In this third article on the role of international comparative practices in the formation of national health care systems I discuss a familiar group of systems-builders--medical professional organisations--and so focus on some early comparisons undertaken by organised groups of doctors. So far in this series I have argued that any attempt to make international comparisons--whether in the 19th-century or today--is bound to be based on a 'characteristically national' understanding. Not infrequently such an understanding finds its clearest expression in the very (...) act of undertaking practical tasks like 'comparing'. Dependent on whether comparisons are carried out by individuals privately, collectively by larger groups within the medical profession, or by government agencies the descriptions of 'national characteristics' (of medical organisation, institutional formation, clinical practice, research, public health and education) will differ in emphasis. -/- The examination of collective professional attempts at international comparison can enhance our understanding of the cultural distinctions that were incorporated by emerging national medical professions. This process can show which aspects of foreign medical systems were deemed pertinent, and also reveals methodology. What did such collective endeavours add to the more biographically coloured comparisons undertaken by the individual mid-century authors I discussed in part II of this series? (shrink)

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive in their direct interactions with patients. On the basis of the observations of the 24 respondents five strategies were formulated to (...) improve the delivery of care in a multicultural environment. Their findings were further evaluated by confronting the empirical data with care-ethical notions (attentiveness, responsibility, competence, and responsiveness) and intercultural communication-theory. (shrink)

The accounts of Wunderlich and Lee, which have been presented in the second part of this brief series, are two representative examples of a well-respected 19th-century genre of international comparison of medical systems. Since these early comparative accounts consist of observations on medical systems by doctor-travellers at a time when intense medical reform debates about the national significance of medicine were taking place, the focus of attention is often intra-professional. In texts such as those by Wunderlich and Lee, creating coherence (...) within a national health care system was primarily understood as constructing national coherence within the medical profession. The comparisons which derived from international travellers of the period were on the whole cast in a literary, narrative form, and were based on personal observation and occasional hands-on experience in foreign practice. The relevance of this type of publication for national policy at this early stage of national system development was defined in terms of the perceived advantages which a more detailed explication of differences between the medical educational structures, medical philosophies and practical professional roles in different nations might bring. (shrink)

While 4E approaches to cognition are increasingly introduced in educational contexts, little has been said about how 4E commitments can inform pedagogy aimed at fostering ethical competencies. Here, we evaluate a 4E-inspired ethics exercise that we developed at a technical university to enliven the moral imagination of engineering students. Our students participated in an interactive tinkering workshop, during which they materially redesigned a healthcare artifact. The aim of the workshop was twofold. Firstly, we wanted students to experience how material choices (...) at the levels of design and functionality can enable morally significant reimaginings of the affordances commonly associated with existing artifacts. We term this type of reimagining world-directed moral imagination. Secondly, through the design process, we wanted students to robustly place themselves in the lived embodied perspectives of (potential) users of their selected artifacts. We term this person-directed moral imagination. While student testimonies about the exercise indicate that both their world-directed and person-directed moral imagination were enlivened, we note that the fostering of robust person-directed moral imagination proved challenging. Using 4E insights, we diagnose this challenge and ask how it might be overcome. To this end, we engage extensively with a recent 4E-informed critique of person-directed moral imagination, raised by Clavel Vázquez and Clavel-Vázquez (2023). They argue that person-directed moral imagination is profoundly limited, if not fundamentally misguided, particularly when exercised in contexts marked by emphatic embodied situated difference between the imaginer and the imagined. Building upon insights from both the 4E field and testimonies from critical disability studies, we argue that, while their critique is valuable, it ultimately goes too far. We conclude that a 4E approach can take on board recent 4E warnings regarding the limits of person-directed moral imagination while contributing positively to the development of moral imagination in engineering ethics education. (shrink)

Bernard Williams argued that historical and philosophical inquiry were importantly linked in a number of ways. This introductory chapter distinguishes four different connections he identified between philosophy and history. (1) He believed that philosophy could not ignore its own history in the way that science can. (2) He thought that when engaging with philosophy’s history primarily to produce history, one still had to draw on philosophy. (3) Even doing history of philosophy philosophically, i.e. primarily to produce philosophy, required a keen (...) sense of how historically distant from us past philosophers were, on his view, because the point of reading them was to confront something different from the present. (4) He held that systematic philosophy itself needed to be done historically, engaging not necessarily with its own history, but with that of the concepts it sought to understand. The chapter closes with an overview of the volume’s structure and content. (shrink)

What do players of videogames mean when they say they want to shoot zombies? Surely they know that the zombies are not real, and that they cannot really shoot them, but only control a fictional character who does so. Some philosophers of fiction argue that we need the concept of imaginative desires to explain situations in which people feel desires towards fictional characters or desires that motivate pretend actions. Others claim that we can explain these situations without complicating human psychology (...) with a novel mental state. Within their debates, however, these scholars exclusively focus on non-interactive fictions and children’s games of make-believe. In this paper, I argue that our experience of immersive, interactive fictions like videogames gives us cause to reappraise the concept of imaginative desires. Moreover, I describe how i-desires are a useful conceptual tool within videogame development and can shed new light on apparently immoral in-game actions. (shrink)

In this paper I address the current debate on ontic versus epistemic conceptualizations of mechanistic explanation in the mechanisms literature. Illari recently argued that good explanations are subject to both ontic and epistemic constraints: they must describe mechanisms in the world in such fashion that they provide understanding of their workings. Elaborating upon Illari’s ‘integration’ account, I argue that causal role function discovery of mechanisms and their components is an epistemic prerequisite for achieving these two aims. This analysis extends Illari’s (...) account in important ways, putting more pressure on ontic readings of mechanistic explanation and providing an answer to the question how ontic and epistemic constraints on mechanistic explanation are related. I argue these point in terms of cases on memory research drawn from neuroscience and research on extinct neurogenetic mechanisms from early nervous systems biology. (shrink)

The method of positron emission tomography illustrates the circular logic popular in subtractive neuroimaging and linear reductive cognitive psychology. Both require that strictly feed-forward, modular, cognitive components exist, before the fact, to justify the inference of particular components from images after the fact. Also, both require a "true" componential theory of cognition and laboratory tasks, before the fact, to guarantee reliable choices for subtractive contrasts. None of these possibilities are likely. Consequently, linear reductive analysis has failed to yield general, reliable, (...) componential accounts. (shrink)

ROBERT A. COOKE, CPA, has owned or co-owned three successful small businesses and is the author of six books, including Doing Business Tax-Free and How to Start Your Own S Corporation, Second Edition, both from Wiley.

This paper investigates conceptions of explanation, teleology, and analogy in the works of Immanuel Kant (1724-1804) and Georges Cuvier (1769-1832). Richards (2000, 2002) and Zammito (2006, 2012, 2018) have argued that Kant’s philosophy provided an obstacle for the project of establishing biology as a proper science around 1800. By contrast, Russell (1916), Outram (1986), and Huneman (2006, 2008) have argued, similar to suggestions from Lenoir (1989), that Kant’s philosophy influenced the influential naturalist Georges Cuvier. In this article, I wish to (...) expand on and further the work of Russell, Outram, and Huneman by adopting a novel perspective on Cuvier and considering (a) the similar conceptions of proper science and explanation of Kant and Cuvier, and (b) the similar conceptions of the role of teleology and analogy in the works of Kant and Cuvier. The similarities between Kant and Cuvier show, contrary to the interpretation of Richards and Zammito, that some of Kant’s philosophical ideas, whether they derived from him or not, were fruitfully applied by some life scientists who wished to transform life sciences into proper sciences around 1800. However, I also show that Cuvier, in contrast to Kant, had a workable strategy for transforming the life sciences into proper sciences, and that he departed from Kant’s philosophy of science in crucial respects. (shrink)

The guiding premise of this chapter is that we, as teachers in higher education, must consider how the content and form of our teaching can foster inclusivity through a responsiveness to neurodiverse learning styles. A narrow pedagogical focus on lectures, textual engagement, and essay-writing threatens to exclude neurodivergent students whose ways of learning and making sense of the world may not be best supported through these traditional forms of pedagogy. As we discuss in this chapter, we, as engineering ethics educators, (...) designed and implemented a new engineering ethics exercise with which we aimed to promote inclusivity at the levels of form and content. At the content level, students were invited to critically engage with inclusivity-undermining ableist assumptions in technology development. This took shape, at the formal level, through a hands-on ‘material tinkering’ workshop in which students collaboratively and creatively altered (or ‘hacked’) artifacts used in contexts of disability and healthcare, so as to operationalize values of inclusivity and accessibility. Our hunch was that this hands-on tinkering workshop would simultaneously encourage a meaningful way of engagement with these ethical issues and values, while also enacting a more inclusive learning environment by enriching the range of pedagogical activities and learning formats available to our students. As we aim to show in this chapter, we believe this hunch largely panned out - though there are clear areas for future improvement pertaining to the pilot exercise itself and the research we conducted on the exercise. We begin by offering a description of our tinkering exercise. We discuss the exercise’s source of inspiration (2.1) and its implementation (2.2), which is visually captured via photographic documentation. We then discuss (3) how we utilized a triangulated research method to assess the pedagogical value of the exercise. After we discuss our findings, we conclude by identifying areas for future improvement (4). (shrink)

‘The God of peace’ in the New Testament. Why does the New Testament use the expression ‘the God of peace’ and what is the meaning of this phrase? In the Old Testament, the God of Israel is often connected with peace, but he is never called ‘the God of peace’. Not until the Hellenistic period is this expression sporadically found in Judaism (once in the Testaments of the Twelve Patriarchs and once in Philo). As for the biblical Umwelt, the gods (...) of the ancient Near East were not very peace-loving, and in the perception of Greco-Roman culture the god of war, Arès/Mars, as one of the twelve Olympians was much more prominent than Eirènè/Pax. However, the expression ‘the God of peace’ is found several times in the Corpus Paulinum and once in the letter to the Hebrews. This article investigates all New Testament texts that have this formula, suggesting that the apostle Paul could be responsible for the wording. In conclusion, Paul states that the God of Israel desires to establish a definitive peace in his creation through the crucifixion and resurrection of Jesus Christ and by finally defeating all powers of evil. This apostolic message further indicates that Christians are supposed to be bearers of peace, promoting a peaceful atmosphere in their environment and in the world. (shrink)

For Bernard Williams, philosophy and history are importantly connected. His work exploits this connection in a number of directions: he believes that philosophy cannot ignore its own history the way science can; that even when engaging with philosophy’s history primarily to produce history, one needs to draw on philosophy; and that when doing the history of philosophy primarily to produce philosophy, one still needs a sense of how historically distant past philosophers are, because the point of reading them is to (...) confront something different from the present. But Williams also holds that systematic philosophy itself needs to be done historically, engaging not just with its own history, but with that of the concepts it seeks to understand. To explore these different ways in which philosophy and history intertwine, this volume assembles specially commissioned contributions by A. W. Moore, Terence Irwin, Sophie-Grace Chappell, Catherine Rowett, Marcel van Ackeren, John Cottingham, Gerald Lang, Lorenzo Greco, Paul Russell, Carla Bagnoli, Peter Kail, David Owen, Giuseppina D’Oro, James Connelly, Matthieu Queloz, Nikhil Krishnan, John Marenbon, Ralph Wedgwood, Garrett Cullity, Hans-Johann Glock, Geraldine Ng, Ilaria Cozzaglio, Amanda R. Greene, and Miranda Fricker. They critically appraise Williams’s work in and on the history of philosophy as well as his historicist turn and his use of genealogy. The resulting collection uniquely combines substantive discussions of historical figures from Homer to Wittgenstein with methodological discussions of how and why the history of philosophy should be done, and how and why philosophy should draw on history. (shrink)

L’intégration des technologies de l’information et de la communication (TIC) à l’apprentissage représente une avenue explorée à la fois par les milieux scientifique, institutionnel et scolaire afin de développer des environnements éducatifs stimulants pour les apprenants. Au Québec, L’École en réseau, un projet d’innovation technologique rassemblant 23 commissions scolaires et près d’une centaine d’écoles majoritairement de l’ordre primaire (6 à 12 ans), a mis entre autres en place le forum de coélaboration de connaissances (FCC) pour répondre à certains besoins émergents (...) de professionnels de l’éducation en matière d’avancées technopédagogiques ainsi qu’à ceux des apprenants baignant aujourd’hui dans la culture du numérique. Cette plateforme propose entre autres un espace de collaboration sous forme de discours écrit asynchrone dans lequel chaque élève collabore et construit sa compréhension d’un phénomène, d’un problème à résoudre ou d’un texte dans le cadre de multiples activités liées à différentes matières scolaires. Les participants – élèves, enseignants et conseillère pédagogique – sont amenés à écrire des textes, de longueur et de type divers, à les annoter, à les améliorer et à les enrichir à l’intérieur d’une base de connaissances qui conserve les traces de leurs échanges sous forme de toile interactive. Cet article traite du potentiel de documentation du FCC qui permet aux utilisateurs, soit les élèves, les enseignants, les conseillers pédagogiques, voire les chercheurs, de visualiser les activités, les progrès et les habitudes d’utilisation de chacun sous différents angles grâce à ses diverses fonctionnalités. Les traces laissées par la communication asynchrone facilitent en effet, selon Gikand, Morrow et Davis (2011), l’auto-évaluation de la compréhension qu’ont les élèves du contenu en plus de leur permettre le partage de questionnements ainsi qu’une réflexion sur leur contribution aux discussions sur le forum. Le potentiel relié à l’archivage de différentes données d’un forum, tel que défini par Heinrich, Milne et Moore (2009), permet l’analyse statistique et le profilage d’élèves afin de mieux répondre à leurs besoins en tant qu’apprenants. Aussi, l’analyse des interactions (posting behaviours) et suivis de fréquentation sur la plateforme (non-posting behaviours) peut amener les enseignants et les élèves à réfléchir sur leurs pratiques et diriger leurs interventions pédagogiques (Xie, 2013). Par ailleurs, la notion de transparence comme la définissent Lafuente Martínez et al. (2015), appliquée au FCC, est également présentée ici. Celle-ci comprend les échanges entre les élèves durant la réalisation de l’activité d’apprentissage et d’évaluation : les versions antérieures du travail tout au long de la réalisation de la tâche d’écriture et tout élément témoignant de leur processus réflexif (plans, notes, schémas, etc.). Cette mise en disponibilité du brouillon des textes des élèves représente une opportunité de documenter la progression des apprentissages de l’apprenant et d’exploiter le potentiel d’autorégulation de l’évaluation formative (Pachler, Daly, Mor, Mellar, 2010). Enfin, la possibilité de suivre l’évolution de la pensée critique de l’apprenant, à savoir si celui-ci, par ses interventions sur les textes des autres, propose des commentaires qui favorisent le dialogue et qui amènent des éléments de réflexion pour faire progresser les discussions (Olofsson, Lindberg, Stödberg, 2011) est mise en relief à l’aide des interventions des élèves, recueillies à même la plateforme. (shrink)

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive in their direct interactions with patients. On the basis of the observations of the 24 respondents five strategies were formulated to (...) improve the delivery of care in a multicultural environment. Their findings were further evaluated by confronting the empirical data with care-ethical notions (attentiveness, responsibility, competence, and responsiveness) and intercultural communication-theory. (shrink)

Many readings of the Parable of the Labourers in the vineyard want to treat the owner as representing God. Knowledge of actual agricultural practices relating to the management of vineyards suggest, on the contrary, that the details of the parable obstruct an easy identification of the owner with God, and that he displays unusual behaviour not only by paying all the labourers the same wage, but by his very intervention in the hiring process. The conclusion reached is that the parable (...) constructs the vineyard owner, typically one of the nouveau riche who lived in cities, not only as a ‘good employer’ but also, contrary to expectation, as a patron who intervened well beyond the strict norms of economic exchange. (shrink)

The Russian invasion of Ukraine on February 24, 2022, has already caused large amounts of greenhouse gas (GHG) emissions and will continue to do so for manyyears after hostilities have ceased mainly because of the emissions linked to the rebuilding of destroyed or damaged housing, public buildings, infrastructure, factories, and the like. My aim in this paper is to discuss how in a time of climate emergency such emissions of war should impact the political morality of states initiating, continuing, and (...) ending war (through a just and enduring peace) as understood by just war theory (JWT). My point of departure is a study by Lennard de Klerk and six co-authors detailing the emissions of the first year of the Russo-Ukrainian war. (shrink)

Abstract‘Social inclusion’ is the leading ideal in services and care for people with intellectual disabilities in most countries in the Global North. ‘Social inclusion’ can refer simply to full equal rights, but more often it is taken to mean something like ‘community participation’. This narrow version of social inclusion has become so ingrained that it virtually goes unchallenged. The presumption appears to be that there is a clear moral consensus that this narrow understanding of social inclusion is good. However, that (...) moral consensus is not clear in the case of people with profound intellectual and/or multiple disabilities (PIMD), who are not able to express their needs and preferences verbally. Moreover, social inclusion has proven to be difficult to conceptualize and implement for people with PIMD. Therefore, it becomes imperative to ask about the ethical rationale of the narrow understanding of social inclusion. For what reasons do we think social inclusion is good? And do those reasons also apply for people with PIMD? This article addresses these questions by providing an ethical analysis of the ideal of social inclusion for people with PIMD. It discusses four ethical arguments for social inclusion and probes their relevance for people with PIMD. The article argues that none of these arguments fully convince of the value of the narrow understanding of social inclusion for people with PIMD. It ends with advocating for an ethical space for imagining a good life for people with PIMD otherwise. (shrink)

A great deal of philosophy of mind in the modern era has been driven by an intense aversion to Cartesian dualism. In the 1950s, materialists claimed to have succeeded once and for all in exorcising the Cartesian ghost by identifying the mind with the brain. In subsequent decades, cognitive science put scientific meat on this metaphysical skeleton by explicating mental processes as digital computation implemented in the brain's hardware.

Nelson Goodman’s attempt to analyse the expressiveness of artworks in semantic terms has been widely criticised. In this paper I try to show how the use of an adapted version of his concept of exemplification, as proposed by Mark Textor, can help to alleviate the worst problems with his theory of expression. More particularly I argue that the recognition of an intention, which is central to Textor’s account of exemplification, is also fundamental to our understanding of expressiveness in art. Moreover (...) I propose that the recognition of this intention depends on our interpretation of the artwork – an insight Goodman tried to capture with his assertion that our attributions of expressive properties to artworks function metaphorically. The realisation of the context-dependence of our expressive judgements about art and, hence, of the central role interpretation plays in these judgements, I contend, counts in favour of theories of expression like Goodman’s that focus on semantic concerns. (shrink)

Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond (...) its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials. (shrink)

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

This paper inquires into the nature of intertheoretic relations between psychology and neuroscience. This relationship has been characterized by some as one in which psychological explanations eventually will fall away as otiose, overthrown completely by neurobiological ones. Against this view it will be argued that it squares poorly with scientific practices and empirical developments in the cognitive neurosciences. We analyse a case from research on visual perception, which suggests a much more subtle and complex interplay between psychology and neuroscience than (...) a complete take-over of the former by the latter. In the case of vision, cross-theory influences between psychology and neuroscience go back and forth, resulting in refinement in both disciplines.We interpret this case study as showing that:(1) Mutual co-evolution of psychological and neurobiological theories, exemplifying persisting top-down influences from psychology, is a more empirically adequate way to describe psychoneural theory relations than a view on co-evolution, favoured by reductionists, which regards the cross-theory contributions from psychology as merely heuristically useful with no enduring influence on neurobiological theorizing;(2) In research on vision, discovering (or hypothesizing) the neural basis of functions vindicates psychological approaches, it does not eliminate them;(3) Current work on vision shows that many perceptual phenomena must be understood in terms of dynamical interactions between an observer and his/her environment. Therefore, we argue that internalist characterizations of the visual system must be supplemented with externalist accounts that address these reciprocal observer-environment interactions involved in vision. Such processes seem quite different from (internal) cellular and molecular ones, and as such seem to lie outside the scope of neuroscientific inquiry. We conclude that psychoneural reduction or elimination is implausible as a meta-theoretical prediction of theory choice in empirical work. Instead, this case study of vision shows that both psychology and neuroscience contribute to, and complement one another in the study of visual perception. 1. Psychoneural reductionism1.1Introduction1.2New Wave Reductionism1.3NWR and psychology: three characteristics of psychoneural reductionism1.4NWR and the problem of mutual feedback1.4.1The ‘Mere Heuristics’ claim1.4.2The disappearance of psychology as an irrelevant historical accident1.5Summary: three claims of NWR on psychoneural reduction2. Vision: a case study2.1Introduction2.1.1Three opposing claims2.1.2Psychology and neuroscience of vision: the orthodoxy2.2Testing claim 1: vanishing heuristics or persisting influences?2.2.1From what and where to perception and action2.2.2Real co-evolution: more than vanishing heuristics2.2.3First moral2.3Testing claim 2: replacement or vindication?2.3.1Perception and action revisited: mapping approaches on systems2.3.2Vindicating psychological approaches2.3.3Second moral2.4Testing claim 3: equipotent image or explanatory loss?2.4.1Perception and action extended: including the environment2.4.2Distinguishing levels, widening explanations2.4.3Third moral3. Conclusion: three morals. (shrink)

Pleidooi om in een democratie naast of zelfs in plaats van verkiezingen een systeem van loting in te voeren.

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.