The informed consent process is the legal embodiment of the fundamental right of the individual to make decisions affecting his or her health., and the patient’s permission is a crucial form of respect of freedom and dignity, it becomes extremely important to enhance the patient’s understanding and recall of the information given by the physician. This statement acquires additional weight when the medical treatment proposed can potentially be detrimental or even fatal. This is the case of thalassemia patients pertaining to (...) class 3 of the Pesaro classification where Allogenic hematopoietic stem cell transplantation remains the only potentially curative treatment. Unfortunately, this kind of intervention is burdened by an elevated transplantation-related mortality risk , equal to 30% according to published reports. In thalassemia, the role of the patient in the informed consent process leading up to HSCT has not been fully investigated. This study investigated the hypothesis that information provided by physicians in the medical scenario of HSCT is not fully understood by patients and that misunderstanding and communication biases may affect the clinical decision-making process. (shrink)

BackgroundBeta thalassemia major is a severe inherited form of hemolytic anemia that results from ineffective erythropoiesis. Allogenic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative therapy. Unfortunately, the subgroup of adult thalassemia patients with hepatomegaly, portal fibrosis and a history of irregular iron chelation have an elevated risk for transplantation-related mortality that is currently estimated to be about 29 percent.DiscussionThalassemia patients may be faced with a difficult choice: they can either continue conventional transfusion and iron chelation therapy or (...) accept the high mortality risk of HSCT in the hope of obtaining complete recovery.Throughout the decision making process, every effort should be made to sustain and enhance autonomous choice. The concept of conscious consent becomes particularly important. The patient must be made fully aware of the favourable and adverse outcomes of HSCT. Although it is the physician's duty to illustrate the possibility of completely restoring health, considerable emphasis should be put on the adverse effects of the procedure. The physician also needs to decide whether the patient is eligible for HSCT according to the "rule of descending order". The patient must be given full details on self-care and fundamental lifestyle changes and be fully aware that he/she will be partly responsible for the outcome.SummaryOnly if all the aforesaid conditions are satisfied can it be considered reasonable to propose unrelated HSCT as a potential cure for high risk thalassemia patients. (shrink)

World food production is facing exorbitant challenges like climate change, use of resources, population growth, and dietary changes. These, in turn, raise major ethical and political questions, such as how to uphold the right to adequate nutrition, or the right to enact a gastronomic culture and to preserve the conditions to do so. Proposals for utopic solutions vary from vertical farming and lab meat to diets filled with the most fanciful insects and seaweeds. Common to all proposals is a polarized (...) understanding of food and diets, famously captured by Warren Belasco in the contraposition between technological fixes and anthropological fixes. According to the first, technology will deliver clean, just, pleasurable, affordable food; future generations will not need to adjust much of their dietary cultures. According to the second, future generations should dramatically change their dietary habits (what they eat and how they eat it) to achieve a sustainable diet. The two fixes found remarkably distinct perspectives over dietary politics and the ethics of food production and consumption. In this paper we argue that such polarized thinking rests on a misrepresentation of the ontological status of food, which in turn affects the underlying ethical and political issues. Food is a socially constructed object that draws in specific ways on habits, norms, traditions, geographical, and climatic conditions. Although this thesis seems somewhat obvious, its consequences on the ethical and political perspectives on the future of food have not been derived properly. After introducing the issue at stake (¤1), we point out the polarities that characterize food utopias (¤2) and their ontological faults (¤3). We hence suggest that a socio-ontological analysis of food can better deliver the principles for a foundation of food utopias (¤4). (shrink)

In this paper we discuss the role that individual and collective acts of interpretation play in shaping a metaphysics of food. Our analysis moves from David Kaplan’s recent contention that food is always open to interpretation, and substantially expands its theoretical underpinnings by drawing on recent scholarship on food and social ontology. After setting up the terms of the discussion (§1), we suggest (§2) that the contention can be read subjectively or structurally, and that the latter can be given three (...) sub-readings. We then lay out (§3) three case studies that, we submit, any viable theory of a metaphysics of food should be able to account for. We show that one structural reading—based on the idea of negotiation—swiftly accommodates for the three case studies. We thus conclude that this reading is most promising for charting a metaphysics of food. (shrink)

In this paper we ask whether the two-factor theory of delusions is compatible with two claims, that delusions are pathological and that delusions are adaptive. We concentrate on two recent and influential models of the two-factor theory: the one proposed by Max Coltheart, Peter Menzies and John Sutton (2010) and the one developed by Ryan McKay (2012). The models converge on the nature of Factor 1 but diverge about the nature of Factor 2. The differences between the two models are (...) reflected in different accounts of the pathological and adaptive nature of delusions. We will explore such differences, considering naturalist and normativist accounts of the pathological and focusing on judgements of adaptiveness that are informed by the shear-pin hypothesis (McKay and Dennett 2009). After reaching our conclusions about the two models, we draw more general implications for the status of delusions within two-factor theories. Are there good grounds to claim that delusions are pathological? Are delusions ever adaptive? Can delusions be at the same time pathological and adaptive? (shrink)

Gustave Le Gray was one of the most technically accomplished and aesthetically enlightened of the early "artist-photographers." Trained as a painter of portraits and landscapes, Le Gray was attracted in the 1840s to the artistic potential of photographic processes. As a photographer he evolved and refined much of photography's primary aesthetic theory. By 1855 he had influenced, if not taught, every important photographer in France. Drawing on entirely new material Eugenia Parry Janis fully analyzes the life and work of (...) Le Gray and demonstrates the originality of his artistic achievement in the context of discoveries about his personal and professional history. Janis, approaching the photographs of Le Gray with the methods and sensibilities of an art historian, reveals telling connections between Le Gray's choices of subject matter and formal means of presentation and the existing pictorial practice of other media such as painting. This same approach makes her sensitive to Le Gray's departures from such traditional practice, and she skillfully illustrates how he evolved from student painter into master photographer. In doing so she gives us a glimpse of the way in which Le Gray's manipulation of the photographic process was always informed by his pictorial needs and by his developing style. (shrink)

Delusions are usually considered as harmful and dysfunctional beliefs, one of the primary symptoms of a psychiatric illness and the mark of madness in popular culture. However, in recent times a much more positive role has been advocated for delusions. More specifically, it has been argued that delusions might be an answer to a problem rather than problems in themselves. By delivering psychological and epistemic benefits, delusions would allow people who face severe biological or psychological difficulties to survive in their (...) environment - although this has obvious epistemic costs, as the delusion is fixed and irresponsive to compelling counterevidence. In other words, it has been argued that delusions are biologically adaptive. The adaptiveness of delusions has been compared by Ryan McKay and Daniel Dennett to a shear pin, a mechanism installed in the drive engine of some machines which is designed to shear whenever the machine is about to break down. By breaking, shear pins prevent the machine from collapsing and allow it to keep functioning, although in an impaired manner. Similarly, when delusions form, they would allow a cognitive or psychological system which is about to collapse to continue its functioning, although in an impaired manner. However, this optimistic picture of delusions risks being undermined by both theoretical and empirical considerations. Using Sarah Fineberg and Philip Corlett’s recent predictive coding account as a paradigmatic model of the biological adaptiveness of delusions, I develop two objections to it: principles of parsimony and simplicity suggest that maladaptive models of delusions have an upper hand over adaptive models; and the available empirical evidence suggests that at least some delusions stand good chances of being psychologically adaptive, but it is unlikely that they also qualify as biologically adaptive. (shrink)

This paper outlines a theory and computer implementation of causal meanings and reasoning. The meanings depend on possibilities, and there are four weak causal relations: A causes B, A prevents B, A allows B, and A allows not‐B, and two stronger relations of cause and prevention. Thus, A causes B corresponds to three possibilities: A and B, not‐A and B, and not‐A and not‐B, with the temporal constraint that B does not precede A; and the stronger relation conveys only the (...) first and last of these possibilities. Individuals represent these relations in mental models of what is true in the various possibilities. The theory predicts a number of phenomena, and, contrary to many accounts, it implies that the meaning of causation is not probabilistic, differs from the meaning of enabling conditions, and does not depend on causal powers or mechanisms. The theory also implies that causal deductions do not depend on schemas or rules. (shrink)

Delusions are symptoms of psychiatric disorders such as schizophrenia and dementia. By and large, delusions are characterized by their behavioral manifestations and defined as irrational beliefs that compromise good functioning. In this overview paper, we ask whether delusions can be adaptive notwithstanding their negative features. Can they be a response to a crisis rather than the source of the crisis? Can they be the beginning of a solution rather than the problem? Some of the psychological, psychiatric, and philosophical literature has (...) recently suggested that they can. We consider different types of delusions and different ways in which they can be considered as adaptive: psychologically (e.g., by increasing wellbeing, purpose in life, intrapsychic coherence, or good functioning) and biologically (e.g., by enhancing genetic fitness). Although further research is needed to map the costs and benefits of adopting and maintaining delusional beliefs, a more nuanced picture of the role of delusions in people's lives has started to emerge. (shrink)

In the present paper, we substantiate the theory according to which the ailments of imagination presented by Immanuel Kant, especially in his work Anthropology from a Pragmatic Point of View, are sources of artistic creation. It is obvious that not anyone suffering from melancholia, nostalgia, hypochondria or any other ailment of the soul, which Immanuel Kant refers to, becomes a creator of culture. Genius is required for this, but instead of diminishing the creative power of the genius, it seems to (...) be enhanced by the ailments of imagination or generally, by the ailments of the soul. The hypertrophic imagination in the case of a genius plays a major role in the process of fixation in the individual and collective memory of what Immanuel Kant names. (shrink)

Boundaries are the outermost parts of objects, with a twofold function: dividing objects from their environment and allowing objects to touch each other. The task of this paper is to classify and describe the human dependent boundaries, i.e., the so-called fiat boundaries, on the basis of the seminal work by Smith and Varzi. Roughly, a fiat boundary is a marker of discontinuity between two or more objects which relies on a human function assignment, usually called ‘fiat act’. In what follow (...) I outline the different ways in which human beings make fiat boundaries out of nature. Along the way I shall give evidence that a theory of fiat boundaries can be useful to take up as a starting point for doing metaphysics and for giving an account of the ontology of both the material and the social world. The chief goal is to shed light on how some objects depend upon human beings: either in a deliberative or non-deliberative way; either a priori or a posteriori; by means of individual or collective act; by modal strength, namely possible and necessary boundaries. (shrink)

Delusions are usually depicted in one of two contrasting ways. They are either characterized as harmful and dysfunctional beliefs or as fostering engagement with the environment and sometimes even psychological wellbeing in the face of psychological or biological difficulties – something which, according to some accounts, would make them biologically adaptive. It is this “adaptive hypothesis” that I focus on in this paper, by empirically investigating the adaptiveness of delusions in a sample of people suffering from OCD. The paper shows (...) that delusions in OCD entertain complex and heterogeneous relationships with psychological wellbeing and engagement with the environment, highlighting some future directions that clinical and philosophical research on the topic should take. (shrink)

In Rita Charon's account of narrative medicine, empathy seems to be an essential element of the clinical relationship. However, empathy has not received much attention, which I believe is problematic. First, I show that not only is there no clear definition of what empathy is, but that this conceptual gap creates ambiguity about its role in the practice of narrative medicine. Second, I argue that certain passages in Charon's work seem to implicitly characterize empathy as a combination of cognitive empathy, (...) affective empathy, and sympathy, and that its inclusion in the practice of narrative medicine can be problematic. Third, following Dan Zahavi, I argue that a phenomenological account of empathy not only seems most compatible with the practices, values, and theoretical framework of narrative medicine, but is also capable of resolving the problems posed by alternative definitions of empathy and the ambiguity about the role of empathy in narrative medicine. (shrink)

Bioethics, Volume 36, Issue 5, Page 486-493, June 2022.

The concept of wild food does not play a significant role in contemporary nutritional science and it is seldom regarded as a salient feature within standard dietary guidelines. The knowledge systems of wild edible taxa are indeed at risk of disappearing. However, recent scholarship in ethnobotany, field biology, and philosophy demonstrated the crucial role of wild foods for food biodiversity and food security. The knowledge of how to use and consume wild foods is not only a means to deliver high-end (...) culinary offerings, but also a way to foster alternative models of consumption. Our aim in this paper is to provide a conceptual framework for wild foods, which can account for diversified wild food ontologies. In the first section of the paper, we survey the main conception of wild foods provided in the literature, what we call the Nature View. We argue that this view falls short of capturing characteristics that are core to a sound account of wilderness in a culinary sense. In the second part of the paper, we provide the foundation for an improved model of wild food, which can countenance multiple dimensions and degrees connoting wilderness in the culinary world. In the third part of the paper we argue that thanks to a more nuanced ontological analysis, the gradient framework can serve ethnobiologists, philosophers, scientists, and policymakers to represent and negotiate theoretical conflicts on the nature of wild food. (shrink)

Empathizing with others is thought to be a useful, if not necessary, skill for a wise person to possess. Beyond this general conceptual assonance, however, there have been few systematic attempts to conceptualize this relationship. This paper aims to address this issue by investigating what role empathy is said to play in phronesis and whether there is a legitimate place for it in Aristotelian (or neo-Aristotelian) accounts of practical wisdom. First, after a brief overview of Aristotle’s account of phronesis, I (...) will try to define three different ways in which empathy is thought to contribute to it according to the existing literature, based on a conceptual distinction between affective empathy, cognitive empathy, and sympathy. Second, I will ask whether empathy is the best conceptual candidate for Aristotle’s account of phronesis and, more generally, whether the wise person should always rely on empathy in order to deliberate and act well. My tentative answer will be that empathy does not seem to be perfectly compatible with the concept of phronesis, nor is it its best ally. (shrink)

Contemporary philosophers have studied food and its consumption from several disciplinary perspectives, including normative ethics, bioethics, environmental ethics, political philosophy, epistemology, and aesthetics. Many questions remain, however, underexplored or unaddressed. It is in the spirit of contributing to fill in these scholarly gaps that we designed the current issue, which represents the first collection of papers dedicated to food from a perspective of analytic metaphysics. Before presenting the five papers published in this issue, we shall briefly frame the current research (...) on food linked to analytic metaphysics and point out future directions of research in this area. We begin with the most basic interroga- tive, namely What is food?, and then offer three illustrations of more specific re- search questions. We hope these examples suffice to demonstrate that food is a fertile terrain of inquiry for analytic metaphysics and that it deserves to be devel- oped. (shrink)

Counterfactual conditionals are frequently used in language to express potentially valid reasoning from factually false suppositions. Counterfactuals provide two pieces of information: their literal meaning expresses a suppositional dependency between an antecedent (If the dice had been rigged...) and a consequent (… then the game would have been unfair). Their second, backgrounded meaning refers to the opposite state of affairs and suggests that, in fact, the dice were not rigged and the game was fair. Counterfactual antecedents are particularly intriguing because (...) they set up a counterfactual world which is known to be false, but which is nevertheless kept to when evaluating the conditional’s consequent. In the last years several event-related potential (ERP) studies have targeted the processing of counterfactual consequents, yet counterfactual antecedents have remained unstudied. We present an EEG/ERP investigation which employed German conditionals to compare subjunctive mood (which marks counterfactuality) with indicative mood at the critical point of mood disambiguation via auxiliary introduction in the conditional’s antecedent. Conditional sentences were presented visually one word at a time. Participants completed an acceptability judgement and probe detection task which was not related to the critical manipulation of linguistic mood. ERPs at the point of mood disambiguation in the antecedent were compared between indicative and subjunctive. Our main finding is a transient negative deflection in frontal regions for subjunctive compared to indicative mood in a time-window of 450-600 ms. We discuss this novel finding in respect to working memory requirements for rule application and increased referential processing demands for the representation of counterfactuals’ dual meaning. Our result suggests that the counterfactually implied dual meaning is processed without any delay at the earliest point where counterfactuality is marked by subjunctive mood. (shrink)

In How to Bake Pi, math professor Eugenia Cheng provides an accessible introduction to the logic and beauty of mathematics, powered, unexpectedly, by insights from the kitchen: we learn, for example, how the béchamel in a lasagna can be a lot like the number 5, and why making a good custard proves that math is easy but life is hard.

Where does math come from? From a textbook? From rules? From deduction? From logic? Not really, Eugenia Cheng writes in Is Math Real?: it comes from curiosity, from instinctive human curiosity, "from people not being satisfied with answers and always wanting to understand more." And most importantly, she says, "it comes from questions": not from answering them, but from posing them. Nothing could seem more at odds from the way most of us were taught math: a rigid and autocratic (...) model which taught us to follow specific steps to reach specific answers. Instead of encouraging a child who asks why 1+1 is 2, our methods of education force them to accept it. Instead of exploring why we multiply before we add, a textbook says, just to get on with the order of operations. Indeed, the point is usually just about getting the right answer, and those that are good at that, become "good at math" while those who question, are not. And that's terrible: These very same questions, as Cheng shows, aren't simply annoying questions coming from people who just don't "get it" and so can't do math. Rather, they are what drives mathematical research and push the boundaries in our understanding of all things. Legitimizing those questions, she invites everyone in, whether they think they are good at math or not. And by highlighting the development of mathematics outside Europe, Cheng shows that-western chauvinism notwithstanding--that math can be for anyone who wishes to do it, and how much we gain when anyone can. (shrink)

We have questioned the assumption that SV (agent-action) structures are basic and primary and have shown that thetic VS unaccusative structures, involving an event+theme unit, are better candidates for simple, primary proto-syntactic “fossils.” We have shown that thetic unaccusative structures are simpler syntactically, prosodically, semantically and informationally, and have suggested that this is due to the fact that syntactic evolution progressed from a stage with thetic statements (with no arguments, such as It is cold, or with only one argument, typically (...) unaccusative, such as Spanish Ha llegado Juan (has arrived Juan) or Serbian Pao sneg (fallen.PP snow)), to more complex categorical assertions, involving agents and a syntactic and intonational separation between the subject and the predicate. Obviously, this raises many questions. How did thetic statements intergrade into categorical statements, and what were the evolutionary factors that facilitated this transition? Did both of the informational dichotomies (Topic-Comment and Focus-Background) develop from thetic statements or are F-B structures simpler than T-C? We leave these questions for future research. (shrink)

Resumen En el presente artículo se analiza la presencia de polaridades pasionales en El arte de la guerra de Nicolás Maquiavelo. Primero, se analiza de modo sucinto los frescos de Ambrogio Lorenzetti que se encuentran en el Palacio Comunal de Siena, poniendo particular atención en las presencias de la guerra y la paz para realizar posteriormente una comparación con el abordaje de Maquiavelo. Segundo, se analiza cómo la literatura especializada aborda este tratado militar de Maquiavelo. Tercero, se examinan las referencias (...) del amor en el juego de polaridades pasionales a lo largo del texto en torno a dos ejes: por un lado, las referencias explícitas al amor bajo su forma de amor a la patria y amor a la paz; por otro lado, cómo aparece la pasión del amor en el circuito pasional entre el capitán y su tropa. Por último, se explicitan las conclusiones que se desglosan del trabajo realizado. (shrink)

The aim of this article is to analyze how Niccolò Machiavelli conceptualizes the people in the Discorsi sopra prima deca di Tito Livio. For this purpose, in first place, we will sequentially restore the mentions on people that are linked to the passions. In second place, we will focus on the treatment of the different passions. Finally, we will illuminate what kind of people are at stake and how the people intervene in the construction of the political bond.

En el año 2019, salió editado una carta inédita de Nicolás Maquiavelo a Lorenzo Strozzi sobre la peste en Florencia bajo el cuidado de Pasquale Stoppelli. A continuación proponemos la primera traducción de la carta al español acompañada con un estudio introductorio.

Este artículo tiene como objetivo analizar la figura de Castruccio Castracani de Nicolás Maquiavelo quien desarrolla una particular escritura que es necesario seguir de cerca: a partir de este análisis podemos encontrar insumos para interrogar cómo operan los liderazgos en la obra maquiaveliana y cómo los líderes interactúan con el pueblo a través de un círculo pasional que se genera entre ambos. A estos efectos, procederemos en este artículo del siguiente modo: en primer lugar, restableceremos la historia que reconstruye Maquiavelo (...) en torno a la figura de Castruccio. Solo una vez proporcionada esta reconstrucción nos dirigiremos al tratamiento de los ejes temáticos que resultan relevantes con el fin de pensar el liderazgo maquiaveliano. Por último, presentaremos las conclusiones de nuestro trabajo: a través del análisis sistemático de Castruccio se indaga cómo se construye una noción de “liderazgo maquiaveliano”. La especificidad de los liderazgos en Maquiavelo está dada en cómo se reconoce al pueblo como interlocutor válido, esto es, no de una manera manipuladora, perversa u opresora, sino como condición de la propia posibilidad del liderazgo. (shrink)

This paper focuses on the years preceding Salvador Allende’s Popular Unity in Chile (1970-1973) and, more precisely, on the Movimiento de Izquierda Revolucionaria (MIR). Since 1969, this Marxist revolutionary group had actively participated in the class struggle in Chile. However its political and social activism was not oriented towards the working class, but instead towards marginalized social sectors (inhabitants of informal settlements and landless rural workers). The paper thus seeks to elucidate the process which led the MIR to invest social (...) sectors that should have been considered as “unorthodox,” from a Marxist organization’s point of view. More generally, the analysis of a political experience taking place in a country where the working class was not as coherent or as massive as it was in 20th Century Western Europe and the United States aims at “deprovincializing” history and at using the concepts of “class” and “class struggle” in a manner which distances them from their potentially economicist and sociologizing implications. (shrink)

Este artículo se focaliza en el Movimiento de Izquierda Revolucionaria (MIR) y la problemática de la violencia política, que fue central en su historia. Abarcaremos el período 1965-1970 y estudiaremos el discurso que tuvo el MIR sobre este punto, construido tanto en los escritos teóricos como en los discursos de sus dirigentes, el lugar y el rol que ocupó la violencia en la práctica política del MIR, y por último la articulación entre prácticas políticas y representaciones. El artículo está estructurado (...) en torno a los siguientes ejes: el contexto político, ideológico e intelectual que provee al MIR argumentos permitiéndole legitimar el recurso a la violencia (ante los militantes y la sociedad); el debate en torno a la violencia en tanto regulador de las tensiones y divisiones internas; y por último, la interacción entre el uso de la fuerza por el MIR y el espacio público (la violencia y su efecto mediático, las respuestas del Estado). (shrink)

La concezione tradizionale che vede la sinistra e la critica sociale volte al rovesciamento del sistema economico-sociale si fonda su quattro presupposti: 1) la proprietÀ privata č la radice del dominio sociale; 2) č possibile pensare un regime di proprietÀ e di organizzazione economica diverso da quello capitalistico, accettabile in termini di equitÀ ed efficienza; 3) č possibile individuare nell'ordine sociale esistente le forze sociali che lo rovesceranno; 4) il cambiamento verso il nuovo ordine sociale puň essere realizzato con l'azione (...) politica. Il saggio prova a dimostrare perché queste quattro condizioni non si danno, e come, se la sinistra riesce ad accettarlo, possa pensare la sua azione come cambiamento reale dei rapporti sociali esistenti, e non come il loro rovesciamento. (shrink)

The surviving pictorial hagiographical cycles of St Panteleimon were executed in the period between the 10th and 15th centuries. The most elaborate one is on a vita icon, consisting of sixteen scenes, at the monastery of St Catherine, Mt. Sinai and is at the centre of this research. The painter used the Passion of St Panteleimon by Symeon Metaphrastes as a main textual source for its creation. In addition, we may presume that the iconography of the images was influenced by (...) other existing pictorial cycles of the life of the saint. Also, the selection of the images, included in the saint's cycle, reflects the devotional needs and wishes of the unknown donor. (shrink)