The fundamental cognitive problem for active organisms is to decide what to do next in a changing environment. In this article, we analyze motor and action control in computational models that utilize reinforcement learning (RL) algorithms. In reinforcement learning, action control is governed by an action selection policy that maximizes the expected future reward in light of a predictive world model. In this paper we argue that RL provides a way to explicate the so-called action-oriented views of cognitive systems in (...) representational terms. (shrink)

According to radical enactivists, cognitive sciences should abandon the representational framework. Perceptuomotor cognition and action control are often provided as paradigmatic examples of nonrepresentational cognitive phenomena. In this article, we illustrate how motor and action control are studied in research that uses reinforcement learning algorithms. Crucially, this approach can be given a representational interpretation. Hence, reinforcement learning provides a way to explicate action-oriented views of cognitive systems in a representational way.

What does it mean to be an expert? What sort of authority do experts really have? And what role should they play in today's society? Addressing why ever larger segments of society are skeptical of what experts say, Expertise: A Philosophical Introduction reviews contemporary philosophical debates and introduces what an account of expertise needs to accomplish in order to be believed. Drawing on research from philosophers and sociologists, chapters explore widely held accounts of expertise and uncover their limitations, outlining a (...) set of conceptual criteria a successful account of expertise should meet. By providing suggestions for how a philosophy of expertise can inform practical disciplines such as politics, religion, and applied ethics, this timely introduction to a topic of pressing importance reveals what philosophical thinking about expertise can contribute to growing concerns about experts in the 21st century. (shrink)

Posthumous Life launches critical life studies: a mode of inquiry that neither endorses nor dismisses a wave of recent "turns" toward life, matter, vitality, inhumanity, animality, and the real. Questioning the nature and limits of life in the natural sciences, the essays in this volume examine the boundaries and significance of the human and the humanities in the wake of various redefinitions of what counts as life. They explore the possibility of theorizing life without assuming it to be either a (...) simple substrate or an always-mediated effect of culture and difference. Posthumous Life provides new ways of thinking about animals, plants, humans, difference, sexuality, race, gender, identity, the earth, and the future. (shrink)

Consumption is essentially an institutional action. While both the formal institutional environment and cultural embeddedness shape consumption, individuals may reciprocally amend the institutional setting through consumption choices that challenge the prevalent institutional constraints. This paper reconciles theoretical and conceptual premises from institutional and practice theory literature to study the sustainability of consumption. Using institutional ethnography as a methodological approach, the study explores the pendulum between embeddedness and agency in shaping the sustainability of day-to-day consumption of necessary goods; and further, how (...) the external institutional environment may interact with human behaviour to contribute towards sustainability. The study finds a hierarchy of informal institutions, each level of which interacts differently with external changes. For example, sustainability is found to be more widespread the more it is embedded in practices, and this is a result of overall institutional development beyond regulation and choice editing. The results also highlight the importance of understanding unintentional sustainability in consumption practices. (shrink)

Climate change is reshaping patterns of displacement around the world. Extreme weather events destroy homes, environmental degradation threatens the viability of livelihoods, sea level rise and coastal erosion force communities to relocate, and risks to food and resource security magnify the sources of political instability. Climate displacement—the displacement of people driven at least in part by the impacts of climate change—is a pressing moral challenge that is incumbent upon us to address. -/- This book develops a political theory of climate (...) displacement. Most work on climate displacement has tended to take an idealized ‘climate refugee’ as its focus. But focusing on the figure of the climate refugee obscures the complexity and heterogeneity of climate displacement. Instead, this book takes the empirical dynamics of climate displacement as its starting point. It examines the moral and political problems raised by the interaction of climate change and displacement in five domains: community relocation, territorial sovereignty, labour migration, refugee movement, and internal displacement. In each context, climate displacement raises distinct questions, which this book explores on their own terms. At the same time, this book treats climate displacement as a unified phenomenon by examining the overarching questions of responsibility and fairness that it raises. The result is an empirically grounded political theory that both maps the conceptual terrain of climate displacement and charts a course for meeting the moral challenge that it raises. (shrink)

The problem of religious disagreement between epistemic peers is a potential threat to the epistemic justification of one’s theistic belief. In this paper, I develop a response to this problem which draws on the central epistemological thesis of skeptical theism concerning our inability to make proper judgements about God’s reasons for permitting evil. I suggest that this thesis may extend over to our judgements about God’s reasons for self-revealing, and that when it does so, it can enable theists to remain (...) steadfast amid disagreement with epistemic peers who hold a contrary theistic belief (i.e., atheistic belief). For if we’re unable to make proper judgements about God’s reasons for self-revealing, then for all we know, God has some reason for not revealing Himself to our apparent epistemic peer. Thus, their epistemic credentials needn’t provide reason to reduce one’s confidence to such a degree as to no longer uphold one’s theistic belief. (shrink)

Recent research has suggested that not all grapheme-colour synaesthetes are alike. One suggestion is that they can be divided, phenomenologically, in terms of whether the colours are experienced in external or internal space. Another suggestion is that they can be divided according to whether it is the perceptual or conceptual attributes of a stimulus that is critical. This study compares the behavioural performance of 7 projector and 7 associator synaesthetes. We demonstrate that this distinction does not map on to behavioural (...) traits expected from the higher–lower distinction. We replicate previous research showing that projectors are faster at naming their synaesthetic colours than veridical colours, and that associators show the reverse profile. Synaesthetes who project colours into external space but not on to the surface of the grapheme behave like associators on this task. In a second task, graphemes presented briefly in the periphery are more likely to elicit reports of colour in projectors than associators, but the colours only tend to be accurate when the grapheme itself is also accurately identified. We propose an alternative model of individual differences in grapheme-colour synaesthesia that emphasises the role of different spatial reference frames in synaesthetic perception. In doing so, we attempt to bring the synaesthesia literature closer to current models of non-synaesthetic perception, attention and binding. (shrink)

United in Hate analyzes the Left's contemporary romance with militant Islam as a continuation of the Left's love affair with communist totalitarianism in the ...

If one can judge a society by how it treats its prisoners, one can surely judge a society by how it treats cognitively- and learning-impaired children. In the United States children with physical and cognitive impairments are subjected to higher rates of corporal punishment than are non-disabled children. Children with disabilities make up just over 13% of the student population in the U.S. yet make up over 18% of those children who receive corporal punishment. Autistic children are among the most (...) likely to receive corporal punishment. -/- Although they may deny or redescribe particular instances of corporal punishment or their use of restraints, educators defend such actions as legitimate punishment. In this paper, I assess the logic underlying the use of restraints and corporal punishment on autistic children by educators. The rationalizations for the corporal punishment or restraint of autistics stems from the educator’s desire to control the autistic children so as to end typical autistic behaviors such as rocking, repetitive verbalizations, or “flapping” but also the autistic child’s non-affective responses such as not appearing to feel remorse or shame or the absence of a verbal acknowledgement of remorse or shame. The educators assume that the autistic’s failure to exhibit the desired responses is evidence of the autistic’s moral incorrigibility and is, therefore, evidence of the appropriateness of corporal punishment. But this assumption of the incorrigibility of the autistic child is questionable. -/- Indeed accepting this incorrigibility assumption reveals two important problems. First, instructors using physical punishment on autistic children do not understand autism. Second, they are not working with a tenable conception of punishment. Any action undertaken to induce socially acceptable behaviors (whether it be the end of autistic acts or responses such as remorse) is to fail to understand what the legitimate punishment of children is about. (shrink)

'You shouldn't drink too much. The Earth is round. Milk is good for your bones.' Are any of these claims true? How can you tell? Can you ever be certain you are right? For anyone tackling philosophical logic and critical thinking for the first time, Critical Thinking: An Introduction to Reasoning Well provides a practical guide to the skills required to think critically. From the basics of good reasoning to the difference between claims, evidence and arguments, Robert Arp and Jamie (...) Carlin Watson cover the topics found in an introductory course. Now revised and fully updated, this Second Edition features a glossary, chapter summaries, more student-friendly exercises, study questions, diagrams, and suggestions for further reading. Topics include: the structure, formation, analysis and recognition of arguments deductive validity and soundness inductive strength and cogency inference to the best explanation truth tables tools for argument assessment informal and formal fallacies With real life examples, advice on graduate school entrance exams and an expanded companion website packed with additional exercises, an answer key and help with real life examples, this easy-to-follow introduction is a complete beginner's tool set to good reasoning, analyzing and arguing. Ideal for students in basic reasoning courses and students preparing for graduate school. (shrink)

Ethicists, policy-makers, and the general public have questioned whether artificial entities such as robots warrant rights or other forms of moral consideration. There is little synthesis of the research on this topic so far. We identify 294 relevant research or discussion items in our literature review of this topic. There is widespread agreement among scholars that some artificial entities could warrant moral consideration in the future, if not also the present. The reasoning varies, such as concern for the effects on (...) artificial entities and concern for the effects on human society. Beyond the conventional consequentialist, deontological, and virtue ethicist ethical frameworks, some scholars encourage “information ethics” and “social-relational” approaches, though there are opportunities for more in-depth ethical research on the nuances of moral consideration of artificial entities. There is limited relevant empirical data collection, primarily in a few psychological studies on current moral and social attitudes of humans towards robots and other artificial entities. This suggests an important gap for psychological, sociological, economic, and organizational research on how artificial entities will be integrated into society and the factors that will determine how the interests of artificial entities are considered. (shrink)

I argue that the use of the separateness of persons in the debate between the priority view and the competing claims view is deeply flawed. In making the case, I argue for three points. First, that...

Taking Kierkegaard Personally: First Person Responses is a one-of-a-kind volume in which scholars from the world over address personal, existential lessons that Kierkegaard has taught them. Papers were selected from the June 2018 International Kierkegaard Conference, sponsored by the Howard V. and Edna H. Hong Kierkegaard Library at St. Olaf College. The Conference's prompt-The Wisdom of Kierkegaard: What Existential Lessons Have You Learned from Him?-compelled scholars to drop their guards and write primarily in first person narrative instead of standard third (...) person scholarly/professorial narrative. Papers range from a preacher in Texas discussing how this white nineteenth-century Dane's thought speaks to black issues, to a university development director wondering what Kierkegaard can teach Silicon Valley executives, to a Danish scholar struggling with human autonomy versus dependence on God, to a Jewish scholar finding hope in this Danish Protestant's works in which existential alienation from the world is the norm, to a Nigerian scholar introducing Kierkegaard's "single individual" into his Ndi Igbo community (a tribe predicated not on the individual but the collective), to a Slovak scholar surviving a bad divorce, to an Hispanic scholar's passion to teach Kierkegaard along the U.S.-Mexico border to Hispanic students, to an American scholar fielding his father's questions about suicide, to other scholars suffering from and coping with deaths of parents, raising children, working in trauma units, finding the need for self-denial in flourishing countries, preaching valuable sermons, dealing with college campus/department politics, and living perfectly quotidian lives. (shrink)

We all know what water is, and we often take it for granted. But the spectre of a worldwide water crisis suggests that there might be something fundamentally wrong with the way we think about water. Jamie Linton dives into the history of water as an abstract concept, stripped of its environmental, social, and cultural contexts. Reduced to a scientific abstraction – to mere H20 – this concept has given modern society licence to dam, divert, and manipulate water with apparent (...) impunity. Part of the solution to the water crisis involves reinvesting water with social content, thus altering the way we see water. An original take on a deceptively complex issue, What Is Water? offers a fresh approach to a fundamental problem. (shrink)

This investigation is motivated by the lack of scholarship examining the content of what firms are communicating to various stakeholders about their commitment to socially responsible behaviors. To address this query, a qualitative study of the legal, ethical and moral statements available on the websites of Forbes Magazine''s top 50 U.S. and top 50 multinational firms of non-U.S. origin were analyzed within the context of stakeholder theory. The results are presented thematically, and the close provides implications for social responsibility among (...) managers of global organizations as well as researchers interested in business ethics. (shrink)

Despite the prominence of person‐centred care (PCC) in nursing, there is no general agreement on the assumptions and the meaning of PCC. We sympathize with the work of others who rethink PCC towards relational, embedded, and temporal selfhood rather than individual personhood. Our perspective addresses criticism of humanist assumptions in PCC using critical posthumanism as a diffraction from dominant values We highlight the problematic realities that might be produced in healthcare, leading to some people being more likely to be disenfranchised (...) from healthcare than others. We point to the colonial, homo‐ and transphobic, racist, ableist, and ageist consequences of humanist traditions that have influenced the development of PCC. We describe the deep rooted conditions that structurally uphold inequality and undermine nursing practice that PCC reproduces. We advocate for the self‐determination of patients and emphasize that we support the fundamental mechanisms of PCC enabling patients' choice; however, without critical introspection, these are limited to a portion of humans. Last, we present limitations of our perspective based on our white*‐cisheteropatriarchy** positionality. We point to the fact that any reimagining of models such as PCC should be carefully done by listening, following, and ceding power to people with diversity dimensions*** and the lived experience or expertise that exists from diverse perspectives. We point towards Black, queer feminism, and critical disabilities studies to contextualize our point of critique with humanism and PCC to amplify equity for all people and communities. Theory and philosophy are useful to understand restrictive factors in healthcare delivery and to inform systematic strategies to improve the quality of care so as not to perpetuate the oppression of groups of people with diversity dimensions. *We purposely capitalize Black and use lower case for white to decentre whiteness and as an intentional act of antiracism (see White Homework a podcast series by Tori W. Douglas). **Cisheteropatriarchy describes people with intersecting identities of dominant social groups; cisgender is the gender identity that aligns with the gender you were assigned at birth, hetero means heterosexual, and patriarchy refers to structural systems of power based on maleness where women are often excluded and hold less power. ***With diversity dimensions, we refer to subjective lived experience and material realities of people that exist outside the ‘dominant minorities' of white‐cisheteropatriarchy, meaning groups of people in society who historically and currently hold more power and through this, structurally dominate the norms and possibilities of living for other people. (shrink)

Amongst intellectuals and activists, neoliberalism has become a potent signifier for the kind of free-market thinking that has dominated politics for the past three decades. Forever associated with the conviction politics of Ronald Reagan and Margaret Thatcher, the free-market project has since become synonymous with the 'Washington consensus' on international development policy and the phenomenon of corporate globalization, where it has come to mean privatization, deregulation, and the opening up of new markets. But beyond its utility as a protest slogan (...) or buzzword as shorthand for the political-economic Zeitgeist, what do we know about where neoliberalism came from and how it spread? Who are the neoliberals, and why do they studiously avoid the label? Constructions of Neoliberal Reason presents a radical critique of the free-market project, from its origins in the first half of the 20th Century through to the recent global economic crisis, from the utopian dreams of Friedrich von Hayek through the dogmatic theories of the Chicago School to the hope and hubris of Obamanomics. The book traces how neoliberalism went from crank science to common sense in the period between the Great Depression and the age of Obama. Constructions of Neoliberal Reason dramatizes the rise of neoliberalism and its uneven spread as an intellectual, political, and cultural project, combining genealogical analysis with situated case studies of formative moments throughout the world, like New York City's bankruptcy, Hurricane Katrina, and the Wall Street crisis of 2008. The book names and tracks some of neoliberalism's key protagonists, as well as some of the less visible bit-part players. It explores how this adaptive regime of market rule was produced and reproduced, its logics and limits, its faults and its fate. (shrink)

Focusing on the body as a visual and discursive platform across public space, this book explores marginalization as a sociocultural practice and hegemonic schema. The chapters center upon physical contexts, discursive spaces, and philosophical arenas to deconstruct seemingly intrinsic connections between body and behavior, whiteness, and normativity.

In this work, Jamie Mayerfeld undertakes a careful inquiry into the meaning and moral significance of suffering. Understanding suffering in hedonistic terms as an affliction of feeling, he claims that it is an objective psychological condition, amenable to measurement and interpersonal comparison, although its accurate assessment is never easy. Mayerfeld goes on to examine the content of the duty to prevent suffering and the weight it has relative to other moral considerations. He argues that the prevention of suffering is morally (...) more important than the promotion of happiness, and that the duty to relieve suffering is much stronger than most of us acknowledge. (shrink)

Recent philosophical literature has turned its attention towards assessments of how to judge scientific proposals as worthy of further inquiry. Previous work, as well as papers contained within this special issue, propose criteria for pursuitworthiness (Achinstein, 1993; Whitt, 1992; DiMarco & Khalifa, 2019; Laudan, 1977; Shan, 2020; Šešelja et al., 2012). The purpose of this paper is to assess the grounds on which pursuitworthiness demands can be legitimately made. To do this, I propose a challenge to the possibility of even (...) minimal criteria of pursuitworthiness, inspired by Paul Feyerabend. I go on to provide a framework for identifying the contexts in which pursuitworthiness criteria may promote the efficiency of scientific inquiry. I then spell out some implications this framework has for values and pursuit. (shrink)

Exchanging the Lies of the World for the Liberating Truth of God.

The Vitruvian Man is a metaphor for the “ideal man” by feminist posthuman philosopher Rosi Braidotti (2013) as a proxy for eurocentric humanist ideals. The first half of this paper extends Braidotti's concept by thinking about the metaphor of the “ideal nurse” (Vitruvian nurse) and how this metaphor contributes to racism, oppression, and burnout in nursing and might restrict the professionalization of nursing. The Vitruvian nurse is an idealized and perfected form of a nurse with self‐sacrificial language (re)producing self‐sacrificing expectations. (...) The second half of this paper looks at how regulatory frameworks (using the example of UK's Nursing and Midwifery Council Code of Conduct) institutionalize the conditions of possibility through collective imaginations. The domineering expectations found within the Vitruvian nurse metaphor and further codified by regulatory frameworks give rise to boredom and burnout. The paper ends by suggesting possible ways to diffract regulatory frameworks to practice with affirmative ethics and reduce feelings of self‐sacrifice and exhaustion among nurses. (shrink)

Allocating access to unapproved COVID-19 drugs available via Pre-Approval Access pathways or Emergency Use Authorization raises unique challenges at the intersection of clinical care and research....

Chat Generative Pre-Trained Transformer (ChatGPT) has been a growing point of interest in medical education yet has not been assessed in the field of bioethics. This study evaluated the accuracy of ChatGPT-3.5 (April 2023 version) in answering text-based, multiple choice bioethics questions at the level of US third-year and fourth-year medical students. A total of 114 bioethical questions were identified from the widely utilised question banks UWorld and AMBOSS. Accuracy, bioethical categories, difficulty levels, specialty data, error analysis and character count (...) were analysed. We found that ChatGPT had an accuracy of 59.6%, with greater accuracy in topics surrounding death and patient–physician relationships and performed poorly on questions pertaining to informed consent. Of all the specialties, it performed best in paediatrics. Yet, certain specialties and bioethical categories were under-represented. Among the errors made, it tended towards content errors and application errors. There were no significant associations between character count and accuracy. Nevertheless, this investigation contributes to the ongoing dialogue on artificial intelligence’s (AI) role in healthcare and medical education, advocating for further research to fully understand AI systems’ capabilities and constraints in the nuanced field of medical bioethics. (shrink)

This anthology will provide the first accessible reader on magic's generative relationship with contemporary art practice.

Words associated with perceptually salient, highly imageable concepts are learned earlier in life, more accurately recalled, and more rapidly named than abstract words (R. W. Brown, 1976; Walker & Hulme, 1999). Theories accounting for this concreteness effect have focused exclusively on semantic properties of word referents. A novel possibility is that word structure may also contribute to the effect. We report a corpus-based analysis of the phonological and morphological structures of a large set of nouns with imageability ratings (N = (...) 2,023). High- and low-imageability nouns differed by length, etymology, prosody, affixation, phonological neighborhood density, and rates of consonant clustering. On average, nouns denoting abstract concepts were longer, more derivationally complex, and emerged in English from a different distribution of languages than did concrete nouns. We address implications for interactivity of word form and meaning as pertain to theories of word concreteness, lexical acquisition, and word processing. (shrink)

The most public-facing forms of contemporary Darwinism happily promote its worldview ambitions. Popular works, by the likes of Richard Dawkins, deflect associations with eugenics and social Darwinism, but also extend the reach of Darwinism beyond biology into social policy, politics, and ethics. Critics of the enterprise fall into two categories. Advocates of Intelligent Design and secular philosophers (like Mary Midgley and Thomas Nagel) recognise it as a worldview and argue against its implications. Scholars in the rhetoric of science or science (...) communication, however, typically take the view that Darwinism isn't a worldview, but a scientific theory, which has been improperly embellished by some; they uphold the distinction between is and ought and argue that science is restricted to the former. This prompts an is–ought problem on another level. I catalogue the ways in which Darwinism plainly is a worldview and why commentators' beliefs that it ought not to be distorts their analysis. Hence, it is their own worldview that precludes them from accepting Darwinism's worldview implications. (shrink)

In this essay I set and explore Buch-Hansen and Nielsen’s Critical Realism: Basics and Beyond. I then move on to discuss arising issues relevant to contemporary critical realism, including time, ca...

Although business and society scholars have sought to demonstrate that corporate social performance (CSP) leads to corporate financial performance (CFP), a complete model of the pathway from CSP to CFP has not been substantiated. One suggestion is that certain indicators of CSP are noticed by stakeholders, who then act in ways that ultimately affect the firm's CFP. The present study focused on the first step in this path: identifying the factors that initially lead a stakeholder group to target a particular (...) firm. Existing theory from the literature on the environmental movement, stakeholder theory, and CSP fostered the development of eight propositions regarding corporate environmental performance. Case studies of five environmental non-governmental organizations (ENGOs) are used to address the propositions. The case studies also supply additional insight into ENGO targeting of particular firms, unrelated to the propositions, thereby facilitating the development of a theoretical model. (shrink)

In the present study, I sought to more fully understand stakeholder organizations’ strategies for influencing business firms. I conducted interviews with 28 representatives of four environmental non-governmental organizations (ENGOs): Natural Resources Defense Council (NRDC), Greenpeace, Environmental Defense (ED), and Union of Concerned Scientists (UCS). Qualitative methods were used to analyze this data, and additional data in the form of reviews of websites and other documents was conducted when provided by interviewees or needed to more fully comprehend interviewee’s comments. Six propositions (...) derived from Frooman (1999) formed the basis for the initial data analysis; all six propositions were supported to some extent. Perhaps more interestingly, the data revealed that Frooman’s model is too parsimonious to adequately describe stakeholder influence strategies and related alliances, necessitating the development of an alternative theoretical model grounded in the data collected. (shrink)

Words associated with perceptually salient, highly imageable concepts are learned earlier in life, more accurately recalled, and more rapidly named than abstract words (R. W. Brown, 1976; Walker & Hulme, 1999). Theories accounting for this concreteness effect have focused exclusively on semantic properties of word referents. A novel possibility is that word structure may also contribute to the effect. We report a corpus-based analysis of the phonological and morphological structures of a large set of nouns with imageability ratings (N = (...) 2,023). High- and low-imageability nouns differed by length, etymology, prosody, affixation, phonological neighborhood density, and rates of consonant clustering. On average, nouns denoting abstract concepts were longer, more derivationally complex, and emerged in English from a different distribution of languages than did concrete nouns. We address implications for interactivity of word form and meaning as pertain to theories of word concreteness, lexical acquisition, and word processing. (shrink)

Although theory refers to organizational culture as an important variable in corrupt organizations, only little empirical research has addressed the characteristics of a corrupt organizational culture. Besides some characteristics that go hand in hand with unethical behavior and other features of corrupt organizations, we are still not able to describe a corrupt organizational culture in terms of its underlying assumptions, values, and norms. With a qualitative approach, we studied similarities of organizational culture across different corrupt organizations. In this study, we (...) performed content analysis on interviews of 14 independent experts about their experience with corrupt organizations. With this approach, we gained insights about different corrupt organizations spanning different branches (e.g., government, foreign trade, pharmacy, sports, building industry). We found that corrupt organizations perceive themselves to fight in a war, which leads to their taken-for-granted assumption that “the end justifies the means”. This assumption inspires many values and norms of the organizational culture. An important value in a corrupt organization is “security”, and an important norm is punishment of deviant (i.e., non-corrupt) behavior. Furthermore, managers and employees differ in their perception of organizational culture. While the management endorses values, such as success, results, and performance, and implements these values in their norms of goal setting, employees make use of rationalization strategies and endorse values of security and team spirit. (shrink)

The provider–patient relationship is typically regarded as an expert-to-novice relationship, and with good reason. Providers have extensive education and experience that have developed in them the competence to treat conditions better and with fewer harms than anyone else. However, some researchers argue that many patients with long-term conditions (LTCs), such as arthritis and chronic pain, have become “experts” at managing their LTC. Unfortunately, there is no generally agreed-upon conception of “patient expertise” or what it implies for the provider–patient relationship. I (...) review three prominent accounts of patient expertise and argue that all face serious objections. I contend, however, that a plausible account of patient expertise is available and that it provides a framework both for further empirical studies and for enhancing the provider–patient relationship. (shrink)