Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

"The development of modern diagnostic neuroimaging techniques led to discoveries about the human brain and mind that helped give rise to the field of neurolaw. This new interdisciplinary field has led to novel directions in analytic jurisprudence and philosophy of law by providing an empirically-informed platform from which scholars have reassessed topics such as mental privacy and self-determination, responsibility and its relationship to mental disorders, and the proper aims of the criminal law. Similarly, the development of neurointervention techniques that promise (...) to deliver new ways of altering people's minds creates opportunities and challenges that raise important and rich conceptual, moral, jurisprudential, and scientific questions. The specific purpose of this volume is to make a contribution to the field of neurolaw by investigating the legal issues raised by the development and use of neurointerventions "--. (shrink)

Was ist Natur oder was könnte sie sein? Diese und weitere Fragen sind grundlegend für Naturdenken und -handeln. Das Lehr- und Studienbuch bietet eine historisch-systematische und zugleich praxisbezogene Einführung in die Naturphilosophie mit ihren wichtigsten Begriffen. Es nimmt den pluralen Charakter der Wahrnehmung von Natur in den philosophischen Blick und ist auch zum Selbststudium bestens geeignet.

Harrowing stories reported in the media describe Covid‐19 ravaging through families. This essay reports professional experiences of this phenomenon, family clustering, as encountered during the pandemic's spread across Southern California. We identify three ethical challenges following from it: Family clustering impedes shared decision‐making by reducing available surrogate decision‐makers for incapacitated patients, increases the emotional burdens of surrogate decision‐makers, and exacerbates health disparities for and the suffering of people of color at increased likelihood of experiencing family clustering. We propose that, in (...) response to these challenges, efforts in advance care planning be expanded, emotional support offered to surrogates and family members be increased, more robust state guidance be issued on ethical decision‐making for unrepresented patients, ethics consultation be increased in the setting of conflict following from family clustering dynamics, and health care professionals pay more attention to systemic and personal racial biases and inequities that affect patient care and the surrogate experience. (shrink)

This paper offers a novel, qualitative approach to evaluating the outcomes of integrating humanities and ethics into a newly revised pre-clerkship medical education curriculum. The authors set out to evaluate medical students’ perceptions, learning outcomes, and growth in identity development. Led by a team of interdisciplinary scholars, this qualitative project examines multiple sources of student experience and perception data, including student essays, end-of-year surveys, and semi-structured interviews with students. Data were analyzed using deductive and inductive processes to identify key categories (...) and recurring themes. Results suggest that students not only engaged with the curricular content and met the stated learning objectives but also acknowledged their experience in the humanities and ethics curriculum as an opportunity to reflect, expand their perceptions of medicine (and what it means to be “in” medicine), connect with their classmates, and further cultivate their personal and professional identities. Results of this qualitative study show how and in what ways the ethics and humanities curriculum motivates students past surface-level memorization of factual knowledge and encourages thoughtful analysis and evaluation about how the course material relates to and influences their thinking and how they see themselves as future doctors. The comprehensive qualitative approach reflects a holistic model for evaluating the integration of humanities and ethics into the pre-clerkship medical education curriculum. Future research should examine if this approach provides a protective factor against the demonstrated ethical erosion and empathy decrease during clinical training. (shrink)

Context Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in (...) which the law permits flexibility for clinicians and health care institutions to adopt best practices. -/- Methods We surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes. -/- Findings Results show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long-term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability. -/- Conclusions -/- Our results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks. (shrink)

This intervention study explored the effects of a newly developed intergenerational encounter program on cross-generational age stereotyping. Based on a biographical-narrative approach, participants were invited to share ideas about existential questions of life. Therefore, the dyadic Life Story Interview had been translated into a group format, consisting of 10 90-min sessions. Analyses verified that LSEP participants of both generations showed more favorable CGAS immediately after, but also 3 months after the program end. Such change in CGAS was absent in a (...) control group. The LSEP-driven short- and long-term effects on CGAS could be partially explained by two program benefits, the feeling of comfort with and the experience of learning from the other generation. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

Prolonging working hours and presenteeism have been conceptualized as self-endangering coping behaviors in employees, which are related to health impairment. Drawing upon the self-regulation of behavior model, the goal achievement process, and Warr's vitamin model, we examined the antecedents and moderation effects regarding quantitative demands, autonomy, emotion regulation, and self-motivation competence of university students' self-endangering coping behaviors. Results from a cross-sectional survey of 3,546 German university students indicate that quantitative demands are positively related and autonomy has a u-shape connection with (...) self-endangering coping. Emotion regulation was shown to be a protective factor for prolonging working hours. Moreover, self-motivation moderated the relationship between quantitative demands and prolonging of working hours, but not in the assumed direction. Self-motivation showed a systematic positive relationship with prolonging of working hours, but no relationship with presenteeism. Autonomy moderated the relationship of quantitative demands with both self-endangering behaviors. We found no moderating effects for emotion regulation of quantitative demands or autonomy and self-endangering behaviors. Besides further practical implications, the results suggest that lecturers should design their courses accordingly with less time pressure and university students should be trained in the use of autonomy. (shrink)

As sharing and secondary research use of biospecimens increases, IRBs and researchers face the challenge of protecting and respecting donors without comprehensive regulations addressing the human subject protection issues posed by biobanking. Variation in IRB biobanking policies about these issues has not been well documented.

ABSTRACTPrior research on attention bias in anxious youth, often utilising a visual dot probe task, has yielded inconsistent findings, which may be due to how bias is assessed and/or variability in the phenomenon. The present study utilises eye gaze tracking to assess attention bias in socially anxious adolescents, and explores several methodological and within-subject factors that may contribute to variability in attention bias. Attention bias to threat was measured in forty-two treatment-seeking adolescents diagnosed with Social Anxiety Disorder. Bias scores toward (...) emotional stimuli and bias scores away from emotional stimuli were explored. Bias scores changed between vigilance and avoidance within individuals and over the course of stimulus presentation. These differences were not associated with participant characteristics nor with self-reported social anxiety symptoms. However, clinician rated severity of social anxiety, explained a signific... (shrink)

ABSTRACTAlthough attention bias toward threat has been associated with Social Anxiety Disorder, concerns regarding the ability of current measures to detect change in AB following treatm...

A major paradox of modern happiness gained wide public exposure in 1776 when Thomas Jefferson substituted the phrase “the pursuit of happiness” in place of Locke’s formulation: “life, liberty, and property.” In substituting happiness for property, Jefferson obscured the central hypocrisy of the Revolution, that—as contemporaries complained—the “loudest yelps for liberty” were made by those practicing slavery. Jefferson elided the overlap between the pursuit of happiness and the protection of human property. And he blurred the connection between the assertion (...) of slave power and the creation of a broad emotional hegemony in the service of multifaceted projects of political-economic mastery. Today, historians of emotion face an urgent need to explore the deep roots of this feeling in systems of unfreedom. (shrink)

In 1516, Thomas More, adviser to King Henry VIII, Catholic, martyr, and saint, published his most controversial book, De optimo reipublicae statu deque noval insula Libellus vere aureus, nec minus salutaris quam festivus. During 2016, special issues of Utopian Studies, edited by Fátima Vieira, have been tracing the translation history of this book that still grips our attention five hundred years later. As in the translation histories in all countries, Utopia’s translation in Germany reflects contemporaneous social and political debates (...) and anxieties. Thus, the... (shrink)

L’utopie est nominalement un nulle part qui est aussi, comme nous le dit Thomas More, un “bon” endroit. Bien qu’il existe des notions concurrentes, la description grecque occupe une place importante dans la plupart des récits d’utopie. Les détails de cet idéal sont si précis que la littérature utopique consiste en un catalogue (et une critique) de ces caractéristiques. Cet essai attire l’attention sur le parfum attribué aux « Îles des bienheureux » de Lucien, ainsi que sur la description (...) qu’en fait Nietzsche, sur sa sensibilité à l’odorat et sur l’attention portée par Illich à l’« atmosphère » et au nez. On aborde également le scepticisme envers l’utopie et des parallèles sont établis, d’une part, avec les critiques pragmatiques de l’utopie comme étant intrinsèquement totalitaires, d’autre part, avec la « bonne vie » dans la théorie politique et le défaut programmatique de la fantaisie techno-utopique. L’article se termine par une discussion d’Illich sur la pax – c’est-à-dire la respiration. (shrink)

Résumé L’Utopie de Thomas More est composée de deux livres : Le Livre Premier, vite escamoté par les rêveurs d’avenir que l’histoire ennuie, nous parle de l’Europe de 1515 à l’aube d’une révolution de tous les savoirs, dominée par un pouvoir politique qui utilise la religion, la peur et l’ ignorance afin de satisfaire un appétit hégémonique insatiable, infiniment corrompu mais parlant haut valeurs morales et familiales. Le Livre Second nous fait miroiter un avenir à l’échelle de l’humanité qui (...) utiliserait les nouvelles techniques, la raison et la bonne gestion de ses ressources pour concilier bien commun et plaisir individuel. Ce Livre est le texte fondateur de notre modernité. C’est la Bible païenne adoptée par les Lumières et que nous avons inscrite dans la charte des institutions de notre temps. Cinq cents ans plus tard et les livres se réécrivent en miroir : le grand rêve humain initié par le Livre Second de 1516 s’englue dans la réalité de 2005. Les nouvelles promesses de l’économisme du libre choix de 2005 ne sont qu’un hallucinant retour en arrière, aux postulats du Livre Premier. (shrink)

A careful analysis of the rhetorical thought of René Descartes and of a distinguished group of post-Cartesians. Covering a unique range of authors, including Bernard Lamy and Nicolas Malebranche, Carr attacks the idea, which has become commonplace in contemporary criticism, that the Cartesian system is incompatible with rhetoric. Carr analyzes the writings of Balzac, the Port-Royalists Arnauld and Nicole, Malebranche, and Lamy, exploring the evolution of Descartes’ thought into their different theories of rhetoric. He constructs his arguments, probing each author’s (...) writings on rhetoric, persuasion, and attention, to demonstrate the basis for rhetorical thought present in Descartes’ theory of persuasion when it is combined with his psychophysiology of attention. (shrink)

A careful analysis of the rhetorical thought of René Descartes and of a distinguished group of post-Cartesians. Covering a unique range of authors, including Bernard Lamy and Nicolas Malebranche, Carr attacks the idea, which has become commonplace in contemporary criticism, that the Cartesian system is incompatible with rhetoric. Carr analyzes the writings of Balzac, the Port-Royalists Arnauld and Nicole, Malebranche, and Lamy, exploring the evolution of Descartes’ thought into their different theories of rhetoric. He constructs his arguments, probing each author’s (...) writings on rhetoric, persuasion, and attention, to demonstrate the basis for rhetorical thought present in Descartes’ theory of persuasion when it is combined with his psychophysiology of attention. (shrink)

This thought piece dealing with the Covid-19 ‘crisis’ was written – in the form of a diary that runs from February to July 2020 – for a special issue of Derrida Today entitled ‘Fire, Flood, Pestilence and Protest’, edited by Nicole Anderson, and published in November 2020. The piece deals with matters of biopolitics, telecommunication, death and mourning through Derrida and Agamben, and interrogates the eventness of what is called an ‘event’.

In “Avoiding a Death Panel Redux,” Nicole Piemonte and Laura Hermer make the argument that the advance care planning consultation provision during the health care reform debate collapsed both because the language in the provision was deliberately misread and because some features of the language could in fact be misleading. We agree on both counts. We add that the cost‐effectiveness provisions of the bill make us face difficult decisions we as a nation would rather avoid, but can and must face (...) squarely and together. It is time for an honest national conversation about at least two issues concerning medical care near the end of life. First, talking about or planning a good death with your doctor or nurse will not make death happen sooner. The data show that better planning for a well‐managed terminal illness leads to longer life as well as better symptom control and less distress. Second, we need to quickly and directly confront the cost of end of life care in the United State, recognize the political consequences, and work with the broad middle to advance the common good. (shrink)

There is, of course, one clear sense in which Spinoza’s axiomatic method is a method of presentation: this is the sense which contrasts a method of presentation with a method of discovery. In the Ethics, Spinoza is stating and explaining his views, not describing how he arrived at them or telling us how to make discoveries for ourselves. Nor does he elsewhere present the axiomatic method as a method of discovery. In the seventeenth century, the distinction between a method of (...) discovery and a method of presentation was often described as a distinction between "analytic" and "synthetic" method; Arnauld and Nicole write. (shrink)

In this paper, I focus on Paul of Venice’s plurality of forms and souls, i.e., his “two total souls” theory. I argue that this specific theory is a result of Paul’s reception of various positions originating from fourteenth-century Parisian philosophers like John of Jandun, the Anonymous Patar, Nicole Oresme, John Duns Scotus, and Walter Burley. By receiving these positions and by making use of merely parts of their doctrines, Paul creates a theory of the hylomorphic compound that fits well within (...) an Aristotelian framework of an Averroistic flavor. Although his position is not Averroistic in any strict sense, it mirrors quite well the growing interest in an Averroistic interpretation of Aristotle in Padua at his time. By looking at some of his successors, such as Gaetano da Thiene, Nicoletto Vernia, and Agostino Nifo, I show that Paul is on the borderline between a traditional, scholastic philosophical psychology or hylomorphism of Parisian origin and an Averroist reading of philosophical psychology or hylomorphism, which had its promoters in fifteenth-century Padua. (shrink)

Thomas More’s Utopia is made up of two books. Book One, quickly skimmed over by those who dream of the future and are bored by history, tells us about Europe in 1515 at the dawn of a revolution in every field of knowledge dominated by a political power that uses religion, fear and ignorance to satisfy an insatiable appetite for hegemony, infinitely corrupt but in public promoting moral, family values. Book Two gives us a glimpse of a future on (...) a human scale using new techniques, reason and good management of its resources to reconcile the common good with the pleasure of the individual. That book is the founding text for our modernity. It is the pagan bible adopted by the Enlightenment, which we have inscribed in the charter of our epoch’s institutions. Five hundred years later the books are being rewritten in reverse: the great human dream set in train by Book Two in 1516 is bogged down in the reality of 2005. The new promises of free-choice economism in 2005 are just a nightmare journey back in time to the postulates of Book One. (shrink)

Was Natur für uns ist und welche Bereiche unserer Umwelt als natürlich erfahren werden, scheint sich einer prinzipiellen Bestimmung zu entziehen. Auch ist weitgehend unklar, worauf sich der verantwortliche Umgang "des" Menschen mit "der" Natur beziehen soll? Etwa auf die Erhaltung des Status quo der Natur oder auf die maßvolle Steuerung des Wandels der Natur? Ist in den gegenwärtigen umweltpolitischen und den Naturschutz betreffenden Überlegungen tatsächlich "die" Natur der Referenzrahmen verantwortlichen Handelns oder geht es uns vor allem um die Erhaltung (...) eines nützlichen Zustands für uns und nachfolgende Generationen? Die Autorinnen und Autoren des Bandes ziehen die Gewissheiten unseres theoretischen und praktischen Umgangs mit der Natur in Frage und suchen nach neuen Perspektiven. -/- Unter den Stichworten Objektive Natur (I.), Natur als Resonanzraum (II.), Natur als Ressource und Wert (III.), Natur als natürliche Umwelt (IV.), Künstliche Natur (V.), Vergesellschaftete Natur (VI.) und Verantwortete Natur (VII.) sind Beiträge der Philosophinnen Heike Baranzke und Christine Zunke sowie der Philosophen Michael Großheim, Michael Hauskeller, Kristian Köchy, Ulrich Krohs und Gregor Schiemann versammelt. Interdisziplinäre Herausforderungen zur Thematik werden in den Studien von Jörn Ahrens (Kultursoziologie), Karl-Werner Brand (Umwelt- und Nachhaltigkeitsforschung), Hans Diefenbacher (Wirtschaftswissenschaften), Thomas Fuchs (Psychiatrie), Ulrich Gebhard (Erziehungswissenschaften), Thomas Kirchhoff (Ökologie), Dörte Martens/ Nicole Bauer (Umweltpsychologie), Hartmut Rosa (Soziologie), Heinrich Spanier (Umweltschutz), Vera Tekken/ Josef Settele (Umweltforschung), Frank Uekötter (Umweltgeschichte) und Michael Wink (Biologie) deutlich herausgearbeitet. Die Beiträge der Theologen Dirk Evers und Thorsten Moos runden den Band ab. (shrink)

Hermeneutical injustice, as a species of epistemic injustice, is when members of marginalized groups are unable to make their experiences communicatively intelligible due to a deficiency in collective hermeneutical resources, where this deficiency is traditionally interpreted as a lack of concepts. Against this understanding, this paper argues that even if adequate concepts that describe marginalized groups’ experiences are available within the collective hermeneutical resources, hermeneutical injustice can persist. This paper offers an analysis of how this can happen by introducing the (...) notion of hermeneutical excess: the introduction of additional concepts into collective hermeneutical resources that function to obscure agents’ understanding of the lived experiences of marginalized groups. The injustice of hermeneutical excesses happens not due to hermeneutical marginalization (the exclusion of members of marginalized groups from the construction of hermeneutical resources), but rather hermeneutical domination: when members of dominant groups have been inappropriately included in the construction of hermeneutical resources. By taking as exemplary cases the concepts of “reverse racism” and “non-consensual sex” this paper shows how such excesses are introduced as a kind of defensive strategy used by dominant ideologies precisely when progress with social justice is made. (shrink)

Issues of reliability are claiming center-stage in the epistemology of machine learning. This paper unifies different branches in the literature and points to promising research directions, whilst also providing an accessible introduction to key concepts in statistics and machine learning – as far as they are concerned with reliability.

Looking back on it, it seems almost incredible that so many equally educated, equally sincere compatriots and contemporaries, all drawing from the same limited stock of evidence, should have reached so many totally different conclusions---and always with complete certainty.

Thomas Reid, the Scottish natural and moral philosopher, was one of the founding members of the Aberdeen Philosophical Society and a significant figure in the Scottish Enlightenment. Reid believed that common sense should form the foundation of all philosophical inquiry. He criticised the sceptical philosophy propagated by his fellow Scot David Hume and the Anglo-Irish bishop George Berkeley, who asserted that the external world did not exist outside the human mind. Reid was also critical of the theory of ideas (...) propagated by Locke and Descartes, arguing that it was incompatible with physical and experiential facts. For Reid, our senses demonstrate that the external world must exist, and this work is organised in chapters examining each of the senses in turn. The book, based on his lectures, was first published in 1764 when Reid was a regent professor at King's College, Aberdeen, and was reissued in 1818. (shrink)

The proliferation of violations within industry sectors (e.g., banking, doping in sport, abuse in religious organizations) highlights how trust violations can thrive in particular sectors. However, scant research examines how macro institutional factors influence micro level trustworthy conduct. To shed light on how sectoral features may influence trust violations in organizations, we adopt a multilevel perspective to investigate the perceived causes of trust violations within the not-for-profit (NFP) sector, a sector that has witnessed a number of high-profile trust breaches. Drawing (...) on interviews with board members and senior executives of NFPs with cross-sectoral experience, we analyze the causes of trust violations to inductively develop a conceptual model of the multilevel factors contributing to trust violations in NFPs. Our model highlights how trust violations have their roots in sectoral-level factors, which trickle-down to influence the ethical infrastructure at the organizational-level, and in turn individual-level factors and violations. We identify how three NFP sectoral features influence trustworthy behavior: corporatization, resource scarcity, and assumed moral integrity. Our findings speak to the importance of looking beyond the organization to understand both the causes and prevention of trust violations and developing the concept of sector-level ethical infrastructure. (shrink)