Background Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. Method We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other key (...) informants. A thematic analysis was conducted. Results Our analysis identified four interrelated themes surrounding participants’ ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. Conclusions Participant’s agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors. (shrink)

In this book, Carlos Montemayor and Harry Haladjian consider the relationship between consciousness and attention. The cognitive mechanism of attention has often been compared to consciousness, because attention and consciousness appear to share similar qualities. But, Montemayor and Haladjian point out, attention is defined functionally, whereas consciousness is generally defined in terms of its phenomenal character without a clear functional purpose. They offer new insights and proposals about how best to understand and study the relationship between consciousness and attention by (...) examining their functional aspects. The book's ultimate conclusion is that consciousness and attention are largely dissociated. -/- Undertaking a rigorous analysis of current empirical and theoretical work on attention and consciousness, Montemayor and Haladjian propose a spectrum of dissociation—a framework that identifies the levels of dissociation between consciousness and attention—ranging from identity to full dissociation. They argue that conscious attention, the focusing of attention on the contents of awareness, is constituted by overlapping but distinct processes of consciousness and attention. Conscious attention, they claim, evolved after the basic forms of attention, increasing access to the richest kinds of cognitive contents. -/- Montemayor and Haladjian's goal is to help unify the study of consciousness and attention across the disciplines. A focused examination of conscious attention will, they believe, enable theoretical progress that will further our understanding of the human mind. (shrink)

Change is inevitable, and increasingly rapid and continuous in healthcare as organizations strive to adapt, improve and innovate. Organizational change challenges healthcare providers because it restructures how and when patient care delivery is provided, changing ways in which nurses must carry out their work. The aim of this doctoral study was to explore frontline nurses’ experiences of living with rapid and continuous organizational change. A critical hermeneutic approach was utilized. Participants described feeling voiceless, powerless and apolitical amidst rapid and continuous (...) organizational changes which fuelled apathy, cynicism and disengagement from the organization. However, critical analysis of the data showed that nurses actively engaged with power, voice and politics through resistant and transgressive behaviours in micro‐ethical moments of practice. There is a need to reconceptualize the concepts of voice, power and politics in nursing as there is dissonance between nurses’ beliefs about these concepts and what they are enacting in practice. Recognizing their enactment of power, voice and political agency at the micro‐level may empower nurses. Empowerment would mitigate the high levels of reports of powerlessness experienced in practice during organizational changes. (shrink)

In this paper, I discuss nurses' ongoing difficulty in engaging with politics and address the persistent belief that political positioning is antithetical to quality nursing care. I suggest that nurses are not faced with choosing either caring for their patients or engaging with politics. I base my discussion on the assumption that such dichotomy is meaningless and that engaging with issues of relationships firmly grounds nursing in the realm of politics. I argue that the ethical merit of nursing care relies (...) instead on positioning nurses squarely at the centre of care activities, experiences, and functions. Such positioning makes possible what Foucault called ‘practices of self‐formation’, that is, micro‐level processes that balance out the ubiquitous economic, cultural, legal, and scientific technologies that steadily constitute subjects in this era of modernity. Nurses, then, become not a group that needs to be controlled and governed, but individuals who must care for their self before they may care for anyone else. (shrink)

The purpose of this text is to tell the story of the implementation of the _Act Respecting End-of-Life Care,_ referred to hereafter as _Law 2_ (Gouvernement du Québec, 2014) with an emphasis on the ambiguous role of ethics in the Interdisciplinary Support Groups (ISGs), created by Quebec's _Ministère de la santé et des services sociaux_ (MSSS). As established, ISGs provide “clinical, administrative and ethical support to health care professionals responding to a request for Medical aid in dying (MAiD)” (Gouvernement du (...) Québec, 2015). It is suggested that their composition includes the participation of a person with an expertise in ethics. These ISGs represent an important innovation for stakeholders involved in MAiD. To date, no scientific research has specifically addressed ISGs and little research has been conducted in other jurisdictions on the roles, operations and practices of MAiD support structures, especially the implication of ethics. Several ISGs have certainly developed promising practices that could benefit all stakeholders in the wider field of ethics and end of life. We will explore the development of ISGs in Quebec as a support structure for MAiD by highlighting the role that ethics has played (and should play) in these morally and humanly challenging situations. (shrink)

Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions. Design: Prospective clinical interventional study. Setting: Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland. Participants: Nine junior physicians in postgraduate training. Intervention: Information on the ethics of DNR and implementation of new DNR orders. Measurements and main results: Accurate understanding, interpretation, and use of (...) DNR orders, especially with respect to the patients’ involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients’ involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision. Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

The main thesis of this paper is that two prevailing theories about cognitive penetration are too extreme, namely, the view that cognitive penetration is pervasive and the view that there is a sharp and fundamental distinction between cognition and perception, which precludes any type of cognitive penetration. These opposite views have clear merits and empirical support. To eliminate this puzzling situation, we present an alternative theoretical approach that incorporates the merits of these views into a broader and more nuanced explanatory (...) framework. A key argument we present in favor of this framework concerns the evolution of intentionality and perceptual capacities. An implication of this argument is that cases of cognitive penetration must have evolved more recently and that this is compatible with the cognitive impenetrability of early perceptual stages of processing information. A theoretical approach that explains why this should be the case is the consciousness and attention dissociation framework. The paper discusses why concepts, particularly issues concerning concept acquisition, play an important role in the interaction between perception and cognition. (shrink)

The definitive account of Aristotle's life and school This definitive biography shows that Aristotle's philosophy is best understood on the basis of a firm knowledge of his life and of the school he founded. First published in Italian, and now translated, updated, and expanded for English readers, this concise chronological narrative is the most authoritative account of Aristotle's life and his Lyceum available in any language. Gathering, distilling, and analyzing all the evidence and previous scholarship, Carlo Natali, one of (...) the world's leading Aristotle scholars, provides a masterful synthesis that is accessible to students yet filled with evidence and original interpretations that specialists will find informative and provocative. Cutting through the controversy and confusion that have surrounded Aristotle's biography, Natali tells the story of Aristotle's eventful life and sheds new light on his role in the foundation of the Lyceum. Natali offers the most detailed and persuasive argument yet for the view that the school, an important institution of higher learning and scientific research, was designed to foster a new intellectual way of life among Aristotle's followers, helping them fulfill an aristocratic ideal of the best way to use the leisure they enjoyed. Drawing a wealth of connections between Aristotle's life and thinking, Natali demonstrates how the two are mutually illuminating. For this edition, ancient texts have been freshly translated on the basis of the most recent critical editions; indexes have been added, including a comprehensive index of sources and an index to previous scholarship; and scholarship that has appeared since the book's original publication has been incorporated. (shrink)

Inner speech has been shown to vary in form along several dimensions. Along condensation, condensed inner speech forms have been described, that are supposed to be deprived of acoustic, phonological and even syntactic qualities. Expanded forms, on the other extreme, display articulatory and auditory properties. Along dialogality, inner speech can be monologal, when we engage in internal soliloquy, or dialogal, when we recall past conversations or imagine future dialogues involving our own voice as well as that of others addressing us. (...) Along intentionality, it can be intentional (when we deliberately rehearse material in short-term memory) or it can arise unintentionally (during mind wandering). We introduce the ConDialInt model, a neurocognitive predictive control model of inner speech that accounts for its varieties along these three dimensions. ConDialInt spells out the condensation dimension by including inhibitory control at the conceptualization, formulation or articulatory planning stage. It accounts for dialogality, by assuming internal model adaptations and by speculating on neural processes underlying perspective switching. It explains the differences between intentional and spontaneous varieties in terms of monitoring. We present an fMRI study in which we probed varieties of inner speech along dialogality and intentionality, to examine the validity of the neuroanatomical correlates posited in ConDialInt. Condensation was also informally tackled. Our data support the hypothesis that expanded inner speech recruits speech production processes down to articulatory planning, resulting in a predicted signal, the inner voice, with auditory qualities. Along dialogality, covertly using an avatar’s voice resulted in the activation of right hemisphere homologues of the regions involved in internal own-voice soliloquy and in cerebellar deactivation, consistent with internal model adaptation. Switching from first-person to third-person perspective resulted in activations in precuneus and parietal lobules. Along intentionality, compared with intentional inner speech, mind wandering with inner speech episodes was associated with greater bilateral inferior frontal activation and decreased activation in left temporal regions. This is consistent with the reported subjective evanescence and presumably reflects condensation processes. Our results provide neuroanatomical evidence compatible with predictive control and in favor of the assumptions made in the ConDialInt model. (shrink)

Winner of the 2000-2002 outstanding publication award of the Section on Environment and Technology of the American Sociological Association.Risk as we now know ...

This paper extends earlier work by its authors on formal aspects of the processes of contracting a theory to eliminate a proposition and revising a theory to introduce a proposition. In the course of the earlier work, Gardenfors developed general postulates of a more or less equational nature for such processes, whilst Alchourron and Makinson studied the particular case of contraction functions that are maximal, in the sense of yielding a maximal subset of the theory (or alternatively, of one of (...) its axiomatic bases), that fails to imply the proposition being eliminated. In the present paper, the authors study a broader class, including contraction functions that may be less than maximal. Specifically, they investigate "partial meet contraction functions", which are defined to yield the intersection of some nonempty family of maximal subsets of the theory that fail to imply the proposition being eliminated. Basic properties of these functions are established: it is shown in particular that they satisfy the Gardenfors postulates, and moreover that they are sufficiently general to provide a representation theorem for those postulates. Some special classes of partial meet contraction functions, notably those that are "relational" and "transitively relational", are studied in detail, and their connections with certain "supplementary postulates" of Gardenfors investigated, with a further representation theorem established. (shrink)

One of the world's most renowned theoretical physicists, Carlo Rovelli has entranced millions of readers with his singular perspective on the cosmos. In Helgoland, Rovelli examines the enduring enigma of quantum theory. The quantum world Rovelli describes is as beautiful as it is unnerving. Helgoland is a treeless island in the North Sea where the 21-year-old Werner Heisenberg first developed quantum theory, setting off a century of scientific revolution. Full of alarming ideas (ghost waves, distant objects that seem to (...) be magically connected, cats that appear both dead and alive), quantum physics has led to countless discoveries and technological advancements. Today our understanding of the world is based on this theory, yet it is still profoundly mysterious. As scientists and philosophers continue to fiercly debate the theory's meaning, Rovelli argues that its most unsettling contradictions can be explained by seeing the world as fundamentally made of relationships, not substances. We and everything around us exist only in our interactions with one another. This bold idea suggests new directions for understanding the structure of reality and even the nature of consciousness. Rovelli makes learning about quantum mechanics an almost psychedelic experience. Shifting our perspective once again, he takes us on a riveting journey through the universe so we can better understand our place in it. (shrink)

In this article, Carlos Pereda introduces the concept of “colonial reason” and explores how philosophical practices and modes of thought are entwined with colonial political structures of exploitation, exclusion, and oppression. Pereda argues that philosophy in Latin America risks perpetuating and reinforcing the colonial gesture, either by turning to the European centers of thought (thus pursuing debates that always take place elsewhere) or by isolating itself and idealising the “own.” According to Pereda, both approaches fail to dismantle colonial violence within (...) philosophy. In his alternative approach, Pereda outlines principles and methodological criteria for the decolonisation of reason and philosophy. He emphasises the importance of methodological prudence that discerns between innocent, paralysing, and strategic uses of identity expressions and advocates for modes of reading and argumentation that conceive philosophy as an inclusive and ongoing dialogue. In Pereda’s terminology, this entails fostering “permeable reason” that manifests itself through “nomadic thinking,” a form of thinking that is capable of questioning itself and being questioned. (shrink)

After presenting Kripke’s criticism to Frege’s ideas on context dependence of thoughts, I present two recent attempts of considering cognitive aspects of context dependent expressions inside a truth conditional pragmatics or semantics: Recanati’s non-descriptive modes of presentation (MOPs) and Kaplan’s ways of having in mind (WHIMs). After analysing the two attempts and verifying which answers they should give to the problem discussed by Kripke, I suggest a possible interpretation of these attempts: to insert a procedural or algorithmic level in semantic (...) representations of indexicals. That a function may be computed by different procedures might suggest new possibilities of integrating contextual cognitive aspects in model theoretic semantic. (shrink)

Minding Time: A Philosophical and Theoretical Approach to the Psychology of Time offers an innovative philosophical account of the most fundamental kinds of time representation.

Effective vaccines for COVID‐19 are already available to humankind. In Peru, 86 million doses were administered to cover the demand for 33 million Peruvian people. Hence, vaccination has been prioritized in groups: health personnel, subjects with pre‐existing health conditions and those over 65 years of age. However, given the social problems and the public health situation in Peru, this work defends that the priority of vaccination should be focused on the population living in extreme poverty. The method used was an (...) ethical argumentation on the distribution of scarce antiSARS‐CoV2 vaccine in Peru. This argument is based on the analysis of the Peruvian population living in extreme poverty, which presents different layers of vulnerability, and that, in the face of an eventual SARS‐CoV2 infection, these would be exacerbated one after the other, through a cascade effect. This scenario would give rise to new vulnerabilities to those already existing, causing greater damage. Vaccination efforts on this key population would give them the opportunity to continue to find ways to bring food to their homes, significantly reducing the risk of contagion in their environment and mitigating the devastating effect of the local diseases to which they are already exposed. Four objections related to this argument are raised with their corresponding responses. Priority access to the vaccine would significantly reduce the humanitarian harm to people living in extreme poverty, prevailing the principles of justice and equity. (shrink)

RACINE L and PERRON A. Nursing Inquiry 2012; 19: 190–201 Unmasking the predicament of cultural voyeurism: a postcolonial analysis of international nursing placementsThe growing interest in international nursing placements cannot be left unnoticed. After 11 years into this twenty‐first century, violations of human rights and freedom of speech, environmental disasters, and armed conflicts still create dire living conditions for men and women around the world. Nurses have an ethical duty to address issues of social justice and global health as a (...) means to fulfil nursing’s social mandate. However, international placements raise some concerns. Drawing on the works of postcolonial theorists in nursing and social sciences, we examine the risk of replicating colonialist practices and discourses of health in international clinical placements. Referring to Bakhtin’s notions of dialogism and unfinalizability, we envision a culturally safe nursing practice arising from dialogical encounters between the Self as an Other and with the Other as an Other. We suggest that exploring the intricacies of cultural and race relations in everyday nursing practice are the premises upon which nurses can understand the broader historic, racial, gendered, political and economic contexts of global health issues. Finally, we make suggestions for developing culturally safe learning opportunities at the international level without minimizing the impact of dialogical cultural encounters occurring at the local and community levels. (shrink)

La humanidad ya dispone de vacunas eficaces contra el COVID‐19. En Perú se administraron 86 millones de dosis para cubrir la demanda de 33 millones de peruanos. Para ello, se ha priorizado la vacunación en grupos clave: personal de salud, sujetos con condiciones de salud preexistentes y mayores de 65 años. Sin embargo, dada la problemática social y la situación de la salud pública en Perú, este trabajo defiende que la prioridad de la vacunación debe centrarse en la población que (...) vive en extrema pobreza. El método utilizado fue una argumentación ética sobre la distribución de la vacuna contra el COVID‐19 en Perú. Esta argumentación se basa en el análisis de la población peruana que vive en extrema pobreza, la cual presenta diferentes estratos de vulnerabilidad, y que, ante una eventual infección por SARS‐CoV‐2, se irían agravando uno tras otro, a través de un efecto en cascada. Este escenario daría lugar a nuevas vulnerabilidades de las ya existentes, causando mayores daños. Los esfuerzos de vacunación en esta población clave les brindaría oportunidad de seguir encontrando formas de llevar alimentos a sus hogares, reduciendo significativamente el riesgo de contagio en su entorno y mitigando el efecto devastador de las enfermedades locales a las que ya está expuesta. Se plantean cuatro objeciones relacionadas con este argumento, con sus correspondientes respuestas. El acceso prioritario a la vacuna reduciría significativamente el daño a las personas que viven en la extrema pobreza, haciendo prevalecer los principios de justicia y equidad. (shrink)

- la prima parte dà una presentazione sommaria dei principali paradigmi di filosofia del linguaggio, mostrando alcune connessioni tra i principali autori di riferimento. Dovrebbe contenere il minimo indispensabile per avere una panoramica delle tematiche della filosofia del linguaggio e addentrarsi negli argomenti in modo più approfondito. La conoscenza dei contenuti di questa parte è un prerequisito per l’esame.

Many of the computing systems programmed using Machine Learning are opaque: it is difficult to know why they do what they do or how they work. Explainable Artificial Intelligence aims to develop analytic techniques that render opaque computing systems transparent, but lacks a normative framework with which to evaluate these techniques’ explanatory successes. The aim of the present discussion is to develop such a framework, paying particular attention to different stakeholders’ distinct explanatory requirements. Building on an analysis of “opacity” from (...) philosophy of science, this framework is modeled after accounts of explanation in cognitive science. The framework distinguishes between the explanation-seeking questions that are likely to be asked by different stakeholders, and specifies the general ways in which these questions should be answered so as to allow these stakeholders to perform their roles in the Machine Learning ecosystem. By applying the normative framework to recently developed techniques such as input heatmapping, feature-detector visualization, and diagnostic classification, it is possible to determine whether and to what extent techniques from Explainable Artificial Intelligence can be used to render opaque computing systems transparent and, thus, whether they can be used to solve the Black Box Problem. (shrink)

The question of clinical science in public health emergencies (e.g., natural disasters, environmental releases, infectious diseases, and especially pandemics) raised by Edwards (2013) is a typical...

What is morally valuable—if anything at all—in entrepreneurship? Existing normative takes can be broadly categorized as belonging to two main views: a backward and a forward-looking approach. The former sees entrepreneurial activity as a permissible emergent product of individuals’ interactions within the boundaries of people’s existing rights; the latter looks at entrepreneurship in the broader context of market processes and emphasizes its role in generating Pareto-improvements in social welfare. In this paper, I suggest that certain instances of entrepreneurship can be (...) intrinsically valuable when they constitute Millian Experiments in Living, that is when entrepreneurial ventures are the expression of an entrepreneur’s conception of the good. Engaging in entrepreneurial activity which reflects one’s conception of the good helps individuals in cultivating their individuality and originality by means of subjecting their normative beliefs to empirical scrutiny, thus allowing one to confirm, revise, or refine them. (shrink)

onl y to discuss some claims concerning the relationship between mathematical logic and the philosophy of mathematics that repeatedly occur in his writings. Although I do not know to what extent they are representative of his present position, they correspond to widespread views of the logical community and so seem worth discussing anyhow. Such claims will be used as reference to make some remarks about the present state of relations between mathematical logic and the philosophy of mathematics.

t. 1. Livres I à IV -- t. 2. Livres V à VII et Notes marginales de Nicolas de Cues.

The idea of agency has long been used in the nursing literature in the study of nurses' roles regarding the patients they take care of, but it has not often been used to study its relationship with nurses themselves and their status in the healthcare system. The purpose of this article is to analyze how the idea of agency is used in nursing research to better understand how we might advance our thinking around nurses' agency to shape nursing and healthcare (...) with an emancipatory intent. Based on the results of a literature review focused on the study of conceptions, treatments, and applications of the concept of agency in nursing, we present a critical discussion to reflect on the need to consistently define the idea of nurses' agency, to guide research concerned with this topic in theoretical frameworks with emancipatory and social change tenets, and to make a call to develop the idea of agency as a central one to rework nurses' relationship with themselves. The idea of agency provides a valuable analytical framework for the study of a wide range of issues around nurses' status in healthcare organizations and in the healthcare system while offering a means for nurses' emancipation. (shrink)

In everyday discourse and in the context of social scientific research we often attribute intentional states to groups. Contemporary approaches to group intentionality have either dismissed these attributions as metaphorical or provided an analysis of our attributions in terms of the intentional states of individuals in the group.Insection1, the author argues that these approaches are problematic. In sections 2 and 3, the author defends the view that certain groups are literally intentional agents. In section 4, the author argues that there (...) are significant reasons for social scientists and philosophers of social science to acknowledge the adequacy of macro-level explanations that involve the attribution of intentional states to groups. In section 5, the author considers and responds to some criticisms of the thesis she defends. (shrink)

It has been commonplace to equate Foucault’s 1979 series of lectures at the Collège de France with the claim that for neoliberalism, unlike for classical liberalism, the market needs to be artificially constructed. The article expands this claim to its full expression, taking it beyond what otherwise would be a simple divulgation of a basic neoliberal tenet. It zeroes in on Foucault’s own insight: that neoliberal constructivism is not directed at the market as such, but, in principle, at society, arguing (...) that the value of this insight goes beyond the critique of a neoliberal present. The neoliberal rationale rather helps him to reveal a unique historical architecture, a latent approach to the social dissimilar to the one that has long predominated in the human sciences. The inversion of homo œconomicus in neoliberal theory amounted to the unearthing of a ‘social subject of interest’ within civil society. Such a subject, barely recognized by neoliberals who simply instrumentalize it for the sake of the market, demonstrates that the social is not necessarily the natural product of ethical subjects; that society may also need to be constructed. (shrink)

In “Group Testimony” (2007) I argued that the testimony of a group cannot be understood (or at least cannot always be understood) in a summative fashion; as the testimony of some or all of the group members. In some cases, it is the group itself that testifies. I also argued that one could extend standard reductionist accounts of the justification of testimonial belief to the case of testimonial belief formed on the basis of group testimony. In this paper, I explore (...) the issue of group testimony in greater detail by focusing on one putative source of testimony, that of Wikipedia. My aim is to the answer the following questions: Is Wikipedia a source of testimony? And if so, what is the nature of that source? Are we to understand Wikipedia entries as a collection of testimonial statements made by individuals, some subset of individuals, or is Wikipedia itself (the organization or the Wikipedia community) the entity that testifies? If Wikipedia itself is a source of testimony, what resources do we have for assessing the trustworthiness of such an unusual epistemic source? In answering these questions I hope to further elucidate the nature of collective epistemic agency (Tollefsen 2006), of which group testimony is a paradigm example. When a mans Discourse begineth…at some saying of another, of whose ability to know the truth, and of whose honesty in not deceiving, he doubteth not; and then the Discourse is not so much concerning the Thing, as the Person; and the Resolution is called Beleefe, and Faith: Faith in the man. (1651/1991, Ch. 7; p. 48). (shrink)