Though antiretroviral therapy is the standard of care for people living with HIV, its treatment limitations, burdens, stigma and costs lead to continued interest in HIV cure research. Early-phase cure trials, particularly those that include analytic treatment interruption, involve uncertain and potentially high risk, with minimal chance of clinical benefit. Some question whether such trials should be offered, given the risk/benefit imbalance, and whether those who choose to participate are acting rationally. We address these questions through a longitudinal decision-making study (...) nested in a Thai acute HIV research cohort. In-depth interviews revealed central themes about decisions to join. Participants felt they possessed an important identity as members of the acute cohort, viewing their bodies as uniquely suited to both testing and potentially benefiting from HIV cure approaches. While acknowledging risks of ATI, most perceived they were given an opportunity to interrupt treatment, to test their own bodies and increase normalcy in a safe, highly monitored circumstance. They were motivated by potential benefits to themselves, the investigators and larger acute cohort, and others with HIV. They believed their own trial experiences and being able to give back to the community were sufficient to offset participation risks. These decisions were driven by the specific circumstances experienced by our participants. Judging risk/benefit ratios without appreciating these lived experiences can lead to false determinations of irrational decision- making. While this does not minimise vital oversight considerations about risk reduction and protection from harm, it argues for inclusion of a more participant-centered approach. (shrink)

This volume offers an exciting new reading of John Ruskin's economic and social criticism, based on recent research into rhetoric in economics. Willie Henderson uses notions derived from literary criticism, the rhetorical turn in economics and more conventional approaches to historical economic texts to reevaluate Ruskins economic and social criticism. By identifying Ruskin's rhetoric, and by reading his work through that of Plato, Xenophon, and John Stuart Mill, Willie Henderson reveals how Ruskin manipulated a knowledge base. Moreover (...) in analysis of the writings of William Smart, John Bates Clark and Alfred Marshall, the author shows that John Ruskin's influence on the cultural significance of economics and on notions of economic well-being has been considerable. (shrink)

The essays in this volume, with the exception of Gary Ferngren's, derive from ancestral versions originally presented at a symposium, 'Conflicts with Newborns: Saving Lives, Scarce Resources, and Euthanasia: held May 10-12,1984, at the Mercer University School of Medicine, Macon, Georgia. We wish to express our gratitude to the Georgia Endowment for the Humanities for a generous grant for the symposium and to Mercer University and the Medical Center of Central Georgia for additional financial support. The vit:ws expressed in this (...) volume do not necessarily represent those of the Georgia Endowment for the Humani ties, Mercer University, or the Medical Center of Central Georgia. We have endeavored to bring together a group of individuals with contrast ing viewpoints to display some of the range of approaches to a major problem in public policy: medical decisions regarding the treatment of defective newborns. So many persons contributed to the symposium that acknowledg ment of each would be impossible. Although unnamed, we express our sincere appreciation to each. Three individuals, however, must be recognized: R. Kirby Godsey, President, Mercer University; William P. Bristol, Dean, Mercer University School of Medicine; and Kenneth C. Henderson, Medical Director and Director of Medical Education, Medical Center of Central Georgia. Without their support, the symposium could not have succeeded and this volume would not have been possible. We wish also to express our gratitude to S. G. M. (shrink)

This volume argues for a new image of science that understands both natural and social phenomena to be the product of mechanisms, casting the work of science as an effort to understand those mechanisms. Glennan offers an account of the nature of mechanisms and of the models used to represent them in physical, life, and social sciences.

The dictum ‘“ought” implies “can”’ has a status in moral philosophy in some respects like that of ‘a good player needs good co-ordination’ in talk about ball-games. Clearly, you say something important but not conclusive about proficiency in playing a ball-game when you say that it requires good co-ordination: similarly, you say something important but not conclusive about obligation when you say that it implies a certain possibility or power or ability. Each dictum is a reminder: the one about such (...) courses of physical instruction, the other about such exhortations to duty, as are worth persevering with. It would be hopeless to keep on teaching a boy the moves and tricks of rugby football if he could never co-ordinate well enough to get his eye in, so to speak. Correspondingly, it would be meaningless to recommend that someone ought to do something the specification of which involved a contradiction, and pointless to suggest that he ought to do something which, for quite general reasons, was not, and was certain to remain not, within his power. So each dictum expresses a bluff, no-nonsense wisdom which we should count on before involving ourselves in certain more detailed commitments. But probably this is as far as the comparison between the two sayings can well be taken. (shrink)

Stuart Kauffman here presents a brilliant new paradigm for evolutionary biology, one that extends the basic concepts of Darwinian evolution to accommodate recent findings and perspectives from the fields of biology, physics, chemistry and mathematics. The book drives to the heart of the exciting debate on the origins of life and maintenance of order in complex biological systems. It focuses on the concept of self-organization: the spontaneous emergence of order widely observed throughout nature. Kauffman here argues that self-organization plays (...) an important role in the emergence of life itself and may play as fundamental a role in shaping life's subsequent evolution as does the Darwinian process of natural selection. Yet until now no systematic effort has been made to incorporate the concept of self-organization into evolutionary theory. The construction requirements which permit complex systems to adapt remain poorly understood, as is the extent to which selection itself can yield systems able to adapt more successfully. This book explores these themes. It shows how complex systems, contrary to expectations, can spontaneously exhibit stunning degrees of order, and how this order, in turn, is essential for understanding the emergence and development of life on Earth. Topics include the new biotechnology of applied molecular evolution, with its important implications for developing new drugs and vaccines; the balance between order and chaos observed in many naturally occurring systems; new insights concerning the predictive power of statistical mechanics in biology; and other major issues. Indeed, the approaches investigated here may prove to be the new center around which biologicalscience itself will evolve. The work is written for all those interested in the cutting edge of research in the life sciences. (shrink)

This essay deals with plague and plagues in renaissance and early modern Europe over the longue durée, principally from a methodological perspective. I shall combine an historiographical approach with an historical account of developing reactions to plague and in passing compare measures to cope in the early sixteenth century with reactions to the impact of the Great Pox or the Mal de Naples. I shall concentrate on southern Europe and in particular on Italy and my aim is to re-assess the (...) historiography of plague through the lens of some of the more recent Anglo-Saxon literature in this field. In the process I shall outline some of the debates within the field and end with some general methodological observations drawn from early modern Italy. (shrink)

Doctors’ survival predictions for terminally ill patients have been shown to be inaccurate and there has been an argument for less guesswork and more use of carefully constructed statistical indices. As statisticians, the authors are less confident in the predictive value of statistical models and indices for individual survival times. This paper discusses and illustrates a variety of measures which can be used to summarise predictive information available from a statistical model. The authors argue that models and statistical indices can (...) be useful at the group or population level, but that human survival is so uncertain that even the best statistical analysis cannot provide single-number predictions of real use for individual patients. (shrink)

From the operation of the universe to DNA, the brain and the economy, natural and social frequently describe their activity as being concerned with discovering mechanisms. Despite this fact, for much of the twentieth century philosophical discussions of the nature of mechanisms remained outside philosophy of science. The Routledge Handbook of Mechanisms and Mechanical Philosophy is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising over (...) thirty chapters by a team of international contributors the _Handbook_ is divided into four parts: Historical Perspectives on Mechanisms The Nature of Mechanisms Mechanisms and the Philosophy of Science Disciplinary Perspectives. Within these sections central topics and problems are examined, including the rise of mechanical philosophy in the seventeenth century; mechanisms as parts and wholes and their interactive powers; mechanisms and laws and regularities; how mechanisms are discovered and explained; dynamical systems theory; and disciplinary perspectives from physics, chemistry, biology, biomedicine, ecology, neuroscience and the social and political sciences. Essential reading for students and researchers in philosophy of science and philosophy the _Handbook _will also be of interest to those in related fields, such as metaphysics, philosophy of psychology and history of science. (shrink)

British philosopher and economist John Stuart Mill is the author of several essays, including Utilitarianism - a defence of Jeremy Bentham's principle applied to the field of ethics - and The Subjection of Women, which advocates legal equality between the sexes. This work, arguably his most famous contribution to political philosophy and theory, was first published in 1859, and remains a major influence upon contemporary liberal political thought. In it, Mill argues for a limitation of the power of government (...) and society over the individual, and defines liberty as an absolute individual right. According to the still much debated 'harm principle', power against the individual can only be exercised to prevent harm to others. Full of contemporary relevance, this essay also defends freedom of speech as a necessary condition of social and intellectual progress. (shrink)

This paper examines three medical student poems about death to explore how medical students use poetry to understand their encounters with dying patients and to discuss how these poems function as elegies in the context of medical culture.

The word “beautiful” plays a surprisingly unimportant part in the language of sophisticated artistic appreciation; I mean in the informed criticism and comparison of specific works of art. Though in ordinary conversation it can be used naturally and easily, it does not serve readily as a technical term in expert writing or discussion. To become a technical term of this kind it would have to be definable, and definable in terms which commanded sufficient agreement: but attempts to define “beauty” and (...) “beautiful” may well have become restrained by the popularity of philosophical discussion about the significance of these words. No philosophical question is discussed more commonly or from more firmly held opposite positions than the question whether beauty is “objective” or not. Discussion of this and related topics, however, not being the monopoly of professed philosophers but being familiar amongst artists and art critics themselves, tends to remove all shadow of technicality from the crucial terms discussed. Other terms come to serve for the “objective” features of works of art, and others again for the impressions which works of art may make upon us: “beauty” and “beautiful” tend to fall away between these two classes. (shrink)

I want to explore the possibility of an a posteriori approach to the elucidation of certain moral notions. These are: (a) the notion of a duty, some specific thing which it is incumbent on me to do, and (b) the notion of something that is a good thing for me to do. I want to consider these notions, so far as I can, independently of rules. There is a certain sense in which having a duty to do this or that (...) is a function of circumstances, and in which this or that's being a good thing to do is likewise a function of circumstances. I shall suggest specific examples in which this is a conspicuous feature of ‘my duty’ or of what I can, beneficially, do. In these examples what I ought to do, and what it is good to do, can be represented as special ways in which what I am to do presents itself. (shrink)

In the course of his life a man surrounds himself with questions, much as he surrounds himself with furniture, books or pictures. Personality is expressed not only by the selection of a Chippendale chair, the amassing of early colour-plate books, or the purchase of a Renoir, but also by the kind of questions which a man “collects”-raises, without necessarily solving. Some questions, like some books, are to be brooded over and studied; some are introduced only to be contemplated from time (...) to time, like fine bindings; and some occur so casually as hardly to rouse any attention at all. There is an obvious difference between a man who bids carefully at a book auction or forces himself on to his knees to identify a dust-covered quarto in a slum bookshop, and a man whose library is inherited from parents or grandparents; acceptances and not choices will distinguish the casual possessor from the bookman. Similarly, there are many questions which sit lightly on a man's mind, which are as little the object of sustained wondering or bafflement as his ancestors” well bound volumes of theology or game-shooting are the reflection of his own tastes or interests. These may be questions of any sort: they may be factual questions, important or trivial, or they may be theoretical questions, philosophical perhaps, or religious or scientific. A student of literature, for instance, has been known to congratulate himself on his ignorance of modern science, ignorance so deliberate that any scientific question raised in his presence fails even to make him wonder. For any person, however, there are ranges of questions which barely touch his mind: he may be aware that he does not know how to derive answers to them for himself, but his inability will not cause him concern. The memory, the practical or the reasoning skill of the kind that would be required are perhaps so much out of proportion to what he possesses that to bemoan the lack of them is unrealistic -as it is often idle and merely conventional for one who is tone-deaf to say how much he wishes he could sing an aria . Other questions altogether, important or trivial, he takes seriously and troubles to answer, because they touch his own special interests directly: he may pride himself on never neglecting a newspaper problem in bridge or chess, or he may never fail to answer correctly a question about the construction of some instrument or machine. The same person, however, will also get the length of raising many questions which remain mere questions. He may be troubled and puzzled about certain political or social question which circumstances do not compel him to answer: but he will not be hypocritical in professing an interest in them. Some of these questions, of course, may become solved after a fashion, if he listens to the voice of politician, statistician, priest or psychologist and is lucky enough to get an answer which satisfies him. But many will survive with just enough recurrences of wondering about them to make them, as you might say, chronic. This is the intermediate class of questions. (shrink)

A fascinating exploration of the very essence of life itself sheds new light on the order and evolution in complex life systems and defines and explains autonomous agents and work within the contexts of thermodynamics and information theory, setting the stage for a dramatic technological revolution. 50,000 first printing.

ABSTRACT:What more can be said about COVID-19 and the social determinants of health? This article describes neglected perspectives that derive from the history of social epidemiology, a field that identifies the social etiology of disease and variations in disease incidence among people differentially located in the social structure. The "discovery" of social determinants of diseases like COVID-19 is nothing new for epidemiology: debate over how to analyze structural determinants versus individual-level risk factors persisted throughout the 19th and 20th centuries. By (...) the late 20th century, research had highlighted fundamental causes of health disparities, such as social conditions and structural racism; these are structural factors, embedded in the social fabric of life. Measurement of structured inequalities within systems faces complex and challenging problems, as research aims to better account for these lived realities at different levels of analysis and as multiple factors merge to influence outcomes (revealed in intersectionality theory). At each of these intersections, there are opportunities for bioethicists to consider their ethical implications. It is imperative to understand the social and ethical roots of our present conversations about health inequalities, in order to partner intelligently with researchers on the forefront of advocating for change. (shrink)

At Home in the Universe presents and extends the intellectual core ofKauffman's earlier book The Origins of Order (OUP 1993) for any intelligentgeneral reader can understand and appreciate. The reader is very effectivelyinvited into Kauffman's vision and thought processes, in one of the moreexhilarating and important books of popular science.

BackgroundChildhood abuse increases risk for high levels of distress in response to future stressors. Interpersonal social support is protective for health, particularly during stress, and may be particularly beneficial for individuals who experienced childhood abuse.ObjectiveInvestigate whether childhood abuse predicts levels of posttraumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic, and test whether the perceived availability of social companionship preceding the pandemic moderates this relationship.MethodsDuring Phase 1, adults (N= 120; AgeM[SD] = 19.4 [0.94]) completed a retrospective measure of childhood (...) adversity along with a measure of perceived availability of opportunities for social engagement immediately preceding the pandemic. Two weeks after the COVID-19 pandemic declaration, participants completed the Impact of Event Scale-Revised (IES-R) with respect to the pandemic. Hierarchical linear regression analyses examined the interaction between childhood abuse and the perceived availability of social companionship preceding the pandemic as a predictor of PTSD symptoms.ResultsAdjusting for covariates, the interaction between childhood abuse and perceived availability of others to engage with before the onset of the pandemic was a significant predictor of IES-hyperarousal (β = −0.19,t= −2.06,p= 0.04, ΔR2= 0.032, CI: [−0.31 to −0.01]).ConclusionLevels of perceived opportunities for social companionship before the pandemic associates with levels of hyperarousal related to the pandemic, particularly for individuals who experienced high levels of childhood abuse. More research is needed to understand how to mitigate the higher levels of distress related to the pandemic for these individuals in order to reduce risk for future psychiatric disorders. (shrink)

“I am not mad, most noble Festus, but speak the words of truth and soberness.” In this cry of Paul's we hear the idealist in all ages making his agonized claim to realism in face of the Powers that Be. Festus and Agrippa represent the ex-officio history-makers in this scene. Paul is proclaiming fundamental facts and possibilities that those who have power fail to see. And so, in claiming to be sane, he becomes the spokesman for all who see the (...) Not-Yet as stronger than the Now, and behold What is Meant to Be as more powerful than What Is. (shrink)

He upon whom has descended the “amor intellectualis Dei” must make up his mind to walk much alone. In the world of “intellectuals” he is at present “out of the swim,” and his work must be done against the prevailing current. And among the generality of religious people, he is regarded as rather a disturbing presence in matters of faith, apt to fall short, apparently, of their own standards in the service of God. “The love of the mind for God” (...) has little popular esteem in English-speaking Christianity. The nineteenth century valued feeling as the chief element in religion, and the emphasis of to-day is on the practical service of the will. But in our tradition, from Colet and the Cambridge Platonists to Westcott and von Hiigel, the “amor intellectualis Dei” has produced a line of great men of God, and surely will never be without its witnesses. Their message is a two-fold one. First that every experience of life can be “produced” into an experience of God by an effort of personality in which creative thought and constructive imagination has its part, second that this “love of the mind” is natural in some degree to all men, and an end in itself, giving to each lover an original vision. “It is Origen,” writes Dean Inge, “who in words thrilling alike by their humility and confidence, proclaims that ‘as the eye seeks the light, as our body craves for food, so our mind is impressed with the natural desire of knowing the truth of God and the causes of what we observe.’”. (shrink)

Machine generated contents note: -- Chapter 1. A Short View of Ignorance -- Chapter 2. Finding Out -- Chapter 3. Limits, Uncertainty, Impossibility, and Other Minor Problems -- Chapter 4. Unpredicting -- Chapter 5. The Quality of Ignorance -- Chapter 6. Ignorance in Action: Case Histories -- Chapter 7. Ignorance beyond the Lab.

The last decades have seen major advances in the study of gestures both in humans and non-human primates. In this paper, we seriously examine the idea that there may be gestural form types that are shared across great ape species, including humans, which may underlie gestural universals, both in form and meaning. We focus on one case study, the hand fling gesture common to chimpanzees and humans, and provide a semantic analysis of this gesture.

Philosophers of science typically associate the causal-mechanical view of scientific explanation with the work of Railton and Salmon. In this paper I shall argue that the defects of this view arise from an inadequate analysis of the concept of mechanism. I contrast Salmon's account of mechanisms in terms of the causal nexus with my own account of mechanisms, in which mechanisms are viewed as complex systems. After describing these two concepts of mechanism, I show how the complex-systems approach avoids certain (...) objections to Salmon's account of causal-mechanical explanation. I conclude by discussing how mechanistic explanations can provide understanding by unification. (shrink)

What is honor? Is it the same as reputation? Or is it rather a sentiment? Is it a character trait, like integrity? Or is it simply a concept too vague or incoherent to be fully analyzed? In the first sustained comparative analysis of this elusive notion, Frank Stewart writes that none of these ideas is correct. Drawing on information about Western ideas of honor from sources as diverse as medieval Arthurian romances, Spanish dramas of the sixteenth and seventeenth centuries, and (...) the writings of German jurists of the nineteenth and twentieth centuries, and comparing the European ideas with the ideas of a non-Western society—the Bedouin—Stewart argues that honor must be understood as a right, basically a right to respect. He shows that by understanding honor this way, we can resolve some of the paradoxes that have long troubled scholars, and can make sense of certain institutions that have not hitherto been properly understood. Offering a powerful new way to understand this complex notion, _Honor_ has important implications not only for the social sciences but also for the whole history of European sensibility. (shrink)

Explores the possiblity and process of evolution beyond the standard and established scientific principles.

"The pursuit of science by professional scientists every day bears less and less resemblance to the perception of science by the general public. It is not the rule-based, methodical system for accumulating facts that dominates the public view. Rather it is the idiosyncratic, often bumbling search for understanding in mostly uncharted places. It is full of wrong turns, cul-de-sacs, mistaken identities, false findings, errors of fact and judgment-and the occasional remarkable success. The widespread but distorted view of science as infallible (...) originates in an education system that teaches nothing but facts using very large, very frightening textbooks, and is spread by media that report on discoveries but almost never on process. It is further reinforced by politicians who pay for it and want to use it to determine policy and therefore want it right and, worst of all, sometimes by scientists who learn early on that talking too much about failures and not enough about successes can harm their careers. Failure, then, is a book that seeks to make science more appealing by exposing its faults. In this sequel to Ignorance, Stuart Firestein shows us that scientific enterprise is riddled with failures, and that this is not only necessary but good. Failure reveals how science got its start, when humans began to use a process-trial and error-as a kind of recipe that includes a hefty dose of failure. It gives the non-scientifically trained public an insider's view of how science is actually done, with the aim of making it accessible, comprehensible, and entertaining."--Publisher description. (shrink)

In this work, Mill reflects on the struggle between liberty and authority and defends the view that “the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.” He questions the justification for the limits of freedom of conscience and religion, freedom of speech, freedom of action, and the nature of liberalism itself. This new Broadview Edition demonstrates the ways in which Mill’s intellectual landscape differed (...) markedly from our own, while also drawing attention to the reasons why the work remains relevant and essential reading in the present day. Appendices include antecedents to Mill’s work, critical discussions by his contemporaries, and related writings by Mill. Please note: Broadview offers two separate editions of On Liberty. The Kahn edition is particularly relevant to readers who are interested in how the work is situated in the history of political philosophy, whereas the Alexander edition is recommended to those most interested in the work’s Victorian literary and social contexts. (shrink)

Mechanism is undoubtedly a causal concept, in the sense that ordinary definitions and philosophical analyses explicate the concept in terms of other causal concepts such as production and interaction. Given this fact, many philosophers have supposed that analyses of the concept of mechanism, while they might appeal to philosophical theories about the nature of causation, could do little to inform such theories. On the other hand, methods of causal inference and explanation appeal to mechanisms. Discovering a mechanism is the gold (...) standard for establishing and explaining causal connections. This fact suggests that it might be possible to provide an analysis of causation that appeals to mechanisms. (shrink)

My aim in this paper is to make a case for the singularist view from the perspective of a mechanical theory of causation, and to explain what, from this perspective, causal generalizations mean, and what role they play within the mechanical theory.