Scientific and medical practice both relate to and differ from each other, as do discussions of how to handle decisions under uncertainty in the laboratory and clinic respectively. While studies of science have pointed out that scientific practice is more complex and messier than dominant conceptions suggest, medical practice has looked to the rigour of scientific and statistical methods to address clinical uncertainty. In this article, we turn to epistemological studies of the laboratory to highlight how clinical practice already has (...) strategies for dealing with messiness. We draw on Hans-Jo ̈rg Rheinberger’s Toward a History of Epistemic Things, in which he invokes the metaphor of a spider’s web to explain the role of tacit practices in experimental biochemistry for helping practitioners manage messiness. We argue that diagnostic practices in clinical medicine employ similar, albeit codified, procedures to evaluate epistemic significance, ensure sensitivity to the unforeseen, and allow focused grounds for action. We consider three practices: (a) the pre-set structure of medical records, ensuring broad coverage in initial anamnesis, (b) the use of lists of differential diagnoses and ongoing ‘anchoring and adjusting’ as inquiry progresses, and (c) shared decision-making as an occasion to synthesize empirical evidence and reopen inquiry for potential missed information. We end by suggesting that while philosophy of medicine may learn from laboratory epistemology, the sciences may learn something from medical practice. (shrink)

Introducing the practices of Eastern Hinduism, Shintoism, Daoism, Confucianism, and Buddhism, a lavishly illustrated volume is complemented by full-color reproductions of sacred art, architecture, symbols, landscapes, ceremonies, and festivals.

Consensus plays an ambiguous role in deliberative democracy. While it formed the horizon of early deliberative theories, many now denounce it as an empirically unachievable outcome, a logically impossible stopping rule, and a normatively undesirable ideal. Deliberative disagreement, by contrast, is celebrated not just as an empirically unavoidable outcome but also as a democratically sound and normatively desirable goal of deliberation. Majority rule has generally displaced unanimity as the ideal way of bringing deliberation to a close. This article offers an (...) epistemic perspective on this question of consensus versus disagreement. For ensuring the production of better decisions, we argue, the normative appeal of consensus varies depending on the deliberative task – whether it entails problem solving or prediction. We argue that in pure problem-solving contexts, consensus retains a strong normative appeal and forms the ideal deliberative outcome of deliberation. In contrast, on predictive tasks, consensus should generally not be used as a stopping rule noris it likely to be epistemically desirable as an outcome. Instead deliberators may be better served by ending the deliberation with a form of deliberative disagreement we call ‘positive dissensus’, which paves the way for more accurate aggregate predictions. (shrink)

For most pre‐modern philosophers, questions about the good life and the happy life were inseparable. Happiness is primarily a subjective notion. The Good Place suggests that relationships are key to the good life. It is a laboratory for testing moral theories, providing the show's writers opportunities to see which theories help the protagonists become better persons. An ethics of virtue is difficult and messy because it does not reduce morality to a simple formula. Instead, it involves an inner transformation of (...) character that leads to virtuous actions. In Aristotle's ethical system, true moral progress toward the good life is within reach. In spite of the verbal commitments made to Kant's ethics, the show ultimately proves to be a vindication of virtue ethics. A universe governed by Aristotelian morality is one in which moral development is possible. (shrink)

The year 2018 was the 40th anniversary of the birth of Louise Joy Brown, marking four decades of clinical in vitro fertilization and embryo transfer. Though this milestone, reached first by Steptoe and Edwards in the United Kingdom, is well acknowledged through Nobel accolade, the achievement was not entirely celebrated at the time. Global contention was not just moral, but political and legislative. In the United States, the achievement led in 1978 to the freezing of federal funds by the National (...) Institute of Health for research on human embryos and oocytes.A report published on May 4, 1979, by the Ethics Advisory Board of the Department of Health... (shrink)

The development of the Functional Genomics Investigation Ontology (FuGO) is a collaborative, international effort that will provide a resource for annotating functional genomics investigations, including the study design, protocols and instrumentation used, the data generated and the types of analysis performed on the data. FuGO will contain both terms that are universal to all functional genomics investigations and those that are domain specific. In this way, the ontology will serve as the “semantic glue” to provide a common understanding of data (...) from across these disparate data sources. In addition, FuGO will reference out to existing mature ontologies to avoid the need to duplicate these resources, and will do so in such a way as to enable their ease of use in annotation. This project is in the early stages of development; the paper will describe efforts to initiate the project, the scope and organization of the project, the work accomplished to date, and the challenges encountered, as well as future plans. (shrink)

Although many new ideas are generated, only a few are ever implemented. Thus, it seems reasonable to conclude that idea evaluation represents an important aspect of the creative process. In the present article, we examine the cognitive operations involved in idea evaluation. We argue that idea evaluation is a complex activity involving appraisal of ideas, forecasting of their implications, and subsequent revision and refinement. We note that the outcomes of these activities depend on both the standards applied in idea evaluation (...) and the context surrounding evaluation of a new idea. Implications for the development of idea evaluation skills are discussed. (shrink)

Bone marrow is the main site for hematopoiesis in adults. It acts as a niche for hematopoietic stem cells (HSCs) and contains non‐hematopoietic cells that contribute to stem cell dormancy, quiescence, self‐renewal, and differentiation. HSC also exist in resting spleen of several species, although their contribution to hematopoiesis under steady‐state conditions is unknown. The spleen can however undergo extramedullary hematopoiesis (EMH) triggered by physiological stress or disease. With the loss of bone marrow niches in aging and disease, the spleen as (...) an alternative tissue site for hematopoiesis is an important consideration for future therapy, particularly during HSC transplantation. In terms of harnessing the spleen as a site for hematopoiesis, here the remarkable regenerative capacity of the spleen is considered with a view to forming additional or ectopic spleen tissue through cell engraftment. Studies in mice indicate the potential for such grafts to support the influx of hematopoietic cells leading to the development of normal spleen architecture. An important goal will be the formation of functional ectopic spleen tissue as an aid to hematopoietic recovery following clinical treatments that impact bone marrow. For example, expansion or replacement of niches could be considered where myeloablation ahead of HSC transplantation compromises treatment outcomes. (shrink)

Trait emotional intelligence concerns people’s perceptions of their emotional functioning. Two studies investigated this construct in surgeons and comparison occupations. We hypothesized that trait EI profiles would differ both within surgical specialties as well as between them and other professions. Study 1 compared the trait EI profiles of four different surgical specialties. There were no significant differences amongst these specialties or between consultant surgeons and trainees in these specialties. Accordingly, the surgical data were combined into a single target sample that (...) was compared against samples of engineers, executives and senior managers, lawyers, junior military managers, nurses, and salespeople. Surgeons scored significantly higher on global trait EI than junior military managers, but lower than executives and senior managers, salespeople, and nurses. There were no significant differences vis-à-vis engineers or lawyers. A MANOVA confirmed a similar pattern of differences in the four trait EI factors. Global trait EI scores correlated strongly with single-question measures of job satisfaction and job performance in the surgical sample. These findings suggest that interventions to optimize the trait EI profiles of surgeons can be helpful in relation to job satisfaction, job performance, and overall psychological wellbeing. (shrink)

This paper stems from an ethnographic, multidisciplinary study that explored the views and experiences of practitioners and scientists on social, ethical and clinical dilemmas encountered when working in the area of pre-implantation genetic diagnosis for serious genetic disorders. We focus here on staff perceptions and experiences of working with embryos and helping women/couples to make choices that will result in selecting embryos for transfer and disposal of 'affected' embryos, compared to the termination of affected pregnancies following prenatal diagnosis. Analysis and (...) discussion of our data led us to consider the possible advantages of pre-implantation genetic diagnosis and whether a gradualist account of the embryo's and fetus's moral status can account for all of these, particularly since a gradualist account concentrates on the significance of time (developmental stage) and makes no comment as to the significance of place (in vitro, in utero). (shrink)

With human language, the same utterance can have different meanings in different contexts. Nevertheless, listeners almost invariably converge upon the correct intended meaning. The classic Gricean explanation of how this is achieved posits the existence of four maxims of conversation, which speakers are assumed to follow. Armed with this knowledge, listeners are able to interpret utterances in a contextually sensible way. This account enjoys wide acceptance, but it has not gone unchallenged. Specifically, Relevance Theory offers an explicitly cognitive account of (...) utterance interpretation that presents a radical challenge to the neo‐Gricean paradigm. Evolutionary considerations are one way in which we can choose between competing theories. A simple game‐theoretic model of the evolution of communication is presented, and it is used to derive a number of basic qualities that will be satisfied by all evolved communication systems. These qualities are observed to precisely predict the foundational principles of Relevance Theory. The model thus provides biological support for that enterprise in general, and for the plausibility of the cognitive mechanisms that it describes in particular. (shrink)

Settling the debate over conscientious refusal (CR) in liberal democracies requires us to develop a conception of the healthcare provider’s moral role. Because CR claims and resulting policy changes take place in specific sociopolitical contexts with unique histories and diverse polities, the _method_ we use for deriving the healthcare norms should itself be a democratic, context-dependent inquiry. To this end, I begin by describing some prerequisites—which I call _publicity conditions_—for any democratic account of healthcare norms that conflict or jibe with (...) CR. Next, drawing on Ronald Dworkin’s jurisprudence and Tom Beauchamp & James Childress’s approach to bioethical reasoning, I briefly introduce one method for generating healthcare norms that is faithful to the publicity conditions and has potential to constructively, and democratically, derive important boundaries for CR. Finally, I argue that many critics of CR fail to similarly ground their accounts of healthcare norms in healthcare professionals’ sociopolitical contexts, often relying instead on their own interpretation of a generally stateable healthcare norm. This leads to their misconstruing both the value judgments on which their own approaches rest and the public, political values that are often invoked in favor of CR. (shrink)

On August 30, 2013, the American Political Science Association sponsored a roundtable on political epistemology as part of its annual meetings. Co-chairing the roundtable were Jeffrey Friedman, Department of Government, University of Texas at Austin; and Hélène Landemore, Department of Political Science, Yale University. The other participants were Scott Althaus, Department of Political Science, University of Illinois at Urbana-Champaign; Mark Bevir, Department of Political Science, University of California at Berkeley; Rogers Smith, Department of Political Science, University of Pennsylvania; and (...) Susan Stokes, Department of Political Science, Yale University. We thank the participants for permission to republish their remarks, which they subsequently edited for clarity. (shrink)

Stakeholder theory is widely recognized as a management theory, yet very little research has considered its implications for individual managerial decision-making. In the two studies reported here, we used stakeholder theory to examine managerial decisions about balancing stakeholder interests. Results of Study 1 suggest that indivisible resources and unequal levels of stakeholder saliency constrain managers’ efforts to balance stakeholder interests. Resource divisibility also influenced whether managers used a within-decision or an across-decision approach to balance stakeholder interests. In Study 2 we (...) examined instrumental and normative implications of these two approaches. We conclude by considering the contributions of this research. (shrink)