In this article, I cast doubt on an apparent truism, namely, that if evidence is available for gathering and use at a negligible cost, then it’s always instrumentally rational for us to gather that evidence and use it for making decisions. Call this ‘value of information’ (VOI). I show that VOI conflicts with two other plausible theses. The first is the view that an agent’s evidence can entail non-trivial propositions about the external world. The second is the view that epistemic (...) rationality requires us to update our credences by conditionalization. These two theses, given some plausible assumptions, make room for rationally biased inquiries where VOI fails. I go on to argue that this is bad news for defenders of VOI. (shrink)

An important question in epistemology is whether the KK principle is true, i.e., whether an agent who knows that p is also thereby in a position to know that she knows that p. We explain how a “transparency” account of self-knowledge, which maintains that we learn about our attitudes towards a proposition by reflecting not on ourselves but rather on that very proposition, supports an affirmative answer. In particular, we show that such an account allows us to reconcile a version (...) of the KK principle with an “externalist” or “reliabilist” conception of knowledge commonly thought to make that principle particularly problematic. (shrink)

According to Bayesian orthodoxy, an agent should update---or at least should plan to update---her credences by conditionalization. Some have defended this claim by means of a diachronic Dutch book argument. They say: an agent who does not plan to update her credences by conditionalization is vulnerable (by her own lights) to a diachronic Dutch book, i.e., a sequence of bets which, when accepted, guarantee loss of utility. Here, I show that this argument is in tension with evidence externalism, i.e., the (...) view that an agent's evidence can entail non-trivial propositions about the external world. I argue that this tension casts doubt on the idea that diachronic Dutch books can be used to justify or vindicate updating plans. (shrink)

Many have claimed that epistemic rationality sometimes requires us to have imprecise credal states (i.e. credal states representable only by sets of credence functions) rather than precise ones (i.e. credal states representable by single credence functions). Some writers have recently argued that this claim conflicts with accuracy-centered epistemology, i.e., the project of justifying epistemic norms by appealing solely to the overall accuracy of the doxastic states they recommend. But these arguments are far from decisive. In this essay, we prove some (...) new results, which show that there is little hope for reconciling the rationality of credal imprecision with accuracy-centered epistemology. (shrink)

It is widely supposed that evolutionary debunking arguments against morality constitute a type of epistemological objection to our moral beliefs. In particular, the debunking force of such arguments is not supposed to depend on the metaphysical claim that moral facts do not exist. In this paper I argue that this standard epistemological construal of EDAs is highly misleading, if not mistaken. Specifically, I argue that the most widely discussed EDAs all make key and controversial metaphysical claims about the nature of (...) morality or the possibility of moral truth that belie their apparently epistemological character. I show that the debunking force of these EDAs derives largely from metaphysical claims about morality and their implications for the possibility of moral reduction, rather than from epistemological worries associated with the existence of an causal/non-moral explanation of our moral judgments. The paper briefly concludes with a dilemma that I believe confronts all EDAs such as those discussed in this paper: either such arguments are unsound, or else they prove too much, debunking our knowledge of science and the external world, as well as morality. (shrink)

This essay explores a problem for Nyāya epistemologists. It concerns the notion of pramā. Roughly speaking, a pramā is a conscious mental event of knowledge-acquisition, i.e., a conscious experience or thought in undergoing which an agent learns or comes to know something. Call any event of this sort a knowledge-event. The problem is this. On the one hand, many Naiyāyikas accept what I will call the Nyāya Definition of Knowledge, the view that a conscious experience or thought is a knowledge-event (...) just in case it is true and non-recollective. On the other hand, they are also committed to what I shall call Nyāya Infallibilism, the thesis that every knowledge-event is produced by causes that couldn’t have given rise to an error. These two commitments seem to conflict with each other in cases of epistemic luck, i.e., cases where an agent arrives a true judgement accidentally or as a matter of luck. While the Nyāya Definition of Knowledge seems to predict that these judgements are knowledge-events, Nyāya Infallibilism seems to entail that they aren’t. In this essay, I show that Gaṅgeśa Upādhyāya, the 14th century Naiyāyika, solves this problem by adopting what I call epistemic localism, the view that upstream causal factors play no epistemically significant role in the production of knowledge. (shrink)

A ‘companions in guilt’ strategy against moral error theory aims to show that the latter proves too much: if sound, it supports an implausible error-theoretic conclusion in other areas such as epistemic or practical reasoning. Christopher Cowie [2016 Cowie, C. 2016. Good News for Moral Error Theorists: A Master Argument Against Companions in Guilt Strategies, Australasian Journal of Philosophy 94/1: 115–30.[Taylor & Francis Online], [Web of Science ®] [Google Scholar]] has recently produced what he claims is a ‘master argument’ against (...) all such strategies. The essence of his argument is that CG arguments cannot work because they are afflicted by internal incoherence or inconsistency. I argue, first, that Cowie's master argument does not succeed. Beyond this, I argue that there is no good reason to think that any such argument—one that purports to identify an internal incoherence in CG arguments—can succeed. Second, I argue that the main substantive area of disagreement between error theorists and CG theorists essentially concerns the conceptual profile of epistemic reasons—specifically, whether they are strongly categorical—not the ontological question of whether such reasons exist. I then develop an argument in favour of the CG theorist's position by considering the moral error theorist's arguments in support of the conceptual claim that moral reasons are strongly categorical. These include, notably, criticisms made by Joyce [2011] and Olson [2014] of Finlay's [2008] ‘end relational’ view of morality, according to which moral reasons are relative to some end or standard, hence not strongly categorical. Examining these criticisms, I argue that, based on what moral error theorists have said regarding the conceptual profile of moral reasons, there is a strong case to be made that moral reasons are strongly categorical if and only if epistemic reasons are. (shrink)

Recently, several epistemologists have defended an attractive principle of epistemic rationality, which we shall call Ur-Prior Conditionalization. In this essay, I ask whether we can justify this principle by appealing to the epistemic goal of accuracy. I argue that any such accuracy-based argument will be in tension with Evidence Externalism, i.e., the view that agent's evidence may entail non-trivial propositions about the external world. This is because any such argument will crucially require the assumption that, independently of all empirical evidence, (...) it is rational for an agent to be certain that her evidence will always include truths, and that she will always have perfect introspective access to her own evidence. This assumption is in tension with Evidence Externalism. I go on to suggest that even if we don't accept Evidence Externalism, the prospects for any accuracy-based justification for Ur-Prior Conditionalization are bleak. (shrink)

This 44-chapter volume tackles a quickly-evolving field of inquiry, mapping the existing discourse as part of a general attempt to place current developments in historical context; at the same time, breaking new ground in taking on novel subjects and pursuing fresh approaches. The term "A.I." is used to refer to a broad range of phenomena, from machine learning and data mining to artificial general intelligence. The recent advent of more sophisticated AI systems, which function with partial or full autonomy and (...) are capable of tasks which require learning and 'intelligence', presents difficult ethical questions, and has drawn concerns from many quarters about individual and societal welfare, democratic decision-making, moral agency, and the prevention of harm. This work ranges from explorations of normative constraints on specific applications of machine learning algorithms today-in everyday medical practice, for instance-to reflections on the (potential) status of AI as a form of consciousness with attendant rights and duties and, more generally still, on the conceptual terms and frameworks necessarily to understand tasks requiring intelligence, whether "human" or "A.I.". (shrink)

In this paper I evaluate some recent virtue-ethical accounts of right action [Hursthouse 1999; Slote 2001; Swanton 2001]. I argue that all are vulnerable to what I call the insularity objection : evaluating action requires attention to worldly consequences external to the agent, whereas virtue ethics is primarily concerned with evaluating an agent's inner states. More specifically, I argue that insofar as these accounts are successful in meeting the insularity objection they invite the circularity objection : they end up relying (...) upon putatively virtue-ethical considerations that themselves depend on unexplained judgments of rightness. Such accounts thus face a dilemma that is characteristic of virtue-ethical accounts of right action. They avoid the insularity objection only at the cost of inviting the circularity objection: they become intuitively plausible roughly to the extent that they lose their distinctively virtue-ethical character. (shrink)

In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often (...) used to explicitly or implicitly reference interventions that do not fall under the standard account. The authors offer an alternative ‘schematic’ definition of invasiveness, whereby medical interventions entail an underlying context-independent property of ‘basic invasiveness’ and may be understood both relative to each other and to a context-specific threshold of what is ‘invasive’. 1 We propose that the meaning of terms such as ‘invasiveness’ is necessarily heterogeneous,... (shrink)

This paper is about a tension between two theses. The first is Value of Evidence: roughly, the thesis that it is always rational for an agent to gather and use cost‐free evidence for making decisions. The second is Rationality of Imprecision: the thesis that an agent can be rationally required to adopt doxastic states that are imprecise, i.e., not representable by a single credence function. While others have noticed this tension, I offer a new diagnosis of it. I show that (...) it arises when an agent with an imprecise doxastic state engages in an unreflective inquiry, an inquiry where they revise their beliefs using an updating rule that doesn't satisfy a weak reflection principle. In such an unreflective inquiry, certain synchronic norms of instrumental rationality can make it instrumentally irrational for an agent to gather and use cost‐free evidence. I then go on to propose a diachronic norm of instrumental rationality that preserves Value of Evidence in unreflective inquiries. This, I suggest, may help us reconcile this thesis with Rationality of Imprecision. (shrink)

In their forthcoming article, Shavelson and colleagues (2023) identify a key ethical concern associated with medical aid-in-dying (MAiD) laws in the eleven US jurisdictions where the practice is le...

This comprehensive analysis dives deep into the intricate interplay between artificial intelligence (AI) and human agency, examining the remarkable capabilities and inherent limitations of large language models (LLMs) such as GPT-3 and ChatGPT. The paper traces the complex trajectory of AI's evolution, highlighting its operation based on statistical pattern recognition, devoid of self-consciousness or innate comprehension. As AI permeates multiple spheres of human life, it raises substantial ethical, legal, and societal concerns that demand immediate attention and deliberation. The metaphorical illustration (...) of humans as “shepherds” of AI, coupled with a thought-provoking examination of “agency without intelligence,” engenders deep reflections on the future of human-AI interplay and the associated philosophical, ethical, and practical ramifications. The paper further elucidates critical challenges associated with AI, such as ethical dilemmas, “agency without intelligence,” the role of human oversight, and the environmental impact of AI technologies. In the pursuit of solutions, the paper maps prospective directions, emphasizing the need for robust AI policies, improved AI literacy, sustainable AI practices, and a continued dialogue on the multifaceted issues surrounding AI. Through a holistic exploration of AI, this paper underlines the necessity for a multidisciplinary, collaborative approach to chart an ethical, beneficial, and sustainable AI future, enabling society to harness the potential of AI responsibly while mitigating the associated risks. (shrink)

Short overview of the From Small Beginnings Project and its relevance for resisting eugenics in contemporary society.

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

We read with interest Dominic Wilkinson’s article “Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?” on the utility of the Clinical Frailty Score in...

There exists in academic medicine a core ethical issue that is seldom pursued: trainees are frequently not the best person in the operating room at a given intervention being performed, and yet as a profession we understand a fundamental need to afford them opportunities to perform. Academic centres are traditionally associated with a higher quality of care than non-academic centres, suggesting that practical measures exist within teaching hospitals that effectively mask the clinical discrepancies between trainees and their preceptors. Nonetheless, we (...) are bound by our ethical commitments as physicians to balance the obligations of care with the duty to teach. In order to ethically validate the model of ‘surgeon as teacher’, we propose that there must be a reconciliation of the tensions between traditional professional values in medicine with the constraints inherent in a time-bound utilitarian medical system. Ultimately, we must consciously accept that ensuring the longitudinal availability of skilled surgeons in society aligns more closely with our core ethical obligations as outlined in the social contract that medical professionals maintain with the general public than does the ethical demand to provide unreservedly individual-focused patient care. It is the duty of individual practitioners, as a necessity of lineage to maintain and fulfil our greater duties to society, to foster deontological relationships where possible within this utilitarian system while accepting short-term imperfection in our practice. There are no data in this manuscript. (shrink)

Objective: To examine the role of explainability in machine learning for healthcare (MLHC), and its necessity and significance with respect to effective and ethical MLHC application. Study Design and Setting: This commentary engages with the growing and dynamic corpus of literature on the use of MLHC and artificial intelligence (AI) in medicine, which provide the context for a focused narrative review of arguments presented in favour of and opposition to explainability in MLHC. Results: We find that concerns regarding explainability are (...) not limited to MLHC, but rather extend to numerous well-validated treatment interventions as well as to human clinical judgment itself. We examine the role of evidence-based medicine in evaluating unexplainable treatments and technologies, and highlight the analogy between the concept of explainability in MLHC and the related concept of mechanistic reasoning in evidence-based medicine. Conclusion: Ultimately, we conclude that the value of explainability in MLHC is not intrinsic, but is instead instrumental to achieving greater imperatives such as performance and trust. We caution against the uncompromising pursuit of explainability, and advocate instead for the development of robust empirical methods to successfully evaluate increasingly inexplicable algorithmic systems. (shrink)

In Sanskrit philosophy, the closest analogue of intuition is pratibhā. Here, I will focus on the theory of pratibhā offered by the Sanskrit grammarian Bhartṛhari (fifth century CE). On this account, states of pratibhā play two distinct psychological roles. First, they serve as sources of linguistic understanding. They are the states by means of which linguistically competent agents effortlessly understand the meaning of novel sentences. Second, states of pratibhā serve as sources of practical knowledge. On the basis of such states, (...) both human and non-human agents unreflectively know which actions they should perform under which circumstances. Given these two roles of pratibhā, modern commentators have often claimed that states of pratibhā, as understood by Bhartṛhari, are intuitions. In this article, I will reconstruct Bhartṛhari's view and to explore its consequences, I will argue that, if Bhartṛhari’s theory of pratibhā is right, then a form of human exceptionalism – which makes rationality a unique trait of human beings – becomes difficult to maintain. (shrink)

Volume 19, Issue 6, June 2019, Page 34-36.

Textures of the Ordinary shows how anthropology finds a companionship with philosophy in the exploration of everyday life. Based on two decades of ethnographic work among low-income urban families in India, Das shows how the notion of texture aligns ethnography with the anthropological tone in Wittgenstein and Cavell, as well as in literary texts. The book shows different routes of return to the everyday as it is corroded not only by catastrophic events but also by repetitive and routine violence within (...) everyday life itself. As an alternative to normative ethics, this book develops ordinary ethics as attentiveness to the other and as the ability of small acts of care to stand up to horrific violence. Textures of the Ordinary offers a model of thinking in which concepts and experience are shown to be mutually vulnerable. The book is an intellectually intimate invitation into the ordinary, that which is most simple yet most difficult to perceive in our lives. (shrink)

In this essay, my aim is to explain Vātsyāyana’s solution to a problem that arises for his theory of liberation. For him and most Nyāya philosophers after him, liberation consists in the absolute cessation of pain. Since this requires freedom from embodied existence, it also results in the absolute cessation of pleasure. How, then, can agents like us be rationally motivated to seek liberation? Vātsyāyana’s solution depends on what I will call the Pain Principle, i.e., the principle that we should (...) treat all aspects of our embodied existence as pain. If we were to follow this advice, we would come to apply the label of pain to all aspects of our embodied existence, including pleasure. This would undermine our attachment to our own embodied existence. I show that this fits with Vātsyāyana’s general theory of motivation. According to this theory, by manipulating the labels using which we think about the world and ourselves, we can induce radical shifts in our patterns of motivation. (shrink)

Within the climate justice debate, the ‘beneficiary pays’ principle holds that those who benefit from greenhouse emissions associated with industrialization ought to pay for the costs of mitigating and adapting to their adverse effects. This principle constitutes a claim of inter-generational justice, and it is widely believed that the non-identity problem raises serious difficulties for any such claim. After briefly sketching the rationale behind ‘beneficiary pays,’ this paper offers a new way of understanding the claim that persons in developed societies (...) have benefited from industrialization. It argues that when we think of the claim in this new way, it evades the non-identity problem entirely. Some objections to this approach are then considered and rebutted. The paper concludes by comparing the present, relatively modest solution to the nonidentity problem with a much more ambitious attempt from the recent literature. (shrink)

BackgroundResponsive neurostimulation has been utilized as a treatment for intractable epilepsy. The RNS System delivers stimulation in response to detected abnormal activity, via leads covering the seizure foci, in response to detections of predefined epileptiform activity with the goal of decreasing seizure frequency and severity. While thalamic leads are often implanted in combination with cortical strip leads, implantation and stimulation with bilateral thalamic leads alone is less common, and the ability to detect electrographic seizures using RNS System thalamic leads is (...) uncertain.ObjectiveThe present study retrospectively evaluated fourteen patients with RNS System depth leads implanted in the thalamus, with or without concomitant implantation of cortical strip leads, to determine the ability to detect electrographic seizures in the thalamus. Detailed patient presentations and lead trajectories were reviewed alongside electroencephalographic analyses.ResultsAnterior nucleus thalamic leads, whether bilateral or unilateral and combined with a cortical strip lead, successfully detected and terminated epileptiform activity, as demonstrated by Cases 2 and 3. Similarly, bilateral centromedian thalamic leads or a combination of one centromedian thalamic alongside a cortical strip lead also demonstrated the ability to detect electrographic seizures as seen in Cases 6 and 9. Bilateral pulvinar leads likewise produced reliable seizure detection in Patient 14. Detections of electrographic seizures in thalamic nuclei did not appear to be affected by whether the patient was pediatric or adult at the time of RNS System implantation. Sole thalamic leads paralleled the combination of thalamic and cortical strip leads in terms of preventing the propagation of electrographic seizures.ConclusionThalamic nuclei present a promising target for detection and stimulation via the RNS System for seizures with multifocal or generalized onsets. These areas provide a modifiable, reversible therapeutic option for patients who are not candidates for surgical resection or ablation. (shrink)

As Alfandre and colleagues describe in “Between Usual and Crisis Phases of a Public Health Emergency: The Mediating Role of Contingency Measures”, efforts to maintain standards of care durin...

How do senior business executives rank their preferences for various ethical principles? And how strongly do the executives believe in these principles? Also, how do these preference rankings relate to the way the executives see the future (wherein business decisions play out)? Research on these questions may provide us with an appreciation of the complexities of ethical behavior in management beyond the traditional issues concerning ethical decision-making in business. Based on a survey of 585 vice presidents of U.S. businesses it (...) was found that: (1) there is a distinct set of principles of ethical conduct that is considered favorable as opposed to another set considered unfavorable among a comprehensive list of 14 ethical principles; (2) the executives believed overwhelmingly that their own individual ethical preferences are better than those of other executives; (3) the strength of their preferences for ethical principles is associated with whether the executives are relatively near-future oriented or more distant-future oriented; and (4), there are very few significant differences in terms of gender, age, education level, private/public education, prestigious/other schools, business/non-business academic backgrounds, and length of job experience. Implications of these findings are discussed. (shrink)

In classical South Asia, most philosophers thought that the self (if it exists at all) is what the first-person pronoun ‘I’ stands for. It is something that persists through time, undergoes conscious thoughts and experiences, and exercises control over actions. The Buddhists accepted the ‘no self’ thesis: they denied that such a self is substantially real. This gave rise to a puzzle for these Buddhists. If there is nothing substantially real that ‘I’ stands for, what are we talking about when (...) we speak of ourselves? In this paper, I present one Buddhist answer to this question, an answer that emerges from the work of the Abhidharma thinker Vasubandhu (4th to 5th century CE). (shrink)

This paper establishes a dialogue between the later works of Wittgenstein, those of Cavell and the novels of J. M. Coetzee concerning the problem of violence, authority and the authoritative voice. By drawing on J. M. Coetzee's Waiting for the Barbarians and Diary of a Bad Year, the paper discusses lessons and insights on the nature of violence and the ways in which it can be accepted as “normal.” The term “normalization” is used in order to show how violence and (...) cruelty can become a “form of life” that develops according to its own actors, cultural practices and legitimacies. (shrink)

In A Confection of Refutation (Khaṇḍanakhaṇḍakhādya), the twelfth-century philosopher and poet Śrīharṣa addresses a version of Meno’s paradox. This version of the paradox was well known in first millennium South Asia through the writings of two earlier Sanskrit philosophers, Śabarasvāmin (4th–5th century ce) and Śaṃkara (8th century ce). Both these thinkers proposed a solution to the paradox. I show how Śrīharṣa rejects this solution, and splits the old paradox into two new ones: the paradox of triviality and the paradox of (...) incoherence. I argue that these paradoxes are connected to Śrīharṣa’s broader pessimism about the possibility of successful rational inquiry into certain philosophical questions. (shrink)

This first full-length study of the Arabic reception of Plato's Timaeus considers the role of Galen of Pergamum in shaping medieval perceptions of the text as transgressing disciplinary norms. It argues that Galen appealed to the entangled cosmological scheme of the dialogue, where different relations connect the body, soul, and cosmos, to expand the boundaries of medicine in his pursuit for epistemic authority – the right to define and explain natural reality. Aileen Das situates Galen's work on disciplinary boundaries in (...) the context of medicine's ancient rivalry with philosophy, whose professionals were long seen as superior knowers of the cosmos vis-à-vis doctors. Her case studies show how Galen and four of the most important Christian, Muslim, and Jewish thinkers in the Arabic Middle Ages creatively interpreted key doctrines from the Timaeus to reimagine medicine and philosophy as well as their own intellectual identities. (shrink)

This paper questions a few assumptions of Gaṅgeśa Upādhyāya’s theory of ordinary verbal cognition (laukika-śābdabodha). The meaning relation (vṛtti) is of two kinds: śakti (which gives us the primary referent of a word) and lakṣaṇā (which yields the secondary referent). For Gaṅgeśa, the ground (bīja) of lakṣaṇā is a sort of inexplicability (anupapatti) pertaining to the composition (anvaya) of word-meanings. In this connection, one notices that the case of lakṣaṇā is quite similar to that of one variety of postulation, namely, (...) śrutārtāthāpatti, where the subject hears only a part of a sentence and immediately grasps the words that are needed to render the sentential meaning complete. Unless he does that, sentential meaning, i.e., the composition (anvaya) of word-meanings shall suffer from the same inexplicability that characterizes instances of lakṣaṇā. In fact, in the ‘Śaktivāda’ section of Tattvacintāmaṇi, Gaṅgeśa himself draws a parallel between the cognition of sentential meaning in a śrutārthāpatti-like case and the cognition of sentential meaning in an instance of lakṣaṇā. However, Gaṇgesa himself treats Śrutārthāpatti as a piece of inferential cognition. If there is no fundamental difference between cases of śrutārthāpatti and cases of lakṣaṇā, then the cognition of sentential meaning in instances of lakṣaṇā must also be inferential in essence. In that case, we must admit, against Gaṅgeśa’s view, that such cognition of sentential meaning cannot be accommodated within the framework of verbal cognition (śābdabodha). Therefore, I conclude that some revision is needed in Gaṅgeśa’s theory of verbal cognition with respect to lakṣaṇā. (shrink)

Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are (...) extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity. (shrink)

Intersexuality, particularly in the global South, remains an under‐researched field of study. In my in‐progress doctoral research project, I explore the cultural, social, and medical discourses that influence how key stakeholders such as healthcare providers make decisions about the sex and gender assignment of the intersex child in India. In this paper I interrogate some of these ideas around gender assignment of intersex people in India, paying particular attention to the context of son preference. I am interested in exploring how (...) decisions of gender assignment by medical professionals are guided by ideas of son preference. Focusing on four qualitative, semi‐structured, in‐depth interviews across two cities with medical doctors from different specializations, this paper is a preliminary attempt to examine some of the factors that guide medical professionals in making decisions about gender assignment of intersex children and explore the dynamics of the decision‐making process. Specifically, I explore the factors that inform doctors’ decision‐making and locate these decision‐making processes within the broader socio‐cultural context of India. (shrink)

The use of single-use items is now ubiquitous in medical practice. Because of the high costs of these items, the practice of reusing them after sterilisation is also widespread especially in resource-poor economies. However, the ethics of reusing disposable items remain unclear. There are several analogous conditions, which could shed light on the ethics of reuse of disposables. These include the use of restored kidney transplantation and the use of generic drugs etc. The ethical issues include the question of patient (...) safety and the possibility of infection. It is also important to understand the role of informed consent before reuse of disposables. The widespread practice of reuse may bring down high healthcare costs and also reduce the huge amount of hospital waste that is generated. The reuse of disposables can be justified on various grounds including the safety and the cost effectiveness of this practice. (shrink)

Type II DNA topoisomerase activity is required to change DNA topology. It is important in the relaxation of DNA supercoils generated by cellular processes, such as transcription and replication, and it is essential for the condensation of chromosomes and their segregation during mitosis. In mammals this activity is derived from at least two isoforms, termed DNA topoisomerase IIα and β. The α isoform is involved in chromosome condensation and segregation, whereas the role of the β isoform is not yet clear. (...) DNA topoisomerase IIβ was first reported in 1987. Here we review the research on DNA topoisomerase IIβ over the last 10 years. BioEssays 20:215–226, 1998.© 1998 John Wiley & Sons, Inc. (shrink)

This paper questions a few assumptions of Gaṅgeśa Upādhyāya’s theory of ordinary verbal cognition (laukika-śābdabodha). The meaning relation (vṛtti) is of two kinds: śakti (which gives us the primary referent of a word) and lakṣaṇā (which yields the secondary referent). For Gaṅgeśa, the ground (bīja) of lakṣaṇā is a sort of inexplicability (anupapatti) pertaining to the composition (anvaya) of word-meanings. In this connection, one notices that the case of lakṣaṇā is quite similar to that of one variety of postulation, namely, (...) śrutārtāthāpatti, where the subject hears only a part of a sentence and immediately grasps the words that are needed to render the sentential meaning complete. Unless he does that, sentential meaning, i.e., the composition (anvaya) of word-meanings shall suffer from the same inexplicability that characterizes instances of lakṣaṇā. In fact, in the ‘Śaktivāda’ section of Tattvacintāmaṇi, Gaṅgeśa himself draws a parallel between the cognition of sentential meaning in a śrutārthāpatti-like case and the cognition of sentential meaning in an instance of lakṣaṇā. However, Gaṇgesa himself treats Śrutārthāpatti as a piece of inferential cognition. If there is no fundamental difference between cases of śrutārthāpatti and cases of lakṣaṇā, then the cognition of sentential meaning in instances of lakṣaṇā must also be inferential in essence. In that case, we must admit, against Gaṅgeśa’s view, that such cognition of sentential meaning cannot be accommodated within the framework of verbal cognition (śābdabodha). Therefore, I conclude that some revision is needed in Gaṅgeśa’s theory of verbal cognition with respect to lakṣaṇā. (shrink)

The search for definitions is ubiquitous in Sanskrit philosophy. In many texts across traditions, we find philosophers presenting their theories by laying down definitions of key theoretical categories, by testing those definitions, and by refuting competing definitions of the same theoretical categories. Call this the method of definitions. The aim of this essay is to explore a challenge that arises for this method: the paradox of definitions. It arises from the claim that the method of definitions is either (i) redundant (...) because it does not provide us any knowledge that we did not already possess, or (ii) impossible to successfully pursue because it leads to an infinite regress. Neither of these alternatives should be acceptable to the defender of this method. To focus our discussion, I will show how this challenge arose for—and was arguably resolved by—early Nyāya-Vaiśeṣika thinkers active in the first millennium CE and at the very beginning of the second millennium. In response to the paradox of definitions, these Nyāya-Vaiśeṣika thinkers claimed that the purpose of a definition is to remove either metaphysical ignorance about the distinction between theoretically significant kinds or kind-membership, or metalinguistic ignorance about the meaning or the application-conditions of theoretically significant terms. I will show how this discussion helps us to ward off certain misconceptions about the method of definitions in Nyāya-Vaiśeṣika. (shrink)

Proteoglycan 4 (PRG4), first identified in synovial fluid, is an extracellular matrix structural protein in the joint implicated in reducing shear at the cartilage surface as well as controlling adhesion‐dependent synovial growth and regulating bulk protein deposition onto the cartilage. However, recent evidence suggests that it can bind to and effect downstream signaling of a number of cell surface receptors implicated in regulating the inflammatory response. Therefore, we pose the hypothesis: Does PRG4 regulate the inflammatory response and maintain tissue homeostasis? (...) Based on these novel findings implicating PRG4 as an inflammatory signaling molecule, we will present and discuss several hypotheses regarding potential mechanisms by which PRG4 may be able to regulate inflammation. If future studies can demonstrate that PRG4 is a potent inflammatory mediator, this will change current paradigms in the musculoskeletal and ophthalmological fields regarding the how the inflammatory microenvironment is regulated in these tissues and potentially others. (shrink)