue, my position helps us to explain how fiction can provide us with reliable testimony ; it helps explain the phenomenon of imaginative resistance ; and it fits with, and so supports, a persuasive theory of the nature of fiction itself. In my final chapter, I show how attending to intentionalist practices of interpreting fictional content can illuminate the nature of propositional imagining itself. (shrink)

I trace a brief history of philosophical discussion of the concept WOMAN and identify two key points at which, I argue, things went badly wrong. The first was where when it was agreed that the concept WOMAN must identify a social not biological kind. The second was where it was decided that the concept WOMAN faced a legitimate challenge of being insufficiently “inclusive”, understood in a certain way. I’ll argue that both of these moves are only intelligible, if at all, (...) in the context of an anti-naturalist picture drawn from either post-structuralism or radical feminism. They become incoherent when adopted by methodological naturalists, who – especially when concerned to track oppression and discrimination – have no good reason to deny that WOMAN refers to a pre-given, biological kind. (shrink)