Providing nursing care for people with dementia residing in long-term care facilities poses specific challenges regarding pain practices. With underlying communication barriers unique to dementia pathologies, this population is often unable to communicate verbal sentiments and descriptions of pain. In turn, nurses caring for older persons with dementia have difficulty assessing, managing and treating pain. Objectivity is an imperative factor in healthcare pain practices; however, it is difficult to objectively evaluate someone who cannot accurately communicate their experience of pain. Therefore, (...) the authors believe that subjectivity is also an essential part of evaluating the person with dementia's experience of pain. In this critical reflection, the authors explore objectivity and subjectivity in relation to pain practices for dementia in long-term care. A historical summary of pain is provided outlining the evolution of objectivity and subjectivity related to pain practices. The authors discuss the complexities of assessing and managing pain and offer a new perspective about the role of objectivity (and co-existence of subjectivity) for nurses treating pain in the older adults with dementia. (shrink)

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

Research on interdisciplinary science has for the most part concentrated on the institutional obstacles that discourage or hamper interdisciplinary work, with the expectation that interdisciplinary interaction can be improved through institutional reform strategies such as through reform of peer review systems. However institutional obstacles are not the only ones that confront interdisciplinary work. The design of policy strategies would benefit from more detailed investigation into the particular cognitive constraints, including the methodological and conceptual barriers, which also confront attempts to work (...) across disciplinary boundaries. Lessons from cognitive science and anthropological studies of labs in sociology of science suggest that scientific practices may be very domain specific, where domain specificity is an essential aspect of science that enables researchers to solve complex problems in a cognitively manageable way. The limit or extent of domain specificity in scientific practice, and how it constrains interdisciplinary research, is not yet fully understood, which attests to an important role for philosophers of science in the study of interdisciplinary science. This paper draws upon two cases of interdisciplinary collaboration; those between ecologists and economists, and those between molecular biologists and systems biologists, to illustrate some of the cognitive barriers which have contributed to failures and difficulties of interactions between these fields. Each exemplify some aspect of domain specificity in scientific practice and show how such specificity may constrain interdisciplinary work. (shrink)

In this paper we take a close look at current interdisciplinary modeling practices in the environmental sciences, and suggest that closer attention needs to be paid to the nature of scientific practices when investigating and planning interdisciplinarity. While interdisciplinarity is often portrayed as a medium of novel and transformative methodological work, current modeling strategies in the environmental sciences are conservative, avoiding methodological conflict, while confining interdisciplinary interactions to a relatively small set of pre-existing modeling frameworks and strategies (a process we (...) call crystallization). We argue that such practices can be rationalized as responses in part to cognitive constraints which restrict interdisciplinary work. We identify four salient integrative modeling strategies in environmental sciences, and argue that this crystallization, while contradicting somewhat the novel goals many have for interdisciplinarity, makes sense when considered in the light of common disciplinary practices and cognitive constraints. These results provide cause to rethink in more concrete methodological terms what interdisciplinarity amounts to, and what kinds of interdisciplinarity are obtainable in the environmental sciences and elsewhere. (shrink)

In this paper, I examine the presumption that Mill endorses a form of metaethical non-cognitivism. I argue that the evidence traditionally cited for this interpretation is not convincing, and suggest that we should instead remain open to a cognitivist reading. I begin, in Section I, by laying out the ‘received view’ of Mill on the status of practical norms, as given by Alan Ryan in the 1970s. There is, I claim in Sections II and III, no firm textual evidence for (...) this reading of Mill: his remarks on ‘art’ and ‘science’ do not show the metaethical commitments they have been taken to. Neither is there firm textual evidence for a cognitivist reading. However, I suggest in Section IV, a non-cognitivist interpretation suffers from the fault of anachronism, and is difficult to reconcile with a clear commitment in Utilitarianism IV.3 to the possibility of evidence being given for the desirability of pleasure. A cognitivist reading would not suffer from these faults, and on that basis, I conclude that we should think further about what a cognitivist reading of Mill might amount to. (shrink)

Because idealizations frequently advance scientific understanding, many claim that falsehoods play an epistemic role. In this paper, we argue that these positions greatly overstate idealiza...

Under what conditions does machine learning (ML) model opacity inhibit the possibility of explaining and understanding phenomena? In this article, I argue that nonepistemic values give shape to the ML opacity problem even if we keep researcher interests fixed. Treating ML models as an instance of doing model-based science to explain and understand phenomena reveals that there is (i) an external opacity problem, where the presence of inductive risk imposes higher standards on externally validating models, and (ii) an internal opacity (...) problem, where greater inductive risk demands a higher level of transparency regarding the inferences the model makes. (shrink)

Viewed this way, the texts yield striking examples of language and notation that are irreducibly ambiguous and productive because they are ambiguous.

Universals are a class of mind independent entities, usually contrasted with individuals, postulated to ground and explain relations of qualitative identity and resemblance among individuals. Individuals are said to be similar in virtue of sharing universals. An apple and a ruby are both red, for example, and their common redness results from sharing a universal. If they are both red at the same time, the universal, red, must be in two places at once. This makes universals quite different from individuals, (...) and controversial. (shrink)

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is obligatory (...) to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

Payment to recruit research subjects is a common practice but raises ethical concerns relating to the potential for coercion or undue influence. We conducted the first national study of IRB members and human subjects protection professionals to explore attitudes as to whether and why payment of research participants constitutes coercion or undue influence. Upon critical evaluation of the cogency of ethical concerns regarding payment, as reflected in our survey results, we found expansive or inconsistent views about coercion and undue influence (...) that may interfere with valuable research. In particular, respondents appear to believe that coercion and undue influence lie on a continuum; by contrast, we argue that they are wholly distinct: whereas undue influence is a cognitive distortion relating to assessment of risks and benefits, coercion is a threat of harm. Because payment is an offer, rather than a threat, payment is never coercive. (shrink)

In this chapter, we address the roles that exemplars might play in a comprehensive response to epistemic injustice. Fricker defines epistemic injustices as harms people suffer specifically in their capacity as (potential) knowers. We focus on testimonial epistemic injustice, which occurs when someone’s assertoric speech acts are systematically met with either too little or too much credence by a biased audience. Fricker recommends a virtue­theoretic response: people who do not suffer from biases should try to maintain their disposition towards naive (...) testimonial justice, and those who find themselves already biased should cultivate corrective testimonial justice by systematically adjusting their credence in testimony up or down depending on whether they are hearing from someone whom they may be biased against or in favor of. We doubt that the prominent admiration­emulation model of exemplarism will be much use in this connection, so we propose two ways of learning from negative exemplars to better conduct one’s epistemic affairs. In the admiration­emulation model, both the identification of what a virtue is and the cultivation of virtues identified thusly proceed through the admiration of virtuous exemplars. We show that this model has serious flaws and argue for two alternatives: the envy­agonism model and the ambivalence­avoidance model. (shrink)

Trust makes cooperation possible. It enables us to learn from others and at a distance. It makes democratic deliberation possible. But it also makes us vulnerable: when we place our trust in another’s word, we are liable to be deceived—sometimes intentionally, sometimes unintentionally. Our evolved mechanisms for deciding whom to trust and whom to distrust mostly rely on face-to-face interactions with people whose reputation we can both access and influence. Online, these mechanisms are largely useless, and the institutions that might (...) supplant them need to have their own trustworthiness verified. Currently, those institutions are mostly corporations such as Facebook and Twitter, which have checkered track records at best. To make matters worse, the social media sector is a natural monopoly, and companies like Facebook have shown that they are willing to use their market power unscrupulously. For these reasons, we argue that social media should be treated like other natural monopolies: it should either be nationalized, highly regulated, or broken up through antitrust legal actions. (shrink)

This book draws its inspiration from Hilbert, Wittgenstein, Cavaillès and Lakatos and is designed to reconfigure contemporary philosophy of mathematics by making the growth of knowledge rather than its foundations central to the study of mathematical rationality, and by analyzing the notion of growth in historical as well as logical terms. Not a mere compendium of opinions, it is organised in dialogical forms, with each philosophical thesis answered by one or more historical case studies designed to support, complicate or question (...) it. The first part of the book examines the role of scientific theory and empirical fact in the growth of mathematical knowledge. The second examines the role of abstraction, analysis and axiomatization. The third raises the question of whether the growth of mathematical knowledge constitutes progress, and how progress may be understood. Readership: Students and scholars concerned with the history and philosophy of mathematics and the formal sciences. (shrink)

Demystifying Legal Reasoning defends the proposition that there are no special forms of reasoning peculiar to law. Legal decision makers engage in the same modes of reasoning that all actors use in deciding what to do: open-ended moral reasoning, empirical reasoning, and deduction from authoritative rules. This book addresses common law reasoning when prior judicial decisions determine the law, and interpretation of texts. In both areas, the popular view that legal decision makers practise special forms of reasoning is false.

What do humility, intellectual humility, and open-mindedness mean in the context of inter-group conflict? We spend most of our time with ingroup members, such as family, friends, and colleagues. Yet our biggest disagreements —— about practical, moral, and epistemic matters —— are likely to be with those who do not belong to our ingroup. An attitude of humility towards the former might be difficult to integrate with a corresponding attitude of humility towards the latter, leading to smug tribalism that masquerades (...) as genuine virtue. These potentially conflicting priorities have recently come to the fore because “tribal epistemology” has so thoroughly infected political and social discourse. Most research on these dispositions focuses on individual traits and dyadic peer-disagreement, with little attention to group membership or inter-group conflict. In this chapter, we dilate the social scale to address this pressing philosophical and social problem. (shrink)

This article contributes to a growing conversation about the role of numbers in promoting gendered agendas in potentially contradictory ways. Drawing from interviews with gender advisors—the professionals tasked with mainstreaming gender in development projects—in an East African country, I begin from the paradox that gender advisors articulate a strong preference for qualitative data to best capture the lives of the women they aim to assist while voicing a need for quantitative metrics. I demonstrate that gender advisors come to imagine metrics (...) as expeditious bureaucratic tools able to inspire cooperation from otherwise reluctant coworkers. I argue that development organizations are gendered in ways—acutely seen in how advisors struggle, are sidelined, and attempt to advance their goals with numbers—that lead to the utility of valuing quantitative metrics over qualitative ones. I establish two theoretical contributions: Gendered organizations theory is essential to understanding the adoption and globalization of performance metrics, and in an age of evidence-based decision making, the utility of quantified data to garner resources is heightened, rewarding those who adopt quantified knowledge production. I coin the term “the paradox of quantified utility” to describe how these material advantages encourage even skeptics to value quantitative metrics. (shrink)

Exploring the intimate tie between body movement and space and time, Lee begins with the position that body movement generates space and time and explores the ethical implications of this responsibility for the situations one’s body movements generate. Whiteness theory has come to recognize the ethical responsibility for situations not of one’s own making and hence accountability for the results of more than one’s immediate personal conscious decisions. Because of our specific history, whites have developed a particular embodiment and body (...) movement that generates places that can only be characterized as more comfortable and more enabling to whites. (shrink)

To ensure that the information resulting from research is relevant to patients, the Patient‐Centered Outcomes Research Institute eschews the “traditional health research” paradigm, in which investigators drive all aspects of research, in favor of one in which patients assume the role of research partner. If we accept the premise that patient engagement can offer fresh perspectives that shape research in valuable ways, then at least two important sets of questions present themselves. First, how are patients being engaged—and how should they (...) be engaged? Second, which patients are being engaged—and which patients should be? This set has received relatively less attention, and the neglect is surprising, given that the “who” question is conceptually prior to the question of “how.”This article focuses attention on the “who” of patient engagement in research. First, we provide background on the rationale for patient engagement, underscoring the importance of ensuring the representativeness of engaged patients. Second, we present what little is known about patients engaged in PCORI‐funded research. Third, we identify and discuss the ethical implications of ways in which current practices of patient identification and recruitment may lead to a lack of representativeness. These practices include reliance on the well‐connected and well‐informed, reliance on patients who are not well trained or well‐informed, and reliance on patient advocacy organizations. Finally, we consider several strategies for addressing these pitfalls in order to maximize the positive goals of patient engagement. Patient engagement is intended to address the inability of researchers, funders, and others to fully represent patient views and priorities, but without sufficient attention, the patients selected for this role may still leave important gaps. (shrink)

This essay explores how the distinctively anthropological concept of culture provides uniquely valuable insights into the workings of science in its cultural context. Recent efforts by anthropologists to dislodge the traditional notion of culture as a homogenous, stable whole have opened up a variety of ways of imagining culture that place power differentials, flux, and contradiction at its center. Including attention to a wide variety of social domains outside the laboratory, attending to the ways nonscientists actively engage with scientific knowledge, (...) and focusing on the complex interactions that flow both into and out of research laboratories are ways the activities of both scientists and nonscientists can be situated in the heterogeneous matrtx of culture. Three images—the citadel, the rhizome, and the string figure—allow us to picture the discontinuous ways science both permeates and is permeated by cultural life. (shrink)

Frege argues that number is so unlike the things we accept as properties of external objects that it cannot be such a property. In particular, (1) number is arbitrary in a way that qualities are not, and (2) number is not predicated of its subjects in the way that qualities are. Most Aristotle scholars suppose either that Frege has refuted Aristotle's number theory or that Aristotle avoids Frege's objections by not making numbers properties of external objects. This has led some (...) to conclude that Aristotle's accounts of arithmetical and geometrical objects differ substantially. I close this supposed gap by showing that Aristotle's arithmetical objects, like geometrical objects, are just certain sensible things qua certain properties they in fact possess. Specifically, numbers are pluralities qua quantitative or relational properties like ten units or ten. I show that this view is resistant to the Fregean concerns about arbitrariness and numerical predication. (shrink)

Under the first-past-the-post electoral system that is still deeply entrenched in such democracies as Canada and the United States, it is not at all uncommon in a provincial, state, or federal election for there to be a striking lack of correspondence between the share of the seats a political party is able to win and its share of the popular vote. From the standpoint of the democratic ideal what is morally unacceptable about this system is that the right to vote (...) it confers on members of the electorate is not a defensible instantiation of the fundamental right citizens have to participate on terms of equality in the collective decision-making processes that help to determine their options in life. Three common attempts by defenders of the system to shield it from this objection are considered and rejected. (shrink)

Under the first-past-the-post electoral system that is still deeply entrenched in such democracies as Canada and the United States, it is not at all uncommon in a provincial, state, or federal election for there to be a striking lack of correspondence between the share of the seats a political party is able to win and its share of the popular vote. From the standpoint of the democratic ideal what is morally unacceptable about this system is that the right to vote (...) it confers on members of the electorate is not a defensible instantiation of the fundamental right citizens have to participate on terms of equality in the collective decision-making processes that help to determine their options in life. Three common attempts by defenders of the system to shield it from this objection are considered and rejected. (shrink)

The literary legacy of Aramaic-speaking Christianity consists predominantly of ecclesiastical works—theological treatises , sermons, hymns, and the like; it is for the most part, one must admit, rather dull stuff. Distinguished from the rest, and of peculiar interest to classical students, are secular works, translated from the Greek, which include, apart from medical and scientific treatises, a handful of writings by Plutarch, Lucian, and Themistius. Baumstark suggests that the translator of these three Greek writers be identified as Sargis , a (...) learned priest and ρχιατρός in Theodosiopolis, with a somewhat chequered ecclesiastical career , who is known as the translator of a number of philosophical and medical treatises. Sargis has his place in the history of thought, for it was in the first place through his Syriac translations that the Arabs became acquainted with Galen, whose works eventually assumed almost canonical status with them. (shrink)

I argue that a reasonably comprehensive doctrine of human rights can be reconciled with at least a good deal of diversity in cultural belief and practice. The reconciliation cannot be achieved by trying to show that there is in fact a cross-cultural consensus about the existence of human rights, partly because no valid inference to the normative status of human rights can be drawn from the existence of such a consensus. However, by highlighting the premises rather than the conclusions of (...) normatively persuasive arguments for human rights, I argue that a reasonably comprehensive doctrine of universal human rights can be squared with what is known about the diversity of cultural beliefs and practices. This is because the (empirically plausible) denial that there is in fact a cross-cultural consensus about the existence of human rights can go hand-in-hand with cross-cultural endorsement of the normative considerations that underpin human rights doctrine. (shrink)

I argue that a reasonably comprehensive doctrine of human rights can be reconciled with at least a good deal of diversity in cultural belief and practice. The reconciliation cannot be achieved by trying to show that there is in fact a cross-cultural consensus about the existence of human rights, partly because no valid inference to the normative status of human rights can be drawn from the existence of such a consensus. However, by highlighting the premises rather than the conclusions of (...) normatively persuasive arguments for human rights, I argue that a reasonably comprehensive doctrine of universal human rights can be squared with what is known about the diversity of cultural beliefs and practices. This is because the (empirically plausible) denial that there is in fact a cross-cultural consensus about the existence of human rights can go hand-in-hand with cross-cultural endorsement of the normative considerations that underpin human rights doctrine. (shrink)

Cet article propose une réponse critique à quelques thèmes du livre de Kyle Johannsen,A Conceptual Investigation of Justice. La discussion se penche sur l’analyse du pluralisme fondamental de la valeur proposée par Johannsen et met en cause cette même analyse. Je soutiens que l’analyse proposée par Johannsen ne parvient pas à expliquer comment des conflits entre des valeurs fondamentales peuvent être résolus et qu’il y a davantage de convergence entre des valeurs fondamentales que ne le reconnaît Johannsen.

Hand-lettered inspirational quotes paired with contemporary illustrations for more than a year of Motivational Mondays, You’ve Totally Got This! has got you covered. Sometimes all we need is a little nudge: this book serves as inspiration for those facing new beginnings, a sudden change, or just a whole lot to do. Great for grads, creatives, and entrepreneurs: every spread is like a greeting card, so this delightful volume serves as a stand-alone championing or as the perfect finishing touch to a (...) gift. (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. Contradicting (...) Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)

The Cartesian method, construed as a way of organizing domains of knowledge according to the "order of reasons," was a powerful reductive tool. Descartes made significant strides in mathematics, physics, and metaphysics by relating certain complex items and problems back to more simple elements that served as starting points for his inquiries. But his reductive method also impoverished these domains in important ways, for it tended to restrict geometry to the study of straight line segments, physics to the study of (...) ambiguously constituted bits of matter in motion, and metaphysics to the study of the isolated, incorporeal knower. This book examines in detail the negative and positive impact of Descartes's method on his scientific and philosophical enterprises, exemplified by the Geometry, the Principles, the Treatise of Man, and the Meditations. (shrink)

In Physics 2.4–6, Aristotle offers an account of things that happen “by luck” and “spontaneously”. Many of these things are what we might think of as “lucky breaks”: cases where things go well for us, even though we don’t expect them to. In Physics 2.5, Aristotle illustrates this idea with the case of a man who goes to the market for some reason unrelated to collecting a debt he is owed. While he is there, this man just so happens to (...) run into his debtor and get his money back—which is what he “wanted” all along. This case has a number of features that have proved puzzling. Most notably, Aristotle seems to think that while “it happened accidentally to him to come and to do this for the sake of getting the money”, nevertheless the man “did not come for the sake of this”—though he “would have”. What must such a proceeding be like to be described in these ways? Physics 2.4–6 makes several important moves towards answering this question. One of them—among the earliest and seemingly a foundational one—is the claim that “for the sake of something are as many things as could be done by thought and by nature”. The aim of this paper is to identify the role that this claim plays in Aristotle’s account of spontaneous proceedings. It defends two main claims. First, Aristotle’s suggestion that spontaneous proceedings could be done by nature and by thought is the product of a more general strategy. His approach is to sketch an intuitive pattern of explanation for proceedings that happen for the sake of something in the ordinary—non-spontaneous—way, and then to try to extend that model to the case of things that do so spontaneously, preserving as much of it as possible. Applying this strategy reveals that whereas nature and thought in fact function as efficient causes of ordinary proceedings that are for the sake of something, this cannot be the case in spontaneous ones. Instead, nature and thought could function as their causes. Second, I argue that Aristotle’s implementation of this strategy is rooted in his account of causation and especially Physics 2.3’s list of “modes” of causes. When he claims that spontaneous proceedings “could” be done by nature and by thought, he is saying that nature and thought are their efficient causes in capacity. In the practical case, spontaneous proceedings are caused by agents who have certain capacities, connected with their desires and abilities. In the right circumstances, these agents would actively exercise those capacities in acting for the sake of a given end. (shrink)

In this issue of the Hastings Center Report, James Sabin and his colleagues ask what responsibility investigators in a learning health organization have to patients when research—particularly research of which patients might be unaware—illuminates problematic aspects of the patients' care. Sabin and his colleagues were confronted by this question in the midst of designing a randomized controlled trial that sought to determine if an educational intervention targeted at patients with atrial fibrillation and their clinicians reduces underuse of oral anticoagulants. Worried (...) about harm that might befall patients in the control group and fearing that they would be negligent bystanders if they knew these patients were at risk and did nothing, the investigators adopted a “workaround.” But the “workaround,” I suggest, was not a solution to the negligent bystander problem. Nor was it a solution to the problem as I would alternatively frame it—how to address instances of suboptimal patient care identified through research within learning health organizations. (shrink)