When first published twenty years ago, The Logic of Medicine presented a new way of thinking about clinical medicine as a scholarly discipline as well as a profession. Since then, advances in research and technology have revolutionized both the practice and theory of medicine. In this new, extensively rewritten edition, Dr. Murphy includes changes to show how these different areas of scholarship may affect details of "the logic of medicine" without compromising its fundamental coherence. New to this edition are (...) discussions of the challenge of the flood of new empirical data, new ideas in genetics, molecular biology, homeostasis, pathogenesis, cancer, aging, and Alzheimer's disease. Murphy also comments on such new theoretical topics as dynamic systems, chaos, and fractals and their impact on the burgeoning fields of philosophy and practice of medicine. Written with medical students in mind, the book includes a glossary, many new examples, and problems for solutions with comments on each. An entirely new chapter deals with modeling. Clinicians and researchers will also find the principles thought-provoking and illuminating. (shrink)

This book reflects upon the manner in which medical research is performed and interpreted.

Thus far in the development of the discipline of medical ethics, the overriding concern has been with solutions to specific problems. But discussion is hampered by lack of understanding of the scope and methodology of medical ethics, and its scientific and philosophical basis. In Underpinnings of Medical Ethics Edmond A. Murphy, James J. Butzow, and Edward L. Suarez-Murias offer much-needed clarification of the purview, ontological basis, and methodology of a medical ethics that is to be comprehensive and yet (...) readily accepted by all. The authors begin by describing the scope of the analysis and discussing possible ethical systems and paradigms. They then deal with the structures and concepts necessary in the formulation of a coherent philosophy: normality and disease, scientific and juridical law, certainty and certitude, decisions. Finally, they introduce particular human dimensions, such as quality of life, pain, and responsibility. Throughout, case examples illustrate the authors' theoretical framework. (shrink)

In this paper are explored the ethical implications of the answers to three questions: Whether or not a diseased state is discrete; the criteria by which that question is answered; and how the diseased state is to be identified. Examples are given showing that some states appear to be clearly discrete, and others equally clearly not discrete. The nature of the pertinent evidence will be affected accordingly. It is shown that a slavish and inappropriate concern with categories leads to anomalous (...) ethics. Finally, it is suggested that many of these problems may be avoided by centering the ethics of medicine on optimizing the welfare of the patient rather than by thinking in terms of categorical disease. (shrink)

The skewness of a distribution, a poorly-defined term, is conventionally deemed to be invariant under linear transformations. A comparison is made of three criteria of it: the sign of odd central moments; the several relationships of the mean, the median and the mode; and asymmetry proper which is the set of ratios of the probability densities of all pairs of points equidistant above and below some arbitrary point, usually the principal mode. Some useful general relationships are discussed. The skeness of (...) convolutions is briefly discussed. A class of distributions is identified for which the skewness of the minimum ofk competing processes is independent ofk. It has importance in the parametric study of survivorship. (shrink)

Some properties are discussed of regular polygons that may result from angular homeostatic processes in stable orbit. To characterize these homeostatic polygons we need to discuss the winding number, the sidedness (integer, fractional and irrational), multiplicity, envelopes, and density. A regular (i.e., equilateral, equiangular) polygon may be closed in one revolution about its unique center, in multiple revolutions, or not at all. A homeostatic polygon can be generated only if all vertices are included in a single polygon, which occurs if (...) and only if the number of vertices and the number of revolutions required to complete the polygon are relatively prime. For the homeostatic polygon to have a finite number of sides (without repeating itself) the angle subtended by any two successive vertices at the center must be a rational multiple of 2. Biological implications of these properties are illustrated. (shrink)

From the standpoint of the theory of medicine, a formulation is given of three types of reasoning used by physicians. The first is deduction from probability models (as in prognosis or genetic counseling for Mendelian disorders). It is a branch of mathematics that leads to predictive statements about outcomes of individual events in terms of known formal assumptions and parameters. The second type is inference (as in interpreting clinical trials). In it the arguments from replications of the same process (data) (...) lead to conclusions about the parameters of a system, without calling into question either the probabilistic model or the criteria of evidence. The third is illation (as in the elucidation of symptoms in a patient). It is a process whereby, in the light of the total evidence and the conclusions from the other types of reasoning, one may modify, expand, simplify or demolish a conceptual framework proposed for deductions, and modify the nature of the evidence sought, the criteriology, the axioms, and the surmised complexity of the scientific theory. (The process of diagnosis as applied to a patient may in extreme cases lead to the discovery of an entirely new disease with its own, quite new, set of diagnostic criteria. This course cannot be accommodated inside either of the other two types of reasoning.) Illation has something of the character of Kuhn's scientific revolution in physics; but it differs in that it is the nature, not the degree or frequency of change that distinguishes it from Kuhn's normal science. (shrink)

SummaryCertain revolutionary changes in medicine—measurement, chemistry, genetics—have led to recasting both the criteriology and the conceptualization of the terms of discourse. But advances along this path rest no longer on naive observation but intimately and inextricably involve modeling, that is, a system of inference which derives no immediate warrant from the primordial data of the senses. This system is not totally new in quality, since all “fact” involves interpretation of data; nor is it entirely new in having heuristic value in (...) unearthing, or calling attention to, unsuspected evidence. But it differs in two major respects. First, it requires patterns of surmise which can no longer be immediately corroborated at all stages by naive means but rest more and more on internal theoretical consistency and confirmatory predictions to be verified by other sophisticated and indirect means. Second, it is leading to fundamental upheavals in even the broad perception of human biology, undermining well-established groupings and exposing certain classical fields of inquiry as meaningless. The problem yet to be confronted in this field is how an epistemology of the model (in this sense) is to be constructed. The model is useless (as the whole scientific endeavor is useless) if it has not a more economical structure than the totality of the raw data, even if the success of this economy is in some degree factitious (“robustness”). On the other hand, the model is also useless unless it has heuristic value and helps in adjudicating among competing interpretations (“power”). A good model will help also to distinguish relevant aspects of the data from the irrelevancies ascribed to error. The paradigmatic function of the model, then, defines certain “sufficient statistics” which condense the relevant features of the data. In fact a close analogy can be developed between the methodology of statistical inference and nosology. Both are necessarily tentative, and healthy development of both, in practice, is iterative; that is, the evidence and the model are mutually correcting and lead to advancement one of another. (shrink)

The epistemology and ontology of experimentation are discussed in depth with special reference to biology and medicine. Two types of experiments are distinguished: exploratory (or "blazing") and consolidating. They Have objectives and canons that are strikingly different. A contrast is drawn between the literalism of the most pragmatic scientists and the formalism of most statisticians. The terms and notions of the one may have imperfect correspondence with those of the other, or perhaps none at all. The dangers are pointed out (...) of both the conclusion that the gap between the two is unbridgeable and the contrary view that the gap is trivial and merits no serious attention. Substantive discussions address the choice and meaning of a metric, the idea of interaction and time series analysis, the ontology of variation, and the epistemology of randomization, hypothesis-seeking, and multiple comparisons. * From the Division of Medical Genetics, Johns Hopkins University School of Medicine, Baltimore Md. 21205. The research in this paper was supported by grants number GM24736 and RR007722 of the National Institutes of Health. Text of a lecture given to the Maryland Institute for Clinical Research and the Department of Social and Preventive Medicine, University of Maryland, October 6, 1980. CiteULike Connotea Del.icio.us What's this? (shrink)

In this paper I shall try to analyse appropriate logic and actual methods as a preliminary to developing expert systems that will simulate clinical diagnosis. It is doubtful that all diagnoses address the same kind of problem and hence no one logic will suffice. Sometimes the signs and symptoms manifest an underlying disorder that cannot be observed directly (the substantialist model); sometimes there seems to be no underlying disorder and the diagnosis is a rearrangement of the data (the nominalist model). (...) In deciding their merits in the particular case, we must identify the sources of variation; what is meant by saying that the data are independent; and what can be meant by wrong diagnosis and misclassification. Problems arise in human diagnosis because the data may be false, even lies; because the known list of diseases is not exhaustive; and because the probability of multiple unrelated diseases increases with age. Special difficulties arise from homeostasis (which is fundamental in defining and understanding disease) because the primary disturbances may be hard to distinguish from the homeostatic responses to them. (shrink)

The formal properties of orbits in a plane are explored by elementary topology. The notions developed from first principles include: convex and polygonal orbits; convexity; orientation, winding number and interior; convex and star-shaped regions. It is shown that an orbit that is convex with respect to each of its interior points bounds a convex region. Also, an orbit that is convex with respect to a fixed point bounds a star-shaped region.Biological considerations that directed interest to these patterns are indicated, and (...) the implications of the prospect of higher orders of star-shapedness mentioned. (shrink)

Farm animal welfare is a knowledge domain that can be regarded as a model for new ways of organizing learning and making higher education more responsive to the needs of society. Global concern for animal welfare has resulted in a great demand for knowledge. As a complement to traditional education in farm animal welfare, higher education can be more demand driven and look at a broad range of methods to make knowledge available. The result of an inventory on farm animal (...) welfare, e-learning, learning resources, and open educational resources in three different search engines is presented. A huge amount of information on animal welfare is available on the Internet but many of the providers lock in the knowledge in a traditional course context. Only a few universities develop and disseminate open learning resources within the subject. Higher education institutions are encouraged to develop open educational resources in animal welfare for the benefit of teachers, students, society, and, indirectly, animal welfare. (shrink)

This comprehensive anthology offers over 40 readings that are critical to the understanding of anthropological theory and the development of anthropology as an academic discipline. The fourth edition maintains a strong focus on the "four-field" roots of the discipline in North America but has been reorganized with a new section on twenty-first-century theory, including coverage of postcolonial and public anthropology. New key terms and introductions accompany each reading and a revamped glossary makes the book more student-friendly. Used on its own, (...) or together with the overview text A History of Anthropological Theory, Fourth Edition, this anthology offers a flexible and unrivaled introduction to anthropological theory that reflects not only the history but also the changing nature of the discipline today. For additional resources, visit the "Teaching Theory" page at www.utpteachingculture.com. (shrink)

Traditional measurement of multisensory facilitation in tasks such as speeded motor reaction tasks (MRT) consistently show age-related improvement during early childhood. However, the extent to which motor function increases with age and hence contribute to multisensory motor reaction times in young children has seldom been examined. Thus, we aimed to investigate the contribution of motor development to measures of multisensory (auditory, visual, and audiovisual) and visuomotor processing tasks in three young school age groups of children (n = 69) aged (5−6, (...) n = 21; 7−8, n = 25.; 9−10 n = 18 years). We also aimed to determine whether age-related sensory threshold times for purely visual inspection time (IT) tasks improved significantly with age. Bayesian results showed decisive evidence for age-group differences in multisensory MRT and visuo-motor processing tasks, though the evidence showed that threshold time for visual identification IT performance was only slower in the youngest age group children (5−6) compared to older groups. Bayesian correlations between performance on the multisensory MRT and visuo-motor processing tasks indicated moderate to decisive evidence in favor of the alternative hypothesis (BF10 = 4.71 to 91.346), though not with the threshold IT (BF10 < 1.35). This suggests that visual sensory system development in children older than 6 years makes a less significant contribution to the measure of multisensory facilitation, compared to motor development. In addition to this main finding, multisensory facilitation of MRT within race-model predictions was only found in the oldest group of children (9−10), supporting previous suggestions that multisensory integration is likely to continue into late childhood/early adolescence at least. (shrink)

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties and cities; (...) communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases. (shrink)

The law ordinarily recognises the woman who gives birth as the mother of a child, but in certain jurisdictions, it will recognise the commissioning couple as the legal parents of a child born to a commercial surrogate. Some commissioning parents have, however, effectively abandoned the children they commission, and in such cases, commercial surrogates may find themselves facing unexpected maternal responsibility for children they had fully intended to give up. Any assumption that commercial surrogates ought to assume maternal responsibility for (...) abandoned children runs contrary to the moral suppositions that typically govern contract surrogacy, in particular, assumptions that gestational carriers are not ‘mothers’ in any morally significant sense. In general, commercial gestational surrogates are almost entirely conceptualised as ‘vessels’. In a moral sense, it is deeply inconsistent to expect commercial surrogates to assume maternal responsibility simply because commissioning parents abandon children for one reason or another. We identify several instances of child abandonment and discuss their implications with regard to the moral conceptualisation of commercial gestational surrogates. We conclude that if gestational surrogates are to remain conceptualised as mere vessels, they should not be expected to assume responsibility for children abandoned by commissioning parents, not even the limited responsibility of giving them up for adoption or surrendering them to the state. (shrink)

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties and cities; (...) communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases. (shrink)

The ability to recognise others’ emotions from nonverbal cues is measured with performance-based tests and has many positive correlates. Although researchers have...

Consumer involvement in clinical research is an essential component of a comprehensive response during emergent health challenges. During the COVID-19 pandemic, the moderation of research policies and regulation to facilitate research may raise ethical issues. Meaningful, diverse consumer involvement can help to identify practical approaches to prioritize, design, and conduct rapidly developed clinical research amid current events. Consumer involvement might also elucidate the acceptability of flexible ethics review approaches that aim to protect participants whilst being sensitive to the challenging context (...) in which research is taking place. This article describes the main ethical challenges arising from pandemic research and how involving consumers and the community could enable resolution of such issues. (shrink)

“Public health legal preparedness” is a term born in the ferment, beginning in the late 1990s, that has led to unprecedented recognition of the essential role law plays in public health and, even more recently, in protecting the public from terrorism and other potentially catastrophic health threats.The initial articulation of public health has not kept pace with rapid evolution in the concept and in practical development of public health preparedness itself. This poses the risk that legal preparedness may fall behind (...) construction of general readiness in the public health system—and may, in fact, undercut achievement of comprehensive public health preparedness for massive threats to health in both the United States and world-wide. Inadvertent results might include both negative health impacts and infringement on individual rights. (shrink)

“Public health legal preparedness” is a term born in the ferment, beginning in the late 1990s, that has led to unprecedented recognition of the essential role law plays in public health and, even more recently, in protecting the public from terrorism and other potentially catastrophic health threats.The initial articulation of public health has not kept pace with rapid evolution in the concept and in practical development of public health preparedness itself. This poses the risk that legal preparedness may fall behind (...) construction of general readiness in the public health system—and may, in fact, undercut achievement of comprehensive public health preparedness for massive threats to health in both the United States and world-wide. Inadvertent results might include both negative health impacts and infringement on individual rights. (shrink)

The problem of justifying legal punishment has been at the heart of legal and social philosophy from the very earliest recorded philosophical texts. However, despite several hundred years of debate, philosophers have not reached agreement about how legal punishment can be morally justified. That is the central issue addressed by the contributors to this volume. All of the essays collected here have been published in the highly respected journal Philosophy & Public Affairs. Taken together, they offer not only significant proposals (...) for improving established theories of punishment and compelling arguments against long-held positions, but also ori-ginal and important answers to the question, "How is punishment to be justified?" Part I of this collection, "Justifications of Punishment," examines how any practice of punishment can be morally justified. Contributors include Jeffrie G. Murphy, Alan H. Goldman, Warren Quinn, C. S. Nino, and Jean Hampton. The papers in Part II, "Problems of Punishment," address more specific issues arising in established theories. The authors are Martha C. Nussbaum, Michael Davis, and A. John Simmons. In the final section, "Capital Punishment," contributors discuss the justifiability of capital punishment, one of the most debated philosophical topics of this century. Essayists include David A. Conway, Jeffrey H. Reiman, Stephen Nathanson, and Ernest van den Haag. (shrink)

Derek Parfit (1942-2017) is the most famous philosopher you've likely never heard of. In 1984, Parfit published what was, and is still, hailed by many philosophers as a work of genius - one of the most cited works of philosophy since World War II, Reasons and Persons. At its core, he argued that we should be concerned less with our own interests and more with the common good. His book brims with brilliant argumentative detail and stunningly inventive thought experiments that (...) challenged contemporary views about what it means to be a person, why one should forego concern for oneself as an identity that persists over time, what it means to act on the basis of reasons, and what we owe to future generations. Parfit also - unfashionably at the time - believed in a kind of grand unified theory of morality, what he called theory x, a non-religious ethical theory wherein all the major moral theories were converging from different sides on the same mountaintop. Parfit has had an enormous influence not only on philosophy, but also beyond, particularly amongst those in the fields of climate ethics, poverty relief, and charitable giving. In this book, the first-full scale biography of Parfit, Dave Edmonds tells the story of the thinker that many philosophers consider the most important moral philosopher of the last century. Edmonds' rendering of the man in full skilfully illuminates the person behind the acclaimed philosopher. Despite Parfit's extraordinary mind, outward appearances suggest his was also an extraordinarily uneventful life - one largely spent in cloistered institutions from Eton to Oxford and one seemingly monomaniacally devoted to ideas. Edmonds' aim is to show how this son and grandson of missionaries went from a genial and outgoing history student to a captivating, yet monkish philosopher singularly devoted to saving morality. In doing so, Edmonds makes Parfit's profound, but often impenetrable, ideas accessible to a broad audience and gives life and body to the thoughts of a seemingly pure thinker that captured the imagination of a generation of philosophers. (shrink)

Mitchell et al.'s claim, that their propositional theory is a single-process theory, is illusory because they relegate some learning to a secondary memory process. This renders the single-process theory untestable. The propositional account is not a process theory of learning, but rather, a heuristic that has led to interesting research.