It is often assumed that two linguistic agents can come to understand one another in part because they use the same words. That is, many philosophical theories of communication posit an intersubjective same-word relation. However, giving an account of this relation is complicated by what I call “The Variation Problem”—a problem resulting from the fact that the same word can be pronounced differently. In this paper, I first argue that previous models of the same-word relation, including Kaplanian and Chomskyan models, (...) fail to escape The Variation Problem. I then propose a new model on which the same-word relation is grounded in a particular kind of social relation that holds between the speaker and the audience. On this model, using the same word requires not that agents make the same sounds, but that they coordinate their internal linguistic representations. (shrink)

Leveraging firsthand experience, BRAIN-funded investigators conducting intracranial human neuroscience research propose two fundamental ethical commitments: (1) maintaining the integrity of clinical care and (2) ensuring voluntariness. Principles, practices, and uncertainties related to these commitments are offered for future investigation.

Medicalization is the process by which conditions, for example, intellectual disability, hyperactivity in children, and posttraumatic stress disorder, become understood as medical disorders. During this process, the medical community often collectively assigns a label to a condition and consequently to those who would be said to have the disorder. We argue that there are at least two previously overlooked ways in which this linguistic practice may be wrongful, and sometimes, unjust: first, when the initial introduction of a medical label is (...) done without the participation of those individuals who are being labelled, and second, when attempts by those individuals to renegotiate the labels are thwarted or otherwise rendered ineffective. In both cases, we argue, individuals are unfairly excluded from a linguistic practice that would be valuable for them to participate in. Furthermore, we argue that their exclusion depends in part on the authority of the medical institution to ignore their demands for participation. In making this case, we will propose the more general claim that participating in the linguistic processes of determining and renegotiating the words that will be used to describe oneself is an exercise of linguistic agency, a capacity that has both instrumental and intrinsic value. (shrink)

Alongside clinical practice, medical schools now confront mounting reasons to examine nontraditional approaches to ethics. Increasing awareness of systems of oppression and their effects on the experiences of trainees, patients, professionals, and generally on medical care, is pushing medical curriculum into an unfamiliar territory. While there is room throughout medical school to take up these concerns, ethics curricula are well-positioned to explore new pedagogical approaches. Feminist ethics has long addressed systems of oppression and broader structures of power. Some of its (...) established concepts can offer distinct value as medical climates change and adapt in response to increased awareness of the experiences of marginalized individuals and populations. In this essay, we offer a set of concepts from feminist ethics that have a fundamental role to play in medical school curriculum: relationality, relational autonomy, and epistemic justice. Though these concepts are not exhaustive, they can be taught in tandem with the concepts that have historically grounded ethics education in medical school, such as autonomy and beneficence. Ultimately, we contend that these concepts hold particular value in ethics curriculum insofar as they diversify mainstream ethical approaches, directly address the pervasiveness of systems of oppression in medicine, and recognize the voices and concerns that may be marginalized in standard approaches. (shrink)

Patient-centred communication is widely regarded as a best practice in contemporary medical care, both in terms of maximising health outcomes and respecting persons. However, not all patients communicate in ways that are easily understood by clinicians and other healthcare professionals. This is especially so for patients with non-speaking intellectual disabilities. We argue that assumptions about intellectual disability—including those in diagnostic criteria, providers’ implicit attitudes and master narratives of disability—negatively affect communicative approaches towards intellectually disabled patients.Non-speakingintellectually disabled patients may also be (...) taken to lack decision-making capacity and resultingly, may be given very little role in determining their care. But, given evidence of the heterogeneous communicative practices available to non-speaking patients, efforts should be made to extend patient-centred communication to them. We offer four suggestions for doing so: (1) treating those with non-speaking intellectual disabilities as potential communicators; (2) lengthening appointment times to develop relationships necessary for communication; (3) disentangling capacity from communication in concept and in practice; and (4) recognising the bidirectional connection between supported decision-making and patient-centred communication. (shrink)

Background: Patients undergoing invasive neurosurgical procedures offer researchers unique opportunities to study the brain. Deep brain stimulation patients, for example, may participate in research during the surgical implantation of the stimulator device. Although this research raises many ethical concerns, little attention has been paid to basic studies, which offer no therapeutic benefits, and the value of patient-participant perspectives.Methods: Semi-structured interviews were conducted with fourteen individuals across two studies who participated in basic intraoperative research during their deep brain stimulator surgery. Interviews (...) explored interpretations of risks and benefits, enrollment motivations, and experiences of participating in awake brain research. Reflexive thematic analysis was conducted.Results: Seven themes were identified from participant narratives, including robust attitudes of trust, high valuations of basic science research, impacts of the surgical context, and mixed experiences of participation.Conclusion: We argue that these narratives raise the potential for a translational misconception and motivate intraoperative re-consent procedures. (shrink)

The field of neurotechnology intervening on blindness is rapidly expanding with several visual neural prostheses currently in development (Lowery 2013; Niketeghad and Pouratian 2019; Ptito et al. 2...

What happens at the end of a clinical trial for an investigational neural implant? It may be surprising to learn how difficult it is to answer this question. While new trials are initiated with increasing regularity, relatively little consensus exists on how best to conduct them, and even less on how to ethically end them. The landscape of recent neural implant trials demonstrates wide variability of what happens to research participants after an neural implant trial ends. Some former research participants (...) continue to receive support for their devices (e.g., battery and component replacements, software updates, etc.). Others, when safe, have their neural implants removed through surgical explantation. Still others continue to live with a deactivated neural implant embedded in their body. In the United States, there are no uniform requirements to provide services, of any kind, after an neural implant study ends, and other nations are similarly facing this challenge. The existence of a post-trial gap in an expanding neural implant research ecosystem invites obvious questions: What is owed to neural implant research participants post-trial, and why has providing it been so difficult to accomplish in practice? To take a step forward on this difficult issue, we assembled one group of stakeholders – researchers funded for neuroethics grants by the National Institutes of Health – to explore possible starting points on one topic: ethical guidance for post-trial care of research participants in neural implant trials. Based on shared concerns discussed in the expert workshop the current paper is a call to action. It reports the key areas of convergence from the meeting and highlights important next steps towards developing much needed guidance. (shrink)

Motivated by exploitation concerns, we argue for the importance of participant engagement in basic human intracranial electrophysiology research. This research takes advantage of unique neurosurgical opportunities to better understand complex systems of the human brain, but it also exposes participants to additional risks without immediate therapeutic intent. We argue that understanding participant values and incorporating their perspectives into the research process may help determine whether and to what extent research practices and the resulting distributions of risks and benefits constitute exploitation (...) and contribute to building a brain research paradigm that is genuinely responsive to participant values. More broadly, we highlight the importance of paying attention to participant interests in non-therapeutic brain research. (shrink)

According to the powerful qualities view, properties are both powerful and qualitative. Indeed, on this view the powerfulness of a property is identical to its qualitativity. Proponents claim that this view provides an attractive alternative to both the view that properties are pure powers and the view that they are pure qualities. It remains unclear, however, whether the claimed identity between powerfulness and qualitativity can be made coherent in a way that allows the powerful qualities view to constitute this sort (...) of alternative. I argue here that this can be done, given a particular conception of both the qualitativity and powerfulness of properties. On this conception, a property is qualitative just in the sense that its essence is fixed independently of any distinct properties, and it is powerful just if its essence grounds its dispositional role. (shrink)

Ashley J. Bohrer argues that it is only by considering race, gender, sexuality, and ability within the structures of capitalism and imperialism that we can understand power relations. Bohrer explains how the purported incompatibilities between Marxism and intersectionality arise more from miscommunication than a fundamental conceptual antagonism.

Discussions about the nature of essence and about the inference problem for non-Humean theories of nomic modality have largely proceeded independently of each other. In this article I argue that the right conclusions to draw about the inference problem actually depend significantly on how best to understand the nature of essence. In particular, I argue that this conclusion holds for the version of the inference problem developed and defended by Alexander Bird. I argue that Bird’s own argument that this problem (...) is fatal for David Armstrong’s influential theory of the laws of nature but not for dispositional essentialism is seriously flawed. In place of this argument, I develop an argument that whether Bird’s inference problem raises serious difficulties for Armstrong’s theory depends on the answers to substantial questions about how best to understand essence. The key consequence is that considerations about the nature of essence have significant, underappreciated implications for Armstrong’s theory. (shrink)

Programmatic secularism aims to secure public reason from rival rationalities, notably those from religious experience and education. The gathering of knowledge in clinical ethics into a concrete array of consensus claims and consensus-derived principles are thought by Janet Malek to secure such public reason—an essential tool for clinical ethics consultants to execute their professional role. The author compares this gathering of knowledge to an understanding of what technology is. Accordingly, the following interrogates Malek’s programmatic secularism, which is a moral technique (...) that not only homogenizes moral dialogue but also dehumanizes persons as it tyrannizes the creative freedom for moral conversation and genuine encounter. Thus, the reader is encouraged to dissent of such a vision for delimiting the role of clinical ethics consultants according to the rule and measure of technology, the ontology of our age. (shrink)

According to a well-known argument, originally due to David Armstrong, powers theory is objectionable, as it leads to a ‘Meinongian’ ontology on which some entities are real but do not actually exist. I argue here that the right conclusion to draw from this argument has thus far not been identified and that doing so has significant implications for powers theory. Specifically, I argue that the key consequence of the argument is that it provides substantial grounds for trope powers theorists, but (...) not other powers theorists, to accept one version of the view that properties are powerful qualities. In particular, they have grounds to favour the view that powerful properties are properties with exclusively qualitative natures that ground modal facts. (shrink)

This paper explores the influence of transpersonal thinking, including the mythological perspective of Joseph Campbell and the holotropic perspective of Stanislav Grof, on actor training using the neutral mask. An outline of training in the neutral mask is given, focusing on the approach of David Latham, as experienced by the author in his own training. Points of correspondence with the vision of Campbell and Grof, and their influence, are discriminated and discussed. These correspondences open up two areas of inquiry: the (...) transformative effect of the mask work when conducted in a transpersonally-oriented set, and the use of the neutral mask as an approach to the study of myth and archetype. Both are discussed, and some preliminary conclusions drawn based on experiences reported by student-actors and the author’s observations during his own research and his practice as actor and teacher. (shrink)

The age of modern biomedical science has raised many difficult ethical questions. Accordingly, leaders in bioethics have articulated methods to direct the on-going discourse while providing the systems necessary for making morally efficient decisions. In this thought-provoking study, Ashley John Moyse suggests a theory of ethics that interrupts and transforms the contemporary and abstract modes of moral discourse. Moyse moves the moral discussion of bioethics beyond abstract ends, obligations, and common moral categories. At the same time, he challenges readers (...) to take seriously the concrete moral tasks of existence. Moyse engages with Karl Barth's philosophical and theological thinking in order to investigate the moral discussions surrounding biomedical ethics. The book engagingly illuminates a path toward moral discernment that recognizes the significance of human flourishing. According to Moyse, Barth's moral theology not only grounds humans as ontologically relational but also fuels responsibility to, with, and for one's neighbors. (shrink)

It is often taken for granted that our desires can contribute to what it is rational for us to do. This paper examines an account of desire—the ‘guise of the good’— that promises an explanation of this datum. I argue that extant guise-of-the-good accounts fail to provide an adequate explanation of how a class of desires—basic desires—contributes to practical rationality. I develop an alternative guise-of-the-good account on which basic desires attune us to our reasons for action in virtue of their (...) biological function. This account emphasises the role of desire as part of our competence to recognise and respond to normative reasons. (shrink)

I defend a new account of constitutive essence on which an entity’s constitutively essential properties are its most fundamental, nontrivial necessary properties. I argue that this account accommodates the Finean counterexamples to classic modalism about essence, provides an independently plausible account of constitutive essence, and does not run into clear counterexamples. I conclude that this theory provides a promising way forward for attempts to produce an adequate nonprimitivist, modalist account of essence. As both triviality and fundamentality in the account are (...) understood in terms of grounding, the theory also potentially has important implications for the relation between essence and grounding. (shrink)

Recent research indicates that interpersonal communication is noisy, and that people exhibit considerable insensitivity to problems in communication. Using a dyadic referential communication task, the goal of which is accurate information transfer, this study examined the extent to which interlocutors are sensitive to problems in communication and use other‐initiated repairs (OIRs) to address them. Participants were randomly assigned to dyads (N = 88 participants, or 44 dyads) and tried to communicate a series of recurring abstract geometric shapes to a partner (...) across a text–chat interface. Participants alternated between directing (describing shapes) and matching (interpreting shape descriptions) roles across 72 trials of the task. Replicating prior research, over repeated social interactions communication success improved and the shape descriptions became increasingly efficient. In addition, confidence in having successfully communicated the different shapes increased over trials. Importantly, matchers were less confident on trials in which communication was unsuccessful, communication success was lower on trials that contained an OIR compared to those that did not contain an OIR, and OIR trials were associated with lower Director Confidence. This pattern of results demonstrates that (a) interlocutors exhibit (a degree of) sensitivity to problems in communication, (b) they appropriately use OIRs to address problems in communication, and (c) OIRs signal problems in communication. (shrink)

A recent, seemingly appealing version of the powerful qualities view defines properties’ qualitativity via an essentialist claim and their powerfulness via a grounding claim. Roughly, this approach holds that properties are qualities because they have qualitative essences, while they are powerful because their instances or essences ground causal-modal facts. I argue that this theory should be replaced with one that defines the powerfulness of qualities in terms of both a grounding claim and a ‘meta-grounding’ claim. Specifically, I formulate and defend (...) a view on which qualities are powerful just if instances of those qualitiesat least partiallyground dispositionsin virtue of the essences of those qualities. (shrink)

For more than a decade, the United States has been fighting wars so far from the public eye as to risk being forgotten, the struggles and sacrifices of its volunteer soldiers almost ignored. Photographer and writer Ashley Gilbertson has been working to prevent that. His dramatic photographs of the Iraq war for the New York Times and his book Whiskey Tango Foxtrot took readers into the mayhem of Baghdad, Ramadi, Samarra, and Fallujah. But with Bedrooms of the Fallen, Gilbertson (...) reminds us that the wars in Afghanistan and Iraq have also reached deep into homes far from the noise of battle, down quiet streets and country roads—the homes of family and friends who bear their grief out of view. The book’s wide-format black-and-white images depict the bedrooms of forty fallen soldiers—the equivalent of a single platoon—from the United States, Canada, and several European nations. Left intact by families of the deceased, the bedrooms are a heartbreaking reminder of lives cut short: we see high school diplomas and pictures from prom, sports medals and souvenirs, and markers of the idealism that carried them to war, like images of the Twin Towers and Osama Bin Laden. A moving essay by Gilbertson describes his encounters with the families who preserve these private memorials to their loved ones, and shares what he has learned from them about war and loss. Bedrooms of the Fallen is a masterpiece of documentary photography, and an unforgettable reckoning with the human cost of war. (shrink)

According to a well-known argument against dispositional essentialism, the nature of unmanifested token powers leaves dispositional essentialists with an objectionable commitment to the reality of non-existent entities. The idea is that, because unmanifested token powers are directed at their non-existent token manifestations, they require the reality of those manifestations. Arguably the most promising response to this argument works by claiming that, if properties are universals, dispositional directedness need only entail the reality of actually existing manifestation types. I argue that this (...) response fails, because no version of the response can adequately accommodate dispositions of the sort that follow from Coulomb’s law. This result both defeats an important argument that dispositional essentialists ought to be realists about universals and appears to leave dispositional essentialists with a problematic commitment to either non-relational connections or a Meinongian ontology. (shrink)

Understanding everyday behavior relies heavily upon understanding our ability to improvise, how we are able to continuously anticipate and adapt in order to coordinate with our environment and others. Here we consider the ability of musicians to improvise, where they must spontaneously coordinate their actions with co-performers in order to produce novel musical expressions. Investigations of this behavior have traditionally focused on describing the organization of cognitive structures. The focus, here, however, is on the ability of the time-evolving patterns of (...) inter-musician movement coordination as revealed by the mathematical tools of complex dynamical systems to provide a new understanding of what potentiates the novelty of spontaneous musical action. We demonstrate this approach through the application of cross wavelet spectral analysis, which isolates the strength and patterning of the behavioral coordination that occurs between improvising musicians across a range of nested time-scales. Revealing the sophistication of the previously unexplored dynamics of movement coordination between improvising musicians is an important step towards understanding how creative musical expressions emerge from the spontaneous coordination of multiple musical bodies. (shrink)

Racial inequities in medicine are the consequence of intersecting, multidimensional factors. As detailed in the articles by Braddock, Mithani, Cooper, and Boyd, and Yearby, the...

Developing a care plan in a critical care context can be challenging when the therapeutic alliance between clinicians and families is compromised by anger. When these cases occur, clinicians often turn to clinical ethics consultants to assist them with repairing this alliance before further damage can occur. This paper describes five different reasons family members may feel and express anger and offers concrete strategies for clinical ethics consultants to use when working with angry families acting as surrogate decision makers for (...) critical care patients. We reviewed records of consults using thematic analysis between January 2015 and June 2016. Each case was coded to identify whether the case involved a negative encounter with an angry family. In our review, we selected 11 cases with at least one of the following concerns or reasons for anger: perceived or actual medical error, concerns about the medical team’s competence, miscommunication, perceived conflict of interest or commitment, or loss of control. To successfully implement these strategies, clinical ethics consultants, members of the medical team, and family members should share responsibility for creating a mutually respectful relationship. (shrink)

Taylor has recently argued that adopting either the standard Kimian or Davidsonian approaches to the metaphysics of events quite directly solves the regress of pure powers. I argue, though, that on closer inspection Taylor’s proposal does not succeed, given either the Kimian or the Davidsonian account of events.

Many philosophers have suggested that claims of need play a special normative role in ethical thought and talk. But what do such claims mean? What does this special role amount to? Progress on these questions can be made by attending to a puzzle concerning some linguistic differences between two types of 'need' sentence: one where 'need' occurs as a verb, and where it occurs as a noun. I argue that the resources developed to solve the puzzle advance our understanding of (...) the metaphysics of need, the meaning of 'need' sentences, and the function of claims of need in ethical discourse. (shrink)

Musical improvisation is a natural case of human pattern formation, and Walton and colleagues investigate the way that different contextual constraints affect patterns of improvisation and their aesthetic quality. The authors find that coordination patterns are more diversified between two musicians when the musical space in which to improvise is relatively more constrained. They also find that listeners experience more diversified, complementary patterns between musicians as more enjoyable and harmonious.

Ashley Woodward demonstrates what a new generation of scholars are just discovering: that Lyotard's incisive work is essential for current debates in the humanities. Lyotard's ideas about the arts and the confrontations between humanist traditions and cutting-edge sciences and technologies are today known as 'posthumanism'. Woodward presents a series of studies to explain Lyotard's specific interventions in information theory, new media arts and the changing nature of the human. He assesses their relevance and impact in relation to a number (...) of important contemporary thinkers including Bernard Stiegler, Luciano Floridi, Quentin Meillassoux and Paul Virilio. (shrink)

While the inference problem is widely thought to be one of the most serious problems facing non-Humean accounts of laws, Jonathan Schaffer has argued that a primitivist response straightforwardly dissolves the problem. On this basis, he claims that the inference problem is really a pseudo-problem. Here I clarify the prospects of a primitivist response to the inference problem and their implications for the philosophical significance of the problem. I argue both that it is a substantial question whether this sort of (...) response ought to be accepted and that the inference problem, contra Schaffer, remains a significant problem with important implications for the non-Humean position. I also argue that this discussion indicates grounds to be wary about applying the Schaffer-style strategy of straightforwardly dissolving problems by stipulation to other philosophical problems. (shrink)

An ongoing debate in affective science concerns whether certain discrete, “basic” emotions have evolutionarily based signals that are easily, universally, and innatel...

Disability studies in education scholars have discussed the need to engage students, and certainly preservice teachers, in critical discussion of disability as a concept. To better understand what such critical discussion entails, Ashley Taylor examines the pedagogical implications of promoting an understanding of disability as a shared experience of being human. In particular, Taylor is concerned with how the appeal to a shared experience of disability might contribute to or impede students' development of critical attitudes toward ableist social and (...) educational practices. She describes two chief limitations of the shared reality view and argues that these complicate efforts to teach about disability in ways that avoid reinforcing students' existing beliefs. Taylor concludes by offering a pedagogical framework that retains valuable aspects of the shared reality view while avoiding its limitations. (shrink)

In this paper I argue that ethics and evidence are intricately intertwined within the clinical practice of differential diagnosis. Too often, when a disease is difficult to diagnose, a physician will dismiss it as being “not real” or “all in the patient’s head.” This is both an ethical and an evidential problem. In the paper my aim is two-fold. First, via the examination of two case studies (late-stage Lyme disease and Addison’s disease), I try to elucidate why this kind of (...) dismissal takes place. Then, I propose a potential solution to the problem. I argue that instead of dismissing a patient’s illness as “not real,” physicians ought to exercise a compassionate suspension of judgment when a diagnosis cannot be immediately made. I argue that suspending judgment has methodological, epistemic, and ethical virtues and therefore should always be preferred to patient dismissal in the clinical setting. (shrink)

The idea that animals make things has entered into popular news and public understanding, but inclusion of animal artifacts within engineering and technology studies lags. This volume works to unite animal construction literature with concepts from epistemology of technology.

What does the development of a truly robust contemporary theory of domination require? Ashley J. Bohrer argues that it is only by considering all of the dimensions of race, gender, sexuality, and class within the structures of capitalism and imperialism that we can understand power relations as we find them nowadays. Bohrer explains how many of the purported incompatibilities between Marxism and intersectionality arise more from miscommunication rather than a fundamental conceptual antagonism. As the first monograph entirely devoted to (...) this issue, »Marxism and Intersectionality« serves as a tool to activists and academics working against multiple systems of domination, exploitation, and oppression. (shrink)

Modern longitudinal studies collect feature data at many timepoints, often of the same order of sample size. Such studies are typically affected by dropout and positivity violations. We tackle these problems by generalizing effects of recent incremental interventions to accommodate multiple outcomes and subject dropout. We give an identifying expression for incremental intervention effects when dropout is conditionally ignorable and derive the nonparametric efficiency bound for estimating such effects. Then we present efficient nonparametric estimators, showing that they converge at fast (...) parametric rates and yield uniform inferential guarantees, even when nuisance functions are estimated flexibly at slower rates. We also study the variance ratio of incremental intervention effects relative to more conventional deterministic effects in a novel infinite time horizon setting, where the number of timepoints can grow with sample size and show that incremental intervention effects yield near-exponential gains in statistical precision in this setup. Finally, we conclude with simulations and apply our methods in a study of the effect of low-dose aspirin on pregnancy outcomes. (shrink)