Sustained attention, a key cognitive skill that improves during childhood and adolescence, tends to be worse in some emotional and behavioural disorders. Sustained attention is typically studied in non-affective task contexts; here, we used a novel task to index performance in affective versus neutral contexts across adolescence (N = 465; ages 11–18). We asked whether: (i) performance would be worse in negative versus neutral task contexts; (ii) performance would improve with age; (iii) affective interference would be greater in younger adolescents; (...) (iv) adolescents at risk for depression and higher in anxiety would show overall worse performance; and (v) would show differential performance in negative contexts. Results indicated that participants performed more poorly in negative contexts and showed age-related performance improvements. Those at risk of depression performed more poorly than those at lower risk. However, there was no difference between groups as a result of affective context. For anxiety there was no difference in performance as a function of severity. However, those with higher anxiety showed less variance in their reaction times to negative stimuli than those with lower anxiety. One interpretation is that moderate levels of emotional arousal associated with anxiety make individuals less susceptible to the distracting effects of negative stimuli. (shrink)

The first section takes up some main details of American constitutional history. At the end of that section and in section two, we concentrate on one constitutional doctrine in particular, judicial review. We argue that this doctrine rests, traditionally, on the foundational idea of a permanent tension between democratic institutions and basic rights. In section three, we deal with the problem just raised, by suggesting an alternative view of the relationship that exists between these fundamental constitutional elements. Here we attempt (...) to show that there is an essential principled harmony between basic constitutional rights and democratic majority rule. And we try to locate judicial review within this alternative conception. Then in section four and in the conclusion we discuss the institutional arrangements for the practice of judicial review in the light of this alternative conception. (shrink)

In this article, I expound and defend an interpretation of Sellars as a metaethical quasi-realist. Sellars analyzes moral discourse in non-cognitivist terms: in particular, he analyzes “ought”-statements as expressions of collective intentions deriving from a collective commitment to provide for the general welfare. But he also endorses a functional-role theory of meaning, on which a statement’s meaning is grounded in its being governed by semantical rules concerning language entry, intra-linguistic, and language departure transitions, and a theory of truth as correct (...) assertibility relative to such semantical rules. On these non-representationalist theories, even though moral statements are expressions of intentions and not fundamentally descriptive, they nevertheless count as assertorically meaningful, and some count as positively true. I further argue that this interpretation is capable not only of explaining Sellars’ explicitly metaethical writings, but also of unifying his scientific realism with his commitment to the ineliminable and indispensable role of the language of intentions: if this linguistic framework does not play an explanatory role, but only an expressive role, this explains both why Sellars’ commitment to it does not contravene his naturalism, as well as why, given the necessity of such language for our practical engagement with the world, the scientific image of humans in the world will only be completed once such language supplements it to enable us to relate practically to it. (shrink)

Theories of language production have long been expressed as connectionist models. We outline the issues and challenges that must be addressed by connectionist models of lexical access and grammatical encoding, and review three recent models. The models illustrate the value of an interactive activation approach to lexical access in production, the need for sequential output in both phonological and grammatical encoding, and the potential for accounting for structural effects on errors and structural priming from learning.

In his Enarrationes in Genesin, Martin Luther finds stories of suffering he can ‘hardly read with dry eyes’. Recent scholars attribute profound ethical value to Luther's tears, especially those shed over the suffering of female characters. This article reconsiders the ethical salience of Luther's tears as a demonstration of interpretive empathy by examining his reading of Hagar and its modern reception history. By comparing Luther's reading of the enslaved Hagar to his reading of her master Abraham, it is argued that (...) gender, power and inequality shape the very conditions in which terms like ‘empathy’, ‘charity’ and ‘suspicion’ appear and this, in turn, invites a reconsideration of the ethical responsibilities we incur as we read texts of terror in light of their role in enduring histories of violence. (shrink)

Many have taken Sellars’s critique of empiricism in “Empiricism and the Philosophy of Mind” (EPM) to be aimed at his teacher C. I. Lewis. But if so, why do the famous arguments of its opening sections carry so little force against Lewis’s views? Understandably, some respond by denying that Lewis’s epistemology is among the positions targeted by Sellars. But this is incorrect. Indeed, Sellars had earlier offered more trenchant (if already familiar) critiques of Lewis’s epistemology. What is original about EPM (...) is that it criticizes empiricist positions like Lewis’s not because of their foundationalism, but because of their psychologism about meaning. Since psychologism turns out to be unacceptable by Lewis’s own lights, EPM has a compelling (if implicit) critique of Lewis to offer after all, one that strikes at the heart of his philosophical system. (shrink)

While C. I. Lewis was traditionally interpreted as an epistemological foundationalist throughout his major works, virtually every recent treatment of Lewis's epistemology dissents. But the traditional interpretation is correct: Lewis believed that apprehensions of "the given" are certain independently of support from, and constitute the ultimate warrant for, objective empirical beliefs. This interpretation proves surprisingly capable of accommodating apparently contrary textual evidence. The non-foundationalist reading, by contrast, simply cannot explain Lewis's explicit opposition to coherentism and his insistence that only apprehensions (...) of the given enable us to answer the regress problem -- and so vindicate the possibility of empirical justification. (shrink)

This article considers how seventeenth-century writer John Milton engages in modes of thinking that register the obstetric revolution occurring during the period. During a time when physicians were gaining entry to the birthing room, a medical rhetoric of childbirth was developing that cast childbirth in new pathological terms. Milton's A Masque Presented at Ludlow Castle demonstrates how childbirth was influenced by emerging obstetrical language and practice, as well as the ways in which a writer might question such influence. Finally, this (...) article also draws links between disrupted historical rituals of childbirth and modern anxieties about medically-centred birthing practices. (shrink)

Edited by Svetla S. Griffin and Ilaria L.E. Ramelli. Harvard University Press, Hellenic Studies 88, 2019, ca 600 pages. ISBN-10: 0674241320; ISBN-13: 978-0674241329. Contributors: Luc Brisson, Kevin Corrigan, John Dillon, Harold Tarrant, John Turner, John Finamore, Ilaria Ramelli, Karla Pollmann, Carlos Lévy, Lenka Karfíková, Pauliina Remes, Mark J. Edwards, Pier Franco Beatrice, Svetla Slaveva-Griffin, Aaron Johnson, Dimka Gocheva, Olivier Dufault, and Robert Hannah.

As an incapacitated patient is unable to make decisions regarding their care, physicians turn to next-of-kin when appointing a surrogate decision-maker in the absence of an advanced directive. With the increasing complexity of modern families, physicians are facing new ethical dilemmas when choosing the individual to make end-of-life decisions for their patients. Legal definitions and hierarchies are no longer adhering to the purpose of a surrogate-decision maker, which is to maintain a patient’s autonomy. Moral criteria for surrogates, which emphasize the (...) importance of making decisions that align with the patient’s desires and wishes and negate biological relationships over emotional connections, are becoming much more important. This paper explores a case study in which physicians must appoint a surrogate decision-maker for an incapacitated patient, forced to choose between a biological relationship and a strong emotional connection. (shrink)

I take up two questions raised by Luz Christopher Seiberth's meticulous reconstruction of Wilfrid Sellars's theory of intentionality. The first is whether we should regard Sellars as a transcendental phenomenalist in the most interesting sense of the term: as denying that even an ideally adequate conceptual structure would enable us to represent worldly objects as they are in themselves. I agree with Seiberth that the answer is probably yes, but I suggest that this is due not to Sellars's rejection of (...) the Myth of the Given or appeal to image-models (as Seiberth maintains), but to his view of modality as categorial but as absent from the world an sich. The second is whether, as Richard Rorty complained, Sellars's appeal to picturing lands his theory of intentionality in intractable skepticism. Pace Seiberth, I argue that the transcendental role of picturing does not mitigate this problem, and I suggest that Sellars's most fruitful resource for doing so is not his semantic externalism, but his purely pragmatic response to skepticism. (shrink)

The Farmers Market Nutrition Program (FMNP) is a federal-state partnership designed to provide fresh, locally grown produce to low-income participants at nutritional risk and expand consumer awareness and use of local produce sold at farmers markets. This paper describes the results of a collaboration initiative based on the typology of a “comprehensive, multisectorial collaboration” to support the FMNP. We report the outcomes of the partnerships that developed over three years, including increased outreach to FMNP participants and strategies to decrease barriers (...) to participation. Those partnerships that reached higher degrees of coordination or collaboration are now addressing market accessibility and market quality in new ways. Those partnerships that exhibited the highest degree of collaboration are contributing to community capacity building beyond FMNP issues per se and to larger issues affecting the agriculture community and the food security of residents. (shrink)

People with a repressive coping style are highly motivated to defend themselves against self-concept threats. But what kinds of unfavourable personal characteristics are they most focused on avoiding? Weinberger (Citation1990) suggested that repressors are primarily concerned with seeing themselves (and having others see them) as calm, unemotional people who are not prone to experiencing negative affect. A content analysis of the actual (self-ascribed) and undesired attributes of 349 male and female college students, however, provided no support for that hypothesis. Instead, (...) relative to other participants, repressors’ undesired selves consisted more of traits exemplifying disagreeableness (as defined by the five-factor model). Repressors might not engage in affective self-regulation for its own sake, but because it allows them to control expression of traits with which they are more directly concerned. (shrink)

In “The Fixation of Belief,” Peirce apparently accepts the causal claim that real physical objects cause us to reach an indefeasible “final opinion” concerning them. In “How to Make Our Ideas Clear,” he apparently accepts the constitutive claim that for physical objects to be real just is for them to be represented in that opinion. These claims initially seem inconsistent, since causal claims are explanatory and since equivalent claims cannot explain one another. Contrary to prominent suggestions that Peirce rejected the (...) constitutive claim, however, he actually accepted both, reconciling them via a Humean denial that causal claims are genuinely explanatory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Toward a Dialectics of Emptiness: Overcoming Nihilism and Combatting Mechanization in Nishitani Keiji’s Postwar ThoughtGriffin WernerIn his postwar writings on nihilism in modernity, Nishitani Keiji (1900–90) does not explicitly articulate the structure of the relationship between the mechanization of the world and nihilism. Instead, he discusses mechanization with respect to his critique of modern worldviews such as atheism, scientism, and liberalism and how they have contributed to the advent (...) of nihilism and the loss of human autonomy in modern Europe and Japan.1 According to Nishitani, before the advent of scientism and the subsequent progression of unfettered technological development, pre-Western-Enlightenment and pre-Meiji-period worldviews consisted of a fundamental embodied connection between a people or culture and their spiritual traditions. In Europe’s case, due to the death of God and the subsequent shift from a Christian worldview to an atheistic and scientistic one, a historical period of nihilism began. Modern mechanistic worldviews like Descartes’s, Nishitani argues, present the world as consisting of dead matter that is fundamentally separated from the indubitable ego. No longer is the world considered to be “alive” in the sense of there being a fundamental connection between human life and the living, breathing world around it. Rather, from the perspective of the ego, the modern world is simply a cold and lifeless world of dead machines.As discussed in Religion and Nothingness, the development of structurally Cartesian worldviews led to or caused the advent of nihilism in Europe. Consequently, European culture lost its cultural ground in Christianity and individuals lost their foundational meaning which supported their understanding of themselves in relation [End Page 129] to others, the world, and a transcendent God. As Japan began to modernize, or, arguably, “Westernize,” it inherited a Cartesian-like worldview and, over time, subsequently lost touch with its traditional philosophical and religious ground as well. As a result, the modern period of nihilism began in both Europe and Japan as both peoples lost touch with the traditional meaning that supported them.While this description between mechanization and nihilism implies a causal relationship, I argue that the relationship between nihilism and the mechanization of the world can be more accurately articulated in terms of a dialectical relationship. In the modern context, not only does the mechanization of the world lead to or exacerbate a culture’s plunge into nihilism or an individual’s confrontation with the abyss of nihility, but nihilism also reinforces and exacerbates the mechanization of the world. As partners in this dialectical oscillation, each reinforces the other as one (culture or person) continuously spirals deeper and deeper into meaninglessness, ultimately to the culminating point that Nishitani calls the “mechanization of man.”2Just as Nishitani argues that the problem of nihilism can only be solved by way of radicalizing nihilism to the “field of emptiness,” the structural oscillation between nihilism and mechanization will continue at the levels of the individual and the culture unless nihilism and mechanization are overcome. However, rather than only overcoming nihilism to reach emptiness in the individual, and that leading to social and political change, I argue that overcoming the dialectical tension between nihilism and mechanization will require a “dialectics of emptiness.” Such a dialectic will combat nihilism and mechanization with a mutually reinforcing tension between personal transformation, which overcomes nihilism by way of stepping back to the field of emptiness, and socio-political transformation by way of a politics of emptiness. Solving the problem of nihilism in modernity—insofar as it is always already in relation to mechanization—will require more than individual existential confrontation and transformation. Through one’s individual overcoming of nihilism, one must also aim to “empty” those institutions which contribute to the mechanization of the world. While Nishitani highlights the individual’s religious quest as the impetus for the social and political change necessary to overcome the problem of nihilism at the cultural level, an analysis of how that might be done and what [End Page 130] may be politically necessary in order to do so is missing from his thought.As such, my aim in this article is twofold: I attempt to shed light on the structure of nihilism and... (shrink)

Ancient Greek Philosophy routinely relied upon concepts of number to explain the tangible order of the universe. Plotinus' contribution to this tradition, however, has been often omitted, if not ignored. The main reason for this, at first glance, is the Plotinus does not treat the subject of number in the Enneads as pervasively as the Neopythagoreans or even his own successors Lamblichus, Syrianus, and Proclus. Nevertheless, a close examination of the Enneads reveals that Plotinus systematically discusses number in relation to (...) each of his underlying principles of existence--the One, Intellect, and Soul. Plotinus on Number offers the first comprehensive analysis of Plotinus' concept of number, beginning with its origins in Plato and the Neopythagoreans and ending with its influence on Porphyry's arrangement of the Enneads. It's main argument is that Plotinus adapts Plato's and the Neopythagoreans' cosmology to place number in the foundation of the intelligible realm and in the construction of the universe. Through Plotinus' defense of Plato's Ideal Numbers from Aristotle's criticism, Svetla Slaveva-Griffin reveals the founder of Neoplatonism as the first post-Platonic philosopher who purposefully and systematically develops what we may call a theory of number, distinguishing between number in the intelligible realm and number in the quantitative, mathematical realm. Finally, the book draws attention to Plotinus' concept as a necesscary and fundamental linke between Platonic and late Neoplatonic schools of philosophy. (shrink)

This study investigated whether perspective-taking reduces belief bias independently of argument strength. Belief bias occurs when individuals evaluate belief-consistent arguments more favourably than belief-inconsistent arguments. Undergraduates read arguments that varied with respect to belief-consistency and strength about the topic of climate change. After participants read each argument, those in the perspective-taking condition rated the argument's strength from a perspective of a climate scientist and then from their own perspectives, whereas those in the no perspective-taking condition only rated the arguments from (...) their own perspectives. Perspective-taking eliminated belief bias for weak arguments, but not for strong arguments. Theoretical and practical implications of the results are discussed, and directions for future research are provided. (shrink)

Processes of rapid and truncated agrarian change—driven through expanding urbanisation, infrastructure development, extractive industries, and commodity crops—are shaping the livelihood opportunities and aspirations of Indonesia’s rural youth. This study describes the everyday experiences of youth as they navigate the changing character of agriculture, aquaculture, and fishing livelihoods across gender, class, and generation. Drawing on qualitative field research conducted in the Maros District of South Sulawesi, we examine young people’s experiences of agrarian change in a landscape of entangled rural, coastal and (...) increasingly urbanised spaces. We find that young people aspire to secure, modern, and salary-based work, while continuing to seek and sustain intergenerational farming or aquaculture-based livelihoods. Youth take advantage of increased connectivity to diversify their incomes, yet their dependence on mobility also introduces new forms of gendered and class based precarity such as insecure working arrangements, disruption to education and violence (especially for young unskilled women and youth from financially insecure households). Our study highlights the persistent conditions of precarity that many young people encounter in both rural and urban settings, while challenging assumptions that youth are uninterested in rural futures. (shrink)

American health policy today faces dual problems of too little health coverage at too high a cost. The mix of public and private financing leaves about one seventh of the population without any insurance coverage. At the same time, the coverage Americans do have costs an ever-larger share of our country's productive capacity. This "paradox of excess and deprivation" results from the incremental approach the U.S. has taken to promoting incompatible policy goals of increasing health insurance coverage and medical quality (...) while trying to control costs, without squarely confronting tradeoffs. This essay examines the record of incremental developments and draws lessons for current efforts at reform. (shrink)

American health policy today faces dual problems of too little coverage at too high a cost. The mix of private and public financing leaves about one seventh of the population without any insurance coverage. At the same time, the coverage Americans do have costs an ever-larger share of our country’s productive capacity. The U.S. pays well above what other countries pay and what many people, health plans, businesses, and governments want to pay. This “paradox of excess and deprivation” results from (...) the incremental approach the U.S. has taken to promoting incompatible policy goals of increasing health insurance coverage and medical quality while trying to control costs, without squarely confronting tradeoffs. This essay examines the record of incremental developments and draws lessons for current efforts at reform. (shrink)

Thomas Hobbes is one of the most ardent and thoroughgoing opponents of participatory democracy among Western political philosophers. Though Hobbes 's alternative to participatory democracy - assent by subjects to rule by an absolute sovereign - no longer constitutes a viable political alternative for Westerners, his critique of participatory democracy is a potentially valuable source of insight about its liabilities. This essay elaborates five theses from Hobbes that stand as cogent warnings to those who embrace participatory democracy, especially those advocating (...) for deliberative democracy based on a rational consensus model. In light of these warnings, the author suggests an alternative, modus vivendi approach to deliberative democracy that would radically alter the current practice of bioethics. (shrink)

In Holding Health Care Accountable , E. Haavi Morreim differentiates between duties of expertise and resource duties, arguing for tort liability respecting the former and contract liability respecting the latter. Though Morreim's book addresses ordinary clinical medicine, her liability scheme may also be relevant elsewhere. Focusing on disaster medicine, and especially the medical management of violent mass disasters (e.g., where terrorists have deployed weapons of mass destruction), I argue in this essay that Morreim's classification of duties still fits, but that (...) it is difficult to hold government powers accountable for their many resource and expertise duties. This difficulty is compounded by political arrangements that foist under-funded mandates for disaster services on healthcare providers. As a result of such arrangements, hospitals and clinicians are prone to liability for expenditures and clinical interventions that are beyond their scope. This problem can be mitigated, I argue, by examining and clarifying the apparent social compact between society and healthcare. (shrink)

As reproductive freedoms in the U.S. undergo significant rollbacks, vital reproductive health services — and the care teams delivering them — face escalating legal threats and complexity. This qualitative case-control community-based participatory research study describes how legal problem-solving supports for reproductive care teams serving mothers with opioid use disorder are protective for both patients and care team members. We describe how medical legal partnerships (MLPs) can promote Reproductive Justice and argue for wider adoption of care-team facing legal supports.

This article examines the development of Russell's treatment of propositions, in relation to the topic of psychologism. In the first section, we outline the concept of psychologism, and show how it can arise in relation to theories of the nature of propositions. Following this, we note the anti-psychologistic elements of Russell's thought dating back to his idealist roots. From there, we sketch the development of Russell's theory of the proposition through a number of its key transitions. We show that Russell, (...) in responding to a variety of different problems relating to the proposition, chose to resolve these problems in ways that continually made concessions to psychologism. (shrink)

Due to the controversy surround his political war-time writings, Nishida Kitarō and his entire corpus has been accused of promoting and supporting Japanese imperialism. Despite the valid criticisms of his writings during the war-time period, Nishida’s early work in An Inquiry into the Good is not so easily interpreted as supporting nationalism. In fact, depending on the lens through which one reads Nishida’s early writings, one can even find the germs of emancipatory ideas that can easily be put in dialogue (...) with other liberatory thinkers such as Marx, Kropotkin, and Adorno. In this article, by considering the pluripotentiality of the text rather than a hermetically sealed off nationalist reading of it, I reread the ethical politics in An Inquiry into the Good through an emancipatory lens, considering how Nishida’s thought could have been taken up in a very different post-1911 Japan that did not move toward authoritarian militarism. Furthermore, I argue that the ambiguity surrounding his early political writings is consistent with his resistance to authoritarian ethics and his emphasis on the autonomy of the individual. (shrink)

The concept of autonomy as self-sovereignty is developed in this essay through an examination of the thought of American transcendentalist philosophers Emerson and Thoreau. It is conceived as the quality of living in accordance with one’s inner nature or genius. This conception is grounded in a transcendentalist moral anthropology that values independence, self-reliance, spirituality, and the capacity to find beauty in the world. Though still exerting considerable popular and academic influence, both the concept of autonomy as self-sovereignty and the underlying (...) anthropology diverge in important ways from counterparts that are prominent in contemporary bioethics. Autonomy as self-sovereignty calls into question the manifold ways that patients (and citizens) are brought to heel by institutional (and political) values they do not themselves affirm. It also emphasizes the inevitable deep plurality of moral visions of health and appropriate healthcare, rejecting tendencies (strong in mainstream bioethics) to regard “health” as a univocal concept or healthcare as a basic need, to attempt to conform “reasonable” clinical decision-making to a single model, and to appoint government as a guarantor of access to healthcare or a regulator of healthcare standards. Autonomy as self-sovereignty, like its competitors, can justify itself only in question-begging terms. Still, bioethics might do well to recognize it within the mix of moral visions. (shrink)

By articulating a Peircean strain of bioethical inquiry, Elizabeth Cooke admirably attempts to avert the anti-realism, subjectivism and focus on consensus that afflict much so-called “pragmatic” bioethics. Yet, like many of her Deweyan colleagues, she falls prey to the egalitarian conviction that inquiry should be undertaken by huge numbers of like-minded individuals, proceeding in accordance with an authoritative canon of rules of discourse. In this essay, I argue that Cooke's egalitarianism is inconsistent with her apparent commitment to Peirce, and that (...) an alternative, libertarian account of inquiry is better and truer to Peirce. (shrink)

The medical profession, challenged by critics and reformers, is hard-pressed to give account of itself. Just what do physicians stand for? What do they revere? Where are they headed? These questions are becoming increasingly important yet increasingly difficult to answer, by established physicians and aspiring medical students alike. The perceived paralysis in the face of such questions and challenges is the central problem around which this book was written. To correct this failure, Dr. Trotter proposes the application of Josiah Royce's (...) "philosophy of loyalty" and the related thought of Alasdair MacIntyre to the practice of medicine. Uniquely qualified as both a professionally trained philosopher and an experienced physician, Trotter is the first to apply systematic philosophical precepts to this fundamentally important professional discipline. (shrink)

Based mainly on unpublished papers this is the first detailed study of the early, neo-Hegelian period of Bertrand Russell's career. It covers his philosophical education at Cambridge, his conversion to neo-Hegelianism, his ambitious plans for a neo-Hegelian dialectic of the sciences and the problems which ultimately led him to reject it.

Studies the central topics of Wittgenstein's philosophy prior to and within the first parts of the Tractatus, covering such subjects as objects, substance, states of affairs, elementary propositions, pictures, and thoughts. He concludes that analysis is reduction to what is basic not in experience but in reference, and argues that the Tractatus is concerned not with problems of knowledge but with problems of sense.

The ethical value—and to some scholars, necessity—of providing trial patients with post-trial access (PTA) to an investigational drug has been subject to significant attention in the field of research ethics. Although no consensus has emerged, it seems clear that, in some trial contexts, various factors make PTA particularly appropriate. We outline the atypical aspects of psychedelic clinical trials that support the case for introducing the provision of PTA within research in this field, including the broader legal status of psychedelics, the (...) nature of the researcher-therapist/participant relationship, and the extended time-frame of the full therapeutic process. As is increasingly understood, the efficacy of psychedelic-assisted psychotherapy is driven as much by extrapharmacological elements and the cultural therapeutic container as by the drug itself. As such, we also advocate for a refocusing of attention from post-trial access to a broader concept encompassing other elements of post-trial care. We provide an overview of some of the potential post-trial care provisions that may be appropriate in psychedelic clinical trials. Although the World Medical Association’s Declaration of Helsinki calls on researchers, sponsors, and governments to make provisions for post-trial access, such provision may feel impracticable or out-of-reach within psychedelic trials that are already constrained by a high resource demand and significant bureaucratic burden. We show how conceiving of post-trial provision as an integral site of the research process, and an appropriate destination for research funding, will serve to develop the infrastructure necessary for the post-legalisation psychedelic medicine ecosystem. (shrink)

Decision making is the physician's major activity. Every day, in doctors' offices throughout the world, patients describe their symptoms and com plaints while doctors perform examinations, order tests, and, on the basis of these data, decide what is wrong and what should be done. Although the process may appear routine-even to the physicians in volved-each step in the sequence requires skilled clinical judgment. Physicians must decide: which symptoms are important, whether any laboratory tests should be done, how the various items (...) of clinical data should be combined, and, finally, which of several treatments (including doing nothing) is indicated. Although much of the information used in clinical decision making is objective, the physician's values (a belief that pain relief is more important than potential addiction to pain-killing drugs, for example) and subjectivity are as much a part of the clinical process as the objective findings of laboratory tests. In recent years, both physicians and psychologists have come to realize that patient management decisions are not only subjective but also prob abilistic (although this is not always acknowledged overtly). When doc tors argue that an operation is fairly safe because it has a mortality rate of only 1 %, they are at least implicitly admitting that the outcome of their decision is based on probability. (shrink)