More instability (MSSD) and variability (SD) of negative affect (NA) have been related to current and future depressive symptoms. We investigated whether NA instability and variability were predictive of the rate of symptom improvement during treatment and of reaching remission status. Forty-six individuals with major depressive disorder completed six days of ecological momentary assessments (10 beeps/day) before starting a combination of pharmacotherapy and supportive therapy. During and after treatment, the Hamilton Depression Rating Scale (HDRS) diagnostic interview was performed monthly for (...) 18 months. The rate of change in HDRS scores over five months (during treatment) and remission status (HDRS ≤ 7) over eighteen months were predicted by the SD, MSSD and Mean of NA, and relevant baseline predictors. Higher Mean NA and baseline symptom severity, but not NA variability or instability, predicted stronger depressive symptom reduction during treatment. Higher odds of remitting were only associated with lower Mean NA. Higher mean NA may indicate more room for improvement and thus for a steeper rate of symptom change, while lower mean NA levels may imply that remission status is more readily reached. To resolve the inconclusive findings for instability and variability as predictors of symptom improvement replication in larger samples is required. (shrink)

BackgroundThe emergence of artificial intelligence (AI) in medicine has prompted the development of numerous ethical guidelines, while the involvement of patients in the creation of these documents lags behind. As part of the European PROFID project we explore patient perspectives on the ethical implications of AI in care for patients at increased risk of sudden cardiac death (SCD).AimExplore perspectives of patients on the ethical use of AI, particularly in clinical decision-making regarding the implantation of an implantable cardioverter-defibrillator (ICD).MethodsSemi-structured, future scenario-based (...) interviews were conducted among patients who had either an ICD and/or a heart condition with increased risk of SCD in Germany (n = 9) and the Netherlands (n = 15). We used the principles of the European Commission’s Ethics Guidelines for Trustworthy AI to structure the interviews.ResultsSix themes arose from the interviews: the ability of AI to rectify human doctors’ limitations; the objectivity of data; whether AI can serve as second opinion; AI explainability and patient trust; the importance of the ‘human touch’; and the personalization of care. Overall, our results reveal a strong desire among patients for more personalized and patient-centered care in the context of ICD implantation. Participants in our study express significant concerns about the further loss of the ‘human touch’ in healthcare when AI is introduced in clinical settings. They believe that this aspect of care is currently inadequately recognized in clinical practice. Participants attribute to doctors the responsibility of evaluating AI recommendations for clinical relevance and aligning them with patients’ individual contexts and values, in consultation with the patient.ConclusionThe ‘human touch’ patients exclusively ascribe to human medical practitioners extends beyond sympathy and kindness, and has clinical relevance in medical decision-making. Because this cannot be replaced by AI, we suggest that normative research into the ‘right to a human doctor’ is needed. Furthermore, policies on patient-centered AI integration in clinical practice should encompass the ethics of everyday practice rather than only principle-based ethics. We suggest that an empirical ethics approach grounded in ethnographic research is exceptionally well-suited to pave the way forward. (shrink)

Developments in medical big data analytics may bring societal benefits but are also challenging privacy and other ethical values. At the same time, an overly restrictive data protection regime can form a serious threat to valuable observational studies. Discussions about whether data privacy or data solidarity should be the foundational value of research policies, have remained unresolved. We add to this debate with an empirically informed ethical analysis. First, experiences with the implementation of the General Data Protection Regulation (GDPR) within (...) a European research consortium demonstrate a gap between the aims of the regulation and its effects in practice. Namely, strictly formalised data protection requirements may cause routinisation among researchers instead of substantive ethical reflection, and may crowd out trust between actors in the health data research ecosystem; while harmonisation across Europe and data sharing between countries is hampered by different interpretations of the law, which partly stem from different views about ethical values. Then, building on these observations, we use theory to argue that the concept of trust provides an escape from the privacy-solidarity debate. Lastly, the paper details three aspects of trust that can help to create a responsible research environment and to mitigate the encountered challenges: trust as multi-agent concept; trust as a rational and democratic value; and trust as method for priority setting. Mutual cooperation in research—among researchers and with data subjects—is grounded in trust, which should be more explicitly recognised in the governance of health data research. (shrink)

In this article, we use the theory of Information Ethics to argue that deceased people have a prima facie moral right to privacy in the context of health data research, and that this should be reflected in regulation and guidelines. After death, people are no longer biological subjects but continue to exist as informational entities which can still be harmed/damaged. We find that while the instrumental value of recognising post-mortem privacy lies in the preservation of the social contract for health (...) research, its intrinsic value is grounded in respect for the dignity of the post-mortem informational entity. However, existing guidance on post-mortem data protection is available only in the context of genetic studies. In comparing the characteristics of genetic data and other health-related data, we identify two features of DNA often given as arguments for this genetic exceptionalism: relationality and embodiment. We use these concepts to show that at the appropriate Level of Abstraction, there is no morally relevant distinction between posthumous genetic and other health data. Thus, genetic data should not automatically receive special moral status after death. Instead we make a plea for ‘contextual exceptionalism’. Our analysis concludes by reflecting on a real-world case and providing suggestions for contextual factors that researchers and oversight bodies should take into account when designing and evaluating research projects with health data from deceased subjects. (shrink)

ObjectiveWhile nudges are increasingly utilized in public policy settings, their potential threat to autonomous choice is the topic of heated debate. Regardless of the actual effects of nudges on autonomy, the mere perception of nudges as autonomy threatening by the general public or policy makers could negatively influence nudge acceptability. The present online studies examined how people expect nudges to affect their perception of autonomy.MethodsIn the first study, participants were presented with a hypothetical choice that employed either a default nudge, (...) direct persuasion, or no persuasion, to steer to the desired choice. The presented influence technique was explained before participants reported their expected autonomy, as well as their expected choice satisfaction. Study 2 involved a replication of Study 1 with an additional social norm nudge condition. In Study 3, the explanation of how choice had been influenced was omitted.ResultsWhile participants expected the default nudge to violate autonomy, they had no such expectations for social norm nudges. Omitting the explanation that most people are unaware of nudges influencing their choice, reduced the negative impact of nudges on expected autonomy.ConclusionEffects of nudges on expectations of autonomy differ by type of nudge. Negative expectations are primarily driven by the explanation that decision makers are often unaware of nudges. (shrink)

BackgroundConsent for data research in acute and critical care is complex as patients become at least temporarily incapacitated or die. Existing guidelines and regulations in the European Union are of limited help and there is a lack of literature about the use of data from this vulnerable group. To aid the creation of a patient-centred framework for responsible data research in the acute setting, we explored views of patients and next-of-kin about the collection, storage, sharing and use of genetic and (...) health-related data for observational research.MethodsWe conducted qualitative interviews (n = 19) with Dutch sudden cardiac arrest survivors who donated clinical and socio-economic data and genetic samples to research. We also interviewed their next-of-kin. Topics were informed by ethics literature and we used scenario-sketches to aid discussion of complex issues.ResultsSudden cardiac arrest survivors displayed limited awareness of their involvement in health data research and of the content of their given consent. We found that preferences regarding disclosure of clinically actionable genetic findings could change over time. When data collection and use were limited to the medical realm, patients trusted researchers to handle data responsibly without concern for privacy or other risks. There was no consensus as to whether deferred consent should be explicitly asked from survivors. If consent is asked, this would ideally be done a few months after the event when cognitive capacities have been regained. Views were divided about the need to obtain proxy consent for research with deceased patients’ data. However, there was general support for the disclosure of potentially relevant post-mortem genetic findings to relatives.ConclusionsSudden cardiac arrest patients’ donation of data for research was grounded in trust in medicine overall, blurring the boundary between research and care. Our findings also highlight questions about the acceptability of a one-time consent and about responsibilities of patients, researchers and ethics committees. Finally, further normative investigation is needed regarding the (continued) use of participants’ data after death, which is of particular importance in this setting. Our findings are thought to be of relevance for other acute and life-threatening illnesses as well. (shrink)

Within current debates about the future impact of Artificial Intelligence on human society, roughly three different perspectives can be recognised: the technology-centric perspective, claiming that AI will soon outperform humankind in all areas, and that the primary threat for humankind is superintelligence; the human-centric perspective, claiming that humans will always remain superior to AI when it comes to social and societal aspects, and that the main threat of AI is that humankind’s social nature is overlooked in technological designs; and the (...) collective intelligence-centric perspective, claiming that true intelligence lies in the collective of intelligent agents, both human and artificial, and that the main threat for humankind is that technological designs create problems at the collective, systemic level that are hard to oversee and control. The current paper offers the following contributions: a clear description for each of the three perspectives, along with their history and background; an analysis and interpretation of current applications of AI in human society according to each of the three perspectives, thereby disentangling miscommunication in the debate concerning threats of AI; and a new integrated and comprehensive research design framework that addresses all aspects of the above three perspectives, and includes principles that support developers to reflect and anticipate upon potential effects of AI in society. (shrink)

Performative methods have been part of history of science research and education for at least three decades. Understood broadly, they cover every methodology in which a historian or philosopher of science engages in embodied interaction with sources, tools and materials that do not traditionally belong to historical research, with the aim of answering a historical research question. The question no longer appears to be whether performative methods have a place within history and philosophy of science research, but what their place (...) is, could, or should be; when and how they can and cannot be used. Because although performative methods are seen as an enrichment of the field by many, their growing popularity also raises questions: what new insights and challenges has the increased use of performative methods in the history of science brought us? How has it changed the field? Should performative research methods become a mandatory part of the training of new generations of historians of science? In this special issue, historians and philosophers of science for whom performative methods play an important role in their work reflect on these questions from their own research and teaching practices. (shrink)

Compared to approach motivation, avoidance motivation evokes vigilance, attention to detail, systematic information processing, and the recruitment of cognitive resources. From a conservation of energy perspective it follows that people would be reluctant to engage in the kind of effortful cognitive processing evoked by avoidance motivation, unless the benefits of expending this energy outweigh the costs. We put forward three empirically testable propositions concerning approach and avoidance motivation, investment of energy, and the consequences of such investments. Specifically, we propose that (...) compared to approach-motivated people, avoidance-motivated people (a) carefully select situations in which they exert such cognitive effort, (b) only perform well in the absence of distracters that occupy cognitive resources, and (c) become depleted after exerting such cognitive effort. (shrink)

This article discusses the (re)construction and use of an Early modern instrument, better known as Herman Boerhaave's (1668–1738) little furnace. We investigate the origins, history and materiality of this furnace, and examine the dynamic relationship between historical study and reconstructing and handling an object. We argue that combining textual analysis with performative methods allows us to gain a better understanding of both the role of lost material culture in historical chemical practice, pedagogy, and knowledge production, and provide a deeper understanding (...) of the embodied experiences and knowledge of historical actors. Having made and used two versions of Boerhaave's furnace, we provide insight in what present‐day working models can tell us about historical materials and practices approximately three centuries ago. (shrink)

For a large proportion of our daily lives, spontaneously occurring thoughts tend to disengage our minds from goal-directed thinking. Previous studies showed that EEG features such as the P3 and alpha oscillations can predict mind-wandering to some extent, but only with accuracies of around 60%. A potential candidate for improving prediction accuracy is the Steady-State Visual Evoked Potential, which is used frequently in single-trial contexts such as brain-computer interfaces as a marker of the direction of attention. In this study, we (...) modified the sustained attention to response task that is usually employed to measure spontaneous thought to incorporate the SSVEP elicited by a 12.5-Hz flicker. We then examined whether the SSVEP could track and allow for the prediction of the stickiness and task-relatedness dimensions of spontaneous thought. Our results show that the SSVEP evoked by flickering words was able to distinguish between more and less sticky thinking but not between whether a participant was on- or off-task. This suggests that the SSVEP is able to track spontaneous thinking when it is strongly disengaged from the task but not off-task thought in general. Future research should determine the exact dimensions of spontaneous thought to which the SSVEP is most sensitive. (shrink)

Several evolutionary accounts of human social cognition posit that language has co-evolved with the sophisticated mindreading abilities of modern humans. It has also been argued that these mindreading abilities are the product of cultural, rather than biological, evolution. Taken together, these claims suggest that the evolution of language has played an important role in the cultural evolution of human social cognition. Here we present a new computational model which formalises the assumptions that underlie this hypothesis, in order to explore how (...) language and mindreading interact through cultural evolution. This model treats communicative behaviour as an interplay between the context in which communication occurs, an agent’s individual perspective on the world, and the agent’s lexicon. However, each agent’s perspective and lexicon are private mental representations, not directly observable to other agents. Learners are therefore confronted with the task of jointly inferring the lexicon and perspective of their cultural parent, based on their utterances in context. Simulation results show that given these assumptions, an informative lexicon evolves not just under a pressure to be successful at communicating, but also under a pressure for accurate perspective-inference. When such a lexicon evolves, agents become better at inferring others’ perspectives; not because their innate ability to learn about perspectives changes, but because sharing a language with others helps them to do so. (shrink)

(2013). ‘A Sense of the World’: Hannah Arendt’s Hermeneutic Phenomenology of Common Sense. International Journal of Philosophical Studies. ???aop.label???. doi: 10.1080/09672559.2012.743156.

In his The Symbolism of Evil Ricœur explores the dynamics of human consciousness of evil in different cultures and times. Consciousness of evil is examined by looking at the different prevailing symbols wherein human beings confess their experience with evil. Although appeared in 1960, this study is still cited in recent publications in psychology, cultural anthropology and religion. In this article I describe the context of The Symbolism of Evil as the last part of Ricœur’s study of the will and (...) give a summary of its relevant content. (shrink)

Rumination is a process of uncontrolled, narrowly focused negative thinking that is often self-referential, and that is a hallmark of depression. Despite its importance, little is known about its cognitive mechanisms. Rumination can be thought of as a specific, constrained form of mind-wandering. Here, we introduce a cognitive model of rumination that we developed on the basis of our existing model of mind-wandering. The rumination model implements the hypothesis that rumination is caused by maladaptive habits of thought. These habits of (...) thought are modeled by adjusting the number of memory chunks and their associative structure, which changes the sequence of memories that are retrieved during mind-wandering, such that during rumination the same set of negative memories is retrieved repeatedly. The implementation of habits of thought was guided by empirical data from an experience sampling study in healthy and depressed participants. On the basis of this empirically derived memory structure, our model naturally predicts the declines in cognitive task performance that are typically observed in depressed patients. This study demonstrates how we can use cognitive models to better understand the cognitive mechanisms underlying rumination and depression. (shrink)

Natural languages make prolific use of conventional constituent‐ordering patterns to indicate “who did what to whom,” yet the mechanisms through which these regularities arise are not well understood. A series of recent experiments demonstrates that, when prompted to express meanings through silent gesture, people bypass native language conventions, revealing apparent biases underpinning word order usage, based on the semantic properties of the information to be conveyed. We extend the scope of these studies by focusing, experimentally and computationally, on the interpretation (...) of silent gesture. We show cross‐linguistic experimental evidence that people use variability in constituent order as a cue to obtain different interpretations. To illuminate the computational principles that govern interpretation of non‐conventional communication, we derive a Bayesian model of interpretation via biased inductive inference and estimate these biases from the experimental data. Our analyses suggest people's interpretations balance the ambiguity that is characteristic of emerging language systems, with ordering preferences that are skewed and asymmetric, but defeasible. (shrink)

Natural languages make prolific use of conventional constituent‐ordering patterns to indicate “who did what to whom,” yet the mechanisms through which these regularities arise are not well understood. A series of recent experiments demonstrates that, when prompted to express meanings through silent gesture, people bypass native language conventions, revealing apparent biases underpinning word order usage, based on the semantic properties of the information to be conveyed. We extend the scope of these studies by focusing, experimentally and computationally, on the interpretation (...) of silent gesture. We show cross‐linguistic experimental evidence that people use variability in constituent order as a cue to obtain different interpretations. To illuminate the computational principles that govern interpretation of non‐conventional communication, we derive a Bayesian model of interpretation via biased inductive inference and estimate these biases from the experimental data. Our analyses suggest people's interpretations balance the ambiguity that is characteristic of emerging language systems, with ordering preferences that are skewed and asymmetric, but defeasible. (shrink)

Many human languages have complex grammatical machinery devoted to temporality, but very little is known about how this came about. This paper investigates how people convey temporal information when they cannot use any conventional languages they know. In a laboratory experiment, adult participants were asked to convey information about simple events taking place at a given time, in spoken language and in silent gesture. It was shown that in spoken language, participants formed utterances according to the rules of their native (...) language, but in silent gesture, the temporal information was presented initially, and structurally separately, from the other information in the utterance. The experimental results are consistent with findings from natural systems emerging in situations of communicative stress: unsupervised adult second language learning and homesign. This confirms that presenting temporal information separately and initially is a robust strategy to talk about past and future when only sparse communicative means are available. (shrink)

How do cognitive biases and mechanisms from learning and use interact when a system of language conventions emerges? We investigate this question by focusing on how transitive events are conveyed in silent gesture production and interaction. Silent gesture experiments have been used to investigate cognitive biases that shape utterances produced in the absence of a conventional language system. In this mode of communication, participants do not follow the dominant order of their native language, and instead condition the structure on the (...) semantic properties of the events they are conveying. An important source of variability in structure in silent gesture is the property of reversibility. Reversible events typically have two animate participants whose roles can be reversed. Without a syntactic/conventional means of conveying who does what to whom, there is inherent unclarity about the agent and patient roles in the event. In experiment 1 we test a novel, fine-grained analysis of reversibility. Presenting a silent gesture production experiment, we show that the variability in word order depends on two factors that together determine how reversible an event is. We relate our experimental results to principles from information theory, showing that our data support the “noisy channel” account of constituent order. In experiment 2, we focus on the influence of interaction on word order variability for reversible and non-reversible events. We show that when participants use silent gesture for communicative interaction, they become more consistent in their usage of word order over time, however, this pattern less pronounced for events that are classified as strongly non-reversible. We conclude that full consistency in word order is theoretically a good strategy, but word order use in practice is a more complex phenomenon. (shrink)

There is a claim that clinical ethics support services (CESS) improve healthcare quality within healthcare organisations. However, there is lack of strong evidence supporting this claim. Rather, the current focus is on the quality of CESS themselves or on individual learning outcomes. In response, this article proposes a theoretical framework leading to empirical hypotheses that describe the relationship between a specific type of CESS, moral case deliberation and the quality of care at the organisational level. We combine insights from the (...) literature on CESS, organisational learning and quality improvement and argue that moral case deliberation causes healthcare professionals to acquire practical wisdom. At the organisational level, where improving quality is a continuous and collective endeavour, this practical wisdom can be aggregated into morisprudence, which is an ongoing formulation of moral judgements across cases encountered within the organisation. Focusing on the development of morisprudence enables refined scrutinisation of CESS-related quality claims. (shrink)

This research article focuses on the use of the water metaphor in column 16 of the Hodayot. Previous scholarship has often concentrated on the garden metaphor in this section, particularly on its intertextual links with the book of Isaiah. By drawing on contemporary metaphor theory, in particular blending theory, I show how the author of the Hodayot creates poetry through a multiple blended network of garden and water metaphors, and how aspects of the linguistic form of the poem, in particular (...) the phrase מבוע מים חיים‘well of living waters’, can be read as an expression of this blend. The aim of this study is to contribute (1) to the study of the Hodayot and its poetic practices, against older dismissals of the poetic quality of the Hodayot, and (2) to our understanding of semantic constellations and the conceptual world of ancient Judaism. Contribution: This article fits within the scope of HTS’s theme ‘Historical Thought and Source Interpretation’ as it contributes to our insights into ancient Jewish thought through the interpretation of a religious source text using metaphor theory. (shrink)

As an attempt to formulate epistemological boundaries , for which Gustave Flaubert becomes a test-case, L'Idiot de la famille can be seen simultaneously as the exemplification of a method and as a re-assertion and further development of Sartre's theory of subjectivity. This article proposes to approach the issue of Sartre's notion of human subjectivity in L'Idiot from the particular angle of the idea of “destiny.” It will be argued that the term “ destin ” provides a focal point for multiple (...) visions of subjectivity as it contains at least three layers of meaning: firstly, Sartre's representation of Flaubert's idea of his life as predetermined destiny; secondly, Sartre's analysis of destiny as a situation created by others; and finally, an understanding of destiny which is close to the notion of the project. It will be argued that precisely the mutual interdependence of these terms is an expression of Sartre's conception of alienation and the possibility of freedom. (shrink)

Most language learners have difficulties acquiring the phonemes of a second language (L2). Unfortunately, they are often judged on their L2 pronunciation, and segmental inaccuracies contribute to miscommunication. Therefore, we aim to determine how to facilitate phoneme acquisition. Given the close relationship between speech and co-speech gesture, previous work unsurprisingly reports that gestures can benefit language acquisition, e.g., in (L2) word learning. However, gesture studies on L2 phoneme acquisition present contradictory results, implying that both specific properties of gestures and phonemes (...) used in training, and their combination, may be relevant. We investigated the effect of phoneme and gesture complexity on L2 phoneme acquisition. In a production study, Dutch natives received instruction on the pronunciation of two Spanish phonemes, /u/ and /θ/. Both are typically difficult to produce for Dutch natives because their orthographic representation differs between both languages. Moreover, /θ/ is considered more complex than /u/, since the Dutch phoneme inventory contains /u/ but not /θ/. The instruction participants received contained Spanish examples presented either via audio-only, audio-visually without gesture, audio-visually with a simple, pointing gesture, or audio-visually with a more complex, iconic gesture representing the relevant speech articulator(s). Preceding and following training, participants read aloud Spanish sentences containing the target phonemes. In a perception study, Spanish natives rated the target words from the production study on accentedness and comprehensibility. Our results show that combining gesture and speech in L2 phoneme training can lead to significant improvement in L2 phoneme production, but both gesture and phoneme complexity affect successful learning: Significant learning only occurred for the less complex phoneme /u/ after seeing the more complex iconic gesture, whereas for the more complex phoneme /θ/, seeing the more complex gesture actually hindered acquisition. The perception results confirm the production findings and show that items containing /θ/ produced after receiving training with a less complex pointing gesture are considered less foreign-accented and more easily comprehensible as compared to the same items after audio-only training. This shows that gesture can facilitate task performance in L2 phonology acquisition, yet complexity affects whether certain gestures work better for certain phonemes than others. (shrink)

The complex emotional work of nurses calls for more recognition of emotional labour and the incorporation of emotional labour in nursing education. Based on participant observation and semistructured interviews, we describe the experiences of student nurses in two nursing homes for elderly people with dementia in the Netherlands. We analyse their interactions using Goffman's dramaturgical view on the front and backstage behaviour and the distinction between surface acting and deep acting. The study reveals the complexity of emotional labour, as nurses (...) swiftly adapt their communication styles and behavioural strategies between settings, patients, and even between moments within one interaction sequence, which shows that the theoretical binaries fail to fully capture their skills. Although student nurses take pride in their emotionally taxing work, the societal undervaluation of the nursing profession negatively impacts their self‐image and ambitions. More explicit recognition of these complexities would enhance their self‐appreciation. This calls for a professional ‘backstage area’ that allows nurses to articulate and strengthen their emotional labour skills. Educational institutions should provide this backstage for nurses‐in‐training to strengthen these skills as part of the professional skill set. (shrink)

Normative literature on the Catalan crisis is largely occupied with the conflict’s central legalistic problem: can political units like Catalonia be allowed to split off from Spain unilaterally? This article reframes the issue and asks why secessionist Catalans should ever abide by Spanish legal constraints, given that Spanish law is precisely the institution they are politically trying to get rid of. It focuses on the anti-secessionist role played by the Spanish Constitutional Court between 2010 and 2017 and studies three arguments (...) why Catalans supposedly have to accept the Court’s authority. The article contends that two arguments—the “mutual benefit argument” and the “law and democracy” argument—will not be independently persuasive to Catalan secessionists. Instead, the Constitutional Court’s authority must ultimately be grounded in a different type of argument: the “law and order argument.” Secessionist Catalans’ supposed duty to obey the orders of the Constitutional Court is ultimately not rooted in a positive service provided by the Court, but in the disruptive effects of disobeying. That exposes an explanatory defect in Joseph Raz’s influential theory of authority, which seeks to ground authority exercises in a concept in prior reason or their capacity to make our life better. That conceptualization misses the key decisionistic element to political authority: its capacity to constitute our reasons, that is, to define the terms that give meaning to our evaluations. (shrink)

Normative literature on the Catalan crisis is largely occupied with the conflict’s central legalistic problem: can political units like Catalonia be allowed to split off from Spain unilaterally? This article reframes the issue and asks why secessionist Catalans should ever abide by Spanish legal constraints, given that Spanish law is precisely the institution they are politically trying to get rid of. It focuses on the anti-secessionist role played by the Spanish Constitutional Court between 2010 and 2017 and studies three arguments (...) why Catalans supposedly have to accept the Court’s authority. The article contends that two arguments—the “mutual benefit argument” and the “law and democracy” argument—will not be independently persuasive to Catalan secessionists. Instead, the Constitutional Court’s authority must ultimately be grounded in a different type of argument: the “law and order argument.” Secessionist Catalans’ supposed duty to obey the orders of the Constitutional Court is ultimately not rooted in a positive service provided by the Court, but in the disruptive effects of disobeying. That exposes an explanatory defect in Joseph Raz’s influential theory of authority, which seeks to ground authority exercises in a concept in prior reason or their capacity to make our life better. That conceptualization misses the key decisionistic element to political authority: its capacity to constitute our reasons, that is, to define the terms that give meaning to our evaluations. (shrink)

The goal of cognitive modeling is to build faithful simulations of human cognition. One of the challenges is that multiple models can often explain the same phenomena. Another challenge is that models are often very hard to understand, explore, and reuse by others. We discuss some of the solutions that were discussed during the 2015 International Conference on Cognitive Modeling.

The goal of cognitive modeling is to build faithful simulations of human cognition. One of the challenges is that multiple models can often explain the same phenomena. Another challenge is that models are often very hard to understand, explore, and reuse by others. We discuss some of the solutions that were discussed during the 2015 International Conference on Cognitive Modeling.

BackgroundVarious forms of Clinical Ethics Support (CES) have been developed in health care organizations. Over the past years, increasing attention has been paid to the question of how to foster the quality of ethics support. In the Netherlands, a CES quality assessment project based on a responsive evaluation design has been implemented. CES practitioners themselves reflected upon the quality of ethics support within each other’s health care organizations. This study presents a qualitative evaluation of this Responsive Quality Assessment (RQA) project.MethodsCES (...) practitioners’ experiences with and perspectives on the RQA project were collected by means of ten semi-structured interviews. Both the data collection and the qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of the decisions.ResultsThe main findings illustrate the relevance of the RQA with regard to fostering the quality of CES by connecting to context specific issues, such as gaining support from upper management and to solidify CES services within health care organizations. Based on their participation in the RQA, CES practitioners perceived a number of changes regarding CES in Dutch health care organizations after the RQA: acknowledgement of the relevance of CES for the quality of care; CES practices being more formalized; inspiration for developing new CES-related activities and more self-reflection on existing CES practices.ConclusionsThe evaluation of the RQA shows that this method facilitates an open learning process by actively involving CES practitioners and their concrete practices. Lessons learned include that “servant leadership” and more intensive guidance of RQA participants may help to further enhance both the critical dimension and the learning process within RQA. (shrink)