Intuition in medical and moral reasoning -- Moral intuitionism -- The place of Aristotelian phronesis in clinical reasoning -- Aristotle's practical syllogism: accounting for the individual through a theory of action and cognition -- Individual and statistical physiognomy: the art and science of making the invisible visible -- Clinical intuition versus statistical reasoning -- Contingency and correlation: the significance of modeling clinical reasoning on statistics -- Abduction: the intuitive support of clinical induction -- Conclusion: medical ethics beyond ontology.

An English language translation accompanies the original Greek text of Aristotle's book about the nature of the state, constitutions, revolutions, democracy, and oligarchy.

This work was the first sustained philosophical study of psychic phenomena to follow C.D. Broad's LECTURES ON PSYCHICAL RESEARCH, written nearly twenty years ...

We are immersed within an odorous sea of chemical currents that we parse into individual odors with complex structures. Odors have been posited as determined by the structural relation between the molecules that compose the chemical compounds and their interactions with the receptor site. But, naturally occurring smells are parsed from gaseous odor plumes. To give a comprehensive account of the nature of odors the chemosciences must account for these large distributed entities as well. We offer a focused review of (...) what is known about the perception of odor plumes for olfactory navigation and tracking, which we then connect to what is known about the role odorants play as properties of the plume in determining odor identity with respect to odor quality. We end by motivating our central claim that more research needs to be conducted on the role that odorants play within the odor plume in determining odor identity. (shrink)

Keith Augustine’s critical evaluation of the essay contest sponsored by the Bigelow Institute of Consciousness Studies (BICS) is an interesting but problematic review. It mixes reasonable and detailed criticisms of the contest and many of the winning essays with a disappointing reliance on some of the most trite and superficial criticisms of parapsychological research. Ironically, Augustine criticizes the winning essays for using straw-man arguments and cherry-picked evidence even though many of his own arguments commit these same errors.

The right temporo-parietal junction (rTPJ) has been associated with two apparently disparate functional roles: in attention and in social cognition. According to one account, the rTPJ initiates a “circuit-breaking” signal that interrupts ongoing attentional processes, effectively reorienting attention. It is argued this primary function of the rTPJ has been extended beyond attention, through a process of evolutionarily cooption, to play a role in social cognition. We propose an alternative account, according to which the capacity for social cognition depends on a (...) network which is both distinct from and in tension with brain areas involved in focused attention and target detection: the default mode network. Theory characterizing the rTPJ based on the area’s purported role in reorienting may be falsely guided by the co-occurrence of two distinct effects in contiguous regions: activation of the supramarginal gyrus (SMG), associated with its functional role in target detection; and the transient release, during spatial reorienting, of suppression of the angular gyrus (AG) associated with focused attention. Findings based on meta-analysis and resting functional connectivity are presented which support this alternative account. We find distinct regions, possessing anti-correlated patterns of resting connectivity, associated with social reasoning (AG) and target detection (SMG) at the rTPJ. The locus for reorienting was spatially intermediate between the AG and SMG and showed a pattern of connectivity with similarities to social reasoning and target detection seeds. These findings highlight a general methodological concern for brain imaging. Given evidence that certain tasks not only activate some areas but also suppress activity in other areas, it is suggested that researchers need to distinguish two distinct putative mechanisms, either of which may produce an increase in activity in a brain area: functional engagement in the task versus release of suppression. (shrink)

Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through (...) analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine’s epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi’s theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine. (shrink)

INTRODUCTION Back in the good old days of philosophy — say, around 400 BC, philosophers played a rather prominent role in the community at large. ...

Evidential Decision Theory and Causal Decision Theory are the leading contenders as theories of rational action, but both face counterexamples. We present some new counterexamples, including one in which the optimal action is causally dominated. We also present a novel decision theory, Functional Decision Theory, which simultaneously solves both sets of counterexamples. Instead of considering which physical action of theirs would give rise to the best outcomes, FDT agents consider which output of their decision function would give rise to the (...) best outcome. This theory relies on a notion of subjunctive dependence, where multiple implementations of the same mathematical function are considered to have identical results for logical rather than causal reasons. Taking these subjunctive dependencies into account allows FDT agents to outperform CDT and EDT agents in, for example, the presence of accurate predictors. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Multiple Personality and Moral ResponsibilityStephen E. Braude (bio)AbstractThe philosophical literature on multiple personality has focused primarily on problems about personal identity and psychological explanation. But multiple personality and other dissociative phenomena raise equally important and even more urgent questions about moral responsibility, in particular: In what respect(s) and to what extent should a multiple be held responsible for the actions of his/her alternate personalities? Cases of dreaming help (...) illustrate why attributions of responsibility in cases of dissociation do not turn on putative changes in identity, as some have supposed. Instead, it is argued that traditional criteria of rationality and behavioral control apply also to cases of dissociation. It is noted, however, that one can distinguish different kinds of responsibility in cases of dissociation, and that one is responsible for one’s dreams in a different sense from that in which one is responsible for actions one can control and evaluate. It is also argued that in cases of multiple personality it is important to distinguish control over switching of personalities from an alter’s control over its own behavior. Moreover, the author considers reasons for thinking that amnesia is less relevant to attributions of responsibility than many have supposed.Keywordsdissociation, dreaming, rationality, amnesiaIntroductionThe philosophical literature on MPD/DID 1 has focused primarily on problems about personhood, personal identity, and the nature of psychological explanation. Presumably, that is because multiples appear to be (or to harbor) more than one person or more than one distinct moral or prudential agent. But philosophers have had almost nothing to say about problems of responsibility in these cases—in particular, the question: In what respect(s) and to what extent should a multiple be held responsible for the actions of his/her alternate personalities (or alters)?Unlike questions about personhood and identity, this question is not simply an abstract matter that we may ponder at our leisure. Clinicians treating multiples must decide whether it is appropriate—or even just therapeutically beneficial—to hold their patients (or specific alters) responsible for behaviors which they seem unable to control or remember. Similarly, and with increasing frequency, our courts must decide whether a defendant claiming to be a multiple may be held guilty for the actions of one or more alters. In fact, the legal issues can be quite dramatic, and even bizarre. Consider: What sort of individual is standing trial? An alter or the multiple as a whole? Should courts accept the claim that the subject being questioned on the stand is not the same as the subject who committed the crime? If so, other questions come immediately to mind. For example, would it be appropriate for each alter of a criminal defendant to have separate legal council?Undoubtedly, some will have trouble taking that last question seriously. But no matter how [End Page 37] clear its solution may appear to one’s moral or legal intuitions, those intuitions are seldom as straightforward as they seem. Indeed, one cannot explain or defend them without taking a stand, at least provisionally, on a wide range of thorny philosophical problems. Moreover, the aforementioned questions are merely the tip of the iceberg, and our answers to them have implications extending beyond the courtroom. For example, with regard to forensic contexts Slovenko (1991) asks,Should a search or arrest warrant be issued for each personality? Must a Miranda warning be given to each personality of a suspect with MPD? May the other personalities exclude evidence on the ground that they were not properly read their rights at the time of the arrest? Would each one of the personalities have to waive his or her rights, or would one waiver be sufficient? Does the doctrine of double jeopardy bar the trial of a personality when another has been put to trial? Must each personality testifying at trial be sworn in and administered the oath?(22, 25)These questions have obvious analogues in clinical situations, and also in personal contexts, say, between friends or members of a family, one of whom is a multiple. For example, to what extent should a DID patient be held responsible for the sociopathic (or simply counter-therapeutic) behavior of... (shrink)

The philosophical literature on multiple personality has focused primarily on problems about personal identity and psychological explanation. But multiple personality and other dissociative phenomena raise equally important and even more urgent questions about moral responsibility, in particular: In what respect(s) and to what extent should a multiple be held responsible for the actions of his/her alternate personalities? Cases of dreaming help illustrate why attributions of responsibility in cases of dissociation do not turn on putative changes in identity, as some have (...) supposed. Instead, it is argued that traditional criteria of rationality and behavioral control apply also to cases of dissociation. It is noted, however, that one can distinguish different kinds of responsibility in cases of dissociation, and that one is responsible for one's dreams in a different sense from that in which one is responsible for actions one can control and evaluate. It is also argued that in cases of multiple personality it is important to distinguish control over switching of personalities from an alter's control over its own behavior. Moreover, the author considers reasons for thinking that amnesia is less relevant to attributions of responsibility than many have supposed. (shrink)

Sells encourages a radical departure from the usual introspection and self-centeredness of psychology in our time. By placing style first, Sells argues that we must turn our eyes and minds outward to the greater world. Emphasizing beauty over emotion and appreciation over feeling, he attempts to break the stranglehold of the self so as to reconstitute our proper place among the many things of the world.

Dans ce long inédit, Benjamin Fondane révèle les implications philosophiques révolutionnaires qui découlent des travaux de Lévy-Bruhl (1857-1939) sur la mentalité primitive. En mettant à jour les mécanismes d'une logique différente, Lévy-Bruhl fait voler en éclat l'universalité de la logique d'Aristote sur laquelle repose notre pensée occidentale. Dès lors cette logique n'est rien d'autre qu'une arme politique qui fonde l'hégémonie de la rationalité.0La démonstration de Fondane est implacable et bouleverse notre conception de la philosophie. Il nous incite à reconsidérer (...) nos manières de penser et de vivre sous la contrainte de la raison, faisant écho à une tradition non aristotélicienne qu'incarnent des penseurs comme Michelstaedter, Lukasiewicz ou Alfred Korzybski. (shrink)

Introduction. Rest and motion. Stability and progress.--The meaning of justice. The science of values.--The equilibration of interests. Cause and effect. The individual and society. Liberty and government.--Liberty and government. Conclusion.

This paper compares clinical intuition and phenomenological intuition. I begin with a brief analysis of Husserl’s conception of intuition. Second, I review the attitude toward clinical intuition by physicians and philosophers. Third, I discuss the Aristotelian conception of intellectual intuition or nous and its relation to phronesis. Phronesis provides a philosophical ground for clinical intuition by linking medicine as both a techné and praxis. Considering medicine as a techné, Pellegrino and Thomasma exclude clinical intuitions from their philosophy of medicine. However, (...) in modeling clinical reasoning on phronesis, they link Aristotelian nous with clinical reasoning. While supporting the application of phronesis to clinical reasoning, I consider Pellegrino and Thomasma’s model deficient for eliminating intuition as an inalienable element of clinical reasoning. Rather, clinical intuitions are necessary in linking medicine as both art and practice. This becomes more obvious through the phenomenological analysis of clinical intuitions. Clinical reasoning and phenomenological intuitions are similar in joining the perceptual and intellectual aspects of human judgment. Furthermore, clinical intuitions can be extended to become phenomenological intuitions through phenomenological reflection. Clinical intuitions may be examined phenomenologically for their originary foundations. In this way, medicine acts as a phenomenological clue. Phenomenology provides a method to restore the Hippocratic synthesis of empirical observation and wholism associated with clinical intuitions. (shrink)

This article argues that teachers of environmental ethics must more aggressively entertain questions of private property in their work and in their teaching. To make this case, it first introduces the three primary positions on property: occupation arguments, labor theory of value arguments, and efficiency arguments. It then contextualizes these arguments in light of the contemporary U.S. wise-use movement, in an attempt to make sense of the concerns that motivate wise-use activists, and also to demonstrate how intrinsic value arguments miss (...) the mark. Finally, it offers some suggestions about further directions for environmental ethics, reasoning that there is a good deal of headway to be gained for environmental ethics by accepting that nature can be owned as property, but nevertheless engaging the idea of private property critically. (shrink)

The so-called “problem of personal identity” can be viewed as either a metaphysical or an epistemological issue. Metaphysicians want to know what it is for one individual to be the same person as another. Epistemologists want to know how to decide if an individual is the same person as someone else. These two problems converge around evidence from mediumship and apparent reincarnation cases, suggesting personal survival of bodily death and dissolution. These cases make us wonder how it might be possible (...) for a person to survive death and either temporarily or permanently animate another body. And they make us wonder how we could decide if such postmortem survival has actually occurred. In this essay I argue, first, that metaphysical worries about postmortem survival are less important than many have supposed. Next, I'll consider briefly why cases suggesting postmortem survival can be so intriguing and compelling, and I'll survey our principal explanatory options and challenges. Then, I'll consider why we need to be circumspect in our appraisal of evidence for mind-body correlations. And finally, I'll try to draw a few tentative and provocative conclusions. (shrink)

The Limits of Influence is a detailed examination and defense of the evidence for largescale-psychokinesis . It examines the reasons why experimental evidence has not, and perhaps cannot, convince most skeptics that PK is genuine, and it considers why traditional experimental procedures are important to reveal interesting facts about the phenomena.

La Conscience malheureuse est un ouvrage majeur de la philosophie existentielle des années trente. Jeune poète et critique roumain expatrié en France en 1923, Benjamin Fondane (1898-1944) fait partie de ces auteurs hantés par l'absence de Dieu dans la culture rationaliste moderne marquée par le positivisme. D'abord proche de l'esprit subversif du dadaïsme, il identifie rapidement sa révolte par l'absurde à la démarche ironique et irrationaliste du philosophe russe émigré en France Léon Chestov. C'est l'adhésion sans conditions à sa (...) philosophie existentielle à partir de 1929 qui lui permet de déconstruire la tradition du logos issue d'Athènes. Il ne cessera dès lors de dénoncer un conflit profond entre le " réel " construit par la culture rationaliste et l'existant singulier, entre le savoir et le " non-voir " des poètes et de certains mystiques, entre Athènes et Jérusalem: ce divorce intime, c'est celui de la " conscience malheureuse ". (shrink)

Given that as much as half of human thought arises in a stimulus independent fashion, it would seem unlikely that such thoughts would play no functional role in our lives. However, evidence linking the mind-wandering state to performance decrement has led to the notion that mind-wandering primarily represents a form of cognitive failure. Based on previous work showing a prospective bias to mind-wandering, the current study explores the hypothesis that one potential function of spontaneous thought is to plan and anticipate (...) personally relevant future goals, a process referred to as autobiographical planning. The results confirm that the content of mind-wandering is predominantly future-focused, demonstrate that individuals with high working memory capacity are more likely to engage in prospective mind-wandering, and show that prospective mind-wandering frequently involves autobiographical planning. Together this evidence suggests that mind-wandering can enable prospective cognitive operations that are likely to be useful to the individual as they navigate through their daily lives. (shrink)

This chapter contains sections titled: References Further reading.

The book contends that contrary to accepted interpretation, moral intuition, rather than any other form of reasoning, least of all formal logic, is the moral method found in the ethics of Aristotle, Aquinas, Kant and Dewey - the first four chapters of the book. These four thinkers represent a dialectical selection of ethical relativism and absolutism as well as a chronological succession from ancient to contemporary thought. The fifth and concluding chapter is a major presentation of the author's thesis on (...) moral intuition as the exact antidote against the dilemma ethics approach, which is widely used today with rapidly diminishing effect and interest. This chapter is a detailed illustration of how moral intuition works out concretely in the lived world. It stresses the unity of moral experience even as this is clouded over by our relatively fewer, but overdramatized, confrontations on some moral issues. (shrink)

This article applies the anthropological concept of liminality to reconceptualize palliative care ethics. Liminality possesses both spatial and temporal dimensions. Both these aspects are analyzed to provide insight into the intersubjective relationship between patient and caregiver in the context of palliative care. Aristotelian practical wisdom, or phronesis, is considered to be the appropriate model for palliative care ethics, provided it is able to account for liminality. Moreover, this article argues for the importance of liminality for providing an ethical structure that (...) grounds the doctrine of double effect and overcomes the impasse of phronesis in the treatment of the terminally ill. (shrink)

This paper examines the ways in which familiar views about the world and our place in it must change in the face of the reality of psi phenomena. It is argued that most commentators are confused on this topic. Contrary to the received opinion, the existence of psi should make almost no difference to our currently accepted body of scientific theories. Nor, as some argue, can it be of much help to a defense of dualism. But the existence of psi (...) has profound implications regarding the pervasiveness of intentions in the world, even in connection with everyday sorts of events. The view is defended that we have no grounds for imposing antecedent restrictions on the range, magnitude, or refinement of psi. Finally, the paper discusses how the evidence for precognition forces serious consideration of a world?view generally associated only with so?called ?primitive? cultures. (shrink)

Over the past several decades the ‘affective revolution’ in cognitive psychology has emphasized the critical role affect and emotion play in human decision-making. Drawing on this affective literature, various commentators have recently proposed strategies for managing therapeutic expectation that use contextual, symbolic, or emotive interventions in the consent process to convey information or enhance comprehension. In this paper, we examine whether affective consent interventions that target affect and emotion can be reconciled with widely accepted standards for autonomous action. More specifically, (...) the ethics of affective consent interventions is assessed in terms of key elements of autonomy, comprehension and voluntariness. While there may appear to be a moral obligation to manage the affective environment to ensure valid informed consent, in circumstances where volunteers may be prone to problematic therapeutic expectancy, this moral obligation needs to be weighed against the potential risks of human instrumentalization. At this point in time we do not have enough information to be able to justify clearly the programmatic manipulation of human subjects' affective states. The lack of knowledge about affective interventions requires corresponding caution in its ethical justification. (shrink)

Shadow of the Other is a discussion of how the individual has two sorts of relationships with an "other"--other individuals. The first regards the other as a s work apart is her brilliant utilization of a systematic dialectical approach to her subject, always maintaining the delicate balance between opposing tensions: masculinity and femininity, subjectivity and objectivity, passivity and activity, love and aggression, fantasy and reality, modernism and postmodernism, the intrapsychic and the intersubjective. Benjamin s work apart is her brilliant (...) utilization of a systematic dialectical approach to her subject, always maintaining the delicate balance between opposing other as a mental repository fo unwanted characteristics cast from the self. Jessica benjamin shows the implications of this dual relationship for male/female hierarchy and offers a possibility for balancing the two. This book continues the author's well-known explorations of the themes of intersubjectivity and gender, taking up issues at the forefront of contemporary debates in feminist theory and psychoanalysis. (shrink)

It is often thought that traditional recidivism prediction tools used in criminal sentencing, though biased in many ways, can straightforwardly avoid one particularly pernicious type of bias: direct racial discrimination. They can avoid this by excluding race from the list of variables employed to predict recidivism. A similar approach could be taken to the design of newer, machine learning-based (ML) tools for predicting recidivism: information about race could be withheld from the ML tool during its training phase, ensuring that the (...) resulting predictive model does not use race as an explicit predictor. However, if race is correlated with measured recidivism in the training data, the ML tool may ‘learn’ a perfect proxy for race. If such a proxy is found, the exclusion of race would do nothing to weaken the correlation between risk (mis)classifications and race. Is this a problem? We argue that, on some explanations of the wrongness of discrimination, it is. On these explanations, the use of an ML tool that perfectly proxies race would (likely) be more wrong than the use of a traditional tool that imperfectly proxies race. Indeed, on some views, use of a perfect proxy for race is plausibly as wrong as explicit racial profiling. We end by drawing out four implications of our arguments. (shrink)

For over thirty years, Stephen Braude has studied the paranormal in everyday life, from extrasensory perception and psychokinesis to mediumship and materialization. _The Gold Leaf Lady and Other Parapsychological Investigations_ is a highly readable and often amusing account of his most memorable encounters with such phenomena. Here Braude recounts in fascinating detail five particular cases—some that challenge our most fundamental scientific beliefs and others that expose our own credulousness. Braude begins with a south Florida woman who can (...) make thin gold-colored foil appear spontaneously on her skin. He then travels to New York and California to test psychokinetic superstars—and frauds—like Joe Nuzum, who claim to move objects using only their minds. Along the way, Braude also investigates the startling allegations of K.R., a policeman in Annapolis who believes he can transfer images from photographs onto other objects—including his own body—and Ted Serios, a deceased Chicago elevator operator who could make a variety of different images appear on Polaroid film. Ultimately, Braude considers his wife’s surprisingly fruitful experiments with astrology, which she has used to guide professional soccer teams to the top of their leagues, as well as his own personal experiences with synchronicity—a phenomenon, he argues, that may need to be explained in terms of a refined, extensive, and dramatic form of psychokinesis. Heady, provocative, and brimming with eye-opening details and suggestions, _The Gold Leaf Lady and Other Parapsychological Investigations_ will intrigue both adherents and detractors of its controversial subject matter alike. (shrink)

We have seen that we cannot de-tense a sentence like (15) simply by changing its verb, since the tense of such a sentence is determined by a temporal adverb. More importantly, we have seen that de-tensing is a process of removing certain temporal restrictions from the truth-conditions of tensed sentences, and that tensed and tenseless forms of a verb do not differ in sense. Once we understand this, and once we realize that it is an historical accident that the tense (...) of sentences in English if often indicated by means of the grammatical device of inflecting verbs, tensed verbs no longer seem to be the sort of item that needs to be purged from ordinary language in constructing its tenseless analogue. Indeed, although the distinction between tensed and tenseless verbs may still be of philosophic interest, this distinction hardly seems to deserve the pivotal role assigned to it in the literature. (shrink)