Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)
The advent of personal genomics companies offering direct translation of scientific data into personal health information, calls into question traditional policies to refuse disclosure of such scientific data to research participants. This seems especially true for population biobanks, as they collect not only genotype information but also associated phenotype information, and thus may be in a unique position to translate their scientific findings into personal health information for their participants. Disclosure of such information seems mandated by the expectations raised by (...) biobanks and their participants' rights to know health information, to know clinical research results, to life and health and particularly their right to benefit. Refusals to disclose such information can be grounded in the lack of analytical validity and/or clinical utility of most findings, the need to avoid the therapeutic misconception, the complexity and costs involved in translation and disclosure and the disproportionate burden resulting from the obligation to respect participants' right not to know before any disclosure can be made. Currently, any demands by participants in population biobanks for full disclosure of all pertinent personal health information potentially resulting from the biobank's scientific findings are unlikely to be granted by a Dutch court under Dutch and international law. As the law stands now, a population biobank is neither a doctor nor a personal genomics company. However, in view of the rapid scientific, medical, technological, commercial and social developments, population biobanks must prepare to take more care of their participants' legitimate interest in receiving as much validated personal health information as reasonably possible, in a timely fashion, by developing appropriate translation and disclosure mechanisms. This paper examines whether population biobank participants have the right, under Dutch civil law and international law, to full disclosure, i.e. to all information generated by the biobank that is pertinent to their present and future health. It pioneers the format of a hypothetical court case to elucidate the legal and policy arguments" for and against full disclosure. (shrink)
We analyze G.M. Hardegree's interpretation of the Sasaki hook as a Stalnaker conditional and explain how he makes use of the basic conceptual machinery of OQL, i.e. the operational quantum logic which originated with the Geneva Approach to the foundations of physics. In particular we focus on measurements which are ideal and of the first kind, since these encode the content of the so-called Sasaki projections within the Geneva Approach. The Sasaki projections play a fundamental role when analyzing the condition (...) under which the properties expressed by Sasaki hooks can be considered as actual. We finish with a note on how the Sasaki hook can be conceived as ``assigning causes for properties to be actual", which links the interpretation of G.M. Hardegree to what has been called ``dynamic OQL". (shrink)
In this paper we show how recent concepts from Dynamic Logic, and in particular from Dynamic Epistemic logic, can be used to model and interpret quantum behavior. Our main thesis is that all the non-classical properties of quantum systems are explainable in terms of the non-classical flow of quantum information. We give a logical analysis of quantum measurements (formalized using modal operators) as triggers for quantum information flow, and we compare them with other logical operators previously used to model various (...) forms of classical information flow: the “test” operator from Dynamic Logic, the “announcement” operator from Dynamic Epistemic Logic and the “revision” operator from Belief Revision theory. The main points stressed in our investigation are the following: (1) The perspective and the techniques of “logical dynamics” are useful for understanding quantum information flow. (2) Quantum mechanics does not require any modification of the classical laws of “static” propositional logic, but only a non-classical dynamics of information. (3) The main such non-classical feature is that, in a quantum world, all information-gathering actions have some ontic side-effects. (4) This ontic impact can affect in its turn the flow of information, leading to non-classical epistemic side-effects (e.g. a type of non-monotonicity) and to states of “objectively imperfect information”. (5) Moreover, the ontic impact is non-local: an information-gathering action on one part of a quantum system can have ontic side-effects on other, far-away parts of the system. (shrink)
The usual way for new cells to come into being is by division of old cells. So the zygote, which is a—new—single cell formed from two, the sperm and ovum, is an exception. Textbooks of human genetics usually say that this new cell is beginning of a new human individual. What this indicates is that they suddenly forget about identical twins.
In this article, I examine the moral dimensions of gender affirmation. I argue that the moral value of gender affirmation is rooted in what Iris Murdoch called loving attention. Loving attention is central to the moral value of gender affirmation because such affirmation is otherwise too fragile or insincere to have such value. Moral reasons to engage in acts that gender affirm derive from the commitment to give and express loving attention to trans people as a way of challenging their (...) marginalization. In the latter part of the paper, I will discuss how my arguments bear on recent arguments by Robin Dembroff and Daniel Wodak (2018) on the use of gender-neutral language. They argue that we have a duty not to use gender-specific pronouns for anyone. Their conclusion turns, in part, on a rejection of gender affirmation as a moral duty. The value of gender affirmation, rooted in our moral perception of trans people, should make us skeptical of this conclusion, in favor of a more nuanced and pluralistic approach to the ethics of gendering. (shrink)
One of the ways of dividing all philosophers into two kinds is by saying of each whether he is an ordinary man's philosopher or a philosophers' philosopher. Thus Plato is a philosophers' philosopher and Aristotle an ordinary man's philosopher. This does not depend on being easy to understand: a lot of Aristotle's Metaphysics is immensely difficult. Nor does being a philosophers' philosopher imply that an ordinary man cannot enjoy the writings, or many of them. Plato invented and exhausted a form: (...) no one else has written such dialogues. So someone with no philosophical bent, or who has left his philosophical curiosity far behind may still enjoy reading some of them. (shrink)
Philosophers of action and perception have reached a consensus: the term ‘intentionality’ has significantly different senses in their respective fields. But Anscombe argues that these distinct senses are analogically united in such a way that one cannot understand the concept if one focuses exclusively on its use in one’s preferred philosophical sub-discipline. She highlights three salient points of analogy: (i) intentional objects are given by expressions that employ a “description under which;” (ii) intentional descriptions are typically vague and indeterminate; and (...) (iii) intentional descriptions may be false. I explore these three features as they apply to both perception and action and defend Anscombe’s view that the analogical concept of intentionality is a grammatical concept. That is, there are two distinctive linguistic/social practices that involve, respectively, a special sense of the question ‘Why?’ and a special sense of the question ‘What?’ To competently ask and answer the questions that constitute these practices not only reflects, but also conveys a grammatical understanding of intentionality’s basic, formal structure. (shrink)
The strong weak truth table (sw) reducibility was suggested by Downey, Hirschfeldt, and LaForte as a measure of relative randomness, alternative to the Solovay reducibility. It also occurs naturally in proofs in classical computability theory as well as in the recent work of Soare, Nabutovsky, and Weinberger on applications of computability to differential geometry. We study the sw-degrees of c.e. reals and construct a c.e. real which has no random c.e. real (i.e., Ω number) sw-above it.