Editors' introduction to 3rd thematic issue on philosophy of medicine.

The author exposes an alienating conception of rationality and its influence over modern liberal thought and practice, looking specifically at the rise in moral relativism and the development of the liberal democratic state.

Given the importance of cross-disciplinary research, facilitating CDR effectiveness is a priority for many institutions and funding agencies. There are a number of CDR types, however, and the effectiveness of facilitation efforts will require sensitivity to that diversity. This article presents a method characterizing a spectrum of CDR designed to inform facilitation efforts that relies on bibliometric techniques and citation data. We illustrate its use by the Toolbox Project, an ongoing effort to enhance cross-disciplinary communication in CDR teams through structured, (...) philosophical dialogue about research assumptions in a workshop setting. Toolbox Project workshops have been conducted with more than 85 research teams, but the project's extensibility to an objectively characterized range of CDR collaborations has not been examined. To guide wider application of the Toolbox Project, we have developed a method that uses multivariate statistical analyses of transformed citation proportions from published manuscripts to identify candidate areas of CDR, and then overlays information from previous Toolbox participant groups on these areas to determine candidate areas for future application. The approach supplies 3 results of general interest: A way to employ small data sets and familiar statistical techniques to characterize CDR spectra as a guide to scholarship on CDR patterns and trends. A model for using bibliometric techniques to guide broadly applicable interventions similar to the Toolbox. A method for identifying the location of collaborative CDR teams on a map of scientific activity, of use to research administrators, research teams, and other efforts to enhance CDR projects. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

There is no question that Hick's theory rests upon multiple assumptions about a singular, transcendental grounding and the fundamental equality of the various religions that cannot be inductively verified beyond all doubt. That need not mean, however, that the “attractiveness” of his theory derives solely from the “peculiar charm” For the Wittgensteinian implications here, see again G. Loughlin, “Noumenon and Phenomena,” pp. 501–502. of supposing that the One and the Many are no more at odds in the realm of (...) religion than anywhere else. For Hick's assumptions are not just an exercise in wishful thinking or wild speculation. They are based upon “experience” from within what he calls the “benign circle of faith.”See Hick, “A Concluding Comment,” p. 451. Because the reality experienced is “ambiguous,” acceptance or rejection of his views will, of course, be a matter of “choice.” And, admittedly, this choice will be dictated not so much by a weighing of empirical evidence that might prove the various religions to be exactly as he sees them, as by a consideration of what we have been surveying in the preceding pages, namely, “the import of seeing things as Hick does.”See G. Loughlin, “Noumenon and Phenomena,” p. 502. (shrink)

The European Legacy, Volume 17, Issue 3, Page 415-416, June 2012.

Philosophers of science discuss whether theory selection depends on aesthetic judgments or criteria, and whether these putatively aesthetic features are genuinely extra-epistemic. As examples, judgments involving criteria such as simplicity and symmetry are often cited. However, other theory selection criteria, such as fecundity, coherence, internal consistency, and fertility, more closely match those criteria used in art contexts and by scholars working in aesthetics. Paying closer attention to the way these criteria are used in art contexts allows us to understand some (...) evaluative and developmental practices in scientific theory selection as genuinely aesthetic, enlarging the scope of the goals of science. (shrink)

Since the publication of Clark and Chalmers' Extended Mind paper, the central claims of that paper, viz. the thesis that cognitive processes and cognitive or mental states extend beyond the brain and body, have been vigorously debated within philosophy of mind and philosophy of cognitive science. Both defenders and detractors of these claims have since marshalled an impressive battery of arguments for and against “active externalism.” However, despite the amount of philosophical energy expended, this debate remains far from settled. We (...) argue that this debate can be understood as answering two metaphysical questions. Yet prominent voices within the debate have assumed that there is a tight relationship between these two questions such that one question can be answered via the other. We defend an alternative ‘wide’ view, whereby mentality is understood as constituted by wide social and cultural factors. Our wide view entails that the two metaphysical questions are separate and should be kept distinct. This suggests that active externalism as understood by prominent voices within that debate requires dissolution, rather than solution. However, if the debate were instead understood as only focusing on the second of the two questions, then there could be a possible future for this debate. (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

Ned Block argues that the higher-order (HO) approach to explaining consciousness is ‘defunct’ because a prominent objection (the ‘misrepresentation objection’) exposes the view as ‘incoherent’. What’s more, a response to this objection that I’ve offered elsewhere (Weisberg 2010) fails because it ‘amounts to abusing the notion of what-it’s-like-ness’ (xxx).1 In this response, I wish to plead guilty as charged. Indeed, I will continue herein to abuse Block’s notion of what-it’s-like-ness. After doing so, I will argue that the HO approach accounts (...) for the sense of what-it’s-like-ness that matters in a theory of consciousness. I will also argue that the only incoherence present in the HO theory is that generated by embracing Block’s controversial notion of what-it’s-like-ness, something no theorist of any stripe ought to do. Block is famous for (among other things) having introduced the notion of ‘phenomenal consciousness’ into contemporary philosophy of mind (Block 1995). This term is widely employed in the philosophical literature and it even appears in the empirical literature. But wide-speared usage has brought about divergent interpretations of the term. We can distinguish a ‘moderate’ and a ‘zealous’ reading of ‘phenomenal consciousness’. On the moderate reading, ‘phenomenal consciousness’ just means ‘experience’. Many people have embraced this sense of the term and use it to roughly pick out conscious experience involving sensory quality (states like conscious visual experiences or conscious pains, for example).2 On the zealous reading, however, phenomenal consciousness is held to be ‘distinct from any cognitive, intentional, or functional property’ (Block 1995: 234). That is, any explanation of phenomenal consciousness in exclusively cognitive, intentional, or functional terms will fail to capture, without remainder, what is really distinctive about phenomenal consciousness. Block, of course, is fully clear about embracing the zealous reading; indeed, his initial introduction of the notion is in those terms. The same ambiguity occurs with the much-used (and abused) idea of ‘what-it’s-like-ness’.. (shrink)

Different beliefs about the nature and justification of bioethics may reflect different assumptions in moral epistemology. Two alternative views (put forward by David Seedhouse and Michael H Kottow) are analysed and some speculative conclusions formed. The foundational questions raised here are by no means settled and deserve further attention.

The success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness. Philosophical analysis of background assumptions of the current paradigmatic model. While these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that frame (...) our thinking about medical care. In this paper we argue that the increased focus on lifestyle and shared decision making requires a new narrative of agency, to supplement the narrative of “the patient”. This narrative is conceptually linked to the developing philosophy of person-centred care. If patients are seen also as “agents” this will result in a substantial shift in practical decisions: The development and adoption of this narrative will help practitioners work with patients to their mutual benefit, harnessing the patients’ motivation, shifting the focus from treatment to prevention and preventing unnecessary and harmful treatments that can come out of our preoccupation with the patient narrative. It will also help to shift research efforts, conceptual and empirical, from “treating” and “battling” diseases and their purported “mechanisms” to understanding complex contributing factors and their interplay. (shrink)

Telling a patient that the outcome of his illness is not good, or even hopeless, requires sensitivity and the ability to communicate with him in the setting of a hospital which is an unnatural environment divorced from family and friends. It is a task which must be taught and learned by doctors and nurses.

BackgroundThe success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness.MethodsPhilosophical analysis of background assumptions of the current paradigmatic model.ResultsWhile these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that frame our thinking (...) about medical care. In this paper we argue that the increased focus on lifestyle and shared decision making requires a new narrative of agency, to supplement the narrative of “the patient”. This narrative is conceptually linked to the developing philosophy of person-centred care.ConclusionsIf patients are seen also as “agents” this will result in a substantial shift in practical decisions: The development and adoption of this narrative will help practitioners work with patients to their mutual benefit, harnessing the patients’ motivation, shifting the focus from treatment to prevention and preventing unnecessary and harmful treatments that can come out of our preoccupation with the patient narrative. It will also help to shift research efforts, conceptual and empirical, from “treating” and “battling” diseases and their purported “mechanisms” to understanding complex contributing factors and their interplay. (shrink)

The Church is a sexed body, in both carnal and symbolic terms. The Church has sex, but being the Church it does so in a radically creative way. This article explores the contrast between sex as imagined by the Church and as imagined by evolutionary psychology (Darwinism). It argues that the latter reduces sex to reproduction (repetition) and makes this a metaphysical principle, whereas the Church transforms sex into a means for final beatitude. (Christian sex is not about self-perpetuation, but (...) about welcoming strangers; not about children as possessions, but as God's most precious gifts.) Darwinism strangely repeats a debased (neoscholastic) form of the natural law, whereas the Church looks to follow a law that is the dispossessive desire of God for God. Sex after this law orders us towards the infinite joy of our consummation with and in God, in the fellowship of Christ and the holy saints. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 261-264 [Access article in PDF] Contingency, Arbitrariness, and Failure Michael Loughlin PICKERING AIMS TO affect the form of the debate about the reality of mental illness. He notices that many influential arguments both for and against the existence of mental illnesses are in an important sense circular. It is observed that a given condition is relevantly similar to conditions we all agree (...) are genuine illnesses and on the basis of this observation it is concluded that it too can be classified as a type of illness—from which it can be inferred that mental illnesses do indeed exist. But Pickering contends that the initial observation can only be made if we already construe the condition in question as a type of illness. Otherwise we may interpret the data differently.So unless we help ourselves to the categorization whose legitimacy it is supposed to establish, the likeness argument cannot get going. He illustrates his point effectively. Most of his examples are taken from authors defending the existence of mental illness and it would have been interesting to see a more detailed account of the argument working in the other direction. Even so, his references to Szasz (Pickering 2003) are sufficient to convince readers familiar with Szasz's work that a version of the likeness argument (the paradigm approach) is as much at work in his refutation of the existence of mental illnesses as is it in Boorse's proof of their reality.This is an incisive analysis, which should be taken very seriously indeed by contributors to the debate. Its most immediate implication is a negative one. We should not rely upon any version of the likeness argument to establish the existence (or nonexistence) of mental illnesses: "the likeness argument must fail" (Pickering 2003, p. 253). One important question left unanswered by the paper concerns what form the debate should take, if its criticisms are accepted. Assuming we agree that the likeness argument is methodologically flawed, what should the methodology be for debating the substantive issues at stake? Put another way, how can we break the circle? How is it possible to construct arguments that do not presuppose their main conclusions, and so to make real intellectual progress in addressing this issue? Is this in fact possible? What would a valid argument in this area look like, and what sort of observational premises (if any) would be acceptable as evidence?On the most skeptical reading of his thesis, Pickering's arguments render the ideal of intellectual progress toward a resolution of this debate strictly unattainable. The circle cannot be broken, because the theory dependence of our categorizations makes the truth about the reality of mental illness either unknowable or irredeemably relative to one's intellectual starting point. Having argued that the likeness argument fails in the case of alcoholism, Pickering states one possible response to this failure on the part of psychiatry as the concession that the classification [End Page 261] of alcoholism as an illness is "very much a matter of opinion (2003, p. 250). Because he then argues that the argument fails for logically analogous reasons in the case of schizophrenia, we may feel invited to draw the same conclusion about that condition. He later admits there is "some truth in the charge" that "the rejection of the likeness argument seems to introduce an unacceptable element of contingency into the way important questions about the categorization of schizophrenia and alcoholism are answered" (p. 253). His response to this is that it is not his arguments that lead to this element of contingency, and he reiterates that the likeness argument cannot get beyond such contingencies (p. 253).Certainly he seems committed to the view that no observational premises can "decide, or help decide, the issue" because the "detectable and observable features" of a purported mental illness "do not determine what description should be given of them" (p. 250). Even the fact that a particular description seems intuitively irresistible or "natural" cannot decide this. His argument on this point concerns the fact that what appears natural or intuitively obvious to us is... (shrink)

The existential analysis -- The death of dasein -- The timeliness of dasein -- The derivation of time -- The time of being.

The achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

Living out of silence, out of a fully functioning, lovingly attentive mind, and not just out of thought, out of a partially functioning mind, is requisite for depth or profundity in living or relating. A fully attentive, truly silent or meditative mind sees that there is real dualism of time and the timeless and that time and the timeless each has its own unique value. The timeless, or real silence, that which alone can make for depth in one's living and (...) relating, can be there only when, in one's awareness, time and all that is related to time, have come to an end. An examination of a wide variety of statements made by writers, both past and present, shows that these understandings are seldom there in contemporary writings, just as they were not there in writings that have come down to us from the past. 'Living beyond the One and the Many' invites readers to consider the possibility that what is presented in it can bring deep meaning to one's way of living in the world"--Publisher's description, back cover. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

Jeffrey Collins’ new book aims to presents Locke’s views on religious toleration in the light of Thomas Hobbes’ political philosophy. At first blush, Hobbes seems an unusual choice as a point of co...

Chapter 1 Who this book is for and who it is not for1 There are already too many books offering solutions to the problems of the health service. ...

I examine error diagnosis (model-model disagreement) in climate model intercomparisons including its difficulties, fruitful examples, and prospects for streamlining error diagnosis. I suggest that features of climate model intercomparisons pose a more significant challenge for error diagnosis than do features of individual model construction and complexity. Such features of intercomparisons include, e.g., the number of models involved, how models from different institutions interrelate, and what scientists know about each model. By considering numerous examples in the climate modeling literature, I distill (...) general strategies (e.g., employing physical reasoning and using dimension reduction techniques) used to diagnose model error. Based on these examples, I argue that an error repertoire could be beneficial for improving error diagnosis in climate modeling, although constructing one faces several difficulties. Finally, I suggest that the practice of error diagnosis demonstrates that scientists have a tacit-yet-working understanding of their models which has been under-appreciated by some philosophers. (shrink)