RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

In six compelling chapters, this book recounts conversations that discuss what is ethical, why it does not occur more often, and how can we improve ethical conduct in our personal and public lives. The conversations include Knowing Ethical Principles, Learning How to Apply Principles in Practice, Moral Reminders, Accountability for Conduct, Addressing Structural Problems, and Ethical Vigilance. Major ethical perspectives are discussed in conversational format, as are fascinating ethical dilemmas taken from actual cases to evaluate and improve our ability to (...) identify ethical principles and make decisions that reflect concerns beyond self-interest. (shrink)

The U.S. Food and Drug Administration's rationale for supporting the development and approval of BiDil for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials , which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted (...) baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. (shrink)

The False Claims Act, 31 U.S.C. § 3729, a post-Civil War law inspired by cases of defense contracting fraud, was revitalized in 1986. Since then it has been used to sue both manufacturers and providers of pharmaceuticals. In some cases, these suits were meant to target offlabel marketing of pharmaceuticals. In 2009, the 11th Circuit rendered a decision in Hopper v. Solvay Pharmaceuticals that dramatically limits the ability of private plaintiff whistle-blowers to bring qui tam suits under the FCA for (...) such marketing. In June 2010, the Supreme Court denied certiorari, making the Circuit court decision final. The Solvay decision creates a significant barrier to certain kinds of qui tam suits, requiring the plaintiff to demonstrate the intent to market off-label, including by showing specific prescriptions that were written as a result of efforts to do so. (shrink)

The first longevity revolution began in the middle of the 19th century, accelerated through the first half of the 20th century, and led to the first and only quantum leap in human life expectancy.In the 20th century alone, life expectancy at birth in most developed nations rose by about 30 years. The first three quarters of the century were notable for gains made at younger and middle ages, and in the last quarter century, old age mortality declined. Nothing in history (...) has ever come close to the magnitude of this benefit to humanity. The rise in life expectancy occurred swiftly because the primary beneficiaries of advances in public health and... (shrink)

Distributional semantic models (DSMs) are a primary method for distilling semantic information from corpora. However, a key question remains: What types of semantic relations among words do DSMs detect? Prior work typically has addressed this question using limited human data that are restricted to semantic similarity and/or general semantic relatedness. We tested eight DSMs that are popular in current cognitive and psycholinguistic research (positive pointwise mutual information; global vectors; and three variations each of Skip-gram and continuous bag of words (CBOW) (...) using word, context, and mean embeddings) on a theoretically motivated, rich set of semantic relations involving words from multiple syntactic classes and spanning the abstract–concrete continuum (19 sets of ratings). We found that, overall, the DSMs are best at capturing overall semantic similarity and also can capture verb–noun thematic role relations and noun–noun event-based relations that play important roles in sentence comprehension. Interestingly, Skip-gram and CBOW performed the best in terms of capturing similarity, whereas GloVe dominated the thematic role and event-based relations. We discuss the theoretical and practical implications of our results, make recommendations for users of these models, and demonstrate significant differences in model performance on event-based relations. (shrink)

For decades, policy-makers in government, development banks and foundations, NGOs, researchers and students have struggled with the problem of how to protect people who are displaced from their homes and livelihoods by development projects. This book addresses these concerns and explores how debates often become deadlocked between 'managerial' and 'movementist' perspectives. Using development ethics to determine the rights and responsibilities of various stakeholders, the authors find that displaced people must be empowered so as to share equitably in benefits rather than (...) being victimized. They propose a governance model for development projects that would transform conflict over displacement into a more manageable collective bargaining process and would empower displaced people to achieve equitable results. Their book will be valuable for readers in a wide range of fields including ethics, development studies, politics and international relations as well as policy making, project management and community development. (shrink)

In this empirical paper, Jay, Stone, Meksin, Merck, Gordon and Hirst examine whether jury deliberations, in which individuals collaboratively recall and discuss evidence of a trial, shape the jurors’ memories. In doing so, Jay and colleagues provide a highly ecologically valid baseline for future investigation into why, how and when selective recall either facilitates remembering or leads to forgetting during jury deliberations. In particular, Jay et al. explore the specific social and cognitive mechanisms that might lead to either memory facilitation (...) (RIFA – Retrieval Induced Facilitation) and forgetting (RIF ‐ Retrieval Induced Forgetting) during jury deliberation. (shrink)

Despite the lack of invariance problem (the many‐to‐many mapping between acoustics and percepts), human listeners experience phonetic constancy and typically perceive what a speaker intends. Most models of human speech recognition (HSR) have side‐stepped this problem, working with abstract, idealized inputs and deferring the challenge of working with real speech. In contrast, carefully engineered deep learning networks allow robust, real‐world automatic speech recognition (ASR). However, the complexities of deep learning architectures and training regimens make it difficult to use them to (...) provide direct insights into mechanisms that may support HSR. In this brief article, we report preliminary results from a two‐layer network that borrows one element from ASR, long short‐term memory nodes, which provide dynamic memory for a range of temporal spans. This allows the model to learn to map real speech from multiple talkers to semantic targets with high accuracy, with human‐like timecourse of lexical access and phonological competition. Internal representations emerge that resemble phonetically organized responses in human superior temporal gyrus, suggesting that the model develops a distributed phonological code despite no explicit training on phonetic or phonemic targets. The ability to work with real speech is a major advance for cognitive models of HSR. (shrink)

H. Jay Dinshah, the father of the modern vegan movement in America and founder of American Vegan Society, eloquently explains ethical reasons for veganism. His daughter Anne updates and edits his pioneering writings. Over forty vegan luminaries tell how they were influenced and inspired by Jay. Together they encourage readers to explore ways to promote positive action in the world towards veganism through “dynamic harmlessness.”.

The stakeholder perspective has provided a rich forum for a variety of debates at the intersection of business and society. Scholars gathered for two consecutive years, first in North America, and then in Europe, to discuss the major issues surrounding what has come to be known as stakeholder theory, to attempt to find common ground, and to uncover areas in need of further inquiry. Those meetings led to a list of “tensions” and a call for papers for this special issue (...) to help address them. In this article, we introduce the resulting articles and provide some brief commentary on their importance. We end with a few of our own observations about the stakeholder perspective and stakeholder research. (shrink)

Philosophy of science has the potential to enhance scientific practice, science policy, and science education; moreover, recent research indicates that many philosophers of science think we ought to increase the broader impacts of our work. Yet, there is little to no empirical data on how we are supposed to have an impact. To address this problem, our research team interviewed 35 philosophers of science regarding the impact of their work in science-related domains. We found that face-to-face engagement with scientists and (...) other stakeholders was one of the most—if not the most—effective pathways to impact. Yet, working with non-philosophers and disseminating research outside philosophical venues is not what philosophers are typically trained or incentivized to do. Thus, there is a troublesome tension between the activities that are likely to lead to broader uptake of one’s work and those that are traditionally encouraged and rewarded in philosophy. We suggest several ways that philosophers of science, either as individuals or as a community, can navigate these tensions. (shrink)

World problems are intercultural, requiring sensitivity to cultural integrity in order to resolve them. Wu Kuang-ming has been grappling with cultural clashes at their boundary for half a century, insisting that we must first let Chinese thinking be Chinese, not Western, leading thereby to a truly fruitful China-West and West-China interculture. Wu has been proposing how to do so in a dozen published volumes and beyond. China-West Interculture reports Wu's personal and academic journey on this matter, followed by fourteen international (...) scholars' critical appreciations and Wu's grateful responses. (shrink)

During John Dewey's lifetime, one public opinion poll after another revealed that he was esteemed to be one of the ten most important thinkers in American history. His body of thought, conventionally identified by the shorthand word "Pragmatism," has been the distinctive American philosophy of the last fifty years. His work on education is famous worldwide and is still influential today, anticipating as it did the ascendance in contemporary American pedagogy of multiculturalism and independent thinking. His University of Chicago Laboratory (...) School thrives still and is a model for schools worldwide, especially in emerging democracies. But how was this lifetime of thought enmeshed in Dewey's emotional experience, in his joys and sorrows as son and brother, husband and father, and in his political activism and spirituality? Acclaimed biographer Jay Martin recaptures the unity of Dewey's life and work, tracing important themes through the philosopher's childhood years, family history, religious experience, and influential friendships. Based on original sources, notably the vast collection of unpublished papers in the Center for Dewey Studies, this book tells the full story, for the first time, of the life and times of the eminent American philosopher, pragmatist, education reformer, and man of letters. In particular, _The Education of John Dewey_ highlights the importance of the women in Dewey's life, especially his mother, wife, and daughters, but also others, including the reformer Jane Addams and the novelist Anzia Yezierska. A fitting tribute to a master thinker, Martin has rendered a tour de force portrait of a philosopher and social activist in full, seamlessly reintegrating Dewey's thought into both his personal life and the broader historical themes of his time. (shrink)

Written by researchers in their field, this book is about the skills beyond basic word recognition that are necessary for the processing and comprehension of spoken and written language. It offers topics such as: language and text analysis; cognitive processing and comprehension; development of literacy; literacy and schooling; and more.

The Hedgehog, the Fox, and the Magister's Pox is a controversial discourse, rich with facts and observations gathered by one of the most erudite minds of our ...

In this paper I argue for the Atlas-Kempson Thesis that sentences of the form The A is not B are not ambiguous but rather semantically general (Quine), non-specific (Zwicky and Sadock), or vague (G. Lakoff). This observation refutes the 1970 Davidson-Harman hypothesis that underlying structures, as full semantic representations, are logical forms. It undermines the conception of semantical presupposition, removes a support for the existence of truth-value gaps for presuppositional sentences (the remaining arguments for which are viciously circular), and lifts (...) the Russell-Strawson dispute of 1950–1964 from stalemate to a formulation in which a resolution is possible for the first time. Suggestions of Davidson, Montague, Stalnaker, Kaplan and H. P. Grice are shown to be inadequate semantic descriptions of negative, presuppositional sentences. I briefly discuss the radical Pragmatics view of my 1975 publications and suggest that it too fails to do justice to the linguistic data. I speculate that Semantic Representations should be given the form (more or less) of computer programs, describable in Dana Scott's mathematical semantics for programming languages. (shrink)

This fresh look at the philosophy of language focuses on the interface between a theory of literal meaning and pragmatics--a philosophical examination of the relationship between meaning and language use and its contexts. Here, Atlas develops the contrast between verbal ambiguity and verbal generality, works out a detailed theory of conversational inference using the work of Paul Grice on Implicature as a starting point, and gives an account of their interface as an example of the relationship between Chomsky's Internalist Semantics (...) and Language Performance. Atlas then discusses consequences of his theory of the Interface for the distinction between metaphorical and literal language, for Grice's account of meaning, for the Analytic/Synthetic distinction, for Meaning Holism, and for Formal Semantics of Natural Language. This book makes an important contribution to the philosophy of language and will appeal to philosophers, linguists, and cognitive scientists. (shrink)

This volume presents Rosenberg's previously published studies of the central elements and implications of Sellars' philosophy, along with three new essays that ...

Providing an accessible examination of ethics, Doing Ethics in Media, introduces students to ethical theory and provides a grounded discussion of ethics in the context of today's media outlets. Emphasizing the understanding of ethics, the text will help readers 'do ethics' expeditiously, honestly, and efficiently when they enter the workplace and need to make critical ethical decisions on deadline. The text is organized around six decision-making questions, and cases demonstrate the application of these questions to real-world scenarios. Each chapter focuses (...) on a specific ethical theory or issue, with a thorough discussion of the key points accompanied by practical applications, demonstrated through references to classic and contemporary issues in media. Student voices are heard throughout the book, illustrating how they have grappled with and applied the concepts in their own worlds and in the media. Distinctive features include: a new approach to ethical decision making through the "5W's and H" questions that serve as the book's framework; discussions and case studies aimed at five media disciplines: journalism, new media, advertising, public relations, and entertainment. Cases engage students at early stages of their careers, and consider that most students will change careers several times comprehensive materials on classic moral theory and current issues such as truth telling and deception, values, persuasion and propaganda, privacy, diversity, loyalty, moral development, and codes of ethics user-friendly approach throughout the book challenges students to think for themselves rather than imposing answers on them connects the model or theory to every decision-making challenge (44 cases and dozens of practical applications) a Companion Website with ancillary materials for students and for instructors (including a test bank and instructor's manual). This text has been written for undergraduates and graduate students studying media ethics in mass media, journalism, and media studies. It also will serve students in rhetoric, popular culture, communication studies, and interdisciplinary social sciences"--Provided by publisher. (shrink)

Part I: The sun of reason. From the Greeks to the age of reason -- Kant: reason as critique; the critique of reason -- Hegel and Marx: dialectical reason -- Reason in crisis -- Part II: Reason's eclipse and return. The critique of instrumental reason: Horkheimer, Marcuse, and Adorno -- Habermas and the communicative turn -- Habermas and his critics.

For nearly two thousand years Buddhism has mystified and captivated both lay people and scholars alike. Seen alternately as a path to spiritual enlightenment, an system of ethical and moral rubrics, a cultural tradition, or simply a graceful philosophy of life, Buddhism has produced impassioned followers the world over. The Buddhist saint Nagarjuna, who lived in South India in approximately the first century CE, is undoubtedly the most important, influential, and widely studied Mahayana Buddhist philosopher. His many works include texts (...) addressed to lay audiences, letters of advice to kings, and a set of penetrating metaphysical and epistemological treatises. His greatest philosophical work, the Mulamadhyamikakarika--read and studied by philosophers in all major Buddhist schools of Tibet, China, Japan, and Korea--is one of the most influential works in the history of Indian philosophy. Now, in The Foundations of the Philosophy of the Middle Way, Jay L. Garfield provides a clear and and eminently readable translation of Nagarjuna's seminal work, offering those with little of no prior knowledge of Buddhist philosophy a view into the profound logic of the Mulamadhyamikakarika. Translated from the Tibetan, the tradition through which Nagarjuna's philosophical influence has largely been transmitted, Garfield presents a superb translation of Mulamadhyamikakarika in its entirety. Illuminating the systematic character of Nagarjuna's reasoning, as well as the works profundity, Garfield shows how Nagarjuna develops his doctrine that all phenomena are empty of inherent existence and essenceless. But, he argues, phenomena nonetheless exist conventionaly, and that indeed conventional existence and ultimate emptiness are in fact the same thing. This represents the radical understanding of the Buddhist doctrine of the two truths, or two levels of reality. Nagarjuna reinterprets all of Buddhist metaphysics and epistemology through this analytical framework--"a systematic and beautifully elegant philosophical dissection of reality." In turn, Garfield goes on to offer the only verse-by-verse commentary based upon the Indo-Tibetan Prasangika-Madhyamika reading of Nagarjuna, the school most influential in the development of Mahayana philosophy in Tibet, China, Korea, and Japan. Written specifically for the Western reader, the commentary explains Nagarjuna's positions and arguments in the language of Western metaphysics and epistemology, and connects Nagarjuna's concerns tho those of Western philosophers such as Sextus, Hume, and Wittgenstein. A fascinating and accessible translation of the foundational text for all Mahayana Buddhism text, The Fundamental Wisdom of the Middle Way will enlighten all those in search of the essence of reality. (shrink)

Spiritual messages of Jayēntira Sarasvati, Jagatguru Sankaracharya of Kamakoti, b. 1935, Hindu religious leader.

Christie, Jaye; Stuart, Stephen The United States have experienced devastating attacks on church-state separation in recent decades. The intrusion of religion into affairs of state is more blatant than in Australia, but there is mounting evidence that the religious right is gaining momentum here. As former Australian High Court judge, Michael Kirby, has said, 'The principle of secularism is one of the greatest developments in human rights in the world. We must safeguard and protect it, for it can come under (...) threat in contemporary Australia.'. (shrink)

Origin of Species was published; he approached the end of his life just before Albert Einstein presented us with General Relativity. His lifetime saw the emergence of psychology as a discipline separate from philosophy, a birth attended by philosopher-psychologists such as his good friend William James. The work of Peirce, like that of the other American Pragmatists, reflects the ferment of the times. His thought bears the imprint of science, not the science of that Nineteenth Century which as Loren Eiseley (...) has remarked, "regarded the 'laws' of nature as imbued with a kind of structural finality, an integral determinism, which it was the scientists’ duty to describe," (Eisele, 1971) but rather, of science as open, as intrinsically revisable, as radically empirical. Working from the model of science in this latter sense, Peirce held that philosophy, and indeed logic.. (shrink)

“I'm not afraid of dying,” he says, despite his plea on arrival. “Listen up, douchebag. Are you calling my cousin or what?” The emergency department might be the only sphere of human exchange where one party—patients (and sometimes family)—are permitted to insult, threaten, and even spit at the very people on whom they depend for help, while the offended parties—physicians, nurses, and other health care providers—must not only tolerate the abuse, but treat their tormentors. Does the ED's collective duty to (...) greater numbers of patients demand a revised ethos of tough love for extreme cases of misbehavior? Can we ask these patients to leave without legal recourse after extending genuine, compassionate efforts to participate in their care—barring evidence of a medical explanation for their toxic comportment or a mental illness that puts them at risk of harming themselves or others? (shrink)