Sometimes it's better to be lucky than good. As new blood filled our young patient's veins, her breathing became regular and her pulse full. She was so far gone I would not have expected her to recover consciousness for a day, if at all, but within an hour, she began to wake up. We removed the breathing tube a couple of hours later— no ventilator ever needed.As life-sustaining technology becomes more widely available in fortunate parts of the developing world, benefits (...) come with complications. The temptation is to focus on the thing—the ventilator itself—as the crucial element and press to buy more, mistaking the problem for one of resource scarcity only. But we need a culturally relevant ethical framework to guide the use and withdrawal of ventilators and similar life-sustaining tools. Resource scarcity is only part of the problem. Buying additional ventilators only defers allocation decisions and entirely fails to address end-of-life suffering. It is unsustainable in Rwanda; it is a dubious solution anywhere. The intangible need for an ethical framework hides beneath apparent scarcity and, when this need is not addressed and luck runs out, one salvageable patient can die for want of a ventilator that serves only to prolong the suffering of another. (shrink)

The man had fallen in the hospital recovery room while attempting to put on his pants, readying himself to return home after an outpatient procedure. The case seemed so pedestrian at first. The emergency department charge nurse was annoyed; she called it a dump. “They’re sending a patient from the PACU to the ER!” she fumed. “Why can’t they take care of their own problems up there? Isn’t this a hospital?”I could relate to the gut aversion to having yet another (...) patient in an already busy emergency department. The case did not fit our usual model. Most patients arrive at the emergency department from outside the hospital, by private car or ambulance. It was tempting say that this was outside our scope of... (shrink)

An earthy smell seeps from the cinderblock room, and a fan in the corner rattles as it circulates the heat. My eyes cross trying to read the square black numbers on the thermometer. I feel achy and tired. I would not be so nervous about the result except that I have been caring for Ebola patients in West Africa.

Noah Rosenberg et al.'s 2002 article “Genetic Structure of Human Populations” reported that multivariate genomic analysis of a large cell line panel yielded reproducible groupings (clusters) suggestive of individuals' geographical origins. The paper has been repeatedly cited as evidence that traditional notions of race have a biological basis, a claim its authors do not make. Critics of this misinterpretation have often suggested that it follows from interpreters' personal biases skewing the reception of an objective piece of scientific writing. (...) I contend, however, that the article itself to some degree facilitates this misrepresentation. I analyze in detail several verbal and visual features of the original article that may predispose aspects of its racial interpretation; and, tracing the arguments of one philosopher and one popular science writer, I show how these features are absorbed, transformed into arguments for a biological basis of race, and re-attributed to the original. The essay demonstrates how even slight ambiguities can enable the misappropriation of scientific writing, unintentionally undermining the authors' stated circumspection on the relationship between cluster and race. (shrink)

Genetic determinism labels the morally problematical claim that some socially significant traits, traits we care about, such as sexual orientation, gender roles, violence, alcoholism, mental illness, intelligence, are largely the results of the operation of genes and not much alterable by environment, learning or other human intervention. Genetic determinism does not require that genes literally fix these socially significant traits, but rather that they constrain them within narrow channels beyond human intervention. In this essay we analyze genetic determinism in light (...) of what is now known about the inborn error of metabolism phenylketonuria , which has for so long been the poster child ‘simple’ argument in favor of some form of genetic determinism. We demonstrate that this case proves the exact opposite of what it has been proposed to support and provides a strong refutation of genetic determinism in all its guises. (shrink)

In this paper the concept of supervenience is employed to explain the relationship between fitness as employed in the theory of natural selection and population biology and the physical, behavioral and ecological properties of organisms that are the subjects of lower level theories in the life sciences. The aim of this analysis is to account simultaneously for the fact that the theory of natural selection is a synthetic body of empirical claims, and for the fact that it continues to be (...) misconstrued, even by biologists, for a tautological system. The notion of supervenience is then employed to provide a new statement of the relation of Mendelian predicates to molecular ones in order to provide for the commensurability and potential reducibility of Mendelian to molecular genetics in a way that circumvents the theoretical complications which appear to stand in the way of such a reduction. (shrink)

Some monothematic types of delusions may arise because subjects have unusual experiences. The role of this experiential component in the pathogenesis of delusion is still not understood. Focussing on delusions of alien control, we outline a model for reality testing competence on unusual experiences. We propose that nascent delusions arise when there are local failures of reality testing performance, and that monothematic delusions arise as normal responses to these. In the course of this we address questions concerning the tenacity with (...) which delusions are maintained, their often bizarre content, the patients' inability to dismiss them, and their often circumscribed character. (shrink)

The underdetermination of theory by evidence must be distinguished from holism. The latter is a doctrine about the testing of scientific hypotheses; the former is a thesis about empirically adequate logically incompatible global theories or "systems of the world". The distinction is crucial for an adequate assessment of the underdetermination thesis. The paper shows how some treatments of underdetermination are vitiated by failure to observe this distinction, and identifies some necessary conditions for the existence of multiple empirically equivalent global theories. (...) We consider how empiricists should respond to the possibility of such systems of the world. (shrink)

The prescriptive force of methodological rules rests, I argue, on the acceptance of scientific theories; that of the most general methodological rules rests on theories in the philosophy of science, which differ from theories in the several sciences only in generality and abstraction. I illustrate these claims by reference to methodological disputes in social science and among philosophers of science. My conclusions substantiate those of Laudan except that I argue for the existence of transtheoretical goals common to all scientists and (...) concrete enough actually to have bearing on methodology. And I argue that Laudan is committed to such goals himself, willy nilly. (shrink)

I note the multitude of ways in which, beginning with the classic paper by Machamer et al., the mechanists have qualify their methodological dicta, and limit the vulnerability of their claims by strategic vagueness regarding their application. I go on to generalize a version of the mechanist requirement on explanations due to Craver and Kaplan :601–627, 2011) in cognitive and systems neuroscience so that it applies broadly across the life sciences in accordance with the view elaborated by Craver and Darden (...) in In Search of Mechanisms. I then go on to explore what ramifications their mechanist requirement on explanations may have for explanatory “dependencies” reported in biology and the special sciences. What this exploration suggests is that mechanism threatens to eliminate instead of underwrite a large number of such “dependencies” reported in higher-levels of biology and the special sciences. I diagnose the source of this threat in mechanism’s demand that explanations identify nested causal differences makers in mechanisms, their components, the components further components, and so forth. Finally, I identify the “love–hate” relationship mechanism must have with functional explanation, and show how it makes mechanism an extremely interesting thesis indeed. (shrink)

Reductionism is a metaphysical thesis, a claim about explanations, and a research program. The metaphysical thesis reductionists advance (and antireductionists accept) is that all facts, including all biological facts, are fixed by the physical and chemical facts; there are no non-physical events, states, or processes, and so biological events, states and processes are “nothing but” physical ones. The research program can be framed as a methodological prescription which follows from the claim about explanations. Antireductionism does not dispute reductionism’s metaphysical claim, (...) but rejects the explanatory claim and so the methodological moral. To a first approximation what reductionists and antireductionists disagree about is whether explanations in functional biology can be or need to be explained by or completed or perhaps replaced by explanations in terms of molecular biology.i And this disagreement over the adequacy of explanations in functional biology drives a significant methodological disagreement with consequence for the research program of biology. (shrink)

Social and behavioral scientists - that is, students of human nature - nowadays hardly ever use the term ‘human nature’. This reticence reflects both a becoming modesty about the aims of their disciplines and a healthy skepticism about whether there is any one thing really worthy of the label ‘human nature’.

Some monothematic types of delusions may arise because subjects have unusual experiences. The role of this experiential component in the pathogenesis of delusion is still not understood. Focussing on delusions of alien control, we outline a model for reality testing competence on unusual experiences. We propose that nascent delusions arise when there are local failures of reality testing performance, and that monothematic delusions arise as normal responses to these. In the course of this we address questions concerning the tenacity with (...) which delusions are maintained, their often bizarre content, the patients’ inability to dismiss them, and their often circumscribed character. (shrink)

Many philosophers call themselves ‘naturalists’ because they believe theism is incompatible with science. However, many also hold that science is compatible with many other theistic beliefs about morality, free will, the mind, and the meaning of life. Those naturalists who reject these other beliefs need a different label for their view. This article recommends the term ‘scientism’.

Almost exactly ten years ago, the now extinct U.S. Congress, Office of Technology Assessment (OTA) released a major report -- The Electronic Supervisor: New Technology, New Tensions. This report describes a number of new technologies available to management in its ongoing search to ensure that labour performs its required job to management's rigid specifications. Social issues raised with respect to electronic monitoring included privacy, fairness, quality of working life, and stress-related illnesses. The study was also concerned with drug testing, genetic (...) screening, polygraph testing, as well as a variety of technologies for eavesdropping and monitoring. It seems to be appropriate to evaluate the analyses and recommendations made in the report and to extend the evaluation to current technologies. (shrink)

The purpose of this study was to assess the presence of ethics committees in rural critical access hospitals across the United States. Several studies have investigated the presence of ethics committees in rural health care facilities. The limitation of these studies is in the definition of ‘rural hospital’ and a regional or state focus. These limitations have created large variations in the study findings. In this nation-wide study we used the criteria of a critical access hospital (CAH), as defined by (...) the Medicare Rural Hospital Flexibility Program (Flex Program, 2007), to bring consistency and clarity to the assessment of the presence of ethics committees in rural hospitals. The Flex Monitoring Team conducted a national telephone survey of 381 CAH administrators throughout the United States. The survey covered a wide variety of questions concerning hospitals’ community benefit, impact activities, and whether the hospital had a formally established an ethics committee. About 230 (60%) of the respondents indicated they had a formally established ethics committee or ethics consultation program at their CAH. The prevalence of ethics committees declined as the CAH location became increasingly rural along a rural–urban continuum. Unlike CAHs, all rural Department of Veterans Affairs Medical Centers have ethics committees. The results of this study provide an understanding of the limited presence of ethics committee in rural America and the need to consider new approaches for providing ethics assistance. A virtual ethics committee network may be the most efficient and effective way of providing rural hospitals access to a knowledgeable ethics committee or consultant. (shrink)

In this article we examine the association between national welfare regime and the propensity of middle–aged and older individuals with adult children of their own to provide social support to aged parents. Using data from mature adults (50+) in 26 European countries, we examine whether older and younger generations compete for the time resources of the middle “sandwiched” generation, and whether national policy context shapes this competition. Contrary to expectations, we found that sandwich generation members were less likely to provide (...) support to their parents in Conservative–Mediterranean and East European regimes, but more likely to do so in universalistic Social–Democratic regimes. This evidence supports the hypothesis that well–developed welfare states “crowd–in” family support to older individuals. Middle generation members who provided social support to their adult children tended to provide to their older parents as well. This was particularly true in the two regimes where resources and public benefits tend to be more generous and may be interpreted as state benefits that reduce intergenerational competition. Findings are discussed in terms of the capacity of state policies to shape the allocation of family resources to older adults where extended family lineages have become the norm. (shrink)

This chapter contains section titled: Reduction as Relation between Theories: Historical Considerations Antireductionism about Intertheoretical Relations Reductionism as a Thesis about Explanations in Biology Reductionism and Explanation in Evolutionary Biology References Further Reading.

This article works from 10th anniversary reporting on the Montréal massacre and its legacy, arguing that the public memory of the massacre, far from being settled, is charged with ambivalence. It is argued that such ambivalence is an effect of the limits of remembrance as a `strategic practice', which has circumscribed sustained encounters with the loss(es) of the massacre. Ambivalence is read in the article as both a limit and resource for feminists interested in re-opening the question of the massacre's (...) public memory for the next decade of memorial-activism. (shrink)

This work presents a new, alternative approach to studying the formation of political ideologies and attitudes, addressing a concern in political science that research in this area is at a crossroads. The authors provide an epistemologically grounded critique on the literature of belief systems, explaining why traditional approaches have reached the limits of usefulness. Following the lead of such continental theorists such as Jurgen Habermas and Anthony Giddens, who stress the importance of Jean Piaget to the development of a strong (...) theoretical perspective in political psychology, the authors develop a different epistemology, theory,and research strategy based on Piaget, then apply it in two emperical studies of belief systems, and finally present a third theoretical study of political culture and political development. (shrink)

Culturally, America is well overdue for a Second Enlightenment, but since the dominant majority of its citizens are regrettably both symbol-minded and star-craving mad, and since the mass media are generally inaccessible to us, the chance that contemporary philosophers could contribute to such a thing, much less help instigate it, is near vanishingly small. As educators, in contrast, we can perhaps make ourselves useful by beginning to clear the extensive muck out of at least some of our students’ minds. In (...) any event, the discipline of philosophy as such is in serious need of renewal, but that, should it unexpectedly happen, will be matter of luck rather than a result of deliberate action. (shrink)

Do the social sciences employ the same methods as the natural sciences? If not, can they do so? And should they do so, given their aims? These central questions of the philosophy of social science presuppose an accurate identification of the methods of natural science. For much of the twentieth century this presupposition was supplied by the logical positivist philosophy of physical science. The adoption of methods from natural science by many social scientists raised another central question: why had these (...) methods so apparently successful in natural science been apparently far less successful when self‐consciously adapted to the research agendas of the several social sciences? Alternative answers to this last question reflect competing philosophies of social science. On one view, the social sciences have not progressed because social scientists have not yet applied the methods of natural science well enough. Another answer has it that the positivists got the methods of natural science wrong, and that social scientists aping wrong methods have produced sterility in their disciplines. Still another response to this question argues that the social sciences are using the right methods and are succeeding, but that the difficulties they face are so daunting that rapid progress is not to be expected. Finally, a fourth answer which has attracted many philosophers of social science has it that social science has made much progress, but that its progress must be measured by different standards from those applied in natural science. This view reflects the belief that social science ought not to employ the methods of natural science, and that many of its problems stem precisely from the employment of an inappropriate method, reflecting profound philosophical confusion. These differing philosophies of social science must be assessed along the dimensions outlined below. (shrink)

In this paper recent research involving interdisciplinary ethnography is presented as an exploration of its contribution to studies of people and technology in the workplace. Three main patterns of interaction between ethnography and ‘the others’ are examined. First, the influence of ethnography in promoting people-oriented perspectives of technology is discussed with reference to workplace studies in manufacturing. Second, ethnography contribution to the development of hybrid methods for the design and implementation of technology for use in the workplace is illustrated by (...) several examples of such frameworks. Third, the influence of ethnographic research to providing a theoretical basis for computer-mediated communication is explored and documented by analyses of design teams working together as part of construction projects. From a practical point of view, this exploration has resulted in a brief discussion of the broad range of ‘users’ in the real-life workplace who benefit from ethnographic research. Future work in this area will rely on a reflexive stance on the part of the ethnographer in relation to both users of technology and users of ethnography. (shrink)

Philosophers have traditionally decried vagueness as an unmitigated evil, and natural scientists have consistently agreed with them. Nevertheless, as I hope to show, the vagueness of scientific terms has some important advantages for the theories in which these terms figure. In so arguing I do not mean to put the best face on some unpleasant facts or to make a virtue out of a necessity. I shall begin, however, by arguing that on some contemporary accounts of scientific language the vagueness (...) of many scientific terms is unavoidable; if it is unavoidable then lamenting it is futile, and justifying it is idle. I shall go on to argue that, independent of these accounts, the advantages of exactness attained can sometimes be substantially outweighed by the disadvantages of vagueness foregone. (shrink)

ABSTRACTDecades of research demonstrate that most people have little knowledge or understanding of politics. Two recent works suggest that this reflects the limits of human cognitive capacity. Rather than being reasoned, political thinking is mostly preconscious, automatic, and recall driven. Consequently, it is vulnerable to contextual cueing, preexisting biases, and biological and genetic predispositions. However, this research is oriented by an inadequate understanding of cognition.

Tumor‐cell diversification mechanisms insure that malignant neoplasms contain diversified tumor‐cell subpopulations. Because of the instability of tumor cell phenotypes, some malignant cells will evolve with the most favorable properties for their progression to highly metastatic cells. The rates of cellular phenotypic diversification vary greatly among different tumors, and they are probably modulated, in part, by genetic and chromosome defects and by epigenetic events that may vary widely depending upon the nature of the tumor cells and their microenvironments. As tumor diversification (...) and selection proceed, the most malignant cell subpopulations may eventually become dominant and gradually lose their microenvironmental responsiveness. Tumor‐cell diversification mechanisms may be similar or identical to normal, developmentally regulated diversification mechanisms that are used during embryonic cell diversification and differentiation. (shrink)