- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns of harm or injury to the person (...) with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

Although pain is widely recognized by clinicians and researchers as an experience, pain is always felt in a patient-specific way rather than experienced for what it objectively is, making perceived meaning important in the study of pain. The book contributors explain why meaning is important in the way that pain is felt and promote the integration of quantitative and qualitative methods to study meanings of pain. For the first time in a book, the study of the meanings of pain is (...) given the attention it deserves. All pain research and medicine inevitably have to negotiate how pain is perceived, how meanings of pain can be described within the fabric of a person’s life and neurophysiology, what factors mediate them, how they interact and change over time, and how the relationship between patient, researcher, and clinician might be understood in terms of meaning. Though meanings of pain are not intensively studied in contemporary pain research or thoroughly described as part of clinical assessment, no pain researcher or clinician can avoid asking questions about how pain is perceived or the types of data and scientific methods relevant in discovering the answers. (shrink)

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. -/- As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What (...) theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? -/- The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. -/- This collection is the first book to address these 21st-century concerns. (shrink)

Functionalism of robot pain claims that what is definitive of robot pain is functional role, defined as the causal relations pain has to noxious stimuli, behavior and other subjective states. Here, I propose that the only way to theorize role-functionalism of robot pain is in terms of type-identity theory. I argue that what makes a state pain for a neuro-robot at a time is the functional role it has in the robot at the time, and this state is type identical (...) to a specific circuit state. Support from an experimental study shows that if the neural network that controls a robot includes a specific 'emotion circuit', physical damage to the robot will cause the disposition to avoid movement, thereby enhancing fitness, compared to robots without the circuit. Thus, pain for a robot at a time is type identical to a specific circuit state. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims (...) to better understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

What is the relationship between pain and the body? I claim that pain is best explained as a type of personal experience and the bodily response during pain is best explained in terms of a type of mechanical neurophysiologic operation. I apply the radical philosophy of identity theory from philosophy of mind to the relationship between the personal experience of pain and specific neurophysiologic mechanism and argue that the relationship between them is best explained as one of type identity. Specifically, (...) pain is a specific type of personal experience identical to a specific type of allostatic stress response comprised of interdependent nervous, endocrine and immune mechanical operations. (shrink)

Adolescence is a period of life during which peers play a pivotal role in decision-making. The narrative of social influence during adolescence often revolves around risky and maladaptive decisions, like driving under the influence, and using illegal substances. However, research has also shown that social influence can lead to increased prosocial behaviors and a reduction in risk-taking. While many studies support the notion that adolescents are more sensitive to peer influence than children or adults, the developmental processes that underlie this (...) sensitivity remain poorly understood. We argue that one important reason for this lack of understanding is the absence of precisely formulated models. To make a first step toward formal models of social influence during adolescence, we first identify three prominent verbal models of social influence in the literature: social motivation, reward sensitivity, and distraction. We then illustrate how these can be translated into formal models, and how such formal models can inform experimental design and help identify developmental processes. Finally, by applying our formal models to existing datasets, we demonstrate the usefulness of formalization by synthesizing different studies with seemingly disparate results. We conclude with a discussion on how formal modeling can be utilized to better investigate the development of peer influence in adolescence. (shrink)

Bedside handover is the delivery of the nurse-to-nurse handover at the patient’s bedside. Although increasingly used in nursing, nurses report many barriers for delivering the bedside handover. Among these barriers is the possibility of breaching the patient’s privacy. By referring to this concept, nurses add a legal and ethical dimension to the delivery of the bedside handover, making implementation of the method difficult or even impossible. In this discussion article, the concept of privacy during handovers is being discussed by use (...) of observations, interviews with nurses, and interviews with patients. These findings are combined with international literature from a narrative review on the topic. We provide a practice-oriented answer in which two mutually exclusive possibilities are discussed. If bedside handover does pose problems concerning privacy, this situation is not unique in healthcare and measures can be taken during the bedside handover to safeguard the patient. If bedside handover does not pose problems concerning privacy, privacy is misused by nurses to hide professional uncertainties and/or a reluctance toward patient participation. Therefore, a possible breach of privacy—whether a justified argument or not—is not a reason for not delivering the bedside handover. (shrink)

Developing social skills is essential to succeed in social relations. Two important social constructs in middle childhood, prosocial behavior and reactive aggression, are often regarded as separate behaviors with opposing developmental outcomes. However, there is increasing evidence for the co-occurrence of prosociality and aggression, as both might indicate responsivity to the social environment. Here, we tested whether a bi-dimensional taxonomy of prosociality and reactive aggression could predict internalizing and externalizing problems over time. We re-analyzed data of two well-validated experimental tasks (...) for prosociality and reactive aggression in a developmental population sample. Results revealed no associations between prosociality and reactive aggression, confirming the independence of those constructs. Interestingly, although prosociality and reactive aggression independently did not predict problem behavior, the interaction of both was negatively predictive of changes in externalizing problems over time. Specifically, only children who scored low on both prosociality and reactive aggression showed an increase in externalizing problems 1 year later, whereas levels of externalizing problems did not change for children who scored high on both types of behavior. Thus, our results suggest that at an individual level, reactive aggression in middle childhood might not always be maladaptive when combined with prosocial behavior, thereby confirming the importance of studying social competence across multiple dimensions. (shrink)

Subliminal primes are assumed to produce weaker and short-lived effects on subsequent behavior compared to clearly visible primes. However, this difference in priming effect may be due to differences in signal strength, rather than level of awareness. In the present study we manipulated prime discriminability by using metacontrast masks and pseudomasks, while keeping the prime strength equal. This manipulation resulted in large differences in discriminability of the primes. However, both immediate response priming and long-term response priming was equal for the (...) poorly discriminable and well discriminable primes, and equal for groups that differed markedly in terms of how well they could discriminate the primes. Our findings imply that discriminability of information is independent of both the immediate and long-term effects that information can have on behavior. (shrink)

Courses on ethics and technology have become compulsory for many students at the three Dutch technical universities during the past few years. During this time, teachers have faced a number of didactic problems, which are partly due to a growing number of students. In order to deal with these challenges, teachers in ethics at the three technical universities in the Netherlands — in Delft, Eindhoven and Twente — have developed a web-based computer program called Agora (see www.ethicsandtechnology.com). This program enables (...) students to exercise their ethical understanding and skills extensively. The program makes it possible for students to participate actively in moral reflection and reasoning, and to develop the moral competencies that are needed in their later professional practice. The developers of the program have tried to avoid two traps. Firstly, they rejected, from the outset, a cookbook style of dealing with ethical problems that applied ethics is often taken to be and, secondly, they wanted to design a flexible program that respects the student’s as well as the teacher’s creativity, and that tries to engage students in moral reflection. Agora meets these requirements. The program offers possibilities that extend beyond the requirements that are usually accepted for case-exercises in applied ethics, and that have been realised in several other computer models for teaching ethics. In this article, we describe the main considerations in the development of Agora and the features of the resulting program. (shrink)

This paper starts from the presupposition that moral codes often do not suffice to make agents understand their moral responsibility. We will illustrate this statement with a concrete example of engineers who design a truck’s trailer and who do not think traffic safety is part of their responsibility. This opinion clashes with a common supposition that designers in fact should do all that is in their power to ensure safety in traffic. In our opinion this shows the need for a (...) moral philosophy that helps engineers to interpret their responsibility and think more critically about it. For this purpose we will explore the moral philosophy of Alasdair MacIntyre, which is particularly interesting because he locates the beginning of moral thinking in the daily practice of a profession. This is consistent with the history of moral codes, for codes are also the product of moral reflection by professionals. We will use MacIntyre’s philosophy to (1) explain what is wrong with the designers’ understanding of their responsibility and (2) show a possible way to bring their reflection to a more self-critical level. We will also inspect MacIntyre’s proposal critically. (shrink)

An important challenge when creating automatically processable laws concerns open-textured terms. The ability to measure open-texture can assist in determining the feasibility of encoding regulation and where additional legal information is required to properly assess a legal issue or dispute. In this article, we propose a novel conceptualisation of open-texture with the aim of determining the extent of open-textured terms in legal documents. We conceptualise open-texture as a lever whose state is impacted by three types of forces: internal forces (the (...) words within the text themselves), external forces (the resources brought to challenge the definition of words), and lateral forces (the merit of such challenges). We tested part of this conceptualisation with 26 participants by investigating agreement in paired annotators. Five key findings emerged. First, agreement on which words are open-texture within a legal text is possible and statistically significant. Second, agreement is even high at an average inter-rater reliability of 0.7 (Cohen’s kappa). Third, when there is agreement on the words, agreement on the Open-Texture Value is high. Fourth, there is a dependence between the Open-Texture Value and reasons invoked behind open-texture. Fifth, involving only four annotators can yield similar results compared to involving twenty more when it comes to only flagging clauses containing open-texture. We conclude the article by discussing limitations of our experiment and which remaining questions in real life cases are still outstanding. (shrink)

In the reported, experiment participants hit a ball to aim at the vertex of a Müller–Lyer configuration. This configuration either remained stable, changed its shaft length or the orientation of the tails during movement execution. A significant illusion bias was observed in all perturbation conditions, but not in the stationary condition. The illusion bias emerged for perturbations shortly after movement onset and for perturbations during execution, the latter of which allowed only a minimum of time for making adjustments . These (...) findings indicate that allocentric information is exploited for online control when people make rapid adjustments in response to a sudden change in the environment and not when people guide their limb movements to interact with a stable environment. (shrink)

This chapter describes a philosophical approach to theorizing justice, mapping out some main strands of the tradition leading up to contemporary political philosophy. We first briefly discuss what distinguishes a philosophical approach to justice from other possible approaches to justice, by explaining the normative focus of philosophical theories of justice – that is, a focus on questions not about how things actually are, but about how things ought to be. Next, we explain what sorts of methods philosophers use to justify (...) theories of justice. Following this, in the longest section, we highlight major questions about justice that have drawn the attention of philosophers, and indicate how competing conceptions of justice have arisen from differing answers to these questions. The goal here is not to answer but to elucidate some of the larger questions about justice, as well as to establish a framework for understanding and distinguishing different kinds of claims about justice and some of the relations between them. (shrink)

This article researches how a corporate code of ethics (CCE) implemented in local government X has influenced the behavior of its employees, middle managers, and managers. Metaphors from the existing and desired CCE elicited by these three groups provided information on how to improve the effectiveness of the CCE. This method proved to be very fruitful. It appeared that continuous systematic attention needed to be paid to the CCE after the CCE had been implemented, particularly by management. Initiatives from management (...) to start discussions about relevant questions of integrity appeared to be also necessary to make the topic a “normal” topic which employees were no longer afraid to discuss. In this way, the possibility could be created to develop collectively a “practical” frame of reference concerning relevant questions of integrity that would help employees to make decisions in difficult situations during their work in the future. (shrink)

The European Union Commission’s whitepaper on Artificial Intelligence proposes shaping the emerging AI market so that it better reflects common European values. It is a master plan that builds upon the EU AI High-Level Expert Group guidelines. This article reviews the masterplan, from a culture cycle perspective, to reflect on its potential clashes with current societal, technical, and methodological constraints. We identify two main obstacles in the implementation of this plan: the lack of a coherent EU vision to drive future (...) decision-making processes at state and local levels and the lack of methods to support a sustainable diffusion of AI in our society. The lack of a coherent vision stems from not considering societal differences across the EU member states. We suggest that these differences may lead to a fractured market and an AI crisis in which different members of the EU will adopt nation-centric strategies to exploit AI, thus preventing the development of a frictionless market as envisaged by the EU. Moreover, the Commission aims at changing the AI development culture proposing a human-centred and safety-first perspective that is not supported by methodological advancements, thus taking the risks of unforeseen social and societal impacts of AI. We discuss potential societal, technical, and methodological gaps that should be filled to avoid the risks of developing AI systems at the expense of society. Our analysis results in the recommendation that the EU regulators and policymakers consider how to complement the EC programme with rules and compensatory mechanisms to avoid market fragmentation due to local and global ambitions. Moreover, regulators should go beyond the human-centred approach establishing a research agenda seeking answers to the technical and methodological open questions regarding the development and assessment of human-AI co-action aiming for a sustainable AI diffusion in the society. (shrink)