Scholars and professional organizations in bioethics describe various approaches to “quality assessment” in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes “quality” in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent (...) evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, in this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction. (shrink)

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Peterson et al. (2023) identify important ethical issues that are relevant to psychedelic therapy and research in various clinical populations and contexts. This is certainly the case in palliative...

Most readers of ancient Greek psychology will agree that the Philebus is where we find Plato’s best attempt to theorize about bodily pain.1 But they will probably also agree that the account he develops there has no real chance of being true, and so should not have much appeal to us today — at least insofar as we are philosophers rather than historians. It’s this second conviction that I want to challenge in what follows. More specifically, I want to argue (...) for two connected claims about the merits of Plato’s account: first, that despite its flaws — which are significant — it is stronger and more subtle than most commentators have yet realized; and second, that it anticipates in interesting ways a view that has become both increasingly popular and increasingly controversial in the last couple of decades: the view that pains — like beliefs, desires, hopes, and fears — are mental states with representational content. I will call this view representationalism. (shrink)

Although ethics consultation services often engage in some of the most complex and delicate clinical situations, little is known about the qual­ity of these services or their effect on patient care and patient and provider satisfaction. There is still significant work to be done in the areas of training, credentialing, and standardization. This article articulates the essential “build­ing blocks” of the Proactive Ethics Integration model developed at Ascension as well as the lessons we have learned along the way.

The literature on mathematical explanation contains numerous examples of explanatory, and not so explanatory proofs. In this paper we report results of an empirical study aimed at investigating mathematicians’ notion of explanatoriness, and its relationship to accounts of mathematical explanation. Using a Comparative Judgement approach, we asked 38 mathematicians to assess the explanatory value of several proofs of the same proposition. We found an extremely high level of agreement among mathematicians, and some inconsistencies between their assessments and claims in the (...) literature regarding the explanatoriness of certain types of proofs. (shrink)

In the Philebus Plato argues that every rational human being, given the choice, will prefer a life that is moderately thoughtful and moderately pleasant to a life that is utterly thoughtless or utterly pleasureless. This is true, he thinks, even if the thoughtless life at issue is intensely pleasant and the pleasureless life at issue is intensely thoughtful. Evidently Plato wants this argument to show that neither pleasure nor thought, taken by itself, is sufficient to make a life choiceworthy for (...) us. But there is some disagreement among commentators about whether or not he also wants the argument to show why. Is the argument designed to establish that we should reject thoughtless and pleasureless lives because some pleasures and some thoughts are goods? Or is it silent on this issue? Many interpreters take the first option, claiming that Plato uses the argument to attack both the hedonist view that only pleasures are goods and the intellectualist view that only thoughts are goods. My aim in this paper is to show that the second option is at least as attractive as the first, both exegetically and philosophically. (shrink)

Bayesians take “definite” or “single-case” probabilities to be basic. Definite probabilities attach to closed formulas or propositions. We write them here using small caps: PROB(P) and PROB(P/Q). Most objective probability theories begin instead with “indefinite” or “general” probabilities (sometimes called “statistical probabilities”). Indefinite probabilities attach to open formulas or propositions. We write indefinite probabilities using lower case “prob” and free variables: prob(Bx/Ax). The indefinite probability of an A being a B is not about any particular A, but rather about the (...) property of being an A. In this respect, its logical form is the same as that of relative frequencies. For instance, we might talk about the probability of a human baby being female. That probability is about human babies in general — not about individuals. If we examine a baby and determine conclusively that she is female, then the definite probability of her being female is 1, but that does not alter the indefinite probability of human babies in general being female. Most objective approaches to probability tie probabilities to relative frequencies in some way, and the resulting probabilities have the same logical form as the relative frequencies. That is, they are indefinite probabilities. The simplest theories identify indefinite probabilities with relative frequencies.3 It is often objected that such “finite frequency theories” are inadequate because our probability judgments often diverge from relative frequencies. For example, we can talk about a coin being fair (and so the indefinite probability of a flip landing heads is 0.5) even when it is flipped only once and then destroyed (in which case the relative frequency is either 1 or 0). For understanding such indefinite probabilities, it has been suggested that we need a notion of probability that talks about possible instances of properties as well as actual instances.. (shrink)

In this paper we critically examine mobile markets as an emerging approach to serving communities with limited healthy food options. Mobile markets are essentially farm stands on wheels, bringing fresh fruits, vegetables and other food staples into neighborhoods, especially those lacking traditional, full service grocery stores, or where a significant proportion of the population lacks transportation to grocery stores. We first trace the emergence of contemporary mobile markets, including a brief summary about how and where they operate, what they aim (...) to achieve, who they serve, and the general constraints on their operations. We then report case study findings that examine the operational benefits and challenges of two mobile markets operating in Syracuse, New York. Our research suggests that although Syracuse’s mobile markets play a positive role in alleviating geographic, economic and social barriers to fresh food access experienced by elderly, immobile and low income residents living in Syracuse’s urban neighborhoods, the impacts of the mobile markets are dampened by both operational constraints and larger political and economic forces. (shrink)

Near the beginning of the Cratylus (385e-387d) Plato's Socrates argues, against his friend Hermogenes, that the standards of correctness for our use of names in speech are in no way up to us. Yet this conclusion should strike us, at least initially, as bizarre. After all, how could it not be up to us whether to call our children by the names of our parents, or whether to call dogs “dogs“? My aim in this paper will be to show that, (...) although Plato's argument does not succeed in establishing this apparently bizarre conclusion, it may well succeed in establishing an equally momentous conclusion: that the standards of correctness for our use of concepts in thought are in no way up to us. (shrink)

Nearly all of us would accept that at least some of our thoughts – desires, beliefs, and intentions, for example – can be causally responsible for movements in our bodies. Starting in antiquity, and especially since Descartes, philosophers have deployed this claim as the pivotal premise in an increasingly popular line of argument against dualism. The purpose of this paper is to show that, in the Phaedo, Socrates uses this very same claim as the pivotal premise in a surprisingly powerful (...) two-part argument for dualism. (shrink)

Recent advances in wireless data transmission technology have the potential to revolutionize clinical neuroscience. Today sensing-capable electrical stimulators, known as “bidirectional devices”, are used to acquire chronic brain activity from humans in natural environments. However, with wireless transmission come potential failures in data transmission, and not all available devices correctly account for missing data or provide precise timing for when data losses occur. Our inability to precisely reconstruct time-domain neural signals makes it difficult to apply subsequent neural signal processing techniques (...) and analyses. Here, our goal was to accurately reconstruct time-domain neural signals impacted by data loss during wireless transmission. Towards this end, we developed a method termed Periodic Estimation of Lost Packets. PELP leverages the highly periodic nature of stimulation artifacts to precisely determine when data losses occur. Using simulated stimulation waveforms added to human EEG data, we show that PELP is robust to a range of stimulation waveforms and noise characteristics. Then, we applied PELP to local field potential recordings collected using an implantable, bidirectional DBS platform operating at various telemetry bandwidths. By effectively accounting for the timing of missing data, PELP enables the analysis of neural time series data collected via wireless transmission—a prerequisite for better understanding the brain-behavior relationships underlying neurological and psychiatric disorders. (shrink)

Despite enthusiasm for patient-centered care, the practice of patient-centered care is proving challenging. Further, it is curious that the literature about this subject does not explicitly address patient autonomy, since patients guide care in patient-centered care, and respect for patient autonomy is a prominent health-care value. We argue that by explicitly adopting a relational conception of autonomy as an essential component, patient-centered care becomes more coherent, is strengthened, and could help practitioners to make better use of a principle of respect (...) for autonomy. Hence, its use appears promising to narrow the theory–practice gap. (shrink)

The essays in this book, by a variety of leading Augustine scholars, examine not only Augustine's multifaceted philosophy and its relation to his epoch-making theology, but also his practice as a philosopher, as well as his relation to other philosophers both before and after him. Thus the collection shows that Augustine's philosophy remains an influence and a provocation in a wide variety of settings today.

Despite increasing scientific interest in self-generated thought-mental content largely independent of the immediate environment-there has yet to be any comprehensive synthesis of the subjective experience and neural correlates of affect in these forms of thinking. Here, we aim to develop an integrated affective neuroscience encompassing many forms of self-generated thought-normal and pathological, moderate and excessive, in waking and in sleep. In synthesizing existing literature on this topic, we reveal consistent findings pertaining to the prevalence, valence, and variability of emotion in (...) self-generated thought, and highlight how these factors might interact with self-generated thought to influence general well-being. We integrate these psychological findings with recent neuroimaging research, bringing attention to the neural correlates of affect in self-generated thought. We show that affect in self-generated thought is prevalent, positively biased, highly variable (both within and across individuals), and consistently recruits many brain areas implicated in emotional processing, including the orbitofrontal cortex, amygdala, insula, and medial prefrontal cortex. Many factors modulate these typical psychological and neural patterns, however; the emerging affective neuroscience of self-generated thought must endeavor to link brain function and subjective experience in both everyday self-generated thought as well as its dysfunctions in mental illness. (shrink)

Scholars of classical philosophy have long disputed whether Aristotle was a dialectical thinker. Most agree that Aristotle contrasts dialectical reasoning with demonstrative reasoning, where the former reasons from generally accepted opinions and the latter reasons from the true and primary. Starting with a grasp on truth, demonstration never relinquishes it. Starting with opinion, how could dialectical reasoning ever reach truth, much less the truth about first principles? Is dialectic then an exercise that reiterates the prejudices of one's times and at (...) best allows one to persuade others by appealing to these prejudices, or is it the royal road to first principles and philosophical wisdom? In From Puzzles to Principles? May Sim gathers experts to argue both these positions and offer a variety of interpretive possibilities. The contributors' thoughtful reflections on the nature and limits of dialectic should play a crucial role in Aristotelian scholarship. (shrink)

Broadening access to both computational and educational resources is crit- ical to diffusing machine learning (ML) innovation. However, today, most ML resources and experts are siloed in a few countries and organizations. In this article, we describe our pedagogical approach to increasing access to applied ML through a massive open online course (MOOC) on Tiny Machine Learning (TinyML). We suggest that TinyML, applied ML on resource-constrained embedded devices, is an attractive means to widen access because TinyML leverages low-cost and globally (...) accessible hardware and encourages the development of complete, self-contained applications, from data collection to deployment. To this end, a collaboration between academia and industry produced a four part MOOC that provides application-oriented instruction on how to develop solutions using TinyML. The series is openly available on the edX MOOC platform, has no prerequisites beyond basic programming, and is designed for global learners from a variety of backgrounds. It introduces real-world applications, ML algorithms, data-set engineering, and the ethi- cal considerations of these technologies through hands-on programming and deployment of TinyML applications in both the cloud and on their own microcontrollers. To facili- tate continued learning, community building, and collaboration beyond the courses, we launched a standalone website, a forum, a chat, and an optional course-project com- petition. We also open-sourced the course materials, hoping they will inspire the next generation of ML practitioners and educators and further broaden access to cutting-edge ML technologies. (shrink)

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

The meanings of donkey sentences cannot be captured using a procedure which, like Montague’s, uses the existential quantifiers of classical logic to translate indefinites and the variables to translate pronouns. The treatment of these examples requires meanings which depend on the context in which sentences appear, and thus necessitates a logic which models this context to some extent. If context is represented as the information conveyed in discourse, and the meanings of pronouns are enriched to depend on this information, the (...) result is the E-Type approach (ETA) adapted by Heim (1990) from proposals in Evans (1980) and Cooper (1979). If the context is represented as a list of potential referents, and the meanings of indefinites are enriched to introduce new referents into this list, the result is a compositional formulation like Groenendijk and Stokhof’s (1990) of the discourse representation theory (DRT) of Kamp (1981) and Heim (1982). Either tack suffices to capture the way in which the referents of he and it systematically correspond to the alternative possibilities described by the antecedent. Disjunction offers a parallel way of introducing alternatives in the antecedent of a conditional, as shown in (2). (shrink)

Kenney, Mark Review(s) of: A source critical edition of the gospels of Matthew and Luke in Greek and English, 2 vols., Christopher J. Monaghan, C.P., Rome: Gregorian and Biblical Press, 2010, pp.378, 45.00.

At least three books struggle to emerge from this volume. One book, at the level of popular science, leads us through the development of physics, from Newton's laws to Bell's inequalities, in order to argue for the relevance of consciousness to the understanding of quantum theory. This is followed by a sketch of an interpretation of quantum mechanics. Interwoven with both is a memoir of Walker's teenage girlfriend, who died of Hodgkin's disease nearly fifty years ago. The theme which holds (...) the volume together is Walker's insistence on the importance of looking beyond materialism. (shrink)

Victorian Critics of Democracy was first published in 1938. Minnesota Archive Editions uses digital technology to make long-unavailable books once again accessible, and are published unaltered from the original University of Minnesota Press editions.

Review of Evan Fox-Decent, _Sovereignty's Promise: The State as Fiduciary_.

In Sovereignty’s Promise: The State as Fiduciary, Evan Fox-Decent uses the idea of fiduciary relationships to explain the legitimate exercise of governmental authority. He makes use of the idea of the state as a fiduciary for the people to ground an account of the duty to obey the law, to explain the proper relationships between colonial (or “settler”) societies and aboriginal populations, the role of agency discretion and judicial review in the administrative state, the rule of law, the relationship between (...) law and morality, and the foundations of human rights. While I was not convinced by several of the arguments, the book does have many important virtues. In particular, it provides a clear discussion of the idea of fiduciary relationships and duties that is useful for, and should be largely accessible to, non-lawyers. And, though I do not think that Fox-Decent has established all that he hoped to in the book, he does a good job of showing how fiduciary relationships are relevant to the above issues and worth considering. (shrink)

This paper takes up the problem of the qualitative dimension from the perspectives of enactivism and John Dewey’s pragmatic naturalism. I suggest that the pragmatic naturalism of Dewey, combined with recent work on enactivism, points the way to a new account of the qualitative dimension, beyond the bifurcation of nature into the subjective and objective, or the qualitative and quantitative. The pragmatist-enactivist view I sketch here has both methodological-explanatory and ontological dimensions. Following the work of Francisco Varela and Evan Thompson, (...) I suggest that the qualitative dimension should be explained in experientialist and ecological terms. Following Dewey, I suggest that the ontology of the qualitative dimension should be understood in dynami c, relational, and ‘transactional’ terms. (shrink)

‘Virtue signaling’ is the practice of using moral talk in order to enhance one’s moral reputation. Many find this kind of behavior irritating. However, some philosophers have gone further, arguing that virtue signaling actively undermines the proper functioning of public moral discourse and impedes moral progress. Against this view, I argue that widespread virtue signaling is not a social ill, and that it can actually serve as an invaluable instrument for moral change, especially in cases where moral argument alone does (...) not suffice. Specifically, virtue signaling can change the broader public’s social expectations, which can in turn motivate the adoption of new, positive social norms. I also argue that the reputation-seeking motives underlying virtue signaling impose important constraints on virtue signalers’ behavior, which serve to keep the worst excesses of virtue signaling in check. (shrink)

Character judgments play an important role in our everyday lives. However, decades of empirical research on trait attribution suggest that the cognitive processes that generate these judgments are prone to a number of biases and cognitive distortions. This gives rise to a skeptical worry about the epistemic foundations of everyday characterological beliefs that has deeply disturbing and alienating consequences. In this paper, I argue that this skeptical worry is misplaced: under the appropriate informational conditions, our everyday character-trait judgments are in (...) fact quite trustworthy. I then propose a mindreading-based model of the socio-cognitive processes underlying trait attribution that explains both why these judgments are initially unreliable, and how they eventually become more accurate. (shrink)

Suppose we consider knowledge to be valuable because of the role known propositions play in practical reasoning. This, I argue, does not provide a reason to think that knowledge is valuable in itself. Rather, it provides a reason to think that true belief is valuable from one standpoint, and that justified belief is valuable from another standpoint, and similarly for other epistemic concepts. The value of the concept of knowledge is that it provides an economical way of talking about many (...) epistemic concepts that are valuable in itself from one standpoint or another. In this way knowledge is like a Swiss Army Knife; a Swiss Army Knife is not useful as such on any occasion, but it provides an efficient way of carrying around different tools that are useful in themselves on different occasions. (shrink)

Postcolonial science studies entails ostensibly contradictory critical and empirical commitments. Science studies scholars influenced by Bruno Latour and Isabelle Stengers embrace forms of realist, radical empiricism, while postcolonial studies scholars influenced by Jacques Derrida trace the limits of the knowable. This essay takes their common use of the term cosmopolitics as an unexpected point of departure for reconciling Derrida’s program with Stengers’s and Latour’s. I read Derrida’s critique of hospitality and Stengers’s and Latour’s ontological politics as necessary complements for conceiving (...) a care-oriented subalternist cosmopolitics, a process of composing common worlds that remains attentive to the limits of representation. (shrink)

In recent years, there has been a heated debate about how to interpret findings that seem to show that humans rapidly and automatically calculate the visual perspectives of others. In the current study, we investigated the question of whether automatic interference effects found in the dot-perspective task (Samson, Apperly, Braithwaite, Andrews, & Bodley Scott, 2010) are the product of domain-specific perspective-taking processes or of domain-general “submentalizing” processes (Heyes, 2014). Previous attempts to address this question have done so by implementing inanimate (...) controls, such as arrows, as stimuli. The rationale for this is that submentalizing processes that respond to directionality should be engaged by such stimuli, whereas domain-specific perspective-taking mechanisms, if they exist, should not. These previous attempts have been limited, however, by the implied intentionality of the stimuli they have used (e.g. arrows), which may have invited participants to imbue them with perspectival agency. Drawing inspiration from “novel entity” paradigms from infant gaze-following research, we designed a version of the dot-perspective task that allowed us to precisely control whether a central stimulus was viewed as animate or inanimate. Across four experiments, we found no evidence that automatic “perspective-taking” effects in the dot-perspective task are modulated by beliefs about the animacy of the central stimulus. Our results also suggest that these effects may be due to the task-switching elements of the dot-perspective paradigm, rather than automatic directional orienting. Together, these results indicate that neither the perspective-taking nor the standard submentalizing interpretations of the dot-perspective task are fully correct. (shrink)

Phillips and colleagues convincingly argue that knowledge attribution is a faster, more automatic form of mindreading than belief attribution. However, they do not explain what it is about knowledge attribution that lends it this cognitive advantage. I suggest an explanation of the knowledge-attribution advantage that would also help to distinguish it from belief-based and minimalist alternatives.