Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...) primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. (shrink)

IntroductionBisphenol A is highly debated and studied in relation to a variety of health outcomes. This large variation in the literature makes BPA a topic that is prone to selective use of literature, in order to underpin one’s own findings and opinion. Over time, selective use of literature, by means of citations, can lead to a skewed knowledge development and a biased scientific consensus. In this study, we assess which factors drive citation and whether this results in the overrepresentation of (...) harmful health effects of BPA.MethodsA citation network analysis was performed to test various determinants of citation. A systematic search identified all relevant publications on the human health effect of BPA. Data were extracted on potential determinants of selective citation, such as study outcome, study design, sample size, journal impact factor, authority of the author, self-citation, and funding source. We applied random effect logistic regression to assess whether these determinants influence the likelihood of citation.ResultsOne hundred sixty-nine publications on BPA were identified, with 12,432 potential citation pathways of which 808 citations occurred. The network consisted of 63 cross-sectional studies, 34 cohort studies, 29 case-control studies, 35 narrative reviews, and 8 systematic reviews. Positive studies have a 1.5 times greater chance of being cited compared to negative studies. Additionally, the authority of the author and self-citation are consistently found to be positively associated with the likelihood of being cited. Overall, the network seems to be highly influenced by two highly cited publications, whereas 60 out of 169 publications received no citations.ConclusionIn the literature on BPA, citation is mostly driven by positive study outcome and author-related factors, such as high authority within the network. Interpreting the impact of these factors and the big influence of a few highly cited publications, it can be questioned to which extent the knowledge development in human literature on BPA is actually evidence-based. (shrink)

Heuristics of evolutionary biology dictate that phylogenetically older processes are inherently more stable and resilient to disruption than younger processes. On the grounds that non-declarative behaviour emerged long before declarative behaviour, Reber argues that implicit learning is supported by neural processes that are evolutionarily older than those supporting explicit learning. Reber suggested that implicit learning thus leads to performance that is more robust than explicit learning. Applying this evolutionary framework to motor performance, we examined whether implicit motor learning, relative to (...) explicit motor learning, conferred motor output that was resilient to physiological fatigue and durable over time. In Part One of the study a fatigued state was induced by a double Wingate Anaerobic test protocol. Fatigue had no affect on performance of participants in the implicit condition; whereas, performance of participants in the explicit condition deteriorated significantly. In Part Two of the study a convenience sample of participants was recalled following a one-year hiatus. In both the implicit and the explicit condition retention of performance was seen and, contrary to the findings in Part One, so was resilience to fatigue. The resilient performance in the explicit condition after one year may have resulted from forgetting or from consolidation of declarative knowledge as implicit memories. In either case, implicit processes were left to more effectively support motor performance. (shrink)

This book is a translation of some of the more important parts of the Grundgesetze of Frege: the introduction, the first part of the first volume which gives an exposition of the construction, rules, axioms of Frege's formal system, and two appendices, one of which is from the second volume and gives Frege's analysis of the paradox found by Russell in his system. The editor has provided a long introduction "for those not familiar with Frege," although it will benefit those (...) who have something more than acquaintance with his name as well. Frege's original two-dimensional symbolism has been preserved, but the editor has provided enough discussion in his introduction so as to make the going easier. Next to a complete translation of the Grundgesetze, this work is the most useful introduction to the magnum opus of the nineteenth century's greatest logician.—P. J. M. (shrink)

This volume is published concurrently with the one reviewed below and together they unite a number of Quine's previously scattered papers into two compact volumes; this volume deals with his more philosophical work while the other is concerned with more purely technical logical studies. The twenty-one essays cover the period 1934-1964 and none have appeared between hard covers before. Several of the articles—"The ways of paradox," "Foundations of mathematics," "On the application of modern logic," and "Necessary truth"—are essentially popular expositions. (...) The others are generally more restricted in both scope and appeal, and deal with the ontology of the sentential calculus, truth by convention, implicit definition, modal logic, and ontological reduction in the sciences. Several articles concern the philosophy of science directly: "On simple theories of a complex world," "Posits and reality," and "The scope and language of science." This fine collection will be of significant help in presenting the work of a distinguished philosopher to a wider audience, as well as providing the professional with a source of discussion.—P. J. M. (shrink)

Multiple measures of decision-making under uncertainty (e.g. jumping to conclusions (JTC), bias against disconfirmatory evidence (BADE), win-switch behavior, random exploration) have been associated with delusional thinking in independent studies. Yet, it is unknown whether these variables explain shared or unique variance in delusional thinking, and whether these relationships are specific to paranoia or delusional ideation more broadly. Additionally, the underlying computational mechanisms require further investigation. To investigate these questions, task and self-report data were collected in 88 individuals (46 healthy controls, (...) 42 schizophrenia-spectrum) and included measures of cognitive biases and behavior on probabilistic reversal learning and explore/exploit tasks. Of those, only win-switch rate significantly differed between groups. In regression, reversal learning performance, random exploration, and poor evidence integration during BADE showed significant, independent associations with paranoia. Only self-reported JTC was associated with delusional ideation, controlling for paranoia. Computational parameters increased the proportion of variance explained in paranoia. Overall, decision-making influenced by strong volatility and variability is specifically associated with paranoia, whereas self-reported hasty decision-making is specifically associated with other themes of delusional ideation. These aspects of decision-making under uncertainty may therefore represent distinct cognitive processes that, together, have the potential to worsen delusional thinking across the psychosis spectrum. (shrink)

This concise work is a study of the semantical aspects of various paradoxes arising in formal logic. The author constructs a second-order system T with an interpretation in order to provide apparatus for stating and dodging the antinomies. After presenting a number of paradoxes, the author discusses a semantic vicious-circle principle, and provides a clarification of the problems by its application. He then discusses semantic aspects of some classical meta-mathematical results of Gödel, Tarski, Kleene, and Turing on unsolvable problems. Also (...) treated is the topic of impredicative definition in mathematics, especially as it relates to the vicious-circle principle.—P. J. M. (shrink)

Novikov is one of Russia's leading logicians and the appearance of this fine textbook is a good indicator of increasing American interest in Soviet logic. The book contains some new material, including a new independence proof of the rule of complete induction from the remaining axioms of first-order arithmetic. The first third of this work consists in chapters on propositional algebra and the propositional calculus. The first-order predicate calculus comes next under discussion: here a number of important classical results—Gödel's incompleteness (...) theorem, the Compactness theorem, Skolem-Löwenheim theorem—are proved rigorously. The author throughout the book leans fairly heavily on model-theoretic techniques, hence knowledge of some algebra, especially elementary field theory, will be useful. The last two chapters are concerned with first order arithmetic and the elements of proof theory. The only shortcoming is the lack of a bibliography and related scholarly apparatus; the student using this text may have difficulty locating material in other publications relevant to that in the book without outside assistance. The translation is very smooth and clear. Altogether, a first-class job.—P. J. M. (shrink)

The first of the authors is an engineer, the second a logician, and they have collaborated to produce a systematic and comprehensive treatise and textbook on the theory of automata—computing machines viewed abstractly—which presupposes only a slight familiarity with logic; there is a long first chapter which develops propositional and predicate logic; the stipulation of logical operators, the "nets" constructed therefrom, and their physical realization comprise the next two chapters. The representation of automata in input-output tables and flow diagrams, and (...) the study of operators in structures come next; the last two chapters concern various practical ways of synthesizing automata and measuring the complexity of logical nets. This is one of the series on logic and foundations of mathematics; the translation from Russian was edited by J. C. Shepherdson.—P. J. M. (shrink)

Chomsky is widely mentioned in those philosophical circles whose interest centers on the analysis of language, but until now he has really been little read; this new work will remedy that situation. Here Chomsky, building on a presupposed acquaintance with linguistics, provides a stimulating examination of four major areas of linguistic theory: first, generative grammars are studied in their relation to language learning and understanding, then they are further considered as theories of linguistic use and competence; Chomsky here sets out (...) the criteria required for a grammar to be considered adequate—the justification of grammars. The second chapter examines syntactic theory with reference to depth structure and the problem of the relation of syntactic description to the traditional, correct account of how language is used. Depth structures and their import with reference to transformations within grammars are the subject matter of the third chapter. The last section considers, among other problems, the interface between syntax and semantics, especially the problems of degrees of grammaticality. A number of notes which go further into certain topics appear after the main text, and there is a useful bibliography. The main thrust of the book is a syntactical treatment of natural language by using transformational generative grammars as descriptive. Although he suggests empirical tests for the models he has constructed, he does not provide an attempt to fully verify the proposed system. This book will certainly be essential for an understanding of the structure of language viewed from the syntactic point of view.—P. J. M. (shrink)

Although Frege is now one of the most important figures in analytical philosophy, there are virtually no full-length studies available. Walker does not try to present all of Frege—that would be a monumental undertaking—but only to consider the philosophical aspects of his thought. Frege's theory of functions, concepts, and objects is first studied; then naming and describing are related to predication and thence to concepts; the notion of the sense of words and expressions, and then the notion of truth, especially (...) as picture-truth, is analyzed with their assistance. The last sections view Frege's general idea of the use of language and symbols, the nature of scientific laws, and the nature of numbers. The author sees Frege as tending to shift his interest from logic to ordinary language and so to the problems of expression in general; this view is reflected in the book itself. The affinities which the author sees with the work of Frege and Wittgenstein is only occasionally treated, but he does make it clear that the Tractatus owes much to Frege. Generally, this compact work will serve well in the study and interpretation of the work of the nineteenth century's greatest logician.—P. J. M. (shrink)