In our society, some aspects of life are off-limits to commerce. We prohibit the selling of children and the buying of wives, juries, and kidneys. Tainted blood is an inevitable consequence of paying blood donors; even sophisticated laboratory tests cannot supplant the gift-giving relationship as a safeguard of the purity of blood. Like blood, health care is too precious, intimate, and corruptible to entrust to the market.The hospice movement in the United States is approximately 40 years old. During these past (...) four decades, the concept of holistic, multidisciplinary care for patients who are suffering from a terminal illness has evolved from a modest, grassroots constellation of primarily volunteer-run and community-governed endeavors to a multimillion dollar industry where the surviving nonprofits compete with for-profit providers, often publicly traded, managed by M.B.A.-trained executives, and governed by corporate boards. The relatively recent emergence of for-profit hospice reflects an increasing commercialization of health care in the United States, the potentially adverse impact of which has been well documented. (shrink)

While positive information in the context of clinical care can lead to placebo effects, negatively framed information can have negative or nocebo effects. Extant literature documents how doctor–patient encounters are fertile ground for suboptimal interactions leading to negative experiences for ethnoracial minority patients. In their _JME_ paper, Blease presents a critical perspective on the potential for patients’ access to their doctors’ clinical notes, ‘open notes’, to engender nocebo effects. 1 In this commentary, we affirm the central claim that nocebo effects (...) could emerge ‘via negative wording or framing of health information expressed by clinicians in documentation’. The advent of electronic health records (EHR) allowed patients the unprecedented opportunity to access personal clinical documentation, giving them a window into decision making around their health. This shift is undoubtedly complex, and thus warrants a more fulsome rendering of the unique challenges faced by ethnoracial minority patients. Herein, we highlight three... (shrink)

Recent work in cognitive neuroscience on the child's Theory of Mind (ToM) has pursued the idea that the ability to metarepresent mental states depends on a domain-specific cognitive subystem implemented in specific neural circuitry: a Theory of Mind Module. We argue that the interaction of several domain-general mechanisms and lower-level domain-specific mechanisms accounts for the flexibility and sophistication of behavior, which has been taken to be evidence for a domain-specific ToM module. This finding is of more general interest since it (...) suggests a parsimonious cognitive architecture can account for apparent domain specificity. We argue for such an architecture in two stages. First, on conceptual grounds, contrasting the case of language with ToM, and second, by showing that recent evidence in the form of fMRI and lesion studies supports the more parsimonious hypothesis. 1. Theory of Mind, Metarepresentation, and Modularity2. Developmental Components of ToM3. The Analogy with Modularity of Language4. Dissociations without Modules5. The Evidence from Neuroscience6. Conclusion. (shrink)

Action research is increasingly used as a means for teachers to improve their instruction, yet for many the idea of doing "research" can be somewhat intimidating. _Using Action Research to Improve Instruction_ offers a comprehensive, easy-to-understand approach to action research in classroom settings. This engaging and accessible guide is grounded in sources of data readily available to teachers, such as classroom observations, student writing, surveys, interviews, and tests. Organized to mirror the action research process, the highly interactive format prompts readers (...) to discover a focus, create research questions, address design and methodology, collect information, conduct data analysis, communicate the results, and to generate evidence-based teaching strategies. Engaging in these decision-making processes builds the skills essential to action research and promotes a deeper understanding of teaching practice. Special Features Include: -An Interactive Text -Reflection Questions and Activity Prompts -A Sample Action Research Report -Numerous Examples and Practice Examples -Numbered Sections for Cross Referencing This original text is a must-read for teachers interested in how they can use their current knowledge of instruction and assessment to meaningfully engage in action research. (shrink)

This article critically questions the commercialization of hospice care and the ethical concerns associated with the industry's movement toward “market-driven medicine” at the end of life. For example, the article examines issues raised by an influx of for-profit hospice providers whose business model appears at its core to have an ethical conflict of interest between shareholders doing well and terminal patients dying well. Yet, empirical data analyzing the experience of patients across the hospice industry are limited, and general claims that (...) end-of-life patient care is inferior among for-profit providers or even that their business practices are somehow unseemly when compared to nonprofit providers cannot be substantiated. In fact, non-profit providers are not immune to potentially conflicting concerns regarding financial viability (i.e., “no margin, no mission”). Given the limitations of existing empirical data and contrasting ideological commitments of for-profit versus non-profit providers, the questions raised by this article highlight important areas for reflection and further study. Policymakers and regulators are cautioned to keep ethical concerns in the fore as an increasingly commercialized hospice industry continues to emerge as a dominant component of the U.S. health care system. Both practitioners and researchers are encouraged to expand their efforts to better understand how business practices and commercial interests may compromise the death process of the patient and patient's family — a process premised upon a philosophy and ethical tradition that earlier generations of hospice providers and proponents established as a trusted, end-of-life alternative. (shrink)

PurposeTo use the power of knowledge acquisition and machine learning in the development of a collaborative computer classification system based on the features of age-related macular degeneration (AMD).MethodsA vocabulary was acquired from four AMD experts who examined 100 ophthalmoscopic images. The vocabulary was analyzed, hierarchically structured, and incorporated into a collaborative computer classification system called IDOCS. Using this system, three of the experts examined images from a second set of digital images compiled from more than 1000 patients with AMD. Images (...) were annotated, and features were identified and defined. Decision trees, a machine learning method, were trained on the data collected and used to extract patterns. Interrelationships between the data from the different clinicians were investigated.ResultsSix drusen classes in the structured vocabulary were largely sufficient to describe all the identified features. The decision trees classified the data with 76.86% to 88.5% accuracy and distilled patterns in the form of hierarchical trees composed of 5 to 15 nodes. Experts were largely consistent in their characterization of soft, and to a lesser extent, hard drusen, but diverge in definition of other drusen. Size and crystalline morphology were the main determinants of drusen type across all experts.ConclusionsMachine learning is a powerful tool for the characterization of disease phenotypes. The creation of a defined feature set for AMD will facilitate the development of an IDOCS-based classification system. (shrink)

This paper proposes that autonomous vehicles should be designed to reduce light pollution. In support of this specific proposal, a moral assessment of autonomous vehicles more comprehensive than the dilemmatic life-and-death questions of trolley problem-style situations is presented. The paper therefore consists of two interrelated arguments. The first is that autonomous vehicles are currently still a technology in development, and not one that has acquired its definitive shape, meaning the design of both the vehicles and the surrounding infrastructure is open-ended. (...) Design for values is utilized to articulate a path forward, by which engineering ethics should strive to incorporate values into a technology during its development phase. Second, it is argued that nighttime lighting—a critical supporting infrastructure—should be a prima facie consideration for autonomous vehicles during their development phase. It is shown that a reduction in light pollution, and more boldly a better balance of lighting and darkness, can be achieved via the design of future autonomous vehicles. Two case studies are examined through which autonomous vehicles may be designed for “driving in the dark.” Nighttime lighting issues are thus inserted into a broader ethics of autonomous vehicles, while simultaneously introducing questions of autonomous vehicles into debates about light pollution. (shrink)

The contributions in this volume map out how technologies are used and designed to plan, maintain, govern, demolish, and destroy the city. The chapters demonstrate how urban technologies shape, and are shaped, by fundamental concepts and principles such as citizenship, publicness, democracy, and nature. The many authors herein explore how to think of technologically mediated urban space as part of the human condition. The volume will thus contribute to the much-needed discussion on technology-enabled urban futures from the perspective of the (...) philosophy of technology. This perspective also contributes to the discussion and process of making cities ‘smart’ and just. This collection appeals to students, researchers, and professionals within the fields of philosophy of technology, urban planning, and engineering. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

Scholars who engage with texts that were written by George Herbert Mead (e.g., 1925e.g., 1926e.g., 1929e.g., 1932e.g., 1938) in the latter half of the 1920s are faced with the task of comprehending Mead’s interpretation of relativity theory and also understanding why relativity theory was considered by Mead to have such profound implications for his own philosophy. As several scholars of Mead’s work have explained (e.g., Joas 1997; Martin 2007; Rosenthal and Bourgeois 1991), Mead was a realist. Mead opposed psychophysical dualism (...) (Cook 1979) and both the behaviorist and the idealist implications that could follow from such a dualism. He wanted to explain human conduct in terms of the self-determination of human .. (shrink)

Evolutionary theories of human cognition should refer to specific times in the primate or hominid past. Though alternative accounts of tool manufacture from Wynn's are possible (e.g., frontal lobe function), Wynn demonstrates the power of archaeology to guide cognitive theories. Many cognitive abilities evolved not in the “Pleistocene hunter-gatherer” context, but earlier, in the context of other patterns of social organization and foraging.

Three experiments examined contributions of study phase awareness of word identity to subsequent word-identification priming by manipulating visual attention to words at study. In Experiment 1, word-identification priming was reduced for ignored relative to attended words, even though ignored words were identified sufficiently to produce negative priming in the study phase. Word-identification priming was also reduced after color naming relative to emotional valence rating (Experiment 2) or word reading (Experiment 3), even though an effect of emotional valence upon color naming (...) (Experiment 2) indicated that words were identified at study. Thus, word-identification priming was reduced even when word identification occurred at study. Word-identification priming may depend on awareness of word identity at the time of study. (shrink)

Technology is no stranger to the city. Cities are planned, built, maintained, governed, demolished, and destroyed by technical means. Yet, the city has yet to receive much attention within the philosophy of technology. This volume addresses this gap, and in doing so contributes to the much-needed discussion on technology-enabled urban futures from the perspective of the philosophy of technology. In this introductory chapter, the larger volume is introduced by reflecting on the rationale and need for such a collection, sketching the (...) main themes analyzed throughout, and providing an overview of the contributions. (shrink)

Recent, well-publicized scandals, involving unethical conduct have rekindled interest in academic misconduct. Prior studies of academic misconduct have focussed exclusively on situational factors (e.g., integrity culture, honor codes), demographic variables or personality constructs. We contend that it is important to also examine how␣these classes of variables interact to influence perceptions of and intentions relating to academic misconduct. In a sample of 217 business students, we examined how integrity culture interacts with Prudence and Adjustment to explain variance in estimated frequency of (...) cheating, suspicions of cheating, considering cheating and reporting cheating. Age, integrity culture, and personality variables were significantly related to different criteria. Overall, personality variables explained the most unique variance in academic misconduct, and Adjustment interacted with integrity culture, such that integrity culture had more influence on intentions to cheat for less well-adjusted individuals. Implications for practice are discussed and future research directions are offered. (shrink)

Public Health Science and practice expanded during the course of the 20th century. Initially focused on controlling infectious disease through basic public health programs regulating water, sanitation and food, by 1988 the Institute of Medicine broadly declared that “public health is what we, as a society, do collectively to. assure the conditions for people to be healthy.” Commensurate with this definition, public health practitioners and policymakers today work on ;in enormous range of issues. The 2002 policy agenda of the American (...) Public Health Association reflects positions on genomics’ role in public health; national health and safety standards for child care programs; sodium in Americans’ diets; the health and safety of emergency rescue workers; and war in Central Asia and the Persian Gulf. (shrink)

Local food systems can have economic and social benefits by providing income for producers and improving community connections. Ongoing global climate change and the acute COVID-19 pandemic crisis have shown the importance of building equity and resilience in local food systems. We interviewed ten stakeholders from organizations and institutions in a U.S. midwestern city exploring views on past, current, and future conditions to address the following two objectives: 1) Assess how local food system equity and resilience were impacted by the (...) COVID-19 pandemic, and 2) Examine how policy and behavior changes could support greater equity and resilience within urban local food systems. We used the Community Capitals Framework to organize interviewees’ responses for qualitative analyses of equity and resilience. Four types of community capital were emphasized by stakeholders: cultural and social, natural, and political capital. Participants stated that the local food system in this city is small; more weaknesses in food access, land access, and governance were described than were strengths in both pre- and post-pandemic conditions. Stakeholder responses also reflected lack of equity and resilience in the local food system, which was most pronounced for cultural and social, natural and political capitals. However, local producers’ resilience during the pandemic, which we categorized as human capital, was a notable strength. An improved future food system could incorporate changes in infrastructure (e.g., food processing), markets (e.g., values-based markets) and cultural values (e.g., valuing local food through connections between local producers and consumers). These insights could inform policy and enhance community initiatives and behavior changes to build more equitable and resilient local food systems in urban areas throughout the U.S. Midwest. (shrink)