Discussions surrounding patient engagement and empowerment often use the terms “patient” and “consumer” interchangeably. But do the two terms hold the same meaning, or is a “patient” a passive actor in the health care arena and a “consumer” an informed, rational decision-maker? Has there been a shift in our usage of the two terms that aligns with the increasing commercialization of health care in the U.S. or has the patient/consumer dynamic always been a part of the buying and selling of (...) health care in the American system? Recent discussions of the issue exist in the popular press and in social media forums such as TEDMED, but few direct analyses of the ethical, legal, and policy ramifications of this possible shift in terminology are available in the academic literature. This paper analyzes our usage of the terms and any recent changes in the dynamic and discusses the ethical, legal, and policy implications of this simple terminology for the physicianpatient relationship. (shrink)

The widespread adoption of health information technology has been recognized as both a necessary element of health reform and a required building block of a modern, high performing health care system.

Information technology is considered a potentially transformative element in the field of health care by payers, providers, vendors, and consumers alike. Because of this transformative potential, health information technology adoption is viewed by many as a key component of health system reform. HIT is in its earliest stages, with diffusion of the technology still relatively limited; at the same time, there is growing awareness of its potential to affect the operation of the entire health care system as a result of (...) the vast amount of information that will become available to both health professionals and patients. (shrink)

During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent's proper role in a health care environment in which electronic information sharing holds primary importance. This article discusses current implementation of the doctrine within health information exchange networks; the relationship between informed consent and privacy; the variety of ways that the concept is referenced in discussions of information sharing; and challenges that surround incorporation of the doctrine into the evolving HIT environment. The (...) article concludes by reviewing the purpose behind the traditional obligation to obtain informed consent and the possibility of maintaining its relevance in the new environment. (shrink)

As policy makers place great hope in health information technology as a means to lower costs and achieve improvements in health care quality, safety, and efficiency, organizations at the forefront of building health information exchange networks attempt to weave the concept and function of informed consent into an evolving information-driven health care system. The vast amount of information that will become available to both health professionals and patients in the new HIT-driven environment can reasonably be expected to affect the relationship (...) between them in many ways, particularly in the area of informed consent. During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent’s proper role in a heretofore unknown health care environment — one in which electronic information sharing holds primary importance. The central and largely unexamined question of whether and how the legal and ethical underpinnings of informed consent will fit into the context of HITenabled treatment is critical to both public policy and clinical practice. (shrink)

As we move toward the creation of a networked health information environment, the potential of privacy intrusions increases, with potentially devastating impact on quality and access to healthcare. This paper describes the risks we face and proposes a framework to minimize those risks. In particular, it proposes nine principles to protect privacy in an information age.

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Patients and family members (N = 671) were surveyed in five Mid-Atlantic U.S. hospitals to ascertain the number and kinds of ethical concerns they are presently experiencing or have previously experienced while being sick or receiving medical care. Seventy percent of participants had at least one (range 0–14) type of ethical concern or question. The most commonly experienced concerns pertained to being unsure how to plan ahead or complete an advance directive (29.4%), being unsure whether someone in the family was (...) able to make their own decisions (29.2%), deciding about limiting life-sustaining treatments (28.6%), wondering about disclosing personal medical information to others in the family (26.4%) and not being sure whether to undergo treatment because of cost (26.2%). Most were interested to some degree in getting help from ethics consultants in the future (76.6%). Given this prevalence, common concerns might usefully be addressed systematically, rather than exclusively on a case-by-case basis. (shrink)

Recent literature on Stalnaker's Thesis, which seeks to vindicate it from Lewis (1976)'s triviality results, has featured linguistic data that is prima facie incompatible with Conditionalization in iterated cases (McGee 1989, 2000; Kaufmann 2015; Khoo & Santorio, 2018). In a recent paper (2021), Goldstein & Santorio make a bold claim: they hold that these departures light the way to a new, non‐conditionalizing theory of rational update.Here, I consider whether this new form of update is subject to a Dutch book. (...) On the official, invariantist version of the theory, I show that the answer is “yes”. On a competing, contextualist theory of indicative conditionals (Bacon, 2015), the answer is “no”, for reasons that have familiar connections to the limits of textbook Bayesianism. After presenting a concrete case, I explore the dialectical ramifications. The upshot is some hard choices for theories that seek to save the linguistic phenomena. (shrink)

One debate in the experimental exploration of everyday judgments about free will is whether most people are compatibilists or incompatibilists. Some recent research suggests that many people who have incompatibilist intuitions are making a mistake; as such, they do not have genuine incompatibilist intuitions. Another worry is whether most people appropriately understand determinism or confuse it with similar, but different, notions such as fatalism. In five studies we demonstrate people distinguish determinism from fatalism. While people overall make this distinction, a (...) large percentage of people still judge that a person who is fated to perform an action is both free and morally responsible for that action. Those who thought that one freely performs and is morally responsible for a fated action had much stronger compatibilist judgments. These data suggest that a substantial percentage of people have “free will no matter what” intuitions. As a result, even though many people may appear to be compatibilist.. (shrink)

Psychologists have emphasized children's acquisition of information through firsthand observation. However, many beliefs are acquired from others' testimony. In two experiments, most 4yearolds displayed sceptical trust in testimony. Having heard informants' accurate or inaccurate testimony, they anticipated that informants would continue to display such differential accuracy and they trusted the hitherto reliable informant. Yet they ignored the testimony of the reliable informant if it conflicted with what they themselves had seen. By contrast, threeyearolds were less selective in trusting a reliable (...) informant. Thus, young children check testimony against their own experience and increasingly recognise that some informants are more trustworthy than others. (shrink)

Between the body and the breathing earth : on the phenomenology of depth perception -- To praise again : phenomenology and the project of ecopsychology -- Postphenomenology and the lifeworld : interconnections, relationships, and environmental wholes : a phenomenological ecology of natural and built worlds.

What is beyond the pale of a pluralist society is a state-directed frontal attack on the evidence for religious beliefs considered as grounds for religious identity, rather than considered as grounds for scientific argument, for example. Religious commitment is not something which pupils should be expected to defend in terms of generally acceptable reasons for belief.

The mother sacrificing herself while rescuing someone else's child is a red herring. Neither behaviorism nor cognitivism can explain it. Unlike behaviorism, however, the cognitive process of projection can explain cooperation in one-shot social dilemmas.

We derive for Bohmian mechanics topological factors for quantum systems with a multiply-connected configuration space Q. These include nonabelian factors corresponding to what we call holonomy-twisted representations of the fundamental group of Q. We employ wave functions on the universal covering space of Q. As a byproduct of our analysis, we obtain an explanation, within the framework of Bohmian mechanics, of the fact that the wave function of a system of identical particles is either symmetric or anti-symmetric.

governed by Newtonian laws. In standard quantum mechanics only the wave function or the results of measurements exist, and to answer the question of how the classical world can be part of the quantum world is a rather formidable task. However, this is not the case for Bohmian mechanics, which, like classical mechanics, is a theory about real objects. In Bohmian terms, the problem of the classical limit becomes very simple: when do the Bohmian trajectories look Newtonian?

This paper considers how parents engage with a large, internationally supported childhood pneumococcal vaccine trial in The Gambia. Current analysis and professional reflection on public engagement is strongly shaped by the imperatives of public health and research institutions, and is thus couched in terms of acceptance and refusal, and . In contrast Gambian parents in the extreme, of free medical treatment, versus onepublic engagement with science’ in a globalized context might be recast, with implications for debates in biomedical ethics, and (...) the sustainability of public participation in medical research. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2017 Heft: 218 Seiten: 21-64.

This article concerns a phenomenon of elementary quantum mechanics that is quite counter-intuitive, very non-classical, and apparently not widely known: a quantum particle can get reflected at a potential step downwards. In contrast, classical particles get reflected only at upward steps. As a consequence, a quantum particle can be trapped for a long time (though not forever) in a region surrounded by downward potential steps, that is, on a plateau. Said succinctly, a quantum particle tends not to fall off a (...) table. The conditions for this effect are that the wave length is much greater than the width of the potential step and the kinetic energy of the particle is much smaller than the depth of the potential step. We point out how the topic is accessible with elementary methods, but also with mathematical rigor and numerically. (shrink)

This edited collection uses critical theory in order to understand the rise of the Alt-Right and the election of Donald Trump—and, in doing so, to assert the necessity and value of various disciplines within the humanities. While neoliberal mainstream culture has expressed shock at the seemingly expeditious rise of the Alt-Right movement and the outcome of the 2016 United States presidential election, a rich tradition of theory may not only explain the occurrence of this “phenomenon,” but may also chart an (...) alternative understanding of the movement, revealing the persistence of right-wing populism throughout the twentieth and twenty-first centuries. Though the humanities have seen themselves undervalued and under attack in recent years, the historical and cultural contextualization of the current moment via theory is a means of reaffirming the value of the humanities in teaching the ever-important and multifaceted skill of critical literacy. This book re-affirms the humanities, particularly the study of literature, theory, and philosophy, through questions such as how the humanities can help us understand the here and now. (shrink)

After decades of single issue movements and identity politics on the U.S. left, the series of large demonstrations beginning in 1999 in Seattle have led many to wonder if activist politics can now come together around a common theme of global justice. This book pursues the prospects for progressive political movements in the 21st century with case studies of ten representative movements, including the anti-globalization forces, environmental interest groups, and new takes on the peace movement.

Name der Zeitschrift: Kierkegaard Studies Yearbook Jahrgang: 2016 Heft: 1 Seiten: 189-216.

Name der Zeitschrift: Kierkegaard Studies Yearbook Jahrgang: 20 Heft: 1 Seiten: 231-258.

This is the first exploration of how ideas of politeia structure both political and extra-political relations throughout the entirety of Greek and Roman philosophy, ranging from Presocratic to classical, Hellenistic, and Neoplatonic thought. A highly distinguished international team of scholars investigate topics such as the Athenian, Spartan and Platonic visions of politeia, the reshaping of Greek and Latin vocabularies of politics, the practice of politics in Plato and Proclus, the politics of value in Plato, Aristotle and the Stoics, and the (...) extension of constitutional order to discussions of animals, gods and the cosmos. The volume is dedicated to Professor Malcolm Schofield, one of the world's leading scholars of ancient philosophy. (shrink)

This paper asks about the climate damages that Indian policymakers can expect. What is the likely magnitude of climate damages, and how sensitive are they to the level of warming? How much worse would climate damages be for Indians under, say, 5° of warming rather than 3°? Understanding the magnitude of climate damages and how rapidly they increase as temperature change increases is critical for finding the right climate mitigation policy. This paper provides projections of India’s climate vulnerability on the (...) basis of new microeconomic and macroeconomic evidence. The authors’ quantifications show that India is highly vulnerable to climate damage. Their baseline macroeconomic approach suggests that climate change peaking at 5°C, rather than 3°C, would be as detrimental to Indian well-being as a reduction in GDP by about 18 percent for each of the years from 2020 to 2040. Such an equivalent threat to near-term economic outcomes would be an overriding policy priority if political leaders anticipated it. The authors’ microeconomic results suggest that this may be an underestimate, because it ignores humidity. Emerging evidence suggests that humans are especially vulnerable to exposure to high temperatures in contexts of high humidity; humidity is a previously underappreciated and unquantified reason way in which India may be more climate-vulnerable even than some hotter developing and middle-income countries. (shrink)

Our interpretation of the "parmenides" 132a1 - 132b2 has the following features. (i) it stresses that the third man argument is an infinite regress and (ii) notes its epistemological thrust. (iii) a faithful translation of the last line of the argument reads "and no longer will each of the forms be for you one but each is infinite in multitude." parmenides' point is that each form, which socrates believed to be complete (one), turns out to be an unbounded, incompletable series (...) of subforms useless for comprehending the unity of many particulars. (iv) related problems are seen to occupy plato in the "philebus" and in the "sophist". (shrink)

Individuals typically resist changing their minds, but support for same-sex marriage increased from 35% to 61% between 2006-2016. What explains this anomaly?

A person skeptical about other minds supposes it is possible in principle that there are no minds other than his. A person skeptical about an external world thinks it is possible there is no world external to him. Some philosophers think a person can refute the skeptic and prove that his world is not the solitary scenario the skeptic supposes might be realized. In this paper I examine one argument that some people think refutes solipsism. The argument, from Wittgenstein, is (...) grounded in a thesis about language. Some people believe that in using language a person necessarily is linked to persons other than himself. Some people think a person can use the ‘communalist’ principle to refute forms of solipsism. I show that people do not refute solipsism with the Wittgensteinian, language-necessarily-is-shared principle. (shrink)

My new homepage is at jostylr.com . The corresponding e-mail address is [email protected] . On my new homepage there will be information about Bohmian mechanics, my papers, professional information, and personal information. As of 7/30/04, there is not much there, but it should improve.