The global response to managing the spread of HIV has recently undergone a significant shift with the advent of ‘treatment as prevention’, a strategy which presumes that scaling-up testing and treatment for people living with HIV will produce a broader preventative benefit. Treatment as prevention includes an array of diagnostic, technological and policy developments that are creating new understandings of how HIV circulates in bodies and spaces. Drawing on the work of Michel Foucault, we contextualize these developments by linking them (...) to systems of governance and discursive subjectivation. The goal of this article is to problematize the growing importance of viral suppression in the management of HIV and the use of related surveillance technologies. For people living with HIV, we demonstrate how treatment-as-prevention’s emphasis on individual and collective viral load is transforming the performative dimensions of embodied risk, affect, subjectivity and sex. (shrink)

We read Marshall et al.’s paper with great interest but were left with many questions and concerns (Marshall et al., in press). As a group of public health researchers and practitioners (nursing, s...

Background There has been growing interest in the use of incentives to increase the uptake of health-related behaviours and achieve desired health outcomes at the individual and population level. However, the use of incentives remains controversial for ethical reasons. An area in which incentives have been not only proposed but used is HIV prevention, testing, treatment and care—each one representing an interconnecting step in the "HIV Cascade." Methods The main objective of this qualitative case study was to document the experiences (...) of health care and service providers tasked with administrating incentivized HIV testing, treatment, and care in British Columbia, Canada. A second objective was to explore the ethical and professional tensions that arise from the use of incentives as well as strategies used by providers to mitigate them. We conducted interviews with 25 providers and 6 key informants, which were analyzed using applied thematic analysis. We also collected documents and took field notes. Results Our findings suggest that incentives target populations believed to pose the most risk to public health. As such, incentives are primarily used to close the gaps in the HIV Cascade by getting the "right populations" to test, start treatment, stay on treatment, and, most importantly, achieve viral suppression. Participants considered that incentives work because they "bring people through the door." However, they believed the effectiveness of incentives to be superficial, short-lived and one-dimensional—thus, failing to address underlying structural barriers to care and structural determinants of health. They also raised concerns about the unintended consequences of incentives and the strains they may put on the therapeutic relationship. They had developed strategies to mitigate the ensuing ethical and professional tensions and to make their work feel relational rather than transactional. Conclusions We identify an urgent need to problematize the use of incentives as a part of the "HIV Cascade" agenda and interrogate the ethics of engaging in this practice from the perspective of health care and service providers. More broadly, we question the introduction of market logic into the realm of health care—an area of life previously not subject to monetary exchanges. (shrink)

Der Band enthält sieben Streitschriften Eberhards gegen die "Kritik der reinen Vernunft" aus dem Jahre 1789 und Kants Erwiderung "Über eine Entdeckung nach der alle neue Kritik der reinen Vernunft durch eine ältere entbehrlich gemacht werden soll" (1. Auflage 1790, 2. Auflage 1791).

Each of the antiretroviral drugs that are currently used to stop the progression of HIV infection causes its own specific side effects. Despite the expansion, multiplication, and simplification of treatment options over the past decade, side effects continue to affect people living with HIV. Yet, we see a clear disconnect between the way side effects are normalized, routinized, and framed in clinical practice and the way they are experienced by people living with HIV. This paper builds on the premise that (...) new approaches are needed to understand side effects in a manner that is more reflective of the subjective accounts of people living with HIV. Drawing on the work of Deleuze and Guattari, it offers an original application of the theory of ‘assemblage’. This theory offers a new way of theorizing side effects, and ultimately the relationship between the body and antiretroviral drugs (as technologies). Combining theory with examples derived from empirical data, we examine the multiple ways in which the body connects not only to the drugs but also to people, things, and systems. Our objective is to illustrate how this theory dares us to think differently about side effects and allows us to originally (re)think the experience of taking antiretroviral drugs. (shrink)

Bioethics experts played a key role in ensuring a coherent ethical response to the COVID-19 pandemic in the fields of healthcare, public health, and scientific research in Canada. In the province of Quebec, a group of academic and practicing bioethicists met periodically in the early months of the pandemic to discuss approaches and solutions to ethical dilemmas encountered during the crisis. These meetings created the opportunity for a national survey of bioethics practitioners from different fields. The survey, in which forty-five (...) Canadian bioethics practitioners (clinical ethicists, ethicist members of REBs and government health policy ethicists, or any bioethicist practicing outside of academia) participated, explored their concerns, challenges and opportunities during the first wave of the pandemic, with the objective of informing bioethics research about the difficulties experienced by bioethicists “in the field”. Participants reported increased stress levels, increased workloads, and a greater proportion of their work being devoted to public health ethics. Most of their concerns focused on groups other than themselves, such as health professionals, patients, research participants, and people in vulnerable socio-economic situations. An optimism about the future of bioethics was noted due to an increased awareness of the importance of bioethics by the public and by health and research institutions. (shrink)

. This paper explores the relationship between gift giving, guanxi and corruption through a study of the relationships between UK manufacturing companies in China and their local component suppliers. The analysis is based on interviews in the China-based operations of 49 UK companies. Interviews were carried out both with senior (often expatriate) staff and with local line managers who were responsible for everyday purchasing decisions and for managing relationships with suppliers. The results suggest that gift giving is perceived to be (...) a significant problem in UK-owned companies in China. However the relationship between these payments and established understanding of gift giving within guanxi-networks appears to be weak. Gift giving appears to be associated with illicit payments, corruption and the pursuit of self-interest. Firms seek to reduce the incidence of illicit transactions by changing staff roles, instituting joint responsibilities, which include the separation of different aspects of sourcing/purchasing, ineasing the involvement of senior staff in the process and through the education of employee and suppliers. (shrink)

Based on our respective research programs (psychiatry, forensic psychiatry, public health, HIV/AIDS, harm reduction) this article aims to use purposely non‐conventional means to present the substantial contribution of poststructuralist perspectives to knowledge development in nursing science in general and in our current research in particular. More specifically, we call on the work of Michel Foucault and Deleuze & Guattari to politicize nursing science using examples from our empirical research programs with marginal and often highly marginalized populations. We discuss the concepts (...) of power, discourse, and resistance to illustrate the essential contribution of poststructuralism to marginal, even “nomadic”, nursing research. (shrink)

The literature on causal discovery has focused on interventions that involve randomly assigning values to a single variable. But such a randomized intervention is not the only possibility, nor is it always optimal. In some cases it is impossible or it would be unethical to perform such an intervention. We provide an account of ‘hard' and ‘soft' interventions and discuss what they can contribute to causal discovery. We also describe how the choice of the optimal intervention(s) depends heavily on the (...) particular experimental setup and the assumptions that can be made. ‡The first author is funded by the Causal Learning Collaborative Initiative supported by the James S. McDonnell Foundation. Many aspects of this paper were inspired by discussions with members of the collaborative. †To contact the authors, please write to: Department of Philosophy, Carnegie Mellon University, Pittsburgh, PA 15213; e-mail: [email protected] and [email protected]. (shrink)

Imagining the Course of Life offers a rich portrait of rural life in contemporary Southeast Asia and an accessible introduction to the complexities of Theravada Buddhism as it is actually lived and experienced. It is both an ethnography of indigenous views of human development and a theoretical consideration of how any ethnopsychology is embedded in society and culture. Drawing on long-term fieldwork in a Shan village in northern Thailand, Nancy Eberhardt illustrates how indigenous theories of the life course are (...) connected to local constructions of self and personhood. In the process, she draws our attention to contrasting models in the Euro-American tradition and invites us to reconsider how we think about the trajectory of a human life. Moving beyond the entrenched categories that can hamper our understanding of other views, Imagining the Course of Life demonstrates the real-life connections between the "religious" and the "psychological." Eberhardt shows how such beliefs and practices are used, sometimes strategically, in people's constructions of themselves, in their interpretations of others' behavior, and in their attempts at social positioning. Individual chapters explore Shan ideas about the overall course of human development, from infancy to old age and beyond, and show how these ideas inform people's understanding of personhood and maturity, gender and social inequality, illness and well-being, emotions and mental health. (shrink)

In 1998, the US Supreme Court first held that asymptomatic HIV infection constituted a disability when it ruled on the case of Bragdon v. Abbott. The use of yet another label to identify women living with HIV has been rarely questioned. While we do value the use of this label as an anti-discriminatory strategy, we believe that there is a need to examine how language and more specifically, the use of words such as disability, limitation, and impairment may create new (...) forms of identities for women living with HIV. Using this legal case as a starting point, the goal of this paper is to critically examine the 'fabrication' of asymptomatic HIV infection as a disability. Grounded in a feminist poststructuralist perspective, this paper exposes the relationship between language, social institutions, subjectivity, and power in the construction of difference. By doing so, it addresses the identification of women living with HIV/AIDS as disabled and the self-differentiation process that they must go through in order to live as normally as possible. (shrink)

An interventionist account of causation characterizes causal relations in terms of changes resulting from particular interventions. I provide a new example of a causal relation for which there does not exist an intervention satisfying the common interventionist standard. I consider adaptations that would save this standard and describe their implications for an interventionist account of causation. No adaptation preserves all the aspects that make the interventionist account appealing. Part of the fallout is a clearer account of the difficulties in characterizing (...) so-called “soft” interventions. (shrink)

We argue that current discussions of criteria for actual causation are ill-posed in several respects. (1) The methodology of current discussions is by induction from intuitions about an infinitesimal fraction of the possible examples and counterexamples; (2) cases with larger numbers of causes generate novel puzzles; (3) “neuron” and causal Bayes net diagrams are, as deployed in discussions of actual causation, almost always ambiguous; (4) actual causation is (intuitively) relative to an initial system state since state changes are relevant, but (...) most current accounts ignore state changes through time; (5) more generally, there is no reason to think that philosophical judgements about these sorts of cases are normative; but (6) there is a dearth of relevant psychological research that bears on whether various philosophical accounts are descriptive. Our skepticism is not directed towards the possibility of a correct account of actual causation; rather, we argue that standard methods will not lead to such an account. A different approach is required. Once upon a time a hungry wanderer came into a village. He filled an iron cauldron with water, built a fire under it, and dropped a stone into the water. “I do like a tasty stone soup” he announced. Soon a villager added a cabbage to the pot, another added some salt and others added potatoes, onions, carrots, mushrooms, and so on, until there was a meal for all. (shrink)

This article is an attempt to provide an example that illustrates Hans Reichenbach’s concept of coordination. Throughout Reichenbach’s career the concept of coordination played an important role in his understanding of the connection between reality and how it is scientifically described. Reichenbach never fully specified what coordination is and how exactly it works. Instead, we are left with a variety of hints and gestures, many not entirely consistent with each other and several that are subject to change over the course (...) of his career. Using the example of how to discover and construct causal variables, I will show that most of the features of coordination that Reichenbach described can be instantiated together and formulated precisely. (shrink)

A symposium on Michael Strevens' book "Tychomancy", concerning the psychological roots and historical significance of physical intuition about probability in physics, biology, and elsewhere.

Hans Reichenbach is well known for his limiting frequency view of probability, with his most thorough account given in The Theory of Probability in 1935/1949. Perhaps less known are Reichenbach's early views on probability and its epistemology. In his doctoral thesis from 1915, Reichenbach espouses a Kantian view of probability, where the convergence limit of an empirical frequency distribution is guaranteed to exist thanks to the synthetic a priori principle of lawful distribution. Reichenbach claims to have given a purely objective (...) account of probability, while integrating the concept into a more general philosophical and epistemological framework. A brief synopsis of Reichenbach's thesis and a critical analysis of the problematic steps of his argument will show that the roots of many of his most influential insights on probability and causality can be found in this early work. (shrink)

Nurse practitioners (NPs), as advanced practice nurses, have evolved over the years to become recognized as an important and growing trend in Canada and worldwide. In spite of sound evidence as to the effectiveness of NPs in primary care and other care settings, role implementation and integration continue to pose significant challenges. This article utilizes postcolonial theory, as articulated by Homi Bhabha, to examine and challenge traditional ideologies and structures that have shaped the development, implementation and integration of the NP (...) role to this day. Specifically, we utilize Bhabha's concepts of third space, hybridity, identity and agency in order to further conceptualize the nurse practitioner role, to examine how the role challenges some of the inherent assumptions within the healthcare system and to explore how development of each to these concepts may prove useful in integration of nurse practitioners within the healthcare system. Our analysis casts light on the importance of a broader, power structure analysis and illustrates how colonial assumptions operating within our current healthcare system entrench, expand and re‐invent, as well as mask the structures and practices that serve to impede nurse practitioner full integration and contributions. Suggestions are made for future analysis and research. (shrink)

This empirical paper examines individual-level cognitive factors associated with developing an orientation to sustainable development issues among a population of business practitioners from France. Across two studies, we survey 180 financial managers and 83 finance students, as well as 144 managers from other business disciplines and 117 non-finance business students. We consider ability and motivation variables integrated and adapted into a cognitive elaboration model for sustainable decision making. Specifically, we examine the degree of influence of two factors on the ethical (...) sensitivity to sustainability: the moral maturity of the individual, and the perceived moral intensity of a sustainability issue. Our investigation offers insights into how financial managers perceive the importance of sustainability for corporate strategy. (shrink)

Imagining the Course of Life offers a rich portrait of rural life in contemporary Southeast Asia and an accessible introduction to the complexities of Theravada Buddhism as it is actually lived and experienced. It is both an ethnography of indigenous views of human development and a theoretical consideration of how any ethnopsychology is embedded in society and culture. Drawing on long-term fieldwork in a Shan village in northern Thailand, Nancy Eberhardt illustrates how indigenous theories of the life course are (...) connected to local constructions of self and personhood. In the process, she draws our attention to contrasting models in the Euro-American tradition and invites us to reconsider how we think about the trajectory of a human life. Moving beyond the entrenched categories that can hamper our understanding of other views, Imagining the Course of Life demonstrates the real-life connections between the "religious" and the "psychological." Eberhardt shows how such beliefs and practices are used, sometimes strategically, in people's constructions of themselves, in their interpretations of others' behavior, and in their attempts at social positioning. Individual chapters explore Shan ideas about the overall course of human development, from infancy to old age and beyond, and show how these ideas inform people's understanding of personhood and maturity, gender and social inequality, illness and well-being, emotions and mental health. (shrink)

The causal Bayes net framework specifies a set of axioms for causal discovery. This article explores the set of causal variables that function as relata in these axioms. Spirtes showed how a causal system can be equivalently described by two different sets of variables that stand in a non-trivial translation-relation to each other, suggesting that there is no “correct” set of causal variables. I extend Spirtes’ result to the general framework of linear structural equation models and then explore to what (...) extent the possibility to intervene or a preference for simpler causal systems may help in selecting among sets of causal variables. (shrink)

This survey presents some of the main principles involved in discovering causal relations. They belong to a large array of possible assumptions and conditions about causal relations, whose various combinations limit the possibilities of acquiring causal knowledge in different ways. How much and in what detail the causal structure can be discovered from what kinds of data depends on the particular set of assumptions one is able to make. The assumptions considered here provide a starting point to explore further the (...) foundations of causal discovery procedures, and how they can be improved. (shrink)

We present an algorithm to infer causal relations between a set of measured variables on the basis of experiments on these variables. The algorithm assumes that the causal relations are linear, but is otherwise completely general: It provides consistent estimates when the true causal structure contains feedback loops and latent variables, while the experiments can involve surgical or `soft' interventions on one or multiple variables at a time. The algorithm is `online' in the sense that it combines the results from (...) any set of available experiments, can incorporate background knowledge and resolves conflicts that arise from combining results from different experiments. In addition we provide a necessary and sufficient condition that determines when the algorithm can uniquely return the true graph, and can be used to select the next best experiment until this condition is satisfied. We demonstrate the method by applying it to simulated data and the flow cytometry data of Sachs et al. (shrink)

Recent studies indicate that mammalian chromosomes contain discretecis‐acting loci that control replication timing, mitotic condensation, and stability of entire chromosomes. Disruption of the large non‐coding RNA gene ASAR6 results in late replication, an under‐condensed appearance during mitosis, and structural instability of human chromosome 6. Similarly, disruption of the mouse Xist gene in adult somatic cells results in a late replication and instability phenotype on the X chromosome. ASAR6 shares many characteristics with Xist, including random mono‐allelic expression and asynchronous replication timing. (...) Additional “chromosome engineering” studies indicate that certain chromosome rearrangements affecting many different chromosomes display this abnormal replication and instability phenotype. These observations suggest that all mammalian chromosomes contain “inactivation/stability centers” that control proper replication, condensation, and stability of individual chromosomes. Therefore, mammalian chromosomes contain four types ofcis‐acting elements, origins, telomeres, centromeres, and “inactivation/stability centers”, all functioning to ensure proper replication, condensation, segregation, and stability of individual chromosomes. (shrink)

Using a variety of different results from the literature, I show how causal discovery with experiments is limited unless substantive assumptions about the underlying causal structure are made. These results undermine the view that experiments, such as randomized controlled trials, can independently provide a gold standard for causal discovery. Moreover, I present a concrete example in which causal underdetermination persists despite exhaustive experimentation and argue that such cases undermine the appeal of an interventionist account of causation as its dependence on (...) other assumptions is not spelled out. (shrink)

This essay explores the nexus between Buddhist discourse, moral reasoning, and aspects of indigenous ethnopsychology in a Shan community in northern Thailand. I suggest that these three strands of thought are routinely braided together in intricate ways and, furthermore, that some version of this conceptual arrangement is necessary in order for any moral thinking to take place. That is, all moral thought entails some conception of the way the world is structured (a conception that may or may not be based (...) on religion) and some ethnotheory of human nature, both of which are culturally mediated. Finally, I discuss the implications of this view for our understanding of human agency and autonomy. (shrink)

By combining experimental interventions with search procedures for graphical causal models we show that under familiar assumptions, with perfect data, N - 1 experiments suffice to determine the causal relations among N > 2 variables when each experiment randomizes at most one variable. We show the same bound holds for adaptive learners, but does not hold for N > 4 when each experiment can simultaneously randomize more than one variable. This bound provides a type of ideal for the measure of (...) success of heuristic approached in active learning methods of casual discovery, which currently use less informative measures. (shrink)

Although the existence of implicit motor learning is now widely accepted, the findings concerning perceptual implicit learning are ambiguous. Some researchers have observed perceptual learning whereas other authors have not. The review of the literature provides different reasons to explain this ambiguous picture, such as differences in the underlying learning processes, selective attention, or differences in the difficulty to express this knowledge. In three experiments, we investigated implicit visual learning within the original serial reaction time task. We used different response (...) devices in order to manipulate selective attention towards response dimensions. Results showed that visual and motor sequence learning differed in terms of RT-benefits, but not in terms of the amount of knowledge assessed after training. Furthermore, visual sequence learning was modulated by selective attention. However, the findings of all three experiments suggest that selective attention did not alter implicit but rather explicit learning processes. (shrink)

Scientific models describe natural phenomena at different levels of abstraction. Abstract descriptions can provide the basis for interventions on the system and explanation of observed phenomena at a level of granularity that is coarser than the most fundamental account of the system. Beckers and Halpern (2019), building on work of Rubenstein et al. (2017), developed an account of abstraction for causal models that is exact. Here we extend this account to the more realistic case where an abstract causal model offers (...) only an approximation of the underlying system. We show how the resulting account handles the discrepancy that can arise between low- and high-level causal models of the same system, and in the process provide an account of how one causal model approximates another, a topic of independent interest. Finally, we extend the account of approximate abstractions to probabilistic causal models, indicating how and where uncertainty can enter into an approximate abstraction. (shrink)

Appearing in English for the first time, Schelling’s 1842 lectures develop the idea that many philosophical concepts are born of religious-mythological notions.

Vaesen infers unique properties of mind from the appearance of specific cultural innovation – a correlation without causal direction. Shifts in habitat, population density, and group dynamics are the only independently verifiable incentives for changes in cultural practices. The transition from Acheulean to Late Stone Age technologies requires that we consider how population and social dynamics affect cultural innovation and mental function.

Volume 20, Issue 10, October 2020, Page 26-29.

The American Journal of Bioethics, Volume 12, Issue 9, Page 57-59, September 2012.

Hilde Lindemann argues that personhood is the shared practice of recognizing and responding to one another. She calls this practice holding. Holding, however, can fail. Holding failure, by stereotyping for example, can inhibit others’ epistemic confidence and ability to recall true beliefs as well as create an environment of racism or sexism. How might we avoid holding failure? Holding failure, I argue, has many epistemic dimensions, so I argue that moral encroachment has the theoretical tools available to avoid holding failures. (...) The goal of this paper, therefore, is to articulate and understand the epistemology of holding in an attempt to remedy holding failure. I show that the virtue of wokeness emerges from an epistemic environment tainted with moral encroachment. I argue that as long as an individual is woke, she will have a tendency to avoid holding failures. Wokeness and moral encroachment, consequently, are fundamental to the epistemology of holding and consistent proper holding. (shrink)

An interventionist account of causation characterizes causal relations in terms of changes resulting from particular interventions. We provide an example of a causal relation for which there does not exist an intervention satisfying the common interventionist standard. We consider adaptations that would save this standard and describe their implications for an interventionist account of causation. No adaptation preserves all the aspects that make the interventionist account appealing.

We provide a critical assessment of the account of causal emergence presented in Erik Hoel’s 2017 article “When the map is better than the territory”. The account integrates causal and information theoretic concepts to explain under what circumstances there can be causal descriptions of a system at multiple scales of analysis. We show that the causal macro variables implied by this account result in interventions with significant ambiguity, and that the operations of marginalization and abstraction do not commute. Both of (...) these are desiderata that, we argue, any account of multi-scale causal analysis should be sensitive to. The problems we highlight in Hoel’s definition of causal emergence derive from the use of various averaging steps and the introduction of a maximum entropy distribution that is extraneous to the system under investigation. (shrink)

We consider the problems arising from using sequences of experiments to discover the causal structure among a set of variables, none of whom are known ahead of time to be an “outcome”. In particular, we present various approaches to resolve conflicts in the experimental results arising from sampling variability in the experiments. We provide a sufficient condition that allows for pooling of data from experiments with different joint distributions over the variables. Satisfaction of the condition allows for an independence test (...) with greater sample size that may resolve some of the conflicts in the experimental results. The pooling condition has its own problems, but should—due to its generality—be informative to techniques for meta-analysis. (shrink)

Within a physicalist-mechanistic worldview, in which we cannot be more than intelligent, self-reproducing biomachines or biobots, fundamentals of a new approach to the science of human self-explanation are outlined. Some a priori logical necessities, or determinants, of any biobot’s control system design are recognized. Evolution had to satisfy them, but neuroscience and cognitive science so far do not clearly see these basics. It is concluded that the old part of the brain still contains the genetically fixed drives, responses, and the (...) physiological control. Here is the seat of an ancient somatic self that is not intelligent but is still the active center of our life. The neocortex has evolved to serve the somatic self with intelligence by individually building a virtual model of the external material and social world. This model is used by the somatic self to “pre-play” intended actions and responses to see whether they would satisfy its needs. This schema of global brain function provides the neurological foundation for the ego-id dichotomy in analytic psychology, as well as some critique of it. Following the groundbreaking experiments by Benjamin Libet and John-Dylan Haynes et al. , consciousness is taken as a “theater” that presents what the neural networks already have worked out, and freedom of the will is limited. The explosive growth of culture and civilization began when neocortical power exceeded a certain threshold. This can be taken as a quasi-mutation that projected us into a supra-biological space of existence that is new to natural history. It is not clear whether this event will lead to a positive future for humanity or to doom. Functional religion is seen as a neurosystemic attempt to bring back the earlier natural state. Thus, it can be valuable when cleared of mythological ballast. (shrink)

[1] Das Werten.--[2] Das Erkennen.--[3] Das Handeln.