Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants of early-phase oncology trials, we (...) conducted a survey with patients over 18 years of age who were enrolled in a phase I, phase I/II, or phase II clinical cancer trial in the New York City area between August 2008 and October 2009. Participants in our study were asked to compare their own chances of experiencing a range of risks and benefits related to the trial they were enrolled in with the chances of the other trial participants. We found a significant optimistic bias in their responses. Respondents tended to overestimate the benefits of the trial they were enrolled in and underestimate its risks. In addition, we found no significant relationship between respondents’ understanding of the trial’s purpose and how susceptible they were to unrealistic optimism. Our findings suggest that improving the consent process for oncology studies requires more than addressing deficits in understanding. (shrink)
This is identical with the first edition (see 21: 2716) except for the addition of a Supplement containing 5 previously published articles and the bringing of the bibliography (now 73 items) up to date. The 5 added articles present clarifications or modifications of views expressed in the first edition. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Functional explanations apply not only in cases of normal functioning, but also in the case of malfunctioning. According to a straightforward analysis, a bearer of the function to F is malfunctioning if and only if it does not F although it should do so. This makes malfunctions and malfunctionings analogous to negative causation and thus peculiarly problematic, because they seem to involve absent dispositions and absent processes. This analysis seems also to require that the function to F cannot be identical (...) with the disposition to F. Then we seem to be trapped in a dilemma: Either the realm of functions is separated from the realm of dispositions; then it seems that functions cannot be causally efficacious. Alternatively, functions are considered to be identical with dispositions; but then malfunctioning seems to be conceptually impossible. The paper defends and further develops the thesis of Röhl and Jansen that functions are not a special type of dispositions. For this purpose, it first reviews different varieties of malfunction and malfunctioning and suggests definitions of both malfunction and malfunctioning. It reviews how causal, etiological and intentional theories of functions can deal with these problems. In particular, the paper discusses the special-disposition account of the Basic Formal Ontology. Spear, Ceusters and Smith :103--128, 2016) have defended the special-disposition account of the Basic Formal Ontology by suggesting various strategies how a special-disposition account can deal with malfunctions. On the one side, the paper evaluates these strategies and indicates several problems arising from them. On the other hand, it describes how to account for the non-optionality and the causal efficacy of functions, if functions are not dispositions. While function types are not identical to disposition types, there are important interrelations between functions and dispositions, namely heuristically, from a design perspective for artefact functions, and from an evolutionary perspective for types of biological functions. (shrink)
It is often claimed that the intentions of physicians are multiple, ambiguous, and uncertain—at least with respect to end-of-life care. This claim provides support for the conclusion that the principle of double effect is of little or no value as a guide to end-of-life pain management. This paper critically discusses this claim. It argues that proponents of the claim fail to distinguish two different senses of “intention,” and that, as a result, they are led to exaggerate the extent to which (...) clinical intentions in end-of-life contexts are ambiguous and uncertain. It argues further that physicians, like others who make life and death decisions, have a duty to get clear on what their intentions are. Finally, it argues that even if the principle of double effect should be rejected, clinical intentions remain ethically significant because they condition the meaning of extraordinary clinical interventions, such as that of palliative sedation. (shrink)
In order to develop the ontology of tendencies for use in the representation of medical knowledge, tendencies are compared with other kinds of entities possessing the realizable-realization structure, specifically: dispositions, propensities, abilities and virtues. The peculiarities of tendencies are discussed and a standard schema of tendency ascription is developed in order to represent the relations between the ascriptions of tendency tokens to particulars and the ascriptions of tendency types to universals. Two nonstandard cases and their epistemic variants are discussed.
In this paper I trace Husserl’s transformation of his notion of phantasy from its strong leanings towards empiricism into a transcendental phenomenology of imagination. Rejecting the view that this account is only more incompatible with contemporary neuroscientific research, I instead claim that the transcendental suspension of naturalistic (or scientific) pretensions precisely enables cooperation between the two distinct realms of phenomenology and science. In particular, a transcendental account of phantasy can disclose the specific accomplishments of imagination without prematurely deciding upon a (...) particular scientific paradigm for its experimental investigation; a decision that is best left to the sciences themselves. (shrink)
Researchers and ethicists have long been concerned about the expectations for direct medical benefit expressed by participants in early phase clinical trials. Early work on the issue considered the possibility that participants misunderstand the purpose of clinical research or that they are misinformed about the prospects for medical benefit from these trials. Recently, however, attention has turned to the possibility that research participants are simply expressing optimism or hope about their participation in these trials. The ethical significance of this therapeutic (...) optimism remains unclear. This paper argues that there are two distinct phenomena that can be associated with the term ‘therapeutic optimism’—one is ethically benign and the other is potentially worrisome. Distinguishing these two phenomena is crucial for understanding the nature and ethical significance of therapeutic optimism. The failure to draw a distinction between these phenomena also helps to explain why different writers on the topic often speak past one another. (shrink)
This study responds to van Eemeren’s call for research on the prototypical argumentative styles used in particular domains or communicative activity types by particular individuals or groups. It explores the argumentative style of Dutch politician Geert Wilders in presenting populist arguments, i.e., arguments claiming that if many people hold a certain standpoint, this standpoint should be accepted. A corpus study of 27 texts taken from the website of Wilders’s political party reveals four characteristics of this presentation that deviate significantly from (...) the general descriptions of this type of argument given in the textbooks: absence of indicators, implicit standpoint, wide range of verbs to indicate what “the people” think or believe, use of a construction indicating that the speaker is acting as a mouthpiece. (shrink)
The ethical standards that regulate clinical research have multiple rationales. Among them is the need to protect potential subjects from making imprudent decisions, which extends beyond the soft paternalistic concern to protect people from making uninformed decisions to participate in trials. This article argues that a plausible risk/benefit restriction on clinical trials is presumptively justified by hard paternalism, which in turn is supported by a deeper fairness-based rationale. This presumptive case for hard paternalism in research is not defeated by the (...) alleged right to participate in clinical trials, by concerns about insult or status, by the need to conduct early phase trials that promise little to no benefit to participants, or by the recognition that some potential subjects are altruistically motivated. (shrink)
Rudolf Carnap delivered the hitherto unpublished lecture ‘Theoretical Concepts in Science’ at the meeting of the American Philosophical Association, Pacific Division, at Santa Barbara, California, on 29 December 1959. It was part of a symposium on ‘Carnap’s views on Theoretical Concepts in Science’. In the bibliography that appears in the end of the volume, ‘The Philosophy of Rudolf Carnap’, edited by Paul Arthur Schilpp, a revised version of this address appears to be among Carnap’s forthcoming papers. But although (...) Carnap started to revise it, he never finished the revision,1 and never published the unrevised transcript. Perhaps this is because variants of the approach to theoretical concepts presented for the first time in the Santa Barbara lecture have appeared in other papers of his (cf. the editorial footnotes in Carnap’s lecture). Still, I think, the Santa Barbara address is a little philosophical gem that needs to see the light of day. The document that follows is the unrevised transcript of Carnap’s lecture.2 Its style, then, is that of an oral presentation. I decided to leave it as it is, making only very minor stylistic changes—which, except those related to punctuation, are indicated by curly brackets.3 I think that reading this lecture is a rewarding experience, punctuated as the lecture is with odd remarks and autobiographical points. One can almost envisage.. (shrink)
It has long been a standard practice for the natural sciences to classify things. Thus, it is no wonder that, for two and a half millennia, philosophers have been reflecting on classifications, from Plato and Aristotle to contemporary philosophy of science. Some of the results of these reflections will be presented in this chapter. I will start by discussing a parody of a classification, namely: the purportedly ancient Chinese classification of animals described by Jorge Luis Borges. I will show that (...) many of the mistakes that account for the comic features of this parody appear in real-life scientific databases as well. As examples of the latter, I will discuss the terminology database of the National Cancer Institute (NCI) of the United States, the NCI Thesaurus. (shrink)
In this paper, we defend the ethics of clinical research against the charge of paternalism. We do so not by denying that the ethics of clinical research is paternalistic, but rather by defending the legitimacy of paternalism in this context. Our aim is not to defend any particular set of paternalistic restrictions, but rather to make a general case for the permissibility of paternalistic restrictions in this context. Specifically, we argue that there is no basic liberty-right to participate in clinical (...) research and that considerations of distributive fairness justify some paternalistic protections of research subjects. (shrink)
Recent years have witnessed a growing concern that terminally illpatients are needlessly suffering in the dying process. This has ledto demands that physicians become more attentive in the assessment ofsuffering and that they treat their patients as `whole persons.'' Forthe most part, these demands have not fallen on deaf ears. It is nowwidely accepted that the relief of suffering is one of the fundamentalgoals of medicine. Without question this is a positive development.However, while the importance of treating suffering has generally (...) beenacknowledged, insufficient attention has been paid to the question ofwhether different types of terminal suffering require differnt responsesfrom health care professionals. In this paper we introduce a distinctionbetween two types of suffering likely to be present at the end of life,and we argue that physicians must distinguish between these types if theyare to respond appropriately to the suffering of their terminally illpatients. After introducing this distinction and explaining its basis,we further argue that the distinction informs a (novel) principle ofproportionality, one that should guide physicians in balancing theircompeting obligations in responding to terminal suffering. As weexplain, this principle is justified by reference to the intereststerminally ill patients have in restoration, as well as in therelief of suffering, at the end of life. (shrink)
Australia’s punitive policy towards people seeking asylum deliberately causes severe psychological harm and meets recognised definitions of torture. Consequently, there is a tension between doctors’ obligation not to be complicit in torture and doctors’ obligation to provide best possible care to their patients, including those seeking asylum. In this paper, we explore the nature of complicity and discuss the arguments for and against a proposed call for doctors to boycott working in immigration detention. We conclude that a degree of complicity (...) is unavoidable when working in immigration detention, but that it may be ethically justifiable. We identify ways to minimise the harms associated with complicity and argue that it is ethical to continue working in immigration detention as long as due care and attention is paid to minimising the harms of complicity. (shrink)
Being an "untimely review", this paper reviews Aristotle's 'Categories' as if they were published today, in the era of computerised information, where categorisation becomes more and more essential for information retrieval. I suggest a systematic ordering of Aristotle's list of categories and argue that Aristotle's discussion of ontological dependency and his focus on concrete entities are still a source of new insight and can indeed be read as a contribution to the emerging field of applied ontology and ontological engineering.
Drawing the line on physician assistance in physician-assisted death continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill that (...) can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill. (shrink)
Is a bank note identical with the piece of paper of which it consists? On the one hand, John Searle, in his reply to Barry Smith, suggests that they are “one and the same object” that is a social or non-social object only under certain descriptions. On the other hand, Lynne Rudder Baker puts forward the claim that bank note and paper are distinct entities that are bound together by the relation of material constitution. I suggest two possible analyses for (...) Searle’s description relativity claim, the Alternative Subject Analysis and the Predicate Modification Analysis. On both accounts his identity claim gets into serious trouble. While Baker’s definition of material constitution deals well with the bank note example, it fails to account for the constitution of bearerless social entities and groups. I point out five respects in which social constitution can differ from Baker’s account of material constitution and discuss compositional, institutional and interactional constitution as additional varieties of social constitution. (shrink)
Time has multiple aspects and is difficult to define as one unique entity, which therefore led to multiple interpretations in physics and philosophy. However, if the perception of time is considered as a composite time concept, it can be decomposed into basic invariable components for the perception of progressive and support-fixed time and into secondary components with possible association to unit-defined time or tense. Progressive time corresponds to Bergson’s definition of duration without boundaries, which cannot be divided for measurements. Time (...) periods are already lying in the past and fixed on different kinds of support. The human memory is the first automatic support, but any other support suitable for time registration can also be considered. The true reproduction of original time from any support requires conditions identical to the initial conditions, if not time reproduction becomes artificially modified as can be seen with a film. Time reproduction can be artificially accelerated, slowed down, extended or diminished, and also inverted from the present to the past, which only depends on the manipulation of the support, to which time is firmly linked. Tense associated to progressive and support fixed time is a psychological property directly dependent on an observer, who judges his present as immediate, his past as finished and his future as uncertain. Events can be secondarily associated to the tenses of an observer. Unit-defined time is essential for physics and normal live and is obtained by comparison of support-fixed time to systems with regular motions, like clocks. The association of time perception to time units can also be broken. Einstein’s time units became relative, in quantum mechanics, some physicist eliminated time units, others maintained them. Nevertheless, even the complete elimination of time units is not identical to timelessness, since the psychological perception of progressive and support-fixed time still remains and cannot be ignored. It is not seizable by physical methods, but experienced by everybody in everyday life. Contemporary physics can only abandon the association of time units or tenses to the basic components in perceived time. (shrink)
To whom do sperm and ova belong? Few tissues are produced by the human body with more waste than the germ cells. Yet dominion over the germ cells, and over the early embryo that results from their union in vitro, is behind much of the emotion that modern reproductive intervention can engender. The germ cells differ from other human tissues that can be donated or transplanted because they carry readily utilizable genetic information. Eventual expression of the germ cells' genetic potential (...) is the legitimate concern and responsibility of their donors, although in the right circumstances the responsibility can by agreement be entrusted to institutions administering gamete or embryo donor programmes; these institutions, in turn, may need to assume responsibility for decisions if, in the case of embryo storage, the wishes of the two donors conflict. The fact of sperm and ovum ownership (and the genetic potential that goes with it) before individuals part with these tissues is beyond dispute. Some contentious issues may be clarified if this area of human dominion, namely control over genetic expression among offspring, is acknowledged to be the legitimate persisting concern of those who have produced sperm and ova after storage commences. (shrink)
This article reflects on the reasonableness of populist arguments supporting a prescriptive standpoint in the context of deliberation. A literature survey shows a divide between authors who claim that populist arguments are always fallacious and those who think that in some situations they can be reasonable, including the context of political deliberation. It is then argued that deliberative populist arguments are based on a linking premise that appeals to majority opinion as a principle of democracy. This linking premise differs from (...) the one underlying the traditional interpretation of a fallacious populist argument and appears at first sight to make the argument reasonable. However, I conclude that a deliberative populist argument is also unreasonable, because it acts merely as a trump card, creating a false impression about democracy and avoiding engagement in real debate and substantive reasons. (shrink)
In English discourse one can find cases of the expression ‘not for nothing’ being used in argumentation. The expression can occur both in the argument and in the standpoint. In this chapter we analyse the argumentative and rhetorical aspects of ‘not for nothing’ by regarding this expression as a presentational device for strategic manoeuvring. We investigate under which conditions the proposition containing the expression ‘not for nothing’ functions as a standpoint, an argument or neither of these elements. It is also (...) examined which type of standpoint and which types of argument scheme the expression typically co-occurs with. In doing so we aim to develop a better understanding of the role and effects of ‘not for nothing’ when used in argumentation. Finally, we show that the strategic potential of ‘not for nothing’ lies in its suggestion that sufficient support has been provided while this support has in fact been left implicit. (shrink)
The concept of imagination is notoriously ambiguous. Thus one must be cautious not to use ‘imagination’ as a placeholder for diverse phenomena and processes that perhaps have not much more in common than that they are difficult to assign to some other, better defined domain, such as perception, conceptual thought, or artistic production. However, this challenge also comes with great opportunities: the fecundity and openness of ‘imagination’ appeal to researchers from different disciplines with different approaches and questions, and it draws (...) together fields of enquiry that are initially considered far apart. Hence, arguably, the field of imagination is particularly poised for interdisciplinary enquiry. In the section on Imagination in Interdisciplinary Research, I will talk about some of the issues that have already entered that field of interdisciplinary inquiry. (shrink)
