Risk prediction in emergency medicine (EM) holds unique challenges due to issues surrounding urgency, blurry research-practise distinctions, and the high-pressure environment in emergency departments (ED). Artificial intelligence (AI) risk prediction tools have been developed with the aim of streamlining triaging processes and mitigating perennial issues affecting EDs globally, such as overcrowding and delays. The implementation of these tools is complicated by the potential risks associated with over-triage and under-triage, untraceable false positives, as well as the potential for the biases of (...) healthcare professionals toward technology leading to the incorrect usage of such tools. This paper explores risk surrounding these issues in an analysis of a case study involving a machine learning triage tool called the Score for Emergency Risk Prediction (SERP) in Singapore. This tool is used for estimating mortality risk in presentation at the ED. After two successful retrospective studies demonstrating SERP’s strong predictive accuracy, researchers decided that the pre-implementation randomised controlled trial (RCT) would not be feasible due to how the tool interacts with clinical judgement, complicating the blinded arm of the trial. This led them to consider other methods of testing SERP’s real-world capabilities, such as ongoing-evaluation type studies. We discuss the outcomes of a risk–benefit analysis to argue that the proposed implementation strategy is ethically appropriate and aligns with improvement-focused and systemic approaches to implementation, especially the learning health systems framework (LHS) to ensure safety, efficacy, and ongoing learning. (shrink)

This article presents a mutual critique of the analytic and phenomenological theory of action. The first perspective focuses on the standard approach introduced by G.E.M. Anscombe. According to Anscombe, actions are events that are intentional under a description. Consequently, the distinction between action and mere behavior depends on the linguistic description of behavior. However, this perspective fails to address the possible transitions between behavior and action. One way to fill this gap is by investigating the specific form of intentionality belonging (...) to striving or tendency. Such an investigation can complement the standard theory of action by illuminating the realm in which volitional and intentional actions are formed. In this regard, it is instructive to examine A. Pfänder’s and E. Husserl’s philosophy of striving and willing. Pfänder’s _Phenomenology of Willing_ (1900) and the essay _Motives and Motivation_ (1911) reflect on the genesis of volition from striving. Both texts view willing as a particular form of striving that may, but does not have to, lead to action. Similarly, Husserl aims to retrace the pre-voluntary roots of willing, but unlike Pfänder, he considers willing and action to be necessarily connected. The second perspective focuses on what analytic philosophy contributes to philosophical action theory: the recognition of language’s constitutive role in determining actions. This is evident not only in terms of how we describe actions (Anscombe), but also in how we ascribe willing, intending, and acting to one another in communicative contexts (H.L.A. Hart). Therefore, a phenomenological investigation of action should be complemented by linguistic analysis. This idea is already outlined in rudiments by Husserl and particularly by Pfänder. (shrink)

Kant's philosophy of arithmetic / by Charles Parsons -- Visual geometry / by James Hopkins -- The proof-structure of Kant's transcendental deduction / by Dieter Henrich -- Imagination and perception / by P.F. Strawson -- Kant's categories and their schematism / by Lauchlan Chipman -- Transcendental arguments / by Barry Stroud -- Strawson on transcendental idealism / by H.E. Matthews -- Self-knowledge / by W.H. Walsh -- The age and size of the world / by Jonathan Bennett.

The ethical issues around decision making on behalf of infants have been illuminated by two empirical research studies carried out in Scotland. In-depth interviews with 176 medical and nursing staff and with 108 parents of babies for whom there was discussion of treatment withholding/withdrawal, generated a wealth of data on both the decision making process and the management of cases. Both staff and parents believe that parents should be involved in treatment limitation decisions on behalf of their babies. However, whilst (...) many doctors and nurses consider the ultimate responsibility too great for families to carry, the majority of parents wish to be the final arbiters. We offer explanations for the differences in perception found in the two groups. The results of these empirical studies provide both aids to ethical reflection and guidance for clinicians dealing with these vulnerable families. They demonstrate the value of empirical data in the philosophical debate. (shrink)

Before and during the times of Confucius and Aristotle, the concept of friendship had very different implications. This paper compares Confucius’ with Aristotle’s thoughts on friendship from two perspectives: xin 信 and le 乐. The Analects emphasizes the xin as the basis of friendship. Aristotle holds that there are three kinds of friends and corresponding to them are three types of friendship. In the friendship for the sake of pleasure, there is no xin; in the legal form of friendship for (...) the sake of utility, xin is guaranteed by law; and in the moral form of friendship for the sake of utility, xin is guaranteed by morality; in the friendship for the sake of virtue, xin is an indispensable part. Both thinkers believe friends can bring joy to human life. According to Confucius, it is the joy of rendao 仁道, whereas for Aristotle, it is the joy of Reason. There are many commonalities and differences between the two. The commonalities reveal some inner links between Confucian rendao and Aristotelian Reason. It seems that the differences between rendao and Reason are the differences between moral reason and logical reason. The comparative study is helpful for us to understand the two masters’ ethics, politics and philosophy. (shrink)

Ideologues of the American Dream doctrine assume that state intervention aimed at providing social safety nets for citizens and reducing economic inequality, restricts freedom and undermines individual opportunity. This assumption is the result of empirical misinformation and, more fundamentally, a conceptual mistake. Robust empirical data indicate that economic equality, far from stifling initiative or undermining opportunity, is conducive to social mobility.

This collection of previously unpublished essays addresses a number of issues arising out of philosophical controversies over the possibility of genuine moral dilemmas. Issues addressed include the form of a moral dilemma; the paradoxes a moral dilemma is said to entail; the question of whether a moral dilemma must exhibit inconsistency; the role of intractable circumstances in occasioning moral dilemmas; and the plausibility of supposing that there might be rational ways of addressing moral dilemmas in practice. The contributors, writing from (...) a number of widely differing points of view, include Simon Blackburn, Ruth Barcan Marcus, Alan Donagan, Terrance McConnell, Walter Sinnott-Armstrong, Mary Mothersill, Norman Dahl, David Brink, Peter Railton, Thomas E. Hill, Jr., Christopher Gowans, and H.E. Mason. (shrink)

Preferentism is the doctrine that "in deciding what is good and what is bad for a given individual, the ultimate criterion can only be his own wants and his own preferences." If preferentism is true then it would seem to follow that modifying a person's preferences so that they are satisfied by what is on offer should be as good as improving the circumstances of her life to satisfy her preferences. Our intuitive response to stories of life-adjustment through brainwashing, psychosurgery (...) and the like suggests otherwise. I sketch a broadly preferentist account drawing upon Sen's (non-preferentist) capability approach that resists such putative counterexamples. (shrink)

In Spring 2008 I went textbook-free. I linked all and only the readings for my Contemporary Analytic Philosophy course to the class website, along with powerpoints, handouts and external links to online resources.

In dit boek neemt de Tsjechisch-Nederlandse geleerde Jan Amos Comenius (1592-1670) een centrale plaats in. Met zijn filosofie en onderwijsleer wilde hij de menselijkheid in de samenleving bevorderen. Hij kwam ervoor op dat mensen met verschillende levensbeschouwelijke visies konden samenwerken om dit doel te helpen realiseren. Ook komen rozenkruisers en vrijmetselaars aan de orde, die reeds in de zestiende en zeventiende eeuw van zich lieten horen. Anders dan de kerken deden, manifesteerden zij een onafhankelijkheid van denken en een streven naar (...) meer menselijkheid in de cultuur.0In hun denken en spreken spelen ook de ideeën van Comenius een rol, direct of indirect, kritisch ondervragend of opbouwend, maar altijd inspirerend. (shrink)

A certain familiar but “deep” joke, which might be called “The Tattletale’s Paradox,” embodies a logical confusion that figures crucially in some discussions of substantive philosophical issues. “I can’t tell you the secret,” it runs, “because if I did it wouldn’t be a secret.” It is easy enough to detect the trick involved here: to tell a secret is not to make known a piece of information that is a secret at the time that it is revealed, but rather to (...) tell a story which was a secret but ceases to be one in the telling. The air of paradox arises insofar as we confuse the two claims. (shrink)

André Gallois argues that individuals that undergo fission are on some occasions identical, but on others distinct. Occasional identity however, is metaphysically costly. I argue that we can get all the benefits of occasional identity without the metaphysical costs. On the proposed account, the names of ordinary material objects refer indeterminately to stages that belong to reference classes determined by the context of utterance or temporal adverbs. In addition, temporal markers indicating the perspective from which we count objects and assign (...) properties to them determine how many count and what is true of them. So, as Gallois holds, the truth value of claims about what is true at a time may change over time and, where fission or fusion occur, does change. The current account, however, secures this result without commitment to occasional identity: reference, predication and counting are “occasional”; identity is not. (shrink)

Standard pedagogy treats topics in general relativity (GR) in terms of tensor formulations in curved space-time. An alternative approach based on treating the vacuum as a polarizable medium is presented here. The polarizable vacuum (PV) approach to GR, derived from a model by Dicke and related to the “THεμ” formalism used in comparative studies of gravitational theories, provides additional insight into what is meant by a curved metric. While reproducing the results predicted by GR for standard (weak-field) astrophysical conditions, for (...) strong fields a divergence of predictions in the two formalisms (GR vs. PV) provides fertile ground for both laboratory and astrophysical tests to compare the two approaches. (shrink)

In its original expression as a medical value confidentiality may have been absolute; this concept has become eroded by patient consent, legal actions and change in the climate of public opinion. In particular requirements arising out of legal statutes and common law judgements have greatly modified the confidentiality of the doctor-patient relationship in societies deriving their law from English origins. Despite this, confidentiality remains a value which the physician must strive to preserve. He cannot however do this without considering its (...) effect upon possible innocent third parties. (shrink)