Health technology assessment consists of thesystematic study of the consequences of theintroduction or continued use of the technology in aparticular context, with the explicit objective toarrive at a judgment of the value or merit of thetechnology. Ideally, it is aimed at assessing allaspects of a given technology or group oftechnologies, including non-technical, e.g.socio-ethical, aspects. However, methods for assessingsocio-ethical implications of health technology arerelatively undeveloped and few mechanisms exist totake action based on the results of such evaluations.Still, the examples of cochlear (...) inplants and other cases illustratethat HTA is not a matter of merely collecting thefacts about a technology. The facts must beplausible and relevant from a particular framework,which is not always shared by different groups. It ishere that socio-ethical aspects are encountered. Ifhealth technology assessment aims to enhance theaccountability of the decision making processregarding funding and use of health technology, it isa major challenge to assessors of health technologiesto deal adequately with existing value pluralism. Inthis respect interactive evaluation may have somethingto offer. (shrink)

• Aggregates of previously isolated cells of Hydra are capable, under suitable solvant conditions, of regeneration forming complete animals. In a first stage, ecto- and endodermal cells sort out, producing the bilayered hollow structure characteristic of Hydra tissue; thereafter, heads are formed (even if the original cell preparation contained no head cells), eventually leading to the separation of normal animals with head, body column and foot. Hydra appears to be the highest type of organism that allows for regeneration of the (...) entire structure from random cell aggregates. The system is particularly useful for studying cell interactions, tissue polarity, pattern formation, and cell differentiation. (shrink)

Pragmatism is a distinctive approach to clinical research ethics that can guide bioethicists and members of institutional review boards (IRBs) as they struggle to balance the competing values of promoting medical research and protecting human subjects participating in it. After defining our understanding of pragmatism in the setting of clinical research ethics, we show how a pragmatic approach can provide guidance not only for the day-to-day functioning of the IRB, but also for evaluation of policy standards, such as the one (...) that addresses acceptable risks for healthy children in clinical research trials. We also show how pragmatic considerations might influence the debate about the use of deception in clinical research. Finally, we show how a pragmatic approach, by regarding the promotion of human research and the protection of human subjects as equally important values, helps to break down the false dichotomy between science and ethics in clinical research. (shrink)

At least since Descartes, philosophers have been interested in the special knowledge or authority that we exhibit when we speak about our own thoughts, attitudes, and feelings. This book contends that even the best work in contemporary philosophy of mind fails to account for this sort of knowledge or authority because it does not pay the right sort of attention to the notion of expression. What's at stake is not only how to understand self-knowledge and first-person authority, but also what (...) it is that distinguishes conscious from unconscious psychological states, what the mental life of a nonlinguistic animal has in common with our sort of mental life, and how to think about Wittgenstein's legacy to the philosophy of mind. (shrink)

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Explanatory models in psychiatry reflect what clinicians deem valuable in rendering people's behavior intelligible and thus help guide treatment choices for mental illnesses. This article outlines some key scientific and ethical principles of clinical explanation in twenty-first century psychiatry. Recent work in philosophy of science, clinical psychiatry, and psychiatric ethics are critically reviewed in order to elucidate conceptual underpinnings of contemporary explanatory models. Many explanatory models in psychiatry are reductionistic or eclectic. The former restrict options for diagnostic and therapeutic paradigm (...) choice, while the latter lack a well-defined theoretical basis. These two methodological approaches stand in a dialectical relation to one another insofar as clinicians often move from one approach to its antithesis, ultimately seeking a synthesis of the two approaches that satisfies clinical needs. Pragmatic considerations can help to transcend the reductionism/eclecticism dialectic. In the absence of a completed science of mental disorders, psychiatrists must tolerate ambiguity and uncertainty as they strive to integrate diverse explanatory concepts in a rigorous and evidence-based fashion. A pragmatic explanatory model in clinical psychiatry must focus on favorable treatment outcomes for patients by respecting the pluralistic, participatory, and provisional nature of psychiatric explanation. (shrink)

Authorising euthanasia and assisted suicide with advance euthanasia directives is permitted, yet debated, in the Netherlands. We focus on a recent controversial case in which a Dutch woman with Alzheimer’s disease was euthanised based on her AED. A Dutch euthanasia review committee found that the physician performing the euthanasia failed to follow due care requirements for euthanasia and assisted suicide. This case is notable because it is the first case to trigger a criminal investigation since the 2002 Dutch euthanasia law (...) was enacted. Thus far, only brief descriptions of the case have been reported in English language journals and media. We provide a detailed description of the case, review the main challenges of preparing and applying AEDs for persons with dementia and briefly assess the adequacy of the current oversight system governing AEDs. (shrink)

In the form of inference known as inference to the best explanation there are various ways to characterise what is meant by the best explanation. This paper considers a number of such characterisations including several based on confirmation measures and several based on coherence measures. The goal is to find a measure which adequately captures what is meant by 'best' and which also yields the truth with a high degree of probability. Computer simulations are used to show that the overlap (...) coherence measure achieves this goal, enabling the true explanation to be identified almost as often as an approach which simply selects the most probable explanation. Further advantages to this approach are also considered in the case where there is uncertainty in the prior probability distribution. (shrink)

This paper considers an application of work on probabilistic measures of coherence to inference to the best explanation. Rather than considering information reported from different sources, as is usually the case when discussing coherence measures, the approach adopted here is to use a coherence measure to rank competing explanations in terms of their coherence with a piece of evidence. By adopting such an approach IBE can be made more precise and so a major objection to this mode of reasoning can (...) be addressed. Advantages of the coherence - based approach are pointed out by comparing it with several other ways to characterize ‘ best explanation ’ and showing that it takes into account their insights while overcoming some of their problems. The consequences of adopting this approach for IBE are discussed in the context of recent discussions about the relationship between IBE and Bayesianism. (shrink)

In “The logic of deep disagreements” (Informal Logic, 1985), Robert Fogelin claimed that there is a kind of disagreement – deep disagreement – which is, by its very nature, impervious to rational resolution. He further claimed that these two views are attributable to Wittgenstein. Following an exposition and discussion of that claim, we review and draw some lessons from existing responses in the literature to Fogelin’s claims. In the final two sections (6 and 7) we explore the role reason can, (...) and sometimes does, play in the resolution of deep disagreements. In doing this we discuss a series of cases, mainly drawn from Wittgenstein, which we take to illustrate the resolution of deep disagreements through the use of what we call “rational persuasion.” We conclude that, while the role of argumentation in “normal” versus “deep” disagreements is characteristically different, it plays a crucial role in the resolution of both. (shrink)

We present a set of algorithms for automated simplification of symbolic constants of the form ∑iαixi with αi rational and xi complex. The included algorithms, called SimplifySum2 and implemented in Mathematica, remove redundant terms, attempt to make terms and the full expression real, and remove terms using repeated application of the multipair PSLQ integer relation detection algorithm. Also included are facilities for making substitutions according to user-specified identities. We illustrate this toolset by giving some real-world examples of its usage, including (...) one, for instance, where the tool reduced a symbolic expression of approximately 100 000 characters in size enough to enable manual manipulation to one with just four simple terms.2Available from https://github.com/alexkaiser/SimplifySum. (shrink)

This paper provides a new approach to inference to the best explanation based on a new coherence measure for comparing how well hypotheses explain the evidence. It addresses a number of criticisms of the use of probabilistic measures in this context by Clark Glymour, including limitations of earlier work on IBE. Computer experiments are used to show that the new approach finds the truth with a high degree of accuracy in hypothesis selection tasks and that in some cases its accuracy (...) is greater than hypothesis selection based on maximizing posterior probability. Hence, by overcoming some of the problems with the previous approach, this work provides a more adequate defence of IBE and suggests that IBE not only tracks truth but also has practical advantages over the previous approach. Applications of the new approach to parameter estimation and model selection are also explored. (shrink)

This article examines the relationship between the principle of double effect and justification for separation surgeries for conjoined twins. First, the principle of double effect is examined in light of its historical context. It is argued that it can only operate under an absolutist view of good and evil that is compatible with the Bible. Given this foundation for application, scenarios for separating conjoined twins are considered against the criteria for the principle of double effect. It is concluded that the (...) principle of double effect cannot be applied to cases wherein one of the twins must be killed. However, it is noted that this does not leave decision makers without options. (shrink)

This new edition includes three new chapters, updating the book to take into account developments in the field over the past fifteen years.

For a stable visual world, the colours of objects should appear the same under different lights. This property of colour constancy has been assumed to be fundamental to vision, and many experimental attempts have been made to quantify it. I contend here, however, that the usual methods of measurement are either too coarse or concentrate not on colour constancy itself, but on other, complementary aspects of scene perception. Whether colour constancy exists other than in nominal terms remains unclear.

Identity, Morality, and Threat offers a critical examination of the social psychological processes that generate outgroup devaluation and ingroup glorification as the source of conflict. Daniel Rothbart and Karyna Korostelina bring together essays analyzing the causal relationship between escalating violence and opposing images of the Self and Other.

Naive mereology studies ordinary, common-sense beliefs about part and whole. Some of the speculations in this article on naive mereology do not bear directly on Peter van Inwagen's "Material Beings". The other topics, (1) and (2), both do. (1) Here is an example of Peter Unger's "Problem of the Many". How can a table be a collection of atoms when many collections of atoms have equally strong claims to be that table? Van Inwagen invokes fuzzy sets to solve this problem. (...) I claim that an alternative treatment of vagueness, supervaluations over many-value valuations, provides a better solution. (2) The Special Composition Question asks how parts compose a whole. One who rejects van Inwagen's answer in terms of constituting a life need not provide some alternative answer. Even if all answers to the Special Question fail, there are a multitude of less general composition questions that are not so difficult. (shrink)

A primary purpose of argument is to increase the degree of reasonable confidence that one has in the truth of the conclusion. A question begging argument fails this purpose because it violates what W. E. Johnson called an epistemic condition of inference. Although an argument of the sort characterized by Robert Hoffman in his response (Analysis 32.2, Dec 71) to Richard Robinson (Analysis 31.4, March 71) begs the question in all circumstances, we usually understand the charge that an argument is (...) question begging with reference to the beliefs of the person, or the sort of person, to whom the argument is directed. (shrink)