Health checks identify disease in individuals without a medical indication. More and more checks are offered by more providers on more risk factors and diseases, so we may speak of an omnipresence of health checks. Current ethical evaluation of health checks considers checks on an individual basis only. However, omnipresent checks have effects over and above the effects of individual health checks. They might give the impression that health is entirely manageable by individual actions and strengthen the norm of individual (...) responsibility for health to the point where people hold themselves and others responsible for health outcomes they cannot reasonably be held accountable for. This process of so-called ‘over-responsibilization’ may result in increased feelings of guilt over health, decreased health solidarity and unfairly distributed health outcomes. Moreover, effects on privacy and peace of mind may be observed. Taking into account all possible harms and benefits of health checks in their ethical evaluation requires evaluation of health checks on an individual basis as well as on the level of all checks. Therefore, we urge the amendment of existing ethical evaluation to include the effects of an omnipresence of health checks. We make a first attempt at the formulation of amended criteria. (shrink)

Health checks identify disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as ‘personal health checks’. Health check providers’ perspective of ‘good’ health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for ‘good’ health checks, and the role these criteria play in their practices. Providers unanimously formulate a (...) number of minimal criteria: Checks must focus on treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health checks potential conflicts between criteria and underlying values should be explicated, guidance in weighing of criteria should be provided and the larger context should be taken into account: other actors than providers need to take up responsibility, and ideally benefits and harms of health checks should be weighed against other measures targeting disease. (shrink)

Health checks or health screenings identify disease in people without a specific medical indication. So far, the perspective of health check users has remained underexposed in discussions about the ethics and regulation of health checks. In 2017, we conducted a qualitative study with lay people from the Netherlands. We asked what participants consider characteristics of good and bad health checks, and whether they saw a role for the Dutch government. Participants consider a good predictive value the most important characteristic of (...) a good health check. Information before, during and after the test, knowledgeable and reliable providers, tests for treatable disease, respect for privacy, no unnecessary health risks and accessibility are also mentioned as criteria for good health checks. Participants make many assumptions about health check offers. They assume health checks provide certainty about the presence or absence of disease, that health checks offer opportunities for health benefits and that the privacy of health check data is guaranteed. In their choice for provider and test they tend to rely more on heuristics than information. Participants trust physicians to put the interest of potential health check users first and expect the Dutch government to intervene if providers other than physicians failed to do so by offering tests with a low predictive value, or tests that may harm people, or by infringing the privacy of users. Assumptions of participants are not always justified, but they may influence the choice to participate. This is problematic because choices for checks with a low predictive value that do not provide health benefits may create uncertainty and may cause harm to health; an outcome diametrically opposite to the one intended. Also, this may impair the relationship of trust with physicians and the Dutch government. To further and protect autonomous choice and to maintain trust, we recommend the following measures to timely adjust false expectations: advertisements that give an accurate impression of health check offers, and the installation of a quality mark. (shrink)

In mirror mark tests dolphins twist, posture, and engage in open-mouth and head movements, often repetitive. Because postures and an open mouth are also dolphin social behaviours, we used self-view television as a manipulatable mirror to distinguish between self-examination and social behavior. Two dolphins were exposed to alternating real-time self-view and playback of the same to determine if they distinguished between them. The adult male engaged in elaborate open-mouth behaviors in mirror mode, but usually just watched when playing back the (...) same material. Mirror mode behavior was also compared to interacting with real dolphins . Mark tests were conducted, as well as switches from front to side self-views to see if the dolphins turned. They presented marked areas to self-views to see if the dolphins turned. They presented marked areas to the self-view television and turned. The results suggest self-examination over social behavior. (shrink)

If a hereditary predisposition to colorectal cancer or breast cancer is diagnosed, most guidelines state that clinical geneticists should request index patients to inform their at-risk relatives about the existence of this condition in their family, thus enabling them to consider presymptomatic genetic testing. Those identified as mutation carriers can undertake strategies to reduce their risk of developing the disease or to facilitate early diagnosis. This procedure of informing relatives through the index patient has been criticised, as it results in (...) relatively few requests for genetic testing, conceivably because a certain number of relatives remain uninformed. This pilot study explored attitudes toward informing family members and relevant practices among clinical geneticists. In general, clinical geneticists consider it to be in the interests of family members to be informed and acknowledge that this goal is not accomplished by current procedures. The reasons given for maintaining present practices despite this include clinical ‘mores’, uncertainty about the legal right of doctors to inform family members themselves, and, importantly, a lack of resources. We discuss these reasons from an ethical point of view and conclude that they are partly uninformed and inconsistent. If informing relatives is considered to be in their best interests, clinical geneticists should consider informing relatives themselves. In the common situation in which index patients do not object to informing relatives, no legal obstacles prevent geneticists from doing so. An evaluation of these findings among professionals may lead to a more active approach in clinical practice. (shrink)

Among the many common criticisms of the Turing test, a valid criticism concerns its scope. Intelligence is a complex and multi-dimensional phenomenon that will require testing using as many different formats as possible. The Turing test continues to be valuable as a source of evidence to support the inductive inference that a machine possesses a certain kind of intelligence and when interpreted as providing a behavioural test for a certain kind of intelligence. This paper raises the novel criticism that the (...) Turing test represents an example of Goodhart’s Law operating in the field of artificial intelligence. As one measure towards the goal of creating genuinely intelligent machines, the Turing test must not be confused with the goal itself. Moreover, the Turing test ought to be augmented such that through its use additional evidence could be secured to support the strong inference that a machine, were it to pass the Turing Test, could think like a human. (shrink)

“Shooting [or ‘guessing’] characters” was a game, and later a communication method, based on phonological analysis of Chinese syllables. Over time, it became used in a variety of ways, including as a teaching tool, a cipher, and a phonological writing aid for the less educated. The actual and proposed applications of one phonological game show that Chinese phonology did not just exist in books, but encompassed distinct non-written practices that were essential to its proliferation. Chinese phonology is generally studied as (...) a source for the history of the Chinese language, but it is also of interest for the history of cultural and intellectual life. (shrink)

One important concern regarding implantable Brain Computer Interfaces is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation, show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne (...) sais quoi despite clear motor improvement. Despite the growing number of cases in the DBS literature, there is currently no accepted or standardized tool in neuroethics specifically designed to capture the phenomenological postoperative experience of patients implanted with DBS or BCI devices. Given potential risks of postoperative maladaptation, it is important for the field of neuroethics to develop a qualitative instrument that can serve as a shared method for capturing postoperative variations in patient experience of identity and agency. The goal of this article is to introduce an instrument we have developed for this purpose and call for further neuroethical efforts to assess the phenomenology of implantable brain device use. (shrink)

A common adage runs that, given a theory manifesting symmetries, the syntax of that theory should be modified in order to construct a new theory, from which symmetry-variant structure of the original theory has been excised. Call this strategy for explicating the underlying ontology of symmetry-related models reduction. Recently, Dewar has proposed an alternative to reduction as a means of articulating the ontology of symmetry-related models—what he calls sophistication, in which the semantics of the original theory is modified, and symmetry-related (...) models of that theory are treated as if they are isomorphic. In this paper, we undertake a critical evaluation of sophistication about symmetries—we find the programme underdeveloped in a number of regards. In addition, we clarify the interplay between sophistication about symmetries, and a separate debate to which Dewar has contributed—viz., that between interpretational versus motivational approaches to symmetry transformations. (shrink)

Recently, there has been increasing interest in the use of heavily restricted randomization designs which enforce balance on observed covariates in randomized controlled trials. However, when restrictions are strict, there is a risk that the treatment effect estimator will have a very high mean squared error. In this article, we formalize this risk and propose a novel combinatoric-based approach to describe and address this issue. First, we validate our new approach by re-proving some known properties of complete randomization and restricted (...) randomization. Second, we propose a novel diagnostic measure for restricted designs that only use the information embedded in the combinatorics of the design. Third, we show that the variance of the MSE of the difference-in-means estimator in a randomized experiment is a linear function of this diagnostic measure. Finally, we identify situations in which restricted designs can lead to an increased risk of getting a high MSE and discuss how our diagnostic measure can be used to detect such designs. Our results have implications for any restricted randomization design and can be used to evaluate the trade-off between enforcing balance on observed covariates and avoiding too restrictive designs. (shrink)

How could the paradigm shift towards enactive embodied cognitive science have implications for society and politics? Translating insights form enactive embodied cognitive science into ways of dealing with real-life issues is an important challenge. This paper focuses of the urgent societal issue of social cohesion, which is crucial in our increasingly segregated and polarized Western societies. We use Rietveld’s philosophical Skilled Intentionality Framework and work by the multidisciplinary studio RAAAF to extend Lambros Malafouris’ Material Engagement Theory to the social domain. (...) How could a landscape of social affordances generate change in the behavioral patterns of people from different socio-cultural backgrounds? RAAAF is currently imagining and planning an ambitious intervention in the public domain that could really change existing socio-cultural practices and aims to contribute to social cohesion. An animation film it made introduces a landscape of social affordances. We will present and discuss this Trusted Strangers animation film, which is a thinking model for new public domain all over the world. Tha animation film visualizes how a well-designed landscape of social affordances could invite all sorts of interactions between people from different socio-cultural backgrounds. (shrink)

Peirce, Ch. S. Die Festlegung einer Überzeugung.--Peirce, Ch. S. Was heisst Pragmatismus?--James, W. Der Wille zum Glauben.--James, W. Der Wahrheitsbegriff des Pragmatismus.--Schiller, F. C. S. Humanismus.--Dewey, J. Pragmatismus und Pädagogik.

A report on the 2019 Bonn “Simplicities and Complexities” Conference, organized by "The Epistemology of the Large Hadron Collider" research unit.

Absolutism about mass claims that mass ratios obtain in virtue of absolute masses. Comparativism denies this. Dasgupta, Oxford studies in metaphysics, Oxford University Press, Oxford, 2013) argues for comparativism about mass, in the context of Newtonian Gravity. Such an argument requires proving that comparativism is empirically adequate. Dasgupta equates this to showing that absolute masses are undetectable, and attempts to do so. This paper develops an argument by Baker to the contrary: absolute masses are in fact empirically meaningful, that is (...) detectable. Additionally, it is argued that the requirement of empirical adequacy should not be cashed out in terms of undetectability in the first place. The paper closes by sketching the possible strategies that remain for the comparativist. Along the way a framework is developed that is useful for thinking about these issues: Ozma games—how could one explain to an alien civilisation what an absolute mass is? (shrink)

In the debate about the nature of social cognition we see a shift towards theories that explain social understanding through interaction. This paper discusses autopoietic enactivism and the we-mode approach in the light of such developments. We argue that a problem seems to arise for these theories: an interactionist account of social cognition makes the capacity of shared intentionality a presupposition of social understanding, while the capacity of engaging in scenes of shared intentionality in turn presupposes exactly the kind of (...) social understanding that it is intended to explain. The social capacity in question that is presupposed by these accounts is then analyzed in the second section via a discussion and further development of Searle’s ‘sense of us’ and ‘sense of the other’ as a precondition for social cognition and joint action. After a critical discussion of Schmid’s recent proposal to analyze this in terms of plural pre-reflective selfawareness, we develop an alternative account. Starting from the idea that infants distinguish in perception between physical objects and other agents we distinguish between affordances and social affordances and cash out the notion of a social affordance in terms of “interaction-oriented representations”, parallel to the analysis of object affordances in terms of “action-oriented representations”. By characterizing their respective features we demonstrate how this approach can solve the problem formulated in the first part. (shrink)

The paper presents a renewed Habermasian view on transnational multi-stakeholder initiatives (MSIs) and assesses the institutional characteristics of the Equator Principles Association (EPA) from a deliberative democracy perspective. Habermas’ work has been widely adopted in the academic literature on the political responsibilities of (multinational) corporations (i.e., political corporate social responsibility), and also in assessing the democratic qualities of MSIs. Commentators, however, have noted that Habermas’ approach relies very much on ‘nation-state democracy’ and may not be applicable to democracy in MSIs—in (...) which nation-states are virtually absent. We argue that Habermas’ detailed conceptualization of the institutionalization of deliberative democracy can be applied to transnational MSIs if these initiatives can be said to have their own ‘dèmoi’ that can be represented in associational decision-making. Therefore, we develop a definition of the dèmos of an MSI based on the notion of collective agency. Subsequently, we explain how Habermas’ approach to democracy can be applied to MSIs and show that it has more to offer than hitherto has been uncovered. Our illustrative analysis of the EPA confirms the criticisms regarding this MSI which have recently been articulated by researchers and practitioners, but also yields new findings and possible avenues for the further development of the EPA: That is, although our assessment suggests that the EPA in its current state is still far from being a democratic MSI, the possibility of a sensible analysis of its democratic character indicates that transnational MSIs can, in principle, help to fill governance gaps in a democratic way. (shrink)

The paper presents a renewed Habermasian view on transnational multi-stakeholder initiatives and assesses the institutional characteristics of the Equator Principles Association from a deliberative democracy perspective. Habermas’ work has been widely adopted in the academic literature on the political responsibilities of corporations, and also in assessing the democratic qualities of MSIs. Commentators, however, have noted that Habermas’ approach relies very much on ‘nation-state democracy’ and may not be applicable to democracy in MSIs—in which nation-states are virtually absent. We argue that (...) Habermas’ detailed conceptualization of the institutionalization of deliberative democracy can be applied to transnational MSIs if these initiatives can be said to have their own ‘dèmoi’ that can be represented in associational decision-making. Therefore, we develop a definition of the dèmos of an MSI based on the notion of collective agency. Subsequently, we explain how Habermas’ approach to democracy can be applied to MSIs and show that it has more to offer than hitherto has been uncovered. Our illustrative analysis of the EPA confirms the criticisms regarding this MSI which have recently been articulated by researchers and practitioners, but also yields new findings and possible avenues for the further development of the EPA: That is, although our assessment suggests that the EPA in its current state is still far from being a democratic MSI, the possibility of a sensible analysis of its democratic character indicates that transnational MSIs can, in principle, help to fill governance gaps in a democratic way. (shrink)