Discussions surrounding patient engagement and empowerment often use the terms “patient” and “consumer” interchangeably. But do the two terms hold the same meaning, or is a “patient” a passive actor in the health care arena and a “consumer” an informed, rational decision-maker? Has there been a shift in our usage of the two terms that aligns with the increasing commercialization of health care in the U.S. or has the patient/consumer dynamic always been a part of the buying and selling of (...) health care in the American system? Recent discussions of the issue exist in the popular press and in social media forums such as TEDMED, but few direct analyses of the ethical, legal, and policy ramifications of this possible shift in terminology are available in the academic literature. This paper analyzes our usage of the terms and any recent changes in the dynamic and discusses the ethical, legal, and policy implications of this simple terminology for the physicianpatient relationship. (shrink)

During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent's proper role in a health care environment in which electronic information sharing holds primary importance. This article discusses current implementation of the doctrine within health information exchange networks; the relationship between informed consent and privacy; the variety of ways that the concept is referenced in discussions of information sharing; and challenges that surround incorporation of the doctrine into the evolving HIT environment. The (...) article concludes by reviewing the purpose behind the traditional obligation to obtain informed consent and the possibility of maintaining its relevance in the new environment. (shrink)

As policy makers place great hope in health information technology as a means to lower costs and achieve improvements in health care quality, safety, and efficiency, organizations at the forefront of building health information exchange networks attempt to weave the concept and function of informed consent into an evolving information-driven health care system. The vast amount of information that will become available to both health professionals and patients in the new HIT-driven environment can reasonably be expected to affect the relationship (...) between them in many ways, particularly in the area of informed consent. During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent’s proper role in a heretofore unknown health care environment — one in which electronic information sharing holds primary importance. The central and largely unexamined question of whether and how the legal and ethical underpinnings of informed consent will fit into the context of HITenabled treatment is critical to both public policy and clinical practice. (shrink)

The widespread adoption of health information technology has been recognized as both a necessary element of health reform and a required building block of a modern, high performing health care system.

Information technology is considered a potentially transformative element in the field of health care by payers, providers, vendors, and consumers alike. Because of this transformative potential, health information technology adoption is viewed by many as a key component of health system reform. HIT is in its earliest stages, with diffusion of the technology still relatively limited; at the same time, there is growing awareness of its potential to affect the operation of the entire health care system as a result of (...) the vast amount of information that will become available to both health professionals and patients. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

This revolutionary book empowers its readers intellectually by providing a snapshot of perennial and timely philosophical topics. Written by twenty expert women in philosophy and representing a diverse and pluralistic approach to philosophy as a discipline, this book appeals to a wide audience. Individual readers, especially girls and women ages 16-24, as well as university and high school educators and students who want a change from standard anthologies that include few or no women will find value in these pages. This (...) volume contains several notable features: the book is divided into four sections that correspond to major fields in Philosophy-metaphysics, epistemology, social and political philosophy, and ethics-but the chapters within those sections provide fresh ways of understanding those fields. " Every chapter begins with a lively anecdote about a girl or woman in literature, myth, history, science, or art to introduce the chapter's specific topic." Chapters are dominated by women's voices, with nearly all primary and secondary sources used coming from women in the history of philosophy and a diverse set of contemporary women philosophers. "All chapters offer the authors' distinct philosophical perspectives written in their own voices and styles, representing diverse training, backgrounds, and interests." The Introduction and Prologue explicitly invite the book's readers to engage in philosophical conversation and reflection, thus setting the stage for continued contemplation and dialogue beyond the book itself. The result is a rigorous yet accessible entry-point into serious philosophical contemplation designed to embolden and strengthen its readers' own senses of philosophical inquiry and competence. The book's readers will feel confident in knowing that expert women affirm an equitable and just intellectual landscape for all and thus have lovingly collaborated to write this book. (shrink)

This article discusses the trajectory of Simone de Beauvoir’s concern with the issue of torture. It argues that Beauvoir’s interest in torture extends back at least to World War II and that her activities and writings against torture during the French-Algerian War of 1954–1962 were pivotal in prompting her to reject ethical philosophical language and to embrace, in its place, a new concept of politics based on need. It further suggests that exploring the development of Beauvoir’s ideas about torture helps (...) elucidate her belated turn to feminism and that in Beauvoir’s disarray and disillusionment regarding the use of torture by the French during the French-Algerian War and her compatriots’ complaisance with regard to this, there are lessons of sorts, though not necessarily entirely comforting ones, for Americans and others facing similar situations. (shrink)

The android Data from Star Trek admired human emotion whereas Spock viewed emotion as irrational and maladaptive. The theory that emotions fulfil adaptive functions is widely accepted in academic psychology but little is known about laypeople’s theories. The present study assessed the extent to which laypeople share Data’s view of emotion as helpful or Spock’s view of emotion as a hindrance. We also assessed how help and hinder theory endorsement were related to reasoning, emotion regulation, and well-being. Undergraduates completed a (...) stressful timed reasoning task and questionnaires that assessed their theories of emotion, emotion regulation strategies, happiness, and social support. Overall, participants viewed emotion more as a help than a hindrance. The more they endorsed the view that emotion helps, the better their reasoning scores. Endorsing a help theory also predicted the use of reappraisal which, in turn, predicted greater happiness and social support. In contrast, endorsing the view that emotion hinders was associated with emotion suppression and less social support. Thus, people’s theories about the functionality of emotion may have important implications for their reasoning and emotional well-being. (shrink)

Alix Cohen argues that the function of feeling in Kantian psychology is to appraise and orient activity. Thus she sees feeling and agency as importantly connected by Kant’s lights. I endorse this broader claim, but argue that feeling, on her account, cannot do the work of orientation that she assigns to it.

This investigation examined how people’s beliefs about the functionality of emotion shape their emotional response and regulatory strategies when encountering distressing events. In Study 1, we present data supporting the reliability and validity of an 8-item instrument, the Help and Hinder Theories about Emotion Measure (HHTEM), designed to assess an individual’s beliefs about the functionality of emotion. Participants who more strongly endorsed a Help Theory reported greater wellbeing, emotional acceptance, and use of reappraisal to regulate emotion. Participants who more strongly (...) endorsed a Hinder Theory reported less wellbeing and more expressive suppression and substance use. In Study 2, we demonstrate that encouraging participants to view emotion as helpful affected their physiological and regulatory response to a distressing event. Participants in the Help Theory condition showed greater physiological reactivity (SCL) during a distressing film than control participants but were more accepting of their emotional response. Shortly after the film, SCL decreased for participants in the Help Theory condition. Compared to control participants, they engaged in less suppression and reported less lingering effect of the film on their mood. Together, these studies suggest that people’s theories about the functionality of emotion influence their reactivity, the strategies they adopt to regulate emotion, and their ability to rebound after distressing events. (shrink)

The competing expressions of ideology flooding the contemporary political landscape have taken a turn toward the absurd. The Radiance Foundation’s recent anti-abortion campaign targeting African-American women, including a series of billboards bearing the slogan “The most dangerous place for an African-American child is in the womb”, is just one example of political "discourse" that is both infuriating and confounding. Discourse with these features – problematic intelligibility, disinterest in the truth, and inflammatory rhetoric – has become increasingly common in politics, the (...) press, and even the arguments made by ordinary folk. It is often criticized for its falsehood or its hurtfulness; however, these critiques tend to miss its pernicious potential. This essay characterizes this insidious discourse as purposeful nonsense. Part of the way that purposeful nonsense functions, we argue, relies on taking advantage of harmful stereotypes and denigrating narratives that are already present in our culture. Purposeful nonsense both draws upon harmful ideology and fortifies it. The effect is that members of oppressed social groups are confronted with disparaging ideology, while its authors are free to deny responsibility for it. Black feminist and intersectional analysis – particularly in the discussion of race, abortion, and reproductive justice – are useful in identifying and criticizing the harmful subtext in the Radiance Foundation’s billboard campaign. The notion of purposeful nonsense serves to extend the reach of these criticisms. Purposeful nonsense – disguised as merely logically confused discourse – is a key factor in maintaining an oppressive and unjust society; however, feminist, black feminist, and intersectional analysis contextualizes purposeful nonsense, potentially disrupting its harmful influence. We conclude that purposeful nonsense employs a variation on stereotype threat, a phenomenon in which being reminded of negative stereotypes about one’s social group causes stereotypical performance failures. We suggest that the notion of stereotype threat combined with intersectional analysis offers a fruitful avenue along which research on this sort of discourse might be expanded. (shrink)

The quantum probability flux of a particle integrated over time and a distant surface gives the probability for the particle crossing that surface at some time. We prove the free fluxacross-surfaces theorem, which was conjectured by Combes, Newton and Shtokhamer [1], and which relates the integrated quantum flux to the usual quantum mechanical formula for the cross section. The integrated quantum flux is equal to the probability of outward crossings of surfaces by Bohmian trajectories in the scattering regime.

A science of prelinguistic infant cognition must take seriously the language-of-thought (LoT) hypothesis. I show how the LoT framework enables us to identify the representational and computational capacities of infant minds and the developmental factors that act on these capacities, and explain how Quilty-Dunn et al.'s take on LoT has important upshots for developmental theory-building.

In this response essay, I borrow a page from Jack Halberstam to explore the ties that bind—ligates, as in re-ligio—the two sibling fields of sociology and religious studies.

Defense of reproductive choice is an important motivation in women's self-protection psychology for which the “staying alive theory” cannot fully account. Evidence indicates that some elements of women's self-protection psychology function to protect reproductive choice rather than survival, or may be equally well explained by either motivation. Integrating perspectives will result in greater explanatory breadth and precision in theory testing.

A dual-audience signaling problem framework provides a deeper understanding of the perpetuation of group-based inequality. We describe a model of underachievement among minority youth that posits a necessary trade-off between academic success and peer social support that creates a dilemma not typically encountered by nonminorities. Preliminary evidence consistent with the approach is discussed. Such strategic agent perspectives complement the psychological approach put forth by Dixon et al., but with minimal ancillary assumptions.

Young children with limited knowledge of formal mathematics can intuitively perform basic arithmetic‐like operations over nonsymbolic, approximate representations of quantity. However, the algorithmic rules that guide such nonsymbolic operations are not entirely clear. We asked whether nonsymbolic arithmetic operations have a function‐like structure, like symbolic arithmetic. Children (n = 74 4‐ to ‐8‐year‐olds in Experiment 1; n = 52 7‐ to 8‐year‐olds in Experiment 2) first solved two nonsymbolic arithmetic problems. We then showed children two unequal sets of objects, and (...) asked children which of the two derived solutions should be added to the smaller of the two sets to make them “about the same.” We hypothesized that, if nonsymbolic arithmetic follows similar function rules to symbolic arithmetic, then children should be able to use the solutions of nonsymbolic computations as inputs into another nonsymbolic problem. Contrary to this hypothesis, we found that children were unable to reliably do so, suggesting that these solutions may not operate as independent representations that can be used inputs into other nonsymbolic computations. These results suggest that nonsymbolic and symbolic arithmetic computations are algorithmically distinct, which may limit the extent to which children can leverage nonsymbolic arithmetic intuitions to acquire formal mathematics knowledge. (shrink)

“What is the structure of thought?” is as central a question as any in cognitive science. A classic answer to this question has appealed to a Language of Thought (LoT). We point to emerging research from disparate branches of the field that supports the LoT hypothesis, but also uncovers diversity in LoTs across cognitive systems, stages of development, and species. Our letter formulates open research questions for cognitive science concerning the varieties of rules and representations that underwrite various LoT-based systems (...) and how these variations can help researchers taxonomize cognitive systems. (shrink)

BACKGROUND: Hallucinations and delusions that complicate Parkinson’s disease could lead to nursing home placement and are linked to increased mortality. Cognitive impairments are typically associated with the presence of hallucinations but there are no data regarding whether such a relationship exists with delusions. OBJECTIVE: We hypothesized that hallucinations would be associated with executive and visuospatial disturbance. An exploratory examination of cognitive correlates of delusions was also completed to address the question of whether they differ from hallucinations. METHODS: 144 PD subjects (...) completed a neuropsychological battery to assess cognition and the SAPS to examine psychosis. Correlational analyses assessed associations between hallucinations and delusions with cognitive domains. RESULTS: 48 subjects reported psychotic symptoms: 25 experienced hallucinations without delusions, 23 had symptoms dominated by delusions. Severity and/or number of hallucination subtypes were significantly correlated with lower scores in language, memory, attention, executive functioning, and visuospatial ability. Correlations with delusions were non-significant. Tests of differences in the size of the correlations between groups revealed a significant relationship between language and visuospatial performance with hallucinations. CONCLUSIONS: Cognitive correlates of hallucinations and delusions appear to be different in PD, suggesting distinct pathogenic mechanisms and possibly anatomical substrates. Hence, delusions may not share the same associations with dementia as hallucinations. Since this is a new finding, further studies will be needed to confirm our results. (shrink)