BackgroundThe interpretation of clinical gait data in children with cerebral palsy (CP) is time-consuming, requires extensive expertise and often lacks transparency. Here we aimed to develop a set of look-up tables to support this process, linking typical gait features as present in CP to their potential underlying impairments.MethodsWe developed an initial core set of gait features and their potential underlying impairments based on biomechanical reasoning, literature and clinical experience. This core set was further specified through a Delphi process in a (...) multidisciplinary group of experts in gait analysis of children with CP and evaluated on 20 patient cases. The likelihood of the listed gait feature–impairment relationships was scored by the expert panel on a five-point scale.ResultsThe final core set included 120 relevant gait feature–impairment relations including likelihood scores. This set was presented in the form of look-up tables in both directions, i.e., sorted by gait features with potential underlying impairment, and sorted by impairments with potential related gait features. The average likelihood score for the relations was 3.5 ± 0.6 (range 2.1–4.6).ConclusionThe developed set of look-up tables linking gait features and impairments, can assist gait analysts and clinicians in standardized biomechanical reasoning, to support treatment decision-making for gait impairments in children with CP. (shrink)

In this analysis I apply a Foucauldian approach to ethics to examine the politically prescribed moral and ethical character required of carers of aged persons at home in Australia and the role of nurses in shaping these behaviours. The work that spousal carers provide, although often founded on love and/or obligation, has been formalized through a variety of policy initiatives and technologies that serve to construct the moral approach they must adopt. This shaping of conduct at the most personal level (...) takes place through the application of codes of behaviour policed largely by nurses. These codes redefine the mode of coexistence between an aged husband and wife and propose a new form of relationship that is derived from and supports policies of the deinstitutionalization of care services for elderly persons. In this way modern carer policy has drawn on knowledge and governance of the self to produce a morality of caring that is both authoritative and scientific. (shrink)

Sentences containing pronouns and indefinite noun phrases can be said toexpress open propositions, propositions which display gaps to be filled.This paper addresses the question what is the linguistic content ofthese expressions, what information they can be said to provide to ahearer, and in what sense the information of a speaker can be said tosupport their utterance. We present and motivate first order notions ofcontent, update and support. The three notions are each defined in acompositional fashion and brought together within a (...) single and coherentframework. (shrink)

This paper considers the justifications for adhering to a principle of confidentiality within medical practice. These are found to derive chiefly from respect for individual autonomy, the doctor/patient contract, and social utility. It is suggested that these will benefit more certainly if secrecy is rejected and the principle of confidentiality is removed from the area of health care.

An assessment of America's preference for "extra-large" shares examples ranging from mega churches and breast augmentation to landfills and mega-malls, in a cautionary report that reveals some of the consequences of these choices.

In this article some of the presuppositions that underly the current ideas about decision making capacity, autonomy and independence are critically examined. The focus is on chronic disorders, especially on chronic physical disorders. First, it is argued that the concepts of decision making competence and autonomy, as they are usually applied to the problem of legal (in)competence in the mentally ill, need to be modified and adapted to the situation of the chronically (physically) ill. Second, it is argued that autonomy (...) and dependence must not be considered as two mutually exclusive categories. It is suggested that decision making may take on the form of a more or less conscious decision not to be involved in making all kinds of explicit and deliberate decisions. Elaborating on Agich's distinction between ideal and actual autonomy, the concept of Socratic autonomy is introduced. (shrink)

For a few decades, patients with Parkinson's disease have been treated with intracerebral transplantations of fetal mesencephalic tissue. The results of open trials have been variable. Double blind, placebo-controlled studies have recently been started in order to further investigate the efficacy of this new medical technique. In this paper we challenge the need for sham surgery in neurotransplantation research on PD patients. Considerations regarding the research subjects' informed consent, therapeutic misconception, the integrity of the human body, and the assessment of (...) risks and benefits argue against sham surgery for patients with PD. Moreover, there is an alternative, less harmful mode of research that can provide the same or comparable scientific evidence. A plea is made for intrapatient research based on quantitative measurements of the patient's pre- and post-operative condition combined with similar research on a reference group of patients who have received the standard treatment. (shrink)

In this chapter, we critique a concept of resilience that has emerged from contemporary positive psychology and its application to health education. We argue that the present popularity of “resilience” as a strategy for managing mental health discourages educational institutions from providing students with the mental health services they need. Using the tools of American pragmatism, especially the work of John Dewey, we criticize the paradigm of resilience and identify several concrete reformulations of disability studies which would make concrete differences (...) in the lives of those with mental disability. (shrink)

Traditional philosophical discussions of knowledge have focused on the epistemic status of full beliefs. In this book, Moss argues that in addition to full beliefs, credences can constitute knowledge. For instance, your .4 credence that it is raining outside can constitute knowledge, in just the same way that your full beliefs can. In addition, you can know that it might be raining, and that if it is raining then it is probably cloudy, where this knowledge is not knowledge of propositions, (...) but of probabilistic contents. -/- The notion of probabilistic content introduced in this book plays a central role not only in epistemology, but in the philosophy of mind and language as well. Just as tradition holds that you believe and assert propositions, you can believe and assert probabilistic contents. Accepting that we can believe, assert, and know probabilistic contents has significant consequences for many philosophical debates, including debates about the relationship between full belief and credence, the semantics of epistemic modals and conditionals, the contents of perceptual experience, peer disagreement, pragmatic encroachment, perceptual dogmatism, and transformative experience. In addition, accepting probabilistic knowledge can help us discredit negative evaluations of female speech, explain why merely statistical evidence is insufficient for legal proof, and identify epistemic norms violated by acts of racial profiling. Hence the central theses of this book not only help us better understand the nature of our own mental states, but also help us better understand the nature of our responsibilities to each other. (shrink)

Medicine does not usually consider the human body from an aesthetic point of view. This article explores the notion of the lived body as aesthetic object in anthropological medicine, concentrating on the views of Buytendijk and Straus on human uprightness and gracefulness. It is argued that their insights constitute a counter-balance to the way the human body is predominantly approached in medicine and medical ethics. In particular, (1) the relationship between anthropological, aesthetic and ethical norms, (2) the possible danger of (...) a naturalistic fallacy, (3) the implications for the care of disabled people and (4) the intrinsic aesthetic quality of the human body are dealt with. (shrink)

This paper develops a precise understanding of the thesis of moral encroachment, which states that the epistemic status of an opinion can depend on its moral features. In addition, I raise objections to existing accounts of moral encroachment. For instance, many accounts fail to give sufficient attention to moral encroachment on credences. Also, many accounts focus on moral features that fail to support standard analogies between pragmatic and moral encroachment. Throughout the paper, I discuss racial profiling as a case study, (...) arguing that moral encroachment can help us identify one respect in which racial profiling is epistemically problematic. (shrink)

Illative combinatory logic consists of the theory of combinators or lambda calculus extended by extra constants intended to capture inference. In a preceding paper, [2], we considered 4 systems of illative combinatory logic that are sound for first order intuitionistic propositional and predicate logic. The interpretation from ordinary logic into the illative systems can be done in two ways: following the propositions-as-types paradigm, in which derivations become combinators, or in a more direct way, in which derivations are not translated. Both (...) translations are closely related in a canonical way. In the cited paper we proved completeness of the two direct translations. In the present paper we prove that also the two indirect translations are complete. These proofs are direct whereas in another version, [3], we proved completeness by showing that the two corresponding illative systems are conservative over the two systems for the direct translations. Moreover we shall prove that one of the systems is also complete for predicate calculus with higher type functions. (shrink)

Periodic attacks of uncertain origin, where the clinical presentationresembles epilepsy but there is no evidence of a somatic disease, arecalled Pseudo-Epilepsy or Pseudo-Epileptic Attack Disorder (PEAD). PEADmay be called a `non-disease', i.e. a disorder on the fringes ofestablished disease patterns, because it lacks a rationalpathophysiological explanation. The first aim of this article is tocriticize the idea, common in medical science, that diseases are realentities which exist separately from the patient, waiting to bediscovered by the doctor. We argue that doctor and (...) patient construct adisease, and that the construction of the disease PEAD includes manynormative evaluations. The second aim is to provide insight into thesuffering of patients with PEAD. We focus on three aspects of thepatient, identity, autonomy and responsibility. We present somecharacteristic descriptions of (pseudo-)epileptic attacks by FjodorDostoevsky, Gustave Flaubert and Thomas Mann. We argue that diagnosingPEAD reduces a meaningful life event into an insignificant, thoughintriguing, medical phenomenon, and that the patient will not benefitfrom being diagnosed as having PEAD. (shrink)

Generic generalizations such as ‘mosquitoes carry the West Nile virus’ or ‘sharks attack bathers’ are often accepted by speakers despite the fact that very few members of the kinds in question have the predicated property. Previous work suggests that such low-prevalence generalizations may be accepted when the properties in question are dangerous, harmful, or appalling. This paper argues that the study of such generic generalizations sheds light on a particular class of prejudiced social beliefs, and points to new ways in (...) which those beliefs might be undermined and combatted. (shrink)

Existing discussions of legal proof address a host of apparently disparate questions: What does it take to prove a fact beyond a reasonable doubt? Why is the reasonable doubt standard notoriously elusive, sometimes considered by courts to be impossible to define? Can the standard of proof by a preponderance of the evidence be defined in terms of probability thresholds? Why is statistical evidence often insufficient to meet the burden of proof? -/- This paper defends an account of proof that addresses (...) each of these questions. Where existing theories take a piecemeal approach to these puzzles, my theory develops an insight that unifies them—namely, the thesis that legal proof requires knowledge. Although this thesis may seem radical at first, I answer several common objections to it, and I argue that it does better than several competing accounts when it comes to making sense of our intuitions about what legal proof requires. (shrink)

This paper motivates and develops a novel semantics for several epistemic expressions, including possibility modals and indicative conditionals. The semantics I defend constitutes an alternative to standard truth conditional theories, as it assigns sets of probability spaces as sentential semantic values. I argue that what my theory lacks in conservatism is made up for by its strength. In particular, my semantics accounts for the distinctive behavior of nested epistemic modals, indicative conditionals embedded under probability operators, and instances of constructive dilemma (...) containing epistemic vocabulary. (shrink)

This chapter defines and defends time-slice epistemology, according to which there are no essentially diachronic norms of rationality. The chapter begins by distinguishing two notions of time-slice epistemology, and ends by defending time-slice theories of action under indeterminacy, i.e. theories about how you should act when the outcome of your decision depends on some indeterminate claim. In a recent chapter, J. Robert G. Williams defends a theory of action under indeterminacy which is subject to several objections. An alternative theory is (...) proposed in its place. The resulting discussion highlights a more general moral about action under indeterminacy, namely that time-slice theories are supported by strong analogies with ethical theories. In particular, our understanding of agents torn between interpretations of a decision situation should be guided by our theories of agents torn between incommensurable values. (shrink)

This paper argues that just as full beliefs can constitute knowledge, so can properties of your credence distribution. The resulting notion of probabilistic knowledge helps us give a natural account of knowledge ascriptions embedding language of subjective uncertainty, and a simple diagnosis of probabilistic analogs of Gettier cases. Just like propositional knowledge, probabilistic knowledge is factive, safe, and sensitive. And it helps us build knowledge-based norms of action without accepting implausible semantic assumptions or endorsing the claim that knowledge is interest-relative.

"One of the most careful and intensive among the introductory texts that can be used with a wide range of students. It builds remarkably sophisticated technical skills, a good sense of the nature of a formal system, and a solid and extensive background for more advanced work in logic.... The emphasis throughout is on natural deduction derivations, and the text's deductive systems are its greatest strength. Lemmon's unusual procedure of presenting derivations before truth tables is very effective." --Sarah Stebbins, (...) The Journal of Symbolic Logic. (shrink)

Aristotle connects modality and time in ways strange and perplexing to modern readers. In this book the author proposes a new solution to this exegetical problem. Although primarily expository, this work explores topics of central concern for current investigations into causality, time, and change.

This paper defends an account of full belief, including an account of its relationship to credence. Along the way, I address several familiar and difficult questions about belief. Does fully believing a proposition require having maximal confidence in it? Are rational beliefs closed under entailment, or does the preface paradox show that rational agents can believe inconsistent propositions? Does whether you believe a proposition depend partly on your practical interests? My account of belief resolves the tension between conflicting answers to (...) these questions that have been defended in the literature. In addition, my account complements fruitful probabilistic theories of assertion and knowledge. (shrink)

Ducks lay eggs' is a true sentence, and `ducks are female' is a false one. Similarly, `mosquitoes carry the West Nile virus' is obviously true, whereas `mosquitoes don't carry the West Nile virus' is patently false. This is so despite the egg-laying ducks' being a subset of the female ones and despite the number of mosquitoes that don't carry the virus being ninety-nine times the number that do. Puzzling facts such as these have made generic sentences defy adequate semantic treatment. (...) However complex the truth conditions of generics appear to be, though, young children grasp generics more quickly and readily than seemingly simpler quantifiers such as `all' and `some'. I present an account of generics that not only illuminates the strange truth conditions of generics, but also explains how young children find them so comparatively easy to acquire. I then argue that generics give voice to our most cognitively primitive generalizations and that this hypothesis accounts for a variety of facts ranging from acquisition patterns to cross-linguistic data concerning the phonological articulation of operators. I go on to develop an account of the nature of these cognitively fundamental generalizations and argue that this account explains the strange truth-conditional behavior of generics. (shrink)

An investigation into Aristotle's metaphysics of nature as expounded in the Physics. It focuses in particular his conception of change, a concept which is shown to possess a unique metaphysical structure, with implications that should engage the attention of contemporary analysis. First published in hardback in 1982, the book is now available for the first time in paperback. 'A powerful and appealing explanatory scheme which succeeds on the whole in drawing together a great many seemingly disparate elements in the Physics (...) into a neat unitary stucture.' Canadian Philosophical Review. (shrink)

This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...) This study provides a rare and important multi-disciplinary perspective on this topic and the findings have implications for administrators and leaders who seek to improve the moral climate of healthcare delivery. (shrink)

One of the main themes that has emerged from behavioral decision research during the past three decades is the view that people's preferences are often constructed in the process of elicitation. This idea is derived from studies demonstrating that normatively equivalent methods of elicitation (e.g., choice and pricing) give rise to systematically different responses. These preference reversals violate the principle of procedure invariance that is fundamental to all theories of rational choice. If different elicitation procedures produce different orderings of options, (...) how can preferences be defined and in what sense do they exist? This book shows not only the historical roots of preference construction but also the blossoming of the concept within psychology, law, marketing, philosophy, environmental policy, and economics. Decision making is now understood to be a highly contingent form of information processing, sensitive to task complexity, time pressure, response mode, framing, reference points, and other contextual factors. (shrink)

Recently, von Fintel (2001) and Gillies (2007) have argued that certain sequences of counterfactuals, namely reverse Sobel sequences, should motivate us to abandon standard truth conditional theories of counterfactuals for dynamic semantic theories. I argue that we can give a pragmatic account of our judgments about counterfactuals without giving up the standard semantics. In particular, I introduce a pragmatic principle governing assertability, and I use this principle to explain a variety of subtle data concerning reverse Sobel sequences.

Recently many have argued that agents must sometimes have credences that are imprecise, represented by a set of probability measures. But opponents claim that fans of imprecise credences cannot provide a decision theory that protects agents who follow it from foregoing sure money. In particular, agents with imprecise credences appear doomed to act irrationally in diachronic cases, where they are called to make decisions at earlier and later times. I respond to this claim on behalf of imprecise credence fans. Once (...) we appreciate the complexity of our intuitions about rational decision making, we can see that diachronic cases are in fact evidence for the essential claims motivating imprecise credence models. I argue that our decision theory for imprecise agents should mirror our decision theory for agents in moral dilemmas, and I develop permissive norms that explain our intuitions about both sorts of agents. (shrink)

This paper discusses three potential varieties of update: updates to the common ground, structuring updates, and updates that introduce discourse referents. These different types of update are used to model different aspects of natural language phenomena. Not-at-issue information directly updates the common ground. The illocutionary mood of a sentence structures the context. Other updates introduce discourse referents of various types, including propositional discourse referents for at-issue information. Distinguishing these types of update allows a unified treatment of a broad range of (...) phenomena, including the grammatical evidentials found in Cheyenne (Algonquian) as well as English evidential parentheticals, appositives, and mood marking. An update semantics that can formalize all of these varieties of update is given, integrating the different kinds of semantic contributions into a single representation of meaning. (shrink)

Many languages grammatically mark evidentiality, i.e., the source of information. In assertions, evidentials indicate the source of information of the speaker while in questions they indicate the expected source of information of the addressee. This dissertation examines the semantics and pragmatics of evidentiality and illocutionary mood, set within formal theories of meaning and discourse. The empirical focus is the evidential system of Cheyenne (Algonquian: Montana), which is analyzed based on several years of fieldwork by the author.

Traditionally, discussions of moral participation – and in particular moral agency – have focused on fully formed human actors. There has been some interest in the development of morality in humans, as well as interest in cultural differences when it comes to moral practices, commitments, and actions. However, until relatively recently, there has been little focus on the possibility that nonhuman animals have any role to play in morality, save being the objects of moral concern. Moreover, when nonhuman cases are (...) considered as evidence of moral agency or subjecthood, there has been an anthropocentric tendency to focus on those behaviors that inform our attributions of moral agency to humans. For example, some argue that the ability to evaluate the principles upon which a moral norm is grounded is required for full moral agency. Certainly, if a moral agent must understand what makes an action right or wrong, then most nonhuman animals would not qualify (and perhaps some humans too). However, if we are to understand the evolution of moral psychology and moral practice, we need to turn our attention to the foundations of full moral agency. We must first pay attention to the more broadly normative practices of other animals. Here, we begin that project by considering evidence that great apes and cetaceans participate in normative practices. (shrink)

It is commonly assumed that when we assign different credences to a proposition, a perfect compromise between our opinions simply ‘splits the difference’ between our credences. I introduce and defend an alternative account, namely that a perfect compromise maximizes the average of the expected epistemic values that we each assign to alternative credences in the disputed proposition. I compare the compromise strategy I introduce with the traditional strategy of compromising by splitting the difference, and I argue that my strategy is (...) a reasonable characterization of epistemic compromise. (shrink)

During the last decade a “technical” approach has become increasingly influential in health care priority setting. The various country reports illustrate, however, that non-technical considerations cannot be avoided. As they often remain implicit in health care package decisions, this paper aims to make these normative judgements an explicit part of the procedure. More specifically, it aims to integrate different models of distributive justice as well as the principle of solidarity in four different phases of a decision-making procedure, and to identify (...) important moral choices which present themselves. First four important justice models are discussed, then a justification is given for their inclusion in a four-step decision making procedure. This is followed by a discussion of different justice and solidarity problems—with their inherent conceptual difficulties in each of these stages. The paper concludes with a summary of the major moral choices that are to be made in health care package decisions. (shrink)

Collaboration requires agents to coordinate their behavior on the fly, sometimes cooperating to solve a single task together and other times dividing it up into sub‐tasks to work on in parallel. Underlying the human ability to collaborate is theory‐of‐mind (ToM), the ability to infer the hidden mental states that drive others to act. Here, we develop Bayesian Delegation, a decentralized multi‐agent learning mechanism with these abilities. Bayesian Delegation enables agents to rapidly infer the hidden intentions of others by inverse planning. (...) We test Bayesian Delegation in a suite of multi‐agent Markov decision processes inspired by cooking problems. On these tasks, agents with Bayesian Delegation coordinate both their high‐level plans (e.g., what sub‐task they should work on) and their low‐level actions (e.g., avoiding getting in each other's way). When matched with partners that act using the same algorithm, Bayesian Delegation outperforms alternatives. Bayesian Delegation is also a capable ad hoc collaborator and successfully coordinates with other agent types even in the absence of prior experience. Finally, in a behavioral experiment, we show that Bayesian Delegation makes inferences similar to human observers about the intent of others. Together, these results argue for the centrality of ToM for successful decentralized multi‐agent collaboration. (shrink)

The concept of "nature as inner principle of change" is fundamental to Aristotle's theory of the physical world; it is the object of the present thesis to substantiate this claim by tracing the effects of this idea in Aristotle's rejection of materialism, in his doctrine of "natural places", in his definition of change and process in general, and in his notion of agency in general and the supreme Unmoved Mover in particular ). Aristotle elucidates "natural" by. contrast with "artificial" - (...) ), holding that natural substances not merely collectively - ) but as individuals each possess an 'innate impulse of change'. But this must be explained so as to allow for the fact that no change is entirely independent of external conditions - ). If, however, change were totally dependent on external conditions, its occurrence would be inexplicable - ), and the very concept of "change" would be incoherent. This latter conclusion emerges from an examination of the ancient paradox of becoming and Aristotle's treatment of it - ). The paradox is expounded -). Aristotle answers it by showing that language assumes a continuing subject of change - ). But this assumption meets the problem only if the metaphysical category of substance is also assumed, and along with it some distinction between substance-constitutive and non-substance-constitutive characteristics - ). The former mark off their subject as a thing of a certain causal type; thus change, in presupposing a substantial subject, presupposes one that makes some causal contribution to its own changes - ). But Aristotle means more than this by 'nature as inner principle'. He holds a natural substance to be the autonomous determinant of certain changes; these therefore are "natural", as manifesting the substantial nature - ). This problematic notion is taken for granted by Aristotle in the Vhys-ics - ), but can be seen to rest on his metaphysic of substance. It is a consequence of this that the natural change of a given substance be of one kind and display a unitary pattern reflecting the unity of the substance ). This view cripples scientific method as we understand it ), but Aristotle's idea of substance anyway cuts him off from the approaches successfully operated in later mechanics and chemistry - ). A summary of the ground so far covered ) introduces a further sense in which Aristotle's natures are "inner" principles of change: the subject of change is not external to the being which is the source of change - ). (shrink)

The present paper focuses on essentialism about natural kinds as a case study in order to illustrate this more general point. Saul Kripke and Hilary Putnam famously argued that natural kinds have essences, which are discovered by science, and which determine the extensions of our natural kind terms and concepts. This line of thought has been enormously influential in philosophy, and is often taken to have been established beyond doubt. The argument for the conclusion, however, makes critical use of intuitions, (...) and I note that the intuitions are of the sort had by preschool children, and that they are traceable to a deep-seated cognitive outlook, which is often called “psychological essentialism.” Further, if we did not have such a cognitive outlook or implicit belief set—a belief set which is in fact in place by at least age 4—then we would not have the relevant philosophical intuitions. In light of this, I consider the question of whether natural kinds actually have scientifically discovered or discoverable essences, and whether these putative essences could determine the extensions of our terms and concepts as Kripke, Putnam, and many others have supposed. In fact, a number of philosophers of biology and chemistry have argued that biological and chemical kinds do not have such essences, yet these arguments—particularly in the case of chemistry—have not been assimilated by philosophers more generally. The reason for this poor assimilation is, I suggest, that the Kripke/Putnam view is just so intuitive. But this fact, I argue, is due to a deep-seated cognitive bias, rather than to any special insight into the nature of reality. (shrink)