Medical schools, like all institutions, are conservative since they seek to maintain and expand on their accomplishments. Stakes are high in carceral medicine given the risks of replicating the inhumane social conditions that exist within prisons and allow prisons to exist. Given the increasing number of partnerships between state and municipal carceral systems with academic medical centers, medical schools must consider which guiding theory they will use to teach carceral medicine. The interdisciplinary theory of prison abolition is best fit for (...) the task of training medical students to think about the long term goals of societal change and public health. (shrink)

Despite there being deep lines of convergence between the philosophies of Alfred North Whitehead, C. S. Peirce, William James, John Dewey, and other classical American philosophers, it remains an open question whether Whitehead is a pragmatist, and conversation between pragmatists and Whitehead scholars have been limited. Indeed, it is difficult to find an anthology of classical American philosophy that includes Whitehead’s writings. These camps began separately, and so they remain. This volume questions the wisdom of that separation, exploring their connections, (...) both historical and in application. The essays in this volume embody original and creative work by leading scholars that not only furthers the understanding of American philosophy, but seeks to advance it by working at the intersection of experience and reality to incite novel and creative thought. This exploration is long overdue. Specific questions that are addressed are: Is Whitehead a pragmatist? What contrasts and affinities exist between American pragmatism and Whitehead’s thought? What new questions, strategies, and critiques emerge by juxtaposing their distinct perspectives? -/- . (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

This volume offers a carefully argued, compelling theory of bioethics while eliciting practical implications for a wide array of issues including medical assistance-in-dying, the right to health care, abortion, animal research, and the definition of death. The authors' dual-value theory features mid-level principles, a distinctive model of moral status, a subjective account of well-being, and a cosmopolitan view of global justice. In addition to ethical theory, the book investigates the nature of harm and autonomous action, personal identity theory, and the (...) 'non-identity problem' associated with many procreative decisions. Readers new to particular topics will benefit from helpful introductions, specialists will appreciate in-depth theoretical explorations and a novel take on various practical issues, and all readers will benefit from the book's original synoptic vision of bioethics. This title is also available as Open Access on Cambridge Core. (shrink)

In a friendly interdisciplinary debate, we interrogate from several vantage points the question of “personhood” in light of contemporary and near-future forms of social AI. David J. Gunkel approaches the matter from a philosophical and legal standpoint, while Jordan Wales offers reflections theological and psychological. Attending to metaphysical, moral, social, and legal understandings of personhood, we ask about the position of apparently personal artificial intelligences in our society and individual lives. Re-examining the “person” and questioning prominent construals of that (...) category, we hope to open new views upon urgent and much-discussed questions that, quite soon, may confront us in our daily lives. (shrink)

While the nature of the virtues and their role in human action are controversial, we wish to explore the thesis that virtues play a causal role in the production of action. One fruitful, though controversial, approach to understanding the nature of the self is through the notion of a narrative and in particular a person’s self narrative or narratives. Similarly we wish to explore the thesis that self narratives play a causal role in action. We consider how virtues and self-narratives (...) interrelate and, in particular, how they play a comparable role in the production of action. The basic ideas in the literature concerning reasons as causes of action provide us with a useful starting point even though the focus on reasons has tended to sideline potential causal roles for both virtues and self-narratives. Without attempting to develop a new theory of causation, we draw a picture of how virtues and self-narratives, in relation to each other, can be regarded as causally effective in producing action. (shrink)

The notion of an agent and the notion of a self are connected, for agency is one role played by the self. Millgram argues for a disunity thesis of agency on the basis of extreme incommensurability across some major life events. We propose a similar negative thesis about the self, that it is composed of relatively independent threads reflecting the different roles and different mind-sets of the person's life. Our understanding of those threads is based on theories of the narrative (...) construction of the self. Our disunity thesis is that there need be no overarching narrative that unifies those narrative threads. To explain how the threads hang together to produce coherent action, we make these positive claims: control normally switches smoothly and unconsciously between threads as circumstances require, within one thread there is likely to be acknowledgment of other threads, some situations require a temporary blending of threads, and some plans and policies reach across different threads and contribute to some coordination among them. Our account of a self provides an account of agency that has merits in comparison to Millgram's. Our narrative approach allows explanations of actions beyond rational deliberation. (shrink)

1. The current political scene in many countries is populated by polarised groups with sharply contrasting loyalties and beliefs implying that there are fundamental schisms between opposing groups....

While the Enlightenment promoted thinking for oneself independent of religious authority, the ‘Endarkenment’ (Millgram 2015) concerns deference to a new authority: the specialist, a hyperspecializer. Non-specialists need to defer to such authorities as they are unable to understand their reasoning. Millgram describes how humans are capable of being serial hyperspecializers, able to move from one specialism to another. We support the basic thrust of Millgram’s position, and seek to articulate how the core idea is deployed in very different ways in (...) relation to extremely different philosophical areas. We attend to the issue of the degree of isolation of different specialists and we urge greater emphasis on parallel hyperspecialization, which describes how different specialisms can be embodied in one person at one time. (shrink)

In this essay, we examine the use of resting state fMRI data for psychological inferences. We argue that resting state studies hold the paired promises of discovering novel functional brain networks, and of avoiding some of the limitations of task-based fMRI. However, we argue that the very features of experimental design that enable resting state fMRI to support exploratory science also generate a novel confound. We argue that seemingly key features of resting state functional connectivity networks may be artefacts resulting (...) from sampling a ‘mixture distribution’ of diverse brain networks active at different times during the scan. We explore the consequences of this ‘mixture view’ for attempts to theorize about the cognitive or psychological functions of resting state networks, as well as the value of exploratory experiments. (shrink)

Physiological investigation has demonstrated that the central nervous system monitors body composition and adjusts energy intake and expenditure to stabilize total adipose tissue mass. Genetic variations in the signalling molecules involved in this regulatory system account for the heritable component of body fat content. The application of molecular techniques to rodent models of Mendelian obesity has resulted in the characterization of five loci at which mutations produce an abnormal accumulation of body fat. The genes at these loci include agouti, which (...) encodes a molecule that antagonizes the binding of alpha melanocyte‐stimulating hormone to its receptor; fat, which encodes carboxypeptidase E; tubby, which encodes a putative phosphodiesterase; obese, which encodes a circulating satiety protein; and diabetes, which encodes the receptor for the obese gene product. A more detailed understanding of the functional interrelationships of these genes should lead to important new insights into the causes and potential therapies for human obesity. (shrink)

Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching (...) Hospitals in a low resource setting. (shrink)

Proposals for allocating scarce lifesaving resources in the face of the Covid-19 pandemic have aligned in some ways and conflicted in others. This paper attempts a kind of priority setting in addressing these conflicts. In the first part, we identify points on which we do not believe that reasonable people should differ—even if they do. These are (i) the inadequacy of traditional clinical ethics to address priority-setting in a pandemic; (ii) the relevance of saving lives; (iii) the flaws of first-come, (...) first-served allocation; (iv) the relevance of post-episode survival; (v) the difference between age and other factors that affect life-expectancy; and (vi) the need to avoid quality-of-life judgments. In the second part, we lay out some positions on which reasonable people can and do differ. These include (i) conflicts between maximizing benefits and priority to the worst off; (ii) role-based priority; and (iii) whether patients’ existing lifesaving resources should be subject to redistribution. (shrink)

Over 40 years of research have shown that traumatic brain injury affects brain volume. However, technical and practical limitations made it difficult to detect brain volume abnormalities in patients suffering from chronic effects of mild or moderate traumatic brain injury. This situation improved in 2006 with the FDA clearance of NeuroQuant®, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. More recent strides were made with the introduction of NeuroGage®, commercially available software that is based (...) on NeuroQuant® and extends its utility in several ways. Studies using these and similar methods have found that most patients with chronic mild or moderate traumatic brain injury have brain volume abnormalities, and several of these studies found—surprisingly—more abnormal enlargement than atrophy. More generally, 102 peer-reviewed studies have supported the reliability and validity of NeuroQuant® and NeuroGage®. Furthermore, this updated version of a previous review addresses whether NeuroQuant® and NeuroGage® meet the Daubert standard for admissibility in court. It concludes that NeuroQuant® and NeuroGage® meet the Daubert standard based on their reliability, validity, and objectivity. Due to the improvements in technology over the years, these brain volumetric techniques are practical and readily available for clinical or forensic use, and thus they are important tools for detecting signs of brain injury. (shrink)

This paper examines the impact of a week-long philosophy summer camp on middle and high school-age youth with specific attention paid to the development of intellectual humility in the campers. In June 2016 a university in Texas hosted its first philosophy summer camp for youth who had just completed sixth through twelfth grades. Basing our camp on the pedagogical model of the Philosophy for Children program, our aim was specifically to develop a community of inquiry among the campers, providing them (...) with a safe intellectual space to be introduced to philosophy and philosophical discussion. In 2017 we launched a formal longitudinal study to determine what impact a week-long philosophy summer camp would have on teens and tweens. Examining quantitative and qualitative data collected from 2016–2020, we found that the camp has had a significant impact on the teenagers who have attended. In particular, we found that intellectual humility increased over the duration of their camp experience and that this increase correlates with an increased affinity for philosophy and philosophical discussion. (shrink)

Virtues can be considered to play a causal role in the production of behaviour and so too can our self-narratives. We identify a point of connection between the two cases and draw a parallel between them. But, those folk psychological notions, virtues and self-narratives, fail to reduce smoothly to the underlying human physiology. As a first step towards handling that failure to connect with the scientific framework that is the familiar grounding for our understanding of causation, we consider the causal (...) theory of action, a leading theory of action, which shows how reasons, understood as an appropriate pair of beliefs and desires, can be treated as causes of action. Davidson’s picture is based on cause as a relation between events, which can have both a description in scientific terms and in folk psychological terms. The character of both virtues and self-narratives is not that of events, even extended ones, so we need to refer to examples of scientific explanation that incorporate structural properties of objects. While we retain the spirit of the causal theory, we wish to guard against any unwarranted optimism that an explicitly scientific explanation for human action lies in our future, drawing on Chomsky’s view that a causal explanation of human actions is likely to remain beyond human science forming capacities. We take a mild-realist view of virtues and self-narratives, in the style of Dennett. We argue that, in spite of that limited form of realism, underlined by Chomsky’s mysterian position in this domain, we still need to frame our explanations of behaviour based on virtues and self-narratives in causal terms. (shrink)

We are currently facing global healthcare crisis that has placed unprecedented stress on healthcare workers as a result of the coronavirus disease 2019. It is imperative that we develop novel tools to assist healthcare workers in dealing with the significant additional stress and trauma that has arisen as a result of the pandemic. Based in research on the effects of immersive environments on mood, a neuroscience research laboratory was rapidly repurposed using commercially available technologies and materials to create a nature-inspired (...) relaxation space. Frontline healthcare workers were invited to book 15-min experiences in the Recharge Room before, during or after their shifts, where they were exposed to the immersive, multisensory experience 496 Recharge Room users completed a short survey about their experience during an unselected, consecutive 14-day period. Average self-reported stress levels prior to entering the Recharge Room were 4.58/6. After a single 15-min experience in the Recharge Room, the average user-reported stress level was significantly reduced 1.85/6. Net Promoter Score for the experience was 99.3%. Recharge Rooms such as those described here produce significant short-term reductions in perceived stress, and users find them highly enjoyable. These rooms may be of general utility in high-stress healthcare environments. (shrink)

Some placebo-controlled trials can continue ethically after a candidate vaccine is found to be safe and efficacious.

This article focuses on the ways that sexual risk behaviors are related to race, class, and gender among low-income, culturally diverse women in South Florida. Data concerning sexual risk and gender are presented in terms of race and class variations. Results indicate that, in general, these women have a high degree of knowledge about acquired immune deficiency syndrome, a quite contemporary awareness of women's gendered subordination, and a lack of trust in heterosexual relationships. Attitudes, beliefs, and knowledge, however, are not (...) translated into sexual behaviors with men partners that would reduce their vulnerability to infection with the human immunodeficiency virus. The data indicate that race is a major factor that places women into an underclass position. Consequently, without socioeconomic resources, gendered behaviors have a direct influence on sexual risk. Multivariate analyses indicate that those women who are sex workers are significantly more likely to negotiate safe sex with clients than with main partners. The research not only challenges mainstream thinking about race, class, and gender but also provides overdue information on the vulnerability of women to HIV infection. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

During the recent Ebola epidemic, some commentators and stakeholders argued that it would be unethical to carry out a study that withheld a potential treatment from affected individuals with such a serious, untreatable disease. As a result, the initial trials of experimental treatments did not have control arms, despite important scientific reasons for their inclusion. In this paper, we consider whether the duty to rescue entails that it would be unethical to withhold an experimental treatment from patient-participants with serious diseases (...) for which there are no effective treatments, even when doing so is scientifically necessary to test the effectiveness of the treatment. We argue that the duty to rescue will rarely apply. The context of medical research also throws new light on the content of the duty to rescue, since the interests of future patients—who stand to benefit from the fruits of medical research—are relevant to whether the duty applies. (shrink)

In 2014, Colonel M. Shane Riza published an article in this journal arguing that remotely piloted aircraft and robotic weapons threaten the US Air Force’s warrior ethos. Riza has clearly articulated the sentiments of one side of a vibrant debate within our service. This paper presents an alternative view; a view held by some who have experienced these new forms and tools of war, and who have wrestled with their implications first-hand. In this paper, we address some methodological concerns with (...) Riza’s approach and then engage some misunderstandings about RPA’s relationship to military history and to risk. The second part of this paper takes a close look at some of the early Just War thinkers to determine what implications the tradition may have on the warrior ethos. We propose, as an alternative to Riza’s position, a return to an ethos grounded in humility, charity, and a conception of war as a last resort; in short, a return to the Just Warrior Ethos. (shrink)