The corporatization of U.S. health care has directed cost containment efforts toward scrutinizing the clinical decisions of physicians. This stimulated a variety of new utilization management interventions, particularly in hospital and managed care settings. Recent changes in fee-for-service medicine and physicians' traditional agency relationships with patients, purchasers, and insurers are examined here. New information systems monitoring of physician ordering behavior has already begun to impact on physician autonomy and the relationship of physicians to provider organizations in both for-profit and not-for-profit (...) sectors. As managed care practice settings proliferate, serious ethical questions will be raised about agency relationships with patients.This article examines health system dynamics altering the historical agency relationship between the physician and patient and eroding the traditional autonomy of the medical profession in the United States. The corporatization of medicine and the accompanying information systems monitoring of physician productivity is seen to account of such change, now posing serious ethical dilemmas. (shrink)

This article describes the most important determinant of contemporary American medical practice: the corporatization of the health care delivery system. It argues that there is an urgent need for greater reflection by physicians on the values inherent in profit-based health care and on the implications of such a model of care. Other pressures on the medical profession and several available responses are examined. The article then poses a challenge to the profession to assume a more forthright advocacy for social equity (...) in health care provision. (shrink)

The philosophical theory of scientific explanation proposed here involves a radically new treatment of causality that accords with the pervasively statistical character of contemporary science. Wesley C. Salmon describes three fundamental conceptions of scientific explanation--the epistemic, modal, and ontic. He argues that the prevailing view is untenable and that the modal conception is scientifically out-dated. Significantly revising aspects of his earlier work, he defends a causal/mechanical theory that is a version of the ontic conception. Professor Salmon's theory furnishes (...) a robust argument for scientific realism akin to the argument that convinced twentieth-century physical scientists of the existence of atoms and molecules. To do justice to such notions as irreducibly statistical laws and statistical explanation, he offers a novel account of physical randomness. The transition from the "reviewed view" of scientific explanation to the causal/mechanical model requires fundamental rethinking of basic explanatory concepts. (shrink)

Philosophical arguments usually are and nearly always should be abductive. Across many areas, philosophers are starting to recognize that often the best we can do in theorizing some phenomena is put forward our best overall account of it, warts and all. This is especially true in esoteric areas like logic, aesthetics, mathematics, and morality where the data to be explained is often based in our stubborn intuitions. -/- While this methodological shift is welcome, it's not without problems. Abductive arguments involve (...) significant theoretical resources which themselves can be part of what's being disputed. This means that we will sometimes find otherwise good arguments which suggest their own grounds are problematic. In particular, sometimes revising our beliefs on the basis of such an argument can undermine the very justification we used in that argument. -/- This feature, which I'll call self-effacingness, occurs most dramatically in arguments against our standing views on the esoteric subject matters mentioned above: logic, mathematics, aesthetics, and morality. This is because these subject matters all play a role in how we reason abductively. This isn't an idle fact; we can resist some challenges to our standing beliefs about these subject matters exactly because the challenges are self-effacing. The self-effacing character of certain arguments is thus both a benefit and limitation of the abductive turn and deserves serious attention. I aim to give it the attention it deserves. (shrink)

Domestic violence and abuse (DVA) are at last coming to be recognised as serious global public health problems. Nevertheless, many women with personal histories of DVA decline to disclose them to healthcare practitioners. In the health sciences, recent empirical work has identified many factors that impede DVA disclosure, known as barriers to disclosure. Drawing on recent work in social epistemology on testimonial silencing, we might wonder why so many people withhold their testimony and whether there is some kind of epistemic (...) injustice afoot here. In this paper, I offer some philosophical reflections on DVA disclosure in clinical contexts and the associated barriers to disclosure. I argue that women with personal histories of DVA are vulnerable to a certain form of testimonial injustice in clinical contexts, namely, testimonial smothering, and that this may help to explain why they withhold that testimony. It is my contention that this can help explain the low rates of DVA disclosure by patients to healthcare practitioners. (shrink)

The Epicurean philosophical system has enjoyed much recent scrutiny, but the question of its philosophical ancestry remains largely neglected. It has often been thought that Epicurus owed only his physical theory of atomism to the fifth-century BC philosopher Democritus, but this study finds that there is much in his ethical thought which can be traced to Democritus. It also finds important influences on Epicurus in Democritus' fourth-century followers such as Anaxarchus and Pyrrho, and in Epicurus' disagreements with his own Democritean (...) teacher Nausiphanes. The result is not only a fascinating reconstruction of a lost tradition, but also an important contribution to the philosophical interpretation of Epicureanism, bearing especially on its ideal of tranquillity and on the relation of ethics to physics. (shrink)

In this chapter, I revisit the question of the philosophical significance of the Great War upon the trajectory of philosophy in the twentieth century. While accounts of this are very rare in philosophy, and this is itself symptomatic, those that are given are also strangely implausible. They usually assert one of two things: that the War had little or no philosophical significance because most of the major developments had already begun, or—at the opposite extreme—they maintain that nothing was ever the (...) same in philosophy (as elsewhere). On the latter view, the creation of the so-called analytic-continental ‘divide’ is but one notable philosophical consequence of the Great War. I want here to steer a middle-way between these positions, both having a grain of truth but over-playing their respective hands. (shrink)

If we want to retain classical logic and standard syntax in light of the liar, we are forced to restrict the T-schema. The traditional philosophical justification for this is sentential – liar sentences somehow malfunction. But the standard formal way of implementing this is conditional, our T-sentences tell us that if “p” does not malfunction, then “p” is true if and only if p. Recently Bacon and others have pointed out that conditional T-restrictions like this flirt with incoherence. If we (...) want to keep the “malfunction” motivation, our only other option is to non-conditionally restrict the T-schema, but Field and others have given powerful philosophical and technical arguments against this kind of approach. Here I argue that if we really take the philosophical motivation for restricting T-sentences seriously, we can explain why conditional restrictions fail, answer Field's argument, and reason in a coherent way about truth using a non-conditional restriction strategy. This cracks the door open for a fully classical response to the liar and related paradoxes. In closing, I argue that, when properly understood, this kind of “restriction” is not really a restriction at all. If this is right, then the holy grail of liar studies (classical logic, naïve truth, and standard syntax) may yet be attainable. (Note for readers: when this paper was first put online, the typesetters had changed some instances of corners to brackets, leading to confusion. The paper has now been corrected online by PPR, so please make sure you have the corrected version before reading or citing.). (shrink)

Once upon a time, logical conventionalism was the most popular philosophical theory of logic. It was heavily favored by empiricists, logical positivists, and naturalists. According to logical conventionalism, linguistic conventions explain logical truth, validity, and modality. And conventions themselves are merely syntactic rules of language use, including inference rules. Logical conventionalism promised to eliminate mystery from the philosophy of logic by showing that both the metaphysics and epistemology of logic fit into a scientific picture of reality. For naturalists of all (...) stripes, this was paradise. Alas, paradise was lost. By the end of the twentieth century, logical conventionalism had been almost universally abandoned. But more recently, it has been revitalized. This chapter provides an overview of logical conventionalism and its history, clears away misunderstandings, and briefly responds to both the canonical objections to conventionalism (from Quine, Dummett, Boghossian, and many others) as well as new objections (from Field and Golan). From paradise lost, to paradise regained: logical conventionalism is back. (shrink)

Reviews the scope, nature, and applications of the philosophical discipline, focusing on methods for distinguishing between valid and fallacious arguments and inferences.

We face reality presented with the data of conscious experience and nothing else. The project of early modern philosophy was to build a complete theory of the world from this starting point, with no cheating. Crucial to this starting point is the data of conscious sensory experience – sense data. Attempts to avoid this project often argue that the very idea of sense data is confused. But the sense-data way of talking, the sense-data language, can be freed from every blemish (...) using ideas from contemporary metaontology. We can adopt a sense-data framework that vindicates the traditional claims of sense-data theories and leads to plausible theories of perception and color. We can, we should, and in a sense, we must. Yet when we do, we face the traditional problem of external world skepticism, head-on. The real challenge of skepticism is forced upon us; it cannot honestly be avoided using externalist tricks, burden of proof shifting, or other razzle dazzle. But the challenge can be met: we are rational to posit the external world as the best explanation of the many synchronic and diachronic patterns over our sense-data. This paper argues for all of these points and ends with a plea for analytic empiricism – a traditional sense-data version of empiricism that uses all of the tools of analytic philosophy while avoiding the more questionable doctrines of the Vienna Circle (phenomenalism, verificationism). Analytic empiricism is our last best hope for completing the great philosophical project of early modern philosophy. (shrink)

In his arguments that science itself can answer moral questions, Sam Harris often appeals to our intuitions about the badness of suffering. If we share these intuitions, Harris argues, we’ve taken a significant step in conceding to a basically utilitarian worldview. In this chapter, I critically assess Harris’ arguments and find them deeply wanting.

Presupposing no familiarity with the technical concepts of either philosophy or computing, this clear introduction reviews the progress made in AI since the inception of the field in 1956. Copeland goes on to analyze what those working in AI must achieve before they can claim to have built a thinking machine and appraises their prospects of succeeding. There are clear introductions to connectionism and to the language of thought hypothesis which weave together material from philosophy, artificial intelligence and neuroscience. John (...) Searle's attacks on AI and cognitive science are countered and close attention is given to foundational issues, including the nature of computation, Turing Machines, the Church-Turing Thesis and the difference between classical symbol processing and parallel distributed processing. The book also explores the possibility of machines having free will and consciousness and concludes with a discussion of in what sense the human brain may be a computer. (shrink)

Because of the “all-or-none” character of nervous activity, neural events and the relations among them can be treated by means of propositional logic. It is found that the behavior of every net can be described in these terms, with the addition of more complicated logical means for nets containing circles; and that for any logical expression satisfying certain conditions, one can find a net behaving in the fashion it describes. It is shown that many particular choices among possible neurophysiological assumptions (...) are equivalent, in the sense that for every net behaving under one assumption, there exists another net which behaves under the other and gives the same results, although perhaps not in the same time. Various applications of the calculus are discussed. (shrink)

The diversity of nanotechnologies and of the governance challenges that their applications raise calls for exploration and learning across different cases. We present an Upstream Oversight Assessment (UOA) of expected benefits and potential harms of nanoparticles made of a synthetic polymer (PLGA) to improve vaccines for farmed salmon. Suggested by Jennifer Kuzma and colleagues, an UOA may help identify and prioritise research needs, and it may support evaluations of the adequacy of relevant existing regulatory frameworks. In this work, the (...) UOA approach is modified and supported with elements from the uncertainty analysis framework developed by Warren Walker and colleagues. Empirically, we draw on relevant available published literature and insights generated in an ongoing nanoparticle salmon vaccine project, in which one of the authors participates. Nanotechnologies have not previously been encountered in the regulatory context of fish vaccines, which in part raises unique challenges due to prospective large scale vaccine use in semi-open aquatic systems. Strengthened through cooperation between ELSA and technology researchers we found the UOA useful for an early mapping of benefits and concerns, and for identifying areas in need of further research prior to a nanoparticle based salmon vaccine is developed and taken into use. We consider our approach to represent one among several complementing initiatives that seek to contribute to early stage evaluations of possible negative side effects, broadly conceived, in order to facilitate a more robust nanotechnology development. (shrink)

Toward a theory of n-tuples of individuals and concepts as surrogates for Russellian singular propositions and singular concepts. Alonzo Church proposed a powerful and elegant theory of sequences of functions and their arguments as singular-concept surrogates. Church’s account accords with his Alternative (0), the strictest of his three competing criteria for strict synonymy. The currently popular objection to strict criteria like (0) on the basis of the Russell-Myhill paradox is here rebutted. Russell-Myhill is not a problem specifically for Alternative (0). (...) Rather it is a disproof of unrestricted concept comprehension. Unrestricted comprehension is also inconsistent with facts about sets of properties. It is demonstrated furthermore that the principal rival conception of propositions--propositions conceived as classes of possible worlds--is subject to a fatal philosophical collapse: It follows on that conception, given that each of us is fallible, that everyone believes everything. Although it is far superior to its principal rival conception, Church’s proposed theory is vulnerable under (0) to a version of Russell’s notorious Gray’s /Elegy/ objection. Some amendments to Church’s proposal are proffered that address Russell’s objection, including an amendment first proposed in the present author’s /Frege’s Puzzle/ (1986). Church’s response (personal correspondence) is considered. (shrink)

Alonzo Church famously provided three principal competing criteria for “strict synonymy,” i.e., sameness of semantic content. These are his Alternatives (0), (1), and (2)—numbered in order of increasing course-grainedness of content. On Alternative (2), expressions are deemed strictly synonymous iff they are logically equivalent. This criterion seems hopeless as an account of the objects of propositional attitude. On Alternative (1), expressions are deemed synonymous iff they are λ-convertible. Alternative (1) also evidently conflicts with discourse about the attitudes. On Alternative (0), (...) expressions are deemed strictly synonymous iff they are “synonymously isomorphic” in Church’s sense. On Alternative (0), semantic content is so fine-grained that not even “Romeo loves Juliet” and “Juliet is loved by Romeo” qualify as strictly synonymous. A fourth alternative, here called “Alternative (3),” deems expressions strictly synonymous iff they are co-intensional, i.e., they have the same semantic extension with respect to the same possible worlds. This criterion’s notion of content is even more course grained than that of Alternative (2). Several objections to Alternative (3) are considered. (This article is wholly contained within the author’s more definitive essay, “Singular Concepts”.). (shrink)

The thesis presented here focuses on the concept of totality in the work of the contemporary cultural critic Fredric Jameson (1934–). By totality, we mean how the human heart enables the human body, but without the body, the heart has no part concerning the whole; they are mutually dependent. This work shall argue that totality is the allegorical figuration framing Jameson’s political critiques of modernity in The Political Unconscious (1981) and Postmodernism (1991). The postmodern world today as an absent totality (...) represents the contradiction in Jameson: We live in a complex world despite its unrepresentability. Whilst studies of early Jameson have interpreted his works through postmodernity and cognitive mapping, their unsubstantiation of Jameson’s later totality has resulted in not being able to explicate Jameson’s view of the a-historicity of postmodernity. Part One shall examine Jameson’s readings of Immanuel Kant and Georg Hegel, demonstrating that Hegel’s critique of Kant concerning the boundary of knowledge includes its overcoming and that Hegelian totality is not closed, permitting Jameson to represent the world as an open totality. Part Two shall argue that Jameson’s reading of the works of Karl Marx and the Marxist tradition of Georg Lukács, Theodor Adorno and Walter Benjamin reinforces totality in their writing styles, which allows Jameson to glimpse totality through writing. Part Three shall argue that totality in Jameson’s interpretation of Johann Wolfgang von Goethe’s novel Wilhelm Meisters Lehrjahre (1796) is at work and that Friedrich Schlegel’s novel Lucinde (1799) elucidates a counterpoint to totality which can be used to understand non-dialectical thinkers which Jameson examines such as Martin Heidegger, Jacques Derrida and Gilles Deleuze. Part Four shall argue that Jameson’s reading of these thinkers is justified in critiquing their productive misreadings of totality as closed, informing their political quietism, thereby re-politicising totality as an allegory. (shrink)

It has recently been argued that hope is polysemous in that it sometimes refers to hoping and other times to being hopeful. That it has these two distinct senses is reflected in the observation that a person can hope for an outcome without being hopeful that it will occur. Below, I offer a new argument for this distinction. My strategy is to show that accepting this distinction yields a rich account of two distinct ways in which hope can be lost, (...) ways that map onto the two senses of hope: A person can lose hope either by ceasing to hope for an outcome (hopelessness) or by ceasing to be hopeful that it will obtain (despair). Thinking about these negative attitudes in these two ways, I contend, is explanatorily rich and fruitfully reveals how they differ in phenomenology, behavioral differences, and the ways in which a person can escape them. (shrink)

In Pascal’s famous wager, he claims that the seeking non-believer can induce genuine religious belief in herself by joining a religious community and taking part in its rituals. This form of belief regulation is epistemologically puzzling: can we form beliefs in this way, and could such beliefs be rationally held? In the first half of the paper, we explain how the regimen could allow the seeking non-believer to regulate her religious beliefs by intervening on her evidence and epistemic standards. In (...) the second half of the paper, we argue that regulated religious beliefs can be rationally held. (shrink)

This paper challenges T. S. Gendler's notion of aliefs, a novel kind of mental state which she introduces to explain a wide variety of belief-discordant behaviors. In particular, I argue that many of the cases which she uses to motivate such a mental state can be fully explained by accounts that make use only of commonplace attitudes such as beliefs and desires.

Introspective evidence is still treated with great suspicion in cognitive science. This work is designed to encourage cognitive scientists to take more account of the subject's unique perspective.

Writings by a thinker—a psychiatrist, a philosopher, a cybernetician, and a poet—whose ideas about mind and brain were far ahead of his time. Warren S. McCulloch was an original thinker, in many respects far ahead of his time. McCulloch, who was a psychiatrist, a philosopher, a teacher, a mathematician, and a poet, termed his work “experimental epistemology.” He said, “There is one answer, only one, toward which I've groped for thirty years: to find out how brains work.” Embodiments of (...) Mind, first published more than fifty years ago, teems with intriguing concepts about the mind/brain that are highly relevant to recent developments in neuroscience and neural networks. It includes two classic papers coauthored with Walter Pitts, one of which applies Boolean algebra to neurons considered as gates, and the other of which shows the kind of nervous circuitry that could be used in perceiving universals. These first models are part of the basis of artificial intelligence. Chapters range from “What Is a Number, that a Man May Know It, and a Man, that He May Know a Number,” and “Why the Mind Is in the Head,” to “What the Frog's Eye Tells the Frog's Brain” (with Jerome Lettvin, Humberto Maturana, and Walter Pitts), “Machines that Think and Want,” and “A Logical Calculus of the Ideas Immanent in Nervous Activity” (with Walter Pitts). Embodiments of Mind concludes with a selection of McCulloch's poems and sonnets. This reissued edition offers a new foreword and a biographical essay by McCulloch's one-time research assistant, the neuroscientist and computer scientist Michael Arbib. (shrink)

**** Reprint of the Indiana U. Press edition of 1966--which is cited in BCL3. Annotation copyright by Book News, Inc., Portland, OR.

A short discussion piece arguing that the neuropsychological phenomenon of double dissociations is most revealing of underlying cognitive architecture because of the capacities that are spared, more than the capacities that are lost.

This book evaluates the consequences of economic, social, environmental and cultural change on people living and working within Teesside in the North-East of England. It assesses the lived experiences, working lives, health and cultural perspectives of residents and key stakeholders in the wake of serious de-industralisation in the region. The narrative is embedded within the long-term industrial history of Stockton: an area once dominated by steel, coal and chemical industries. This past still continues to shape its future and influences the (...) ways in which that future is conceived and envisioned. The author explores a 'biography of place' analytical framework to offer a holistic view of the area, which considers the interaction between the social, economic, cultural, visual and environmental legacy of the community, which is firmly grounded in the past, present and future prospects of those who live and work there. (shrink)

This book offers solutions to two persistent and I believe closely related problems in epistemology. The first problem is that of drawing a principled distinction between perception and inference: what is the difference between seeing that something is the case and merely believing it on the basis of what we do see? The second problem is that of specifying which beliefs are epistemologically basic (i.e., directly, or noninferentially, justified) and which are not. I argue that what makes a belief a (...) perceptual belief, or a basic belief, is not any introspectible feature of the belief but rather the nature of the cognitive system, or "module", that is causally responsible for the belief. Thus, even zombies, who in the philosophical literature lack conscious experiences altogether, can have basic, justified, perceptual beliefs. -/- The theories of perceptual and basic beliefs developed in the monograph are embedded in a larger reliabilist epistemology. I use this theory of basic beliefs to develop a detailed reliabilist theory: Inferentialist Reliabilism, which offers a reliabilist theory of inferential justification and which solves some longstanding problems for other reliabilist views by demanding inferential support for some—but not all—beliefs. The book is an instance of a thoroughgoingly naturalistic approach to epistemology. Many of my arguments have an empirical basis, and the view that I endorse reserves a central role for the cognitive sciences—in particular, cognitive neuroscience—in filling in the details of an applied epistemological theory. (shrink)

Many contemporary Anglo-American philosophers describe themselves as naturalists. But what do they mean by that term? Popular naturalist slogans like, "there is no first philosophy" or "philosophy is continuous with the natural sciences" are far from illuminating. "Understanding Naturalism" provides a clear and readable survey of the main strands in recent naturalist thought. The origin and development of naturalist ideas in epistemology, metaphysics and semantics is explained through the works of Quine, Goldman, Kuhn, Chalmers, Papineau, Millikan and others. The most (...) common objections to the naturalist project - that it involves a change of subject and fails to engage with "real" philosophical problems, that it is self-refuting, and that naturalism cannot deal with normative notions like truth, justification and meaning - are all discussed. "Understanding Naturalism" distinguishes two strands of naturalist thinking - the constructive and the deflationary - and explains how this distinction can invigorate naturalism and the future of philosophical research. (shrink)

Emotion, Social Theory, and Social Structure takes sociology in a new direction. It examines key aspects of social structure by using a fresh understanding of emotions categories. Through that synthesis emerge new perspectives on rationality, class structure, social action, conformity, basic rights, and social change. As well as giving an innovative view of social processes, J. M. Barbalet's study also reveals unappreciated aspects of emotions by considering fear, resentment, vengefulness, shame, and confidence in the context of social structure. While much (...) has been written on the social consequences of excessive or pathological emotions, this book demonstrates the centrality of emotions to routine operations of social interaction. Dr Barbalet also re-evaluates the nature of social theory, for once the importance of emotions to social processes becomes clear, the intellectual constitution of sociology, and therefore its history, must be rethought. (shrink)