The goals of vascular composite allotransplantation for hand are to maximize functional status and psychosocial wellbeing and to improve quality of life. Candidates are carefully vetted by transplant programs through an extensive evaluation process to exclude those patients with contraindications and to select those that are most likely to attain functional or quality of life benefit from transplant. Patient choice for any treatment, however, requires that candidates be able to understand the risks, benefits, and alternatives before choosing to proceed. This (...) study aimed to understand patients’ knowledge and perceptions about treatment options for hand loss, including hand transplant. This study will be used to inform a standardized education approach and develop conversation aids for use by clinicians and patients throughout the treatment decision process. Ten individuals who had experienced hand amputation or had congenital limb loss were interviewed to better understand previous and current decisions about treatment, experiences in adjusting to their treatment, and perceptions about hand VCA. From this qualitative interview data, four findings emerged: knowledge and education around VCA as a treatment option; adaptation of individuals with limb loss; fear of risk associated with transplantation; issues of aging and overuse injuries to existing limbs. Results suggests that there is opportunity for expanding education about all treatment options for patients with new loss, long-term loss, and congenital limb loss. Establishing a baseline of knowledge about all options–prosthetics, rehabilitative strategies, and VCA—can help patients evaluate their values and goals of treatment. Issues associated with aging, including overuse and injury, and adaptability over the life course should be included in considerations about treatment choices. Data indicate the need for routinely assessing patient preferences about treatment choice so patients can plan for their future as they adapt and age and as technology for treatments change. To assure that thorough information is provided for current and future decision-making, education about treatment choices and selection procedures for VCA should be standardized. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Karen J. Warren:Her Work in The Making of EcofeminismTricia Glazebrook (bio)Karen J. Warren was born on Long Island, New York, on September 10, 1947. She received a Bachelor of Arts degree from the University of Minnesota in 1970, and a Master's degree (1974) and Doctorate (1978) from the University of Massachusetts—Amherst. Her dissertation was one of the first on environmental ethics. In the early years of her (...) career, she taught at St. Olaf College in Northfield Minnesota, until 1985 when she joined the Philosophy department at Macalester College in St. Paul, Minnesota. In 1995, she was the second Ecofeminist Scholar-in-Residence at Murdoch University in Australia. In 2002, she was a Round Table Scholar at Oxford University. In 2004, she held the Women's Chair in Humanistic Studies at Marquette.Throughout these achievements, Warren was a dynamic thinker committed to 'real world' issues and strongly committed to public engagement. She took philosophy to be a democratic practice and was committed to the social impacts of philosophy. In her outreach, she taught prison inmates and developed award-winning environmental curricula for schoolchildren, for which she received awards. She was an international scholar who faced issues in peace studies, feminism, and environmental ethics, and is known for bringing those areas of research together. In feminism, her Unconventional History of Philosophy: Conversations Between Men and Women Philosophers (2009), a fifteen-chapter book that pairs female and male philosophers throughout the centuries, is a fascinating book that breaks down the gender bias in philosophy that has rarely recognized women's contributions to the discipline, and seems to be continuing that practice. She is most known for her work as an ecofeminist, that is the focal topic of this paper. [End Page 1]The first time I met Karen was in 1995 when I invited her to Colgate University in upstate New York to celebrate its twenty-fifth year since it began accepting female students. She changed everything—epistemology, ontology, ethics … I learned from her what, beyond contemporary science-based definitions of knowledge, is another kind of knowing from generations of experience built in long-standing cultures. For quite some time, ethics was not considered in philosophy really to be philosophy that, like science, was expected to be grounded on logic. Contemporary 'science,' a generalization that actually covers a wide range of disciplines—e.g., biology, physics, actuarial science, computer science, etc.—is logical in so far as it is more or less based on quantitative assessment using numerical data and mathematics. Ethics, that is inherently qualitative, is not taken to carry the neutrality of mathematics and science. Warren rejected that view and instead, as I will show in more detail below, argued for a different logic based on care. She also argued that understanding what knowledge is is unique to culture, and on this basis, she has advocated for listening to indigenous voices and voices in the global South that are outside Eurocentric knowledge systems despite the impacts of colonialism. Before taking on these issues, however, Warren's role in ecofeminism, that emerged during her higher education in philosophy, and her development in consequence of her ecofeminist thinking, must first be addressed.Practically speaking, the crucially impactful thing that Warren did for ecofeminism was to sustain it. In the 1970s, ecofeminism was emerging with a vision of women's power that was challenged by the women's connection to nature as her reproductive capacity, hence re-awakening an essentialist inscription of biologism for women that once again implied mothers' natural confinement to domesticity. Ecofeminists responded to this challenge. Ortner (1974) argued that women are not closer to nature than men, just constructed to appear so, thereby making change possible only if achieved in both cultural assumptions and social institutions. Amongst such debates, new medical technologies were appropriating the birthing process. Ecofeminist writers, such as Mary Daly in Gyn/Ecology (Daly 1978) and Susan Griffin in Woman and Nature: The Roaring Inside Her (Griffin 1978), both published in 1978, wanted to take that power back from patriarchy through the "Great Goddess" as a "symbol of life and death powers and waxing and waning energies in the universe and in... (shrink)

This book discusses the notion that quantum gravity may represent the "breakdown" of spacetime at extremely high energy scales. If spacetime does not exist at the fundamental level, then it has to be considered "emergent", in other words an effective structure, valid at low energy scales. The author develops a conception of emergence appropriate to effective theories in physics, and shows how it applies (or could apply) in various approaches to quantum gravity, including condensed matter approaches, discrete approaches, and loop (...) quantum gravity. (shrink)

In this article, I explore the role of affective feedback loops in creating and sustaining trust and distrust. Some emotions, such as fear and contempt, drive out trust; others, such as esteem and empathy, drive out distrust. The mechanism here is causal, but not merely causal: affective looping works through changing how the agent interprets the words, deeds, and motives of the other, thus making trust or distrust appear justified. Looping influences not only dyadic trust, but also climates, and networks (...) of trust and distrust. Not all trust-entrenching looping is virtuous, nor all distrust-entrenching looping vicious, but distrust looping is a powerful way to justify xenophobic public policy. I explore options for remedy. (shrink)

Decision making is the physician's major activity. Every day, in doctors' offices throughout the world, patients describe their symptoms and com plaints while doctors perform examinations, order tests, and, on the basis of these data, decide what is wrong and what should be done. Although the process may appear routine-even to the physicians in volved-each step in the sequence requires skilled clinical judgment. Physicians must decide: which symptoms are important, whether any laboratory tests should be done, how the various items (...) of clinical data should be combined, and, finally, which of several treatments (including doing nothing) is indicated. Although much of the information used in clinical decision making is objective, the physician's values (a belief that pain relief is more important than potential addiction to pain-killing drugs, for example) and subjectivity are as much a part of the clinical process as the objective findings of laboratory tests. In recent years, both physicians and psychologists have come to realize that patient management decisions are not only subjective but also prob abilistic (although this is not always acknowledged overtly). When doc tors argue that an operation is fairly safe because it has a mortality rate of only 1 %, they are at least implicitly admitting that the outcome of their decision is based on probability. (shrink)

Social scientists have offered a number of explanations for why Americans commonly deny that human-caused climate change is real. In this paper, I argue that these explanations neglect an important group of climate change deniers: those who say they are on the side of science while also rejecting what they know most climate scientists accept. I then develop a “nature of science” hypothesis that does account for this group of deniers. According to this hypothesis, people have serious misconceptions about what (...) scientific inquiry ought to look like. Their misconceptions interact with partisan biases to produce denial of human-caused climate change. After I develop this hypothesis, I propose ways of confirming that it is true. Then I consider its implications for efforts to combat climate change denial and for other cases of public rejection of science. (shrink)

I suspect the answer to the question in the title of this paper is no. But the scope of my paper will be considerably more limited: I will be concerned with whether certain types of considerations that are commonly cited in favor of dynamic semantics do in fact push us towards a dynamic semantics. Ultimately, I will argue that the evidence points to a dynamics of discourse that is best treated pragmatically, rather than as part of the semantics.

Recent defenses of shaming as an effective tool for identifying bad practice and provoking social change appear compatible with feminism. I complicate this picture by examining two instances of online feminist shaming that resulted in shame backlashes. Shaming requires the assertion of social and epistemic authority on behalf of a larger community, and is dependent upon an audience that will be receptive to the shaming testimony. In cases where marginally situated knowers attempt to “shame up,” it presents challenges for feminist (...) uses. (shrink)

Context-sensitivity raises a metasemantic question: what determines the value of a context-sensitive expression in context? Taking gradable adjectives as a case study, this paper argues against various forms of intentionalist metasemantics, i.e. that speaker intentions determine values for context-sensitive expressions in context, including the coordination account recently defended by King :219–237, 2014a; in: Burgess, Sherman Metasemantics: New essays on the foundations of meaning, Oxford University Press, Oxford, pp 97–118, 2014b). The paper argues that all intentionalist accounts face the speaker authority (...) problem, that speaker intentions are just the wrong sorts of things to determine the standards for gradable adjectives in context. The problem comes to light when we look at cases in which speakers have idiosyncratic, false beliefs that cause their proper communicative intentions to come apart from the non-intentional features of context like the question under discussion, facts about the world, practical goals, and prior linguistic discourse. (shrink)

Typically, a less fundamental theory, or structure, emerging from a more fundamental one is an example of synchronic emergence. A model emerging from a prior model upon which it nevertheless depends is an example of diachronic emergence. The case of spacetime emergent from quantum gravity and quantum cosmology challenges these two conceptions of emergence. Here, I propose two more-general conceptions of emergence, analogous to the synchronic and diachronic ones, but which are potentially applicable to the case of emergent spacetime: an (...) inter-level, hierarchical conception, and an intra-level, ‘flat’ conception. I then explore whether, and how, these ideas may be applicable in the case of several putative examples of relativistic spacetime emergent from the non-spatiotemporal structures described by different approaches to quantum gravity, and of spacetime emergent from a non-spatiotemporal ‘big bang’ state according to different examples of quantum cosmology. (shrink)

This article focuses on foundational issues in dynamic and static semantics, specifically on what is conceptually at stake between the dynamic framework and the truth-conditional framework, and consequently what kinds of evidence support each framework. The article examines two questions. First, it explores the consequences of taking the proposition as central semantic notion as characteristic of static semantics, and argues that this is not as limiting in accounting for discourse dynamics as many think. Specifically, it explores what it means for (...) a static semantics to incorporate the notion of context change potential in a dynamic pragmatics and denies that this conception of static semantics requires that all updates to the context be eliminative and distributive. Second, it argues that the central difference between the two frameworks is whether semantics or pragmatics accounts for dynamics, and explores what this means for the oft-heard claim that dynamic semantics blurs the semantics/pragmatics distinction. (shrink)

An effective theory in physics is one that is supposed to apply only at a given length scale; the framework of effective field theory describes a ‘tower’ of theories each applying at different length scales, where each ‘level’ up is a shorter-scale theory. Owing to subtlety regarding the use and necessity of EFTs, a conception of emergence defined in terms of reduction is irrelevant. I present a case for decoupling emergence and reduction in the philosophy of physics. This paper develops (...) a positive conception of emergence, based on the novelty and autonomy of the ‘levels’, by considering physical examples, involving critical phenomena, the renormalisation group, and symmetry breaking. This positive conception of emergence is related to underdetermination and universality, but, I argue, is preferable to other accounts of emergence in physics that rely on universality. (shrink)

While standard histories of Western political thought represent women’s rights as an offshoot of the earlier movement for the equal rights of men, this essay argues that the eighteenth-century push for democracy and equal rights was grounded in arguments first used to defend women’s right to moral and religious self-determination, based on their rational and spiritual equality with men. In tandem with the rise of critiques of absolute monarchy, ideal marriage, which had previously involved lordship and subjection, was transformed into (...) an equal companionate relationship based on inclination and affection. The essay argues that the transformation, by the time of the American and French revolutions, of neo-Roman republicanism—which had been aristocratic and oligarchic—into egalitarian, democratic republicanism had been mediated by the extension of arguments, widely distributed in the literature criticizing the slavery of marriage, into a general critique of slavery and support for the equal rights of men. (shrink)

Within both philosophy and psychology, a new pro-emotion consensus is replacing the old dogmas that emotions disrupt practical rationality, that they are at best arational, if not outright irrational, and that we can understand what is really central to human cognition without studying them. Emotions are now commonly viewed as evolved capacities that are integral to our practical rationality. An infinite mind, unencumbered by a body, might get along just fine without emotions; but we finite embodied creatures need them if (...) we are to be capable of responding appropriately to our reasons and navigating in a risky world with poor information, limited attention, and restricted computational power. Emotions are clever design solutions to the problem of making fast decisions in response to significant practical problems posed by the natural and social worlds: we perceive a danger and fear immediately primes us to take protective action. On this view, the theory of emotions is an essential part of a theory of ecologically situated and constrained rationality - that is to say, of human rationality. (shrink)

The obesity epidemic among children and adolescents in the United States continues to worsen. The most recent analysis of data from the National Health and Nutrition Examination Survey showed that the prevalence of overweight among children and adolescents – defined as a Body Mass Index at or above the 95th percentile on gender-specific BMI-for-age growth charts developed by the Centers for Disease Control and Prevention – increased significantly between 1999-2000 and 2003-2004. Over this period, the prevalence of overweight among children (...) and adolescents aged 2-19 increased 23% – from 13.9% to 17.1%. In 2003-2004, 18.8% of children aged 6-11 and 17.4% of adolescents aged 12-19 were overweight. Roughly comparable proportions of each age group were considered to be at risk of becoming overweight. (shrink)

In this introduction, we describe the rationale behind this special issue on Principles of Quantum Gravity. We explain what we mean by ‘principles’ and relate this to the various contributions. Finally, we draw out some general themes that can be found running throughout these contributions.

Over the past year media outlets and scientific and bioethics journals have reported about several medical and scientific innovations touted as having the potential to fundamentally change not only how diseases and disorders are diagnosed and treated but even how to alter the genomes of future generations. The purported “miracle” blood-testing technology of Theranos and the potential use of the genome editing technology CRISPR-Cas9 to modify human and nonhuman organisms reflect dramatic advances in scientific understanding about the biological mechanisms of (...) humans and other living organisms. Yet evidence about whether these and other innovative biomedical technologies are safe and effective and lead to improved health outcomes for patients young and old is often in dispute. How to assess the safety and effectiveness of innovative biomedical technologies, who should be involved in that effort, and how to define risks and benefits of those technologies are questions at the intersection of values, interests, and politics. (shrink)

This article will introduce readers to current debates in the philosophy of poetry. This includes discussion of the need for a philosophy of poetry as distinct from a philosophy of literature, the (in)compatibility of poetry and philosophy, poetic meaning and interpretation, and poetry in relation to affect, emotion and expressiveness, which opens up discussion of wider forms of poetry from spoken word to signlanguage poetry. The article ends with suggestions for future directions of research in the philosophy of poetry. I (...) argue that as the philosophy of poetry is gaining interest, the previous debates that presuppose an understanding of poetry as taking form on the page and as having fixed aboutness ought to be abandoned in favour of an understanding of a poem in the affective space, with issues of reception, interpretation, distribution, and performance in play. (shrink)

Introduction for the Synthese Special Issue on Spacetime Functionalism.

Current discussion of scientific realism and antirealism often cites Pierre Duhem’s argument for the underdetermination of theory choice by evidence. Participants draw on an account of his underdetermination thesis that is familiar, but incomplete. The purpose of this article is to complete the familiar account. I argue that a closer look at Duhem’s The aim and structure of physical theory suggests that the rationale for his underdetermination thesis comes from his philosophy of scientific language. I explore how an understanding of (...) physical laws as symbolic is meant to support the thesis. In the course of my argument, I point out that Duhemian underdetermination is not meta-practical but grounded in the practice of science, specifically in the scientist’s use of instruments and measurement techniques. Measurement has a significant limitation, according to Duhem: it always involves approximation and a degree of experimental error. Consequently, it cannot overcome the gap between the ordinary, concrete language of observation and the mathematical language of science. Moreover, Duhem argues that the use of instruments in experiment invokes whole groups of theories. I contend that, ultimately, this reliance on auxiliary assumptions—which makes possible the use of instruments—is the foundation of his thesis and that recognizing this completes the familiar account of his underdetermination argument.Author Keywords: Duhem; Suppes; Underdetermination; Measurement; Physical theory. (shrink)

Dummett's output has been prolific and highly influential, but not always as accessible as it deserves to be. This book sets out to rectify this situation.

Lyric poetry is often associated with expression of the personal. For instance, the work of the so-called “confessional” poets, such as Sylvia Plath and Anne Sexton, is often thought to reveal inmost thoughts and feelings of the poetic voice through first personal expression. The lyric poem, with its use of personal pronouns and singularity of voice, appears to invite the reader to experience the unfolding of the words as the intimate expression of another.Intimacy itself is associated with attention to another (...) and is thought to play a role in feeling sympathy and empathy. As John Gibson comments, “Empathy makes possible an especially intimate and powerful form of identification. It underwrites our capacity...... (shrink)

Schools are ideal settings for implementing multi-component programs to prevent and control childhood obesity. Thoughtful improvements to proven strategies, coupled with careful evaluation, can contribute to accumulation of evidence needed to design and implement the next generation of optimal interventions.

At first glance, Germaine de Staël and Immanuel Kant evince strikingly different attitudes to aesthetic judgment. Yet she promoted Kant's aesthetics and philosophy. This paper examines both Staël's early literary works and her later De l'Allemagne in order to tease out the relationship between their aesthetic theories.

Certaines ont affirmé que le concept de gender était une invention américaine, intraduisible par le mot français « genre ». Pourtant, au-delà des distinctions grammaticales, il existe depuis longtemps - bien avant Beauvoir, Oakley, et l'usage postmoderniste construit par Joan Scott et Judith Butler - un usage français du terme « genre », qui spécifie dans le vocabulaire sociopolitique - notamment féministe - la construction sociale et culturelle des sexes. L’objet de cet article est d’en rétablir les trajectoires historiques et (...) de contribuer peut-être à balayer les dernières réticences manifestées en France à son égard. (shrink)

Levy’s essay (2011) claims that some intuitions leading to one’s moral judgments can be unreliable, and he proposes the use of a more reliable, third party, empirical measure. It is commendable that Levy attempts to work beyond traditional bounds; however, the author’s use of functional magnetic resonance imaging (fMRI) data is questionable in supporting an argument about intentionality. As neuroscientists, we rely upon evidence-based thinking and conclusions to create generalizable knowledge, and while fMRI data can be informative in broad correlational (...) accounts of behavior, to rely upon these data as reliable measures of intuition is arguably just as speculative as the first-person account. It is of deep concern that society may attempt to apply these data in the manner Levy describes. Indeed, alarming misappropriation of fMRI and electroencephalography. (shrink)

A collection of essays by prominent physicists, biologists, geneticists, zoologists, philosophers and other thinkers about the relationship between science and philosophy, particularly the teleological versus the mechanistic explanation of the universe.

We may create a catch-22 so that only people who are unlikely to need health insurance can afford it.... Genetic risk testing is important because it exposes the logic of a system that provides access to health insurance to those least likely to need it.