Background: Informed consent in clinical research is mandated throughout the world. Both patient subjects and investigators are required to understand and accept the distinction between research and treatment.Aim: To document the extent and to identify factors associated with therapeutic misconception in a population of patient subjects or parent proxies recruited from a variety of multicentre trials .Patients and methods: The study comprised two phases: the development of a questionnaire to assess the quality of informed consent and a survey of patient (...) subjects based on this questionnaire.Results: A total of 303 patient subjects or parent proxies were contacted and 279 questionnaires were analysed. The median age was 49.5 years, sex ratio was 1 and 61% of respondents were professionally active. Overall memorisation of the oral or written communication of informed consent was good , and satisfaction with the process was around 70%. Therapeutic misconception was present in 70% of respondents, who expected to receive better care and ignored the consequence of randomisation and treatment comparisons. This was positively associated with the acuteness and severity of the disease.Conclusion: The authors suggest that the risk of therapeutic misconception be specifically addressed in consent forms as an educational tool for both patients and investigators. (shrink)

Prominent philosophers have argued that contradictions contain either too much or too little information to be useful. We dispute this with what we call the “Paradox of the Two Firefighters.” Suppose you are awakened in your hotel room by a fire alarm. You open the door. You see three possible ways out: left, right, straight ahead. You see two firefighters. One says there is exactly one safe route and it is to your left. The other says there is exactly one (...) safe route and it is to your right. While the two firemen are giving you contradictory information, they are also both giving you the perhaps useful information that there is a safe way out and it is not straight ahead. We give two analyses. The first uses the “Opinion Tetrahedron,” introduced by Dunn as a generalization of Audun Jøsang’s “Opinion Triangle.” The Opinion Tetrahedron in effect embeds the values of the “Belnap-Dunn 4-valued Logic” into a context of subjective probability generalized to allow for degrees of belief, disbelief, and two kinds of uncertainty—that in which the reasoner has too little information and that in which the reasoner has too much information. Jøsang had only a single value for uncertainty. We also present an alternative solution, again based on subjective probability but of a more standard type. This solution builds upon “linear opinion pooling.” Kiefer had already developed apparatus for assessing risk using expert opinion, and this influences the second solution. Finally, we discuss how these solutions might apply to “Big Data” and the World Wide Web. (shrink)

We study the minimal complexity of tilings of a plane with a given tile set. We note that every tile set admits either no tiling or some tiling with.

In this paper, we consider how certain longstanding philosophical questions about mental representation may be answered on the assumption that cognitive and perceptual systems implement hierarchical generative models, such as those discussed within the prediction error minimization framework. We build on existing treatments of representation via structural resemblance, such as those in Gładziejewski :559–582, 2016) and Gładziejewski and Miłkowski, to argue for a representationalist interpretation of the PEM framework. We further motivate the proposed approach to content by arguing that it (...) is consistent with approaches implicit in theories of unsupervised learning in neural networks. In the course of this discussion, we argue that the structural representation proposal, properly understood, has more in common with functional-role than with causal/informational or teleosemantic theories. In the remainder of the paper, we describe the PEM framework for approximate Bayesian inference in some detail, and discuss how structural representations might arise within the proposed Bayesian hierarchies. After explicating the notion of variational inference, we define a subjectively accessible measure of misrepresentation for hierarchical Bayesian networks by appeal to the Kullbach–Leibler divergence between posterior generative and approximate recognition densities, and discuss a related measure of objective misrepresentation in terms of correspondence with the facts. (shrink)

To be able to make “change” happen in the lives of patients entrusted to his care, Watzlawick says he tried to produce a theory about it. He was forced to acknowledge that the mechanisms of change resist systematization and, therefore, all wishes to elicit them as well.Well-being is to therapy what discovery is to thought and the event is to History: the position – unforeseen, unforeseeable – in reality of what did not hitherto exist. And heuristics would be, if not (...) a science, since there could be no science of change, then at least the name given to reflection on its mystery. (shrink)

This paper serves two purposes: first, the proposition of an ethical fiduciary theory that substantiates the often-cited assertion that the patient–physician relationship is fiduciary in nature; and second, the application of this theory to the case of informed consent. Patients’ decision-making preferences vary significantly. While some seek fully autonomous decision-making, others prefer to delegate parts of their decision. Therefore, we propose an ethical fiduciary theory that allows physician and patient to jointly determine the physician’s role on a spectrum from fiduciary (...) as advisor to fiduciary as agent. Drawing on legal concepts of the fiduciary relationship and on phenomenological accounts of obligation by Lévinas and Løgstrup, our theory relies on the key attributes of trust, vulnerability and otherness. Finally, practical implications of this theory for the informed consent process are developed: we propose a preassessment of patients’ risk and value profiles as well as a restructuring of the oral consent interview and the written consent materials. (shrink)

The compact and, with \ M\, very massive object located at the center of the Milky Way is currently the very best candidate for a supermassive black hole in our immediate vicinity. The strongest evidence for this is provided by measurements of stellar orbits, variable X-ray emission, and strongly variable polarized near-infrared emission from the location of the radio source Sagittarius A* in the middle of the central stellar cluster. Simultaneous near-infrared and X-ray observations of SgrA* have revealed insights into (...) the emission mechanisms responsible for the powerful near-infrared and X-ray flares from within a few tens to one hundred Schwarzschild radii of such a putative SMBH. If SgrA* is indeed a SMBH it will, in projection onto the sky, have the largest event horizon and will certainly be the first and most important target for very long baseline interferometry observations currently being prepared by the event horizon telescope. These observations in combination with the infrared interferometry experiment GRAVITY at the very large telescope interferometer and other experiments across the electromagnetic spectrum might yield proof for the presence of a black hole at the center of the Milky Way. The large body of evidence continues to discriminate the identification of SgrA* as a SMBH from alternative possibilities. It is, however, unclear when the ever mounting evidence for SgrA* being associated with a SMBH will suffice as a convincing proof. Additional compelling evidence may come from future gravitational wave observatories. This manuscript reviews the observational facts, theoretical grounds and conceptual aspects for the case of SgrA* being a black hole. We treat theory and observations in the framework of the philosophical discussions about “realism and underdetermination”, as this line of arguments allows us to describe the situation in observational astrophysics with respect to supermassive black holes. Questions concerning the existence of supermassive black holes and in particular SgrA* are discussed using causation as an indispensable element. We show that the results of our investigation are convincingly mapped out by this combination of concepts. (shrink)

In this paper, I argue that theories of perception that appeal to Helmholtz’s idea of unconscious inference (“Helmholtzian” theories) should be taken literally, i.e. that the inferences appealed to in such theories are inferences in the full sense of the term, as employed elsewhere in philosophy and in ordinary discourse. -/- In the course of the argument, I consider constraints on inference based on the idea that inference is a deliberate acton, and on the idea that inferences depend on the (...) syntactic structure of representations. I argue that inference is a personal-level but sometimes unconscious process that cannot in general be distinguished from association on the basis of the structures of the representations over which it’s defined. I also critique arguments against representationalist interpretations of Helmholtzian theories, and argue against the view that perceptual inference is encapsulated in a module. (shrink)

The search for a quantum theory of the gravitational field is one of the great open problems in theoretical physics. This book presents a self-contained discussion of the concepts, methods and applications that can be expected in such a theory. The two main approaches to its construction - the direct quantisation of Einstein's general theory of relativity and string theory - are covered. Whereas the first attempts to construct a viable theory for the gravitational field alone, string theory assumes that (...) a quantum theory of gravity will be achieved only through a unification of all the interactions. However, both employ the general method of quantisation of constrained systems, which is described together with illustrative examples relevant for quantum gravity. There is a detailed presentation of the main approaches employed in quantum general relativity: path-integral quantisation, the background-field method and canonical quantum gravity in the metric, connection and loop formulations. The discussion of string theory centres around its quantum-gravitational aspects and the comparison with quantum general relativity. Physical applications discussed at length include the quantisation of black holes, quantum cosmology, the indications of a discrete structure of spacetime, and the origin of irreversibility. This book will be of interest to researchers and students working in relativity and gravitation, cosmology, quantum field theory and related topics. It will also be of interest to mathematicians and philosophers of science. (shrink)

Programmed cell death (PCD) in unicellular organisms is in some instances an altruistic trait. When the beneficiaries are clones or close kin, kin selection theory may be used to explain the evolution of the trait, and when the trait evolves in groups of distantly related individuals, group or multilevel selection theory is invoked. In mixed microbial communities, the benefits are also available to unrelated taxa. But the evolutionary ecology of PCD in communities is poorly understood. Few hypotheses have been offered (...) concerning the community role of PCD despite its far-reaching effects. The hypothesis we consider here is that PCD is a black queen. The Black Queen Hypothesis (BQH) outlines how public goods arising from a leaky function are exploited by other taxa in the community. Black Queen (BQ) traits are essential for community survival, but only some members bear the cost of possessing them, while others lose the trait In addition, BQ traits have been defined in terms of adaptive gene loss, and it is unknown whether this has occurred for PCD. Our conclusion is that PCD fulfils the two most important criteria of a BQ (leakiness and costliness), but that more empirical data are needed for assessing the remaining two criteria. In addition, we hold that for viewing PCD as a BQ, the original BQH needs to include social traits. Thus, despite some empirical and conceptual shortcomings, the BQH provides a helpful avenue for investigating PCD in microbial communities. (shrink)

This study analyzes the symbols present in the sacred image of Our Lady of Guadalupe, contextualizing their meanings in the context of catholic christian symbology and nahuatl symbology, and seeks to relate this symbolic identification of the Virgin with the process of christianization of the indigenous peoples of Mexico, mediated by the theoretical and critical assumptions of interreligious dialogue. The methodology adopted consisted of a bibliographical revision of primary and secondary sources, in order to understand how the socio-cultural construction of (...) devotion was carried out during the first two centuries of its existence and its relation with the conversion of indigenous peoples to catholic faith. The main reference consulted was Nican Mopohua, the first document to bring the account of the apparitions of Our Lady to the indian Juan Diego in 1531, published in 1649 as part of the Huei tlamahuiçoltica, in nahuatl language. The motivation of the work was to understand how Guadalupe devotion, represented symbolically with elements of the nahuatl culture, contributed to the christianization of the indigenous peoples of Mexico, using theoretical presuppositions of interreligious dialogue, such as inculturation and syncretism. From the double interpretation of symbols, it was possible to understand the dimension of the process of inculturation of the Christian faith in Mexico and the use of Marian devotion to influence the Christianization of the Aztec nation, as well as to identify whether or not there was a dialogue among religions in this sense. Along the way, we can see the importance of the Virgin of Guadalupe cult not only for the colonization process, but also for the legitimacy of the culture and nationalism of the Mexican people. (shrink)

Este artigo faz uma análise substancial acerca da concepção do direito em Gustav Radbruch, procurando destacar, dentre outros aspectos, a “injustiça extrema”. É peremptório afirmar que para o grande jurista alemão, a questão da obediência à lei não se resolve pela força, como afirma a tradição. A pergunta essencial não é por que obedecer à “lei injusta”, mas porque se apoia na “lei injusta”, obedecendo-a. Ora, tudo isto significa a rigor, que a positividade no direito se contenta com a validade (...) formal das normas jurídicas, quando todo o problema se situa numa esfera mais profunda, correspondente ao valor ético do direito. Inclusive, a ausência de justiça não aflige apenas o sistema jurídico, mas outros sistemas sociais apresentam injustiças gritantes. (shrink)

An approach to implementing variational Bayesian inference in biological systems is considered, under which the thermodynamic free energy of a system directly encodes its variational free energy. In the case of the brain, this assumption places constraints on the neuronal encoding of generative and recognition densities, in particular requiring a stochastic population code. The resulting relationship between thermodynamic and variational free energies is prefigured in mind–brain identity theses in philosophy and in the Gestalt hypothesis of psychophysical isomorphism.

This chapter focuses on what’s novel in the perspective that the prediction error minimization (PEM) framework affords on the cognitive-scientific project of explaining intelligence by appeal to internal representations. It shows how truth-conditional and resemblance-based approaches to representation in generative models may be integrated. The PEM framework in cognitive science is an approach to cognition and perception centered on a simple idea: organisms represent the world by constantly predicting their own internal states. PEM theories often stress the hierarchical structure of (...) the generative models they posit. The novel explanatory power of the PEM account derives largely from the way in which pairs of generative and recognition models interact. “Predictive coding” refers to an encoding strategy in which predicted portions of an input signal are subtracted from the actual signal received, so that only the difference between the two is passed as output to the next stage of information processing. (shrink)

This paper is concerned with the description of the process of measurement within the context of a quantum theory of the physical world. It is noted that quantum mechanics permits a quasi-classical description of those macroscopic phenomena in terms of which the observer forms his perceptions. Thus, the process of measurement in quantum mechanics can be understood on the quasi-classical level by transcribing from the strictly classical observables of Newtonian physics to their quasi-classical counterparts the known rules for the measurement (...) of the former. The remaining physical problem is the delineation of the circumstances in which the correlation of a peculiarly quantum mechanical observable A with a classically measurable observable B can result in a significant measurement of A. This is undertaken within the context of quantum theory. The resulting clarification of the process of measurement has important implications relative to the philosophic interpretation of quantum mechanics. (shrink)

De 1815 - avec le Congrès de Vienne qui inaugure une ère de Restauration - à mars 1848, avec les répercussions de la révolution de février en Europe, la période du Vormârz ("avant mars") se caractérise, au sein du monde germanique, par une vie intellectuelle d'une particulière effervescence. Les grandes philosophies qui se sont construites pour dépasser Kant, avec Fichte, Schelling et Hegel, autorisent bon nombre de penseurs allemands à considérer l'Allemagne comme étant philosophiquement en avance sur son temps, ou (...) tout au moins à la pointe de la modernité. Cette avance théorique tranche pourtant avec la réalité politique et sociale de l'époque, façonnée par Metternich. Une solution de cette contradiction dans laquelle se trouve l'Allemagne semble alors résider, aux yeux de certains auteurs, dans l'idée suivant laquelle il ne resterait plus à l'Allemagne qu'à réaliser sa philosophie. Le présent ouvrage entend contribuer à l'analyse de la façon dont le thème de la réalisation de la philosophie est élaboré par, ou à partir des réflexions de plusieurs auteurs de l'époque. Il s'agit des Jeunes Hégéliens, et principalement : Eduard Gans, Heinrich Heine, Arnold Ruge, Ludwig Feuerbach, Max Stirner, David Strauss, les frères Bruno et Edgar Bauer, Moses Hess, Michel Bakounine, August von Cieszkowski, Karl Marx et Friedrich Engels."--Page 4 of cover. (shrink)

This paper is concerned with the processing of informal arguments, that is, arguments involving “probable truth.” A model of informal argument processing is presented that is based upon Hample's (1977) expansion of Toulmin's (1958) model of argument structure. The model postulates that a claim activates an attitude, the two components forming a complex that in turn activates reasons. Furthermore, the model holds occurrence of the reason, or possibly the claim and the reason, activates values. Three experiments are described that provide (...) support for the model. (shrink)

This volume offers the reader a singular overview of current thinking on indirect reports. The contributors are eminent researchers from the fields of philosophy of language, theoretical linguistics and communication theory, who answer questions on this important issue. This exciting area of controversy has until now mostly been treated from the viewpoint of philosophy. This volume adds the views from semantics, conversation analysis and sociolinguistics. Authors address matters such as the issue of semantic minimalism vs. radical contextualism, the attribution of (...) responsibility for the modes of presentation associated with Noun Phrases and how to distinguish the indirect reporter’s responsibility from the original speaker’s responsibility. They also explore the connection between indirect reporting and direct quoting. Clearly indirect reporting has some bearing on the semantics/pragmatics debate, however, there is much controversy on “what is said”, whether this is a minimal semantic logical form or a much richer and fully contextualized logical form. This issue will be discussed from several angles. Many of the authors are contextualists and the discussion brings out the need to take context into account when one deals with indirect reports, both the context of the original utterance and the context of the report. It is interesting to see how rich cues and clues can radically transform the reported message, assigning illocutionary force and how they can be mobilized to distinguish several voices in the utterance. Decoupling the voice of the reporting speaker from that of the reported speaker on the basis of rich contextual clues is an important issue that pragmatic theory has to tackle. Articles on the issue of slurs will bring new light to the issue of decoupling responsibility in indirect reporting, while others are theoretically oriented and deal with deep problems in philosophy and epistemology. (shrink)

This volume offers the reader a singular overview of current thinking on indirect reports. The contributors are eminent researchers from the fields of philosophy of language, theoretical linguistics, and communication theory, who answer questions on this important issue. This exciting area of controversy has until now mostly been treated from the viewpoint of philosophy. This volume adds the views from semantics, conversation analysis and sociolinguistics. Authors address matters such as the issue of semantic minimalism vs. radical contextualism, the attribution of (...) responsibility for the modes of presentation associated with Noun Phrases, and how to distinguish the indirect reporter's responsibility from the original speaker's responsibility. They also explore the connection between indirect reporting and direct quoting. Clearly indirect reporting has some bearing on the semantics/pragmatics debate, however, there is much controversy on "what is said", whether this is a minimal semantic logical form (enriched by saturating pronominals) or a much richer and fully contextualized logical form. This issue will be discussed from several angles. Many of the authors are contextualists and the discussion brings out the need to take context into account when one deals with indirect reports, both the context of the original utterance and the context of the report. It is interesting to see how rich cues and clues can radically transform the reported message, assigning illocutionary force, and how they can be mobilized to distinguish several voices in the utterance. Decoupling the voice of the reporting speaker from that of the reported speaker on the basis of rich contextual clues is an important issue that pragmatic theory has to tackle. Articles on the issue of slurs will bring new light to the issue of decoupling responsibility in indirect reporting, while others are theoretically oriented and deal with deep problems in philosophy and epistemology. (shrink)

This contribution presents an adult education workshop implemented in the field of early childhood education. One of the specificities of education and care practices lies in the competences of the professionals to give a central role to the detailed observation of situations, in order to adjust their modalities of action. How can such observational work be developed and transformed? A participatory research-training approach aims to support the co-construction of an analytical view on observable phenomena in the course of interactions. In (...) a perspective of interactional analysis, it focuses on the modalities that favor the construction of such an analytical posture. (shrink)