BackgroundInternationally, patient access to notes is increasing. This has been driven by respect for patient autonomy, often recognised as a primary tenet of medical ethics: patients should be able to access their records to be fully engaged with their care. While research has been conducted on the impact of patient access to outpatient and primary care records and to patient portals, there is no such review looking at access to hospital medical records in real time, nor an ethical analysis of (...) the issues involved in such a change in process.MethodsThis study employed a systematic review framework in two stems, to integrate literature identified from two searches: Medline, CINAHL and Scopus databases were conducted, (for (1) hospitalised patients, patient access to records and its effects on communication and trust within the doctor-patient relationship; and (2) patient access to medical records and the ethical implications identified). The qualitative and quantitative results of both searches were integrated and critically analysed.Results3954 empirical and 4929 ethical studies were identified; 18 papers representing 16 studies were identified for review (12 empirical and 6 ethical). The review reveals a consensus that our current approach to giving information to patients – almost exclusively verbally – is insufficient; that patient access to notes is a welcome next step for patient-centred care, but that simply allowing full access, without explanation or summary, is also insufficient. Several ethical implications need to be considered: increased information could improve patient trust and knowledge but might transfer an (unwelcome) sense of responsibility to patients; doctors and patients have conflicting views on how much information should be shared and when; sharing written information might increase the already significant disparity in access to health care, and have unforeseen opportunity costs. The impact on medical practice of sharing notes in real time will also need to be evaluated.ConclusionsThe review presents encouraging data to support patient access to medical notes. However, sharing information is a critical part of clinical practice; changing how it is done could have significant empirical and ethical impacts; any changes should be carefully evaluated. (shrink)

En los últimas décadas se han elaborado diferentes teorías al interior de la filosofía de la ciencia que pretenden explicar cuál es la mejor manera de entender el progreso científico cognitivo. De entre ellas sobresalen por su extensión, especificidad y alcance las propuestas de Larry Laudan y de Philip Kitcher. Laudan, siguiendo a Karl Popper, Thomas S. Kuhn y retomando varias ideas de Imre Lakatos, defendió una perspectiva funcionalista a partir de la cual propuso la resolución de problemas como (...) el mejor criterio cognitivo para evaluar el progreso científico. Por su parte, Kitcher propuso como criterio del progreso científico la producción de enunciados significativos y verdaderos, defendiendo - no sin ambigüedad - un tipo de realismo científico. En este trabajo pretendo mostrar que los criterios epistémicos, a diferencia de los criterios no epistémicos, complican innecesariamente el análisis de la progresividad científica. (shrink)

Recientemente, Alexander Bird (2007) sugirió que la ciencia progresa cuando muestra “acumulación de conocimiento justificado”. Para validar su postura, Bird contrastó sus ideas con los conceptos sobre el progreso científico construidos por Thomas S. Kuhn y Larry Laudan, respectivamente. El objetivo de Bird fue mostrar que el criterio de “resolución de problemas” defendido por estos autores, es regresivo y, por ello, anti-intuitivo. En este texto analizo los argumentos de Bird en contra de estos autores y muestro en qué fallan. (...) Posteriormente se evalúa su postura a partir de sus propios fundamentos epistemológicos. Al final, presento algunas conclusiones que pueden inferirse del presente estudio. (shrink)

“Problem-solving” as a criterion of scientific progress defended by Thomas S. Kuhn and Larry Laudan, respectively, has been criticized by several authors. Recently, Alexander Bird has suggested that problem-solving as a criterion of scientific progress is regressive and anti-intuitive. In this text I reassess Kuhn, Laudan and Bird’s positions and I show that Bird’s arguments are untenable.

Para desarrollar este trabajo, en el primer capítulo caracterizaré con cierta extensión dos de las principales posturas funcionalistas del progreso científico, a saber, la defendida por Thomas S. Kuhn y Larry Laudan, respectivamente. Posteriormente, haré un análisis crítico de estas posturas. En particular, mostraré que un modelo de progreso científico basado en la resolución de problemas no puede pasar por alto explicar cómo es que se genera un problema científico y cómo puede ser medida no sólo la importancia cognitiva (...) de los problemas científicos a resolver; sino la importancia cognitiva que tienen las soluciones a los problemas que enfrenta la ciencia. En el segundo capítulo caracterizaré y analizaré la postura realista metafísica sobre el progreso científico desarrollada por Philip Kitcher. El análisis del modelo de Kitcher es pertinente para el presente estudio debido a que este autor integró muchas de las críticas que se le hicieron a las posturas funcionalistas anteriores a su propuesta. Sin embargo, como sugeriré en la conclusión de ese capítulo, la postura defendida por Kitcher en torno al progreso cognitivo de la ciencia fluctúa entre la defensa de un realismo de corte metafísico (Kitcher 1993 y 1995) y un realismo de corte semántico (Kitcher 2001a, 2001b, 2002 y 2007) que hace difícil entender con precisión y a cabalidad su postura. Con los anteriores elementos, en el tercer capítulo revisaré el debate entre las posturas funcionalistas y las posturas realistas sobre el progreso cognitivo de la ciencia en el marco del llamado Realismo Epistemológico Convergente, con el objetivo de evaluar si otras posturas realistas pueden explicar de mejor manera el progreso cognitivo de la ciencia. Como mostraré, el realismo epistemológico convergente requiere para su defensa de una definición conceptual precisa en relación a lo que debe entenderse por “verdad” – o “aproximación a la verdad” – y su conexión con el éxito científico; así como la relación de referencia entre las entidades y organismos teóricos observables e inobservables que la ciencia postula y el mundo natural. Para analizar estas conexiones, en este capítulo revisaré varios argumentos anti-realistas en contra de la relación cognitiva que los defensores del realismo epistemológico convergente pretenden establecer entre el éxito empírico y la verdad, por un lado, y el éxito empírico y la referencia, por el otro. Posteriormente, analizaré los contra-argumentos realistas más importantes que a mi juicio se han elaborado para defender el realismo epistemológico convergente. Finalmente, mostraré que los contra-argumentos realistas no logran ser lo suficientemente sólidos para evadir con éxito los ataques anti-realistas en torno al progreso cognitivo de la ciencia. El cuarto capítulo de este trabajo lo dedicaré a caracterizar y analizar la postura fundacionista defendida por Alexander Bird. Este autor sostuvo que la ciencia progresa cuando muestra “acumulación de conocimiento justificado”. Para validar su postura, este autor contrastó sus ideas con los conceptos sobre el progreso científico construidos precisamente por Kuhn y Laudan, respectivamente. El objetivo de Bird fue mostrar que el criterio de “resolución de problemas” defendido por estos autores es regresivo y, por ello, anti-intuitivo. En este capítulo analizo los argumentos de Bird, muestro en qué fallan para, finalmente, evaluar su postura a partir de sus propios fundamentos epistemológicos. En el quinto y último capítulo del libro ofreceré algunas conclusiones que pueden ser inferidas del presente estudio. (shrink)

This book contains the text of Thomas Kuhn's unfinished book, The Plurality of Worlds: An Evolutionary Theory of Scientific Development, which Kuhn himself described as "a return to the central claims of The Structure of Scientific Revolutions, and the problems that it raised but did not resolve." The Plurality of Worlds is preceded by two related texts that Kuhn publicly delivered but never published in English: his paper "Scientific Knowledge as a Historical Product" and his Shearman Memorial (...) Lectures, "The Presence of Past Science." The book opens with an introduction by the editor that describes the origins and structure of The Plurality of Worlds, and sheds light on its central philosophical problems. Kuhn's aims in his last writings are bold. He sets out to develop an empirically grounded theory of meaning that would allow him to make sense of both the possibility of historical understanding and the inevitability of incommensurability between past and present science. Moreover, he intends to show that incommensurability is fully compatible with a robust notion of a real world that science investigates, with the rationality of scientific belief change, and with the idea that scientific development is progressive. This is a must-read follow-up to The Structure of Scientific Revolutions, one of the most important books of the twentieth century. (shrink)

ABSTRACT This paper builds on previous studies that explore entrepreneurship from a critical realist morphogenetic perspective, and incorporates the neglected aspect of how agential reflexivity shapes entrepreneurship. Using the morphogenetic framework and its typology of reflexive modes, we analyse 78 work and life histories gathered from Sri Lanka with the aim of understanding reflexive entrepreneurial action. Our findings suggest that, while autonomous reflexives match the common understanding of entrepreneurship, i.e. that it is individualistic and wealth-driven, nevertheless the other reflexive modalities (...) also exhibit entrepreneurship. For example, communicative reflexives may demonstrate entrepreneurship in achieving their aspiration to maintain a family firm or tradition, and meta-reflexives may demonstrate entrepreneurship in order to realize their value ideals. We conclude that the morphogenetic typology of reflexivity is a reliable guide to understanding subtleties associated with entrepreneurial action and resolving the ongoing debate about whether entrepreneurship is best understood as motivated by the individual or by society. (shrink)

Across species, animals have an intrinsic drive to approach appetitive stimuli and to withdraw from aversive stimuli. In affective science, influential theories of emotion link positive affect with strengthened behavioural approach and negative affect with avoidance. Based on these theories, we predicted that individuals’ positive and negative affect levels should particularly influence their behaviour when innate Pavlovian approach/avoidance tendencies conflict with learned instrumental behaviours. Here, across two experiments – exploratory Experiment 1 (N = 91) and a preregistered confirmatory Experiment 2 (...) (N = 335) – we assessed how induced positive and negative affect influenced Pavlovian-instrumental interactions in a reward/punishment Go/No-Go task. Contrary to our hypotheses, we found no evidence for a main effect of positive/negative affect on either approach/avoidance behaviour or Pavlovian-instrumental interactions. However, we did find evidence that the effects of induced affect on behaviour were moderated by individual differences in self-reported behavioural inhibition and gender. Exploratory computational modelling analyses explained these demographic moderating effects as arising from positive correlations between demographic factors and individual differences in the strength of Pavlovian-instrumental interactions. These findings serve to sharpen our understanding of the effects of positive and negative affect on instrumental behaviour. (shrink)

Researchers seeking to engage in projects related to Tribal communities and their citizens, lands, and non-human relatives are responsible for understanding and abiding by each Tribal nation’s research laws and review processes. Few studies, however, have described the many diverse forms of Tribal research review systems across the United States (US). This study provides one of the most comprehensive examinations of research review processes administered by Tribal Research Review Boards (TRRBs) in the US. Through a systematic analysis, we consider TRRBs’ (...) online presence, online documentation, and themes across documents, for five entity types: Tribal nations and Tribal consortiums, Tribal colleges and universities, Tribal health organizations, Indian Health Services, and other Tribal organizations. Results include an assessment of online presence for 98 potential TRRBs, identification of 118 publicly available online documents, and analysis of 41 themes across four document types: Tribal research codes and TRRBs’ guidelines, applications, and post-approval documents. Altogether, this research provides a macro-level analysis of the most common types of TRRBs in the US in an effort to increase researchers’ understanding of these important processes as they prepare to ethically engage Tribal communities in research. These results aim to empower Tribal decision makers as they align their TRRBs’ online visibility and documentation with community priorities and strengthen their protections for the rights and wellbeing of their citizens and community. Ultimately, by expanding our knowledge of TRRBs across the US, this contribution seeks to uphold Tribal sovereignty in research and promote ethical approaches to research with Indigenous communities. (shrink)

In the past, the European social sciences labelled and discredited knowledge that did not follow the definition for scientific knowledge as applied by the European social sciences as an alternative concept of knowledge, as “indigenous” knowledge. Perception has changed with time: Not only has indigenous knowledge become an entrance ticket to the European social science world, but the indigenization of European theories is seen by some as the contribution of “peripheral” social sciences to join the theories of the “centers”. This (...) book offers contributions to the discourses about alternative concepts of knowledge, inviting the reader to decide if they are alternative, indigenous, or European types of knowledge. However, in order to make this decision, the reader must know what the nature of the European concepts of science and of scientific knowledge is; this might be a motivation to read a book that presents thoughts claiming to be alternative concepts of knowledge, alternative to the European concept of science. (shrink)

Why a theory about social sciences? -- Chapter A: The world's social in social science thinking -- Chapter B: Categorical essentials of disciplinary thinking -- Chapter C: The social science approach to scientific thinking-advancements of teleological theorizing -- Chapter D: The discourse about and the progress of social science knowledge -- Chapter E: Going beyond the social sciences.

Managing Complexity in Healthcare introduces the ComEntEth (Complex Entropic Ethical) model as an integrated bio-medical and philosophical approach to understanding how people get things done in healthcare. Drawing on the complexity sciences, studies of entropy in living organisms, and the ethics of Emmanuel Levinas, healthcare is theorised as energetic relational exchanges between people as entropic and ethical entities that unfold around a central attractor: Reduction in elevated entropy or suffering in patients. Living entities are engaged in a continuous struggle against (...) the tendency to produce entropy. From the cellular to the collective of human endeavours, the tendency of complex systems is to disorder and decay. Yet in the micro-activity of healthcare enterprise, people resist this tendency by expending energy to create order and sustain life. Making sense of how this miraculous work is made possible is the foundation of this book. Through practical examples - from analysis of practitioner burnout, rural and remote healthcare, the functioning of emergency departments, to government, social and institutional responses to the COVID-19 pandemic -this new integral philosophy provides practitioners, managers, policy designers, and scholars an effective way to understand the dynamics of daily processes and practices that link the micro of everyday interactions with the macro-trends of healthcare. (shrink)

Unentwegt werden neue technische Produkte gestaltet. Doch was macht die technische Gestaltung aus? Wie lässt sich ihr Gegenstand - (noch) nicht existierende Artefakte - adäquat auf den Begriff bringen? Michael Kuhn begreift technische Ideen vor ihrer Realisierung als Fiktionen. Er bietet eine fiktionstheoretische Rekonstruktion der Gestaltungstätigkeit und entwickelt hieraus eine Ethik der Gestaltung. Der stark interdisziplinäre Zugang zwischen Technikphilosophie und Ingenieurwissenschaften liefert neue Erkenntnisse für beide Fachrichtungen und stellt wertvolle Grundlagen bereit.

Sofern es im phänomenologischen Sinne nur Sein geben kann, wenn es Erscheinen gibt, ist unsere Seinserfahrung an eine originär leibliche Subjektivität gebunden, welche als Lebenserprobung jeder Seinsbegegnung transzendental vorausliegt. Dem wird im Zusammenhang mit dem abendländischen Transzendenzbegriff nachgegangen, wobei auch die transkulturelle Perspektive der Leere im Buddhismus sowie der urchristlichen Doxa als Herrlichkeit Gottes berücksichtigt wird. Durch die Identität von Lebenserprobung und ursprünglichem Nicht-Wissen hinsichtlich solcher Lebenspassibilität ist zugleich jede Diskursivität aufgehoben, welche den Anspruch erhebt, über eine begriffliche Sinnstiftung diese (...) Originarität unserer abgründigen Seins- als Lebenserprobung einholen zu können. Daraus ergeben sich ethische wie religiöse Konsequenzen für unsere kulturelle Zukunft, die nicht mehr von der Allgemeinheit mittels Wissen und Lebensformen geprägt sein wird, sondern wo Ipseität und Kopathos für alle Individuen in den Mittelpunkt rücken. Der Autor Rolf Kühn ist Univ.-Doz. für Philosphie und Ehrenpräsident der Forschungsstelle für jüngere französische Religionsphilosophie Universität Freiburg im Br. Der Herausgeber Christoph Böhr ist ao. Professor am Institut für Philosophie der Hochschule Heiligenkreuz/Wien und leitet dort die Forschungsstelle für Metaphysik. (shrink)

Great effort is invested in identifying ways to change people's minds on an issue. A first priority should perhaps be enriching their thinking about the issue. With a goal of enriching their thinking, we studied the views of community adults on the DACA issue—young adults who entered the United States illegally as children. A dialogic method was employed, offering dual benefits in providing participants the opportunity to further develop their own ideas and to consider differing ideas. Yet, participants engaged in (...) dialog only vicariously by observing the talk of a pair of actors who held opposing positions on DACA. The effect on participants’ thinking was greatest in the condition in which they viewed a dialog between the two actors, rather than a comparison condition in which the actors individually expressed their positions. In control conditions, no presentation was observed. Probing questions included in all conditions encouraged a participant to examine and clarify for themselves their own position, potentially enriching it. This condition proved unsuccessful in enriching thinking; participants’ justifications for their own positions in fact became simpler and less qualified. In contrast, observing a video of a like-minded and opposing other did enrich observers’ thinking, yet to a greater degree in the dialogic than nondialogic condition. The findings thus suggest observed dialog as a promising practical approach in promoting deeper thinking. (shrink)

This chapter contains sections titled: Introduction Don't Laugh at “Slow” Sailing: Average Versus Instantaneous Motion Motion Relative to What? – Galilean Relativity But There are No Fixed Reference Frames – Special Relativity General Relativity – Can it Really Matter?

This paper appraises the role of critical-feminist figurations within the environmental humanities, focusing on the capacity of figures to produce situated environmental knowledges and pose site-specific ethical obligations. We turn to four environments—the home, the skies, the seas and the microscopic—to examine the work that various figures do in these contexts. We elucidate how diverse figures—ranging from companion animals to birds, undersea creatures and bugs—reflect productive traffic between longstanding concerns in feminist theory and the environmental humanities, and generate new insights (...) related to situated knowledges, feminist care-ethics and the politics of everyday sensory encounters. We also argue, however, that certain figures have tested the limits of theoretical approaches which have emerged as the product of dialogue between feminist theory and environmental studies. In particular, we explore how particular figures have complicated ethical questions of how to intervene in broad environmental threats borne of anthropogenic activities, and of who or what to include in relational ethical frameworks. (shrink)