Data are lacking with regard to participants' perspectives on return of genetic research results to relatives, including after the participant's death. This paper reports descriptive results from 3,630 survey respondents: 464 participants in a pancreatic cancer biobank, 1,439 family registry participants, and 1,727 healthy individuals. Our findings indicate that most participants would feel obligated to share their results with blood relatives while alive and would want results to be shared with relatives after their death.
Background: There are few standardized measures available to assess executive function in a naturalistic setting for children. The Children’s Cooking Task is a complex test that has been specifically developed to assess EF in a standardized open-ended environment. The aim of the present study was to evaluate the internal consistency, inter-rater reliability, sensitivity and specificity, and also convergent and divergent validity of the Norwegian version of CCT among children with pediatric Acquired Brain Injury and healthy controls.Methods: The present study has (...) a cross-sectional design, based on baseline data derived from a multicenter RCT. Seventy-five children with pABI from two university hospitals with parent-reported executive dysfunction and minimum of 12 months since injury/completed cancer therapy, as well as 59 HCs aged 10–17 years, were assessed with CCT using total errors as the main outcome measure. The pABI group completed tests assessing EF on the impairment level within the ICF framework, and on the participation level. In addition, they completed tests of intellectual ability, processing speed, attention, learning, and memory. Finally, overall functional outcome was evaluated for the children with pABI.Results: Acceptable internal consistency and good inter-rater reliability were found for the CCT. Children with pABI performed significantly worse on the CCT than the HCs. The CCT identified group membership, but the sensitivity and specificity were overall classified as poor. Convergent validity was demonstrated by associations between the CCT and performance-based tests assessing inhibition, cognitive flexibility, and working memory, as well as teacher-reported executive dysfunction. Divergent validity was supported by the lack of association with performance-based measures of learning and memory, attention, and verbal intellectual ability. However, there was a moderate association between the CCT and performance-based tests of processing speed. Lastly, better performance on the CCT was associated with a better functional outcome.Conclusion: Our study with a relatively large sample of children with pABI and HC’s demonstrated good psychometric properties of the CCT. CCT performance was associated with the overall level of disability and function, suggesting that CCT is related to the level of activity in everyday life and participation in society. Hence, our study suggests that the CCT has the potential to advance the assessment of EF by providing a valid analysis of real-world performance. Nevertheless, further research is needed on larger samples, focusing on predictors of task performance, and evaluating the ability of CCT to detect improvement in EF over time. The patterns of error and problem-solving strategies evaluated by the CCT could be used to inform neuropsychological rehabilitation treatmentand represent a more valid outcome measure of rehabilitation interventions. (shrink)
"In this concluding volume of his impressive study of the history of Western thought about the nature of love, Irving Singer reviews the principal efforts that have been made by 20th-Century thinkers to analyze the phenomenon of love.... [T]he bulk of the book is taken up with critical accounts of the modern thinkers who have systematically called into question the possibility itself of love as a union of distinct human selves. For the most part, these critiques are effectively executed, and (...) they bring a high level of critical acumen to bear on skeptical theses about love that are now too often accepted as truisms."—Frederick A. Olafson, _Los Angeles Times Book Review_ "Irving Singer... has developed a method of historical analysis flexible enough to deal with all kinds of love, from Greek homosexual love in Plato, to the _philia_ and _agape_ of the New Testament, to the courtly love of medieval romance, to the Romantics, for whom love was magic.... [This] final volume brings us to the present. In 'The Modern World,' Singer offers readings of Freud, Proust, and Sartre, among others. He shows how their work was formed in reaction to the 19th-century ideal of 'merging' of the identities of lover and beloved. More often than not, the great modern writers portray love as impossible, as a field of failure and regret.... This masterpiece of critical thinking is a timely, eloquent, and scrupulous account of what, after all, still makes the world go round."—Thomas D'Evelyn, _Christian Science Monitor_ "This is the third of a three-volume history of the philosophy of love. It begins with Kierkegaard, Tolstoy, and Nietzsche in the nineteenth century and treats Freud, Proust, Bergson, D. H. Lawrence, G. B. Shaw, Santayana, Sartre, and others in the twentieth. Although the author's approach is primarily historical, he intersperses critical remarks throughout. Most of the major themes which are discussed by philosophers of love make their way into this history, including friendship, sexual love, and the distinction between love that is based on the value of the beloved and love that bestows value on the beloved. Singer devotes a number of pages to his own views on falling in love, being in love, and staying in love.... Singer's exposition is lucid and organized; his criticisms are insightful."—_Ethics_ "In this third volume of historical overview of the development of the Western conception of love, Singer uses writers, philosophers, and psychologists to provide the reader with an overview of love in the late 19th and 20th century.... Analyzing authors such as Tolstoy, Proust, D. H. Lawrence, and Shaw and philosophers such as Nietzsche, Kierkegaard, Sartre, and Santayana, as well as Freud, Singer... links each contributor's thoughts to the influence of previous writers and also provides some psycho-historical insight into their personal lives that might have been either a source or direct result of their views. In this final volume, Singer proceeds to look at not just the 'great men' influence but also provides a chapter overviewing scientific contributions to our understanding of love.... Singer's work is a significant contribution to understanding the social construction of important, abstract social and personal values. By tracing love through different historical periods through a variety of voices, Singer has created a rich history of the struggle between the ideal and the real, between the dreams of what love should provide and the reality of what relationships have been in each historical period. By personalizing the voice through psychohistorical analysis, Singer also provides insight into the shaping of ideas through the intimate struggles of the shapers."—Mark V. Chaffee, _Contemporary Psychology_. (shrink)
Julkaisematta jääneessä muistiossaan Mietteitä oikeuden yleiskäsitteestä (1702-1703?) G. W. Leibniz muotoilee uudelleen Platonin Euthyfron-dialogissa esitetyn kuuluisan kysymyksen. Hän kirjoittaa: ”Myönnetään, että kaikki mitä Jumala tahtoo, on hyvää ja oikein. Sen sijaan kysytään, onko se hyvää ja oikein siksi että Jumala niin tahtoo, vai tahtooko Jumala sitä koska se on hyvää ja oikein. Eli kysytään, onko hyvyys tai oikeus jotakin mielivaltaista, vai koostuvatko ne asioiden luonnetta koskevista välttämättömistä ja ikuisista totuuksista, kuten luvut ja suhteet.” Universaaleja, ikuisia totuuksia puolustava filosofi ei voi (...) hyväksyä ensin mainittua vaihtoehtoa. Hänen mukaansa ”Se toden totta tuhoaisi Jumalan oikeudenmukaisuuden. Sillä miksi ylistäisimme häntä oikeudenmukaisista teoista, jos oikeudenmukaisuuden käsite ei hänen tapauksessaan lisää mitään teon käsitteeseen? Ja sanonta stat pro ratione voluntas, minun tahtoni käyköön perusteesta, on todella tyrannin motto.” Leibnizin kritiikki on suunnattu erityisesti hänen aikalaisiaan René Descartesia, Thomas Hobbesia ja Samuel Pufendorfia vastaan. Hän ei voi hyväksyä näkemystä, jonka mukaan oikeudenmukaisuuden mitta on vain Jumalan tahto. Perustan on löydyttävä ikuisista totuuksista, jotka ovat myös Jumalan oikeudenmukaisuuden standardi. Erityisen kuuluisaksi tuli Leibnizin kritiikki Pufendorfin näkemyksiä kohtaan, sillä Pufendorfin laajalle levinneen teoksen De officio hominis et civis ranskalaisen laitoksen neljännen painoksen toimittaja Barbeyrac liitti siihen Leibnizin kiistakirjoituksen, joka tunnetaan lyhyellä nimellä Monita (Epistola viri excellentissimi ad amicum qua monita quaedam ad principia Pufendorfiani operis de officio hominis et civis continentur, 1706) ja puolusti Pufendorfia Leibnizia vastaan. Leibnizin onnistui kuitenkin ilmeisesti osoittaa eräs heikkous Pufendorfin näkemyksissä, jota Barbeyrac ei pystynyt sivuuttamaan: tämän mukaan Jumala on saman aikaan sekä ylin tuomari että lakien laatija. Siten Leibnizin näkökulmasta Jumala on tyranni – hänen tahtonsa on oikeuden ja etiikan mitta ja koska hän on kaikkivaltias, hän voi pakottaa ihmiset noudattamaan sellaista oikeudenmukaisuutta, joka on hänen mieleistään. Koska Jumalan yläpuolella ei ole Pufendorfin mukaan mitään, hän voi toimia aivan mielivaltaisesti. Leibnizin kritiikki kiteytyy Pufendorfin epäselvään erotteluun ulkoisen ja sisäisen velvollisuuden välillä, joka jättää hänen näkemyksensä arvoitukselliseksi. Tutkiskelen tässä esitelmässä oliko Leibnzin kritiikki johdonmukainen ja oikeutettu. Onko Pufendorfin näkemyksissä heikkous, jota hän ei itse huomannut? Vertailen myös asiaa koskevia eri kommentaareja (mm. Kari Saastamoinen, Petter Korkman, Fiametta Palladini) ja arvioin Leibnizin kritiikin reseptiota Pufendorf-tutkimuksessa. (shrink)
While certain substantial moral dilemmas in health care have been given much attention, like abortion, euthanasia or gene testing, doctors rarely reflect on the moral implications of their daily clinical work. Yet, with its aim to help patients and relieve suffering, medicine is replete with moral decisions. In this qualitative study we analyse how doctors handle the moral aspects of everyday clinical practice. About one hundred consultations were observed, and interviews conducted with fifteen clinical doctors from different practices. It turned (...) out that the doctors’ approach to clinical cases followed a rather strict pattern across specialities, which implied transforming patients’ diverse concerns into specific medical questions through a process of ‘essentialising’: Doctors broke the patient’s story down, concretised the patient’s complaints and categorised the symptoms into a medical sense. Patients’ existential meanings were removed, and the focus placed on the patients’ functioning. By essentialising, doctors were able to handle a complex and ambiguous reality, and establish a medically relevant problem. However, the process involved a moral as well as a practical simplification. Overlooking existential meanings and focusing on purely functional aspects of patients was an integral part of clinical practice and not an individual flaw. The study thus questions the value of addressing doctors’ conscious moral evaluations. Yet doctors should be aware that their daily clinical work systematically emphasises beneficence at the expense of others—that might be more important to the patient. (shrink)
Next SectionThe principle of respect for autonomy has shaped much of the bioethics' discourse over the last 50 years, and is now most commonly used in the meaning of respecting autonomous choice. This is probably related to the influential concept of informed consent, which originated in research ethics and was soon also applied to the field of clinical medicine. But while available choices in medical research are well defined, this is rarely the case in healthcare. Consideration of ordinary medical practice (...) reveals that the focus on patient choice does not properly grasp the moral aspects involved in healthcare. Medical decisions are often portrayed as if doctors and patients in confidence confront specific decisions about examinations or treatment, yet the reality often involves many different participants, with decisions being made over time and space. Indeed, most of the decisions are never even presented to patients, as it would be unethical to suggest something that is not medically justifiable. The options patients do confront are somewhat arbitrarily constructed within the narrow framework of both what is deemed to be medically appropriate and how the healthcare system is organised practically. While the autonomy discourse has proven valuable, a failure to distinguish between the fields of medical research and clinical medicine has generated a focus on patient choice that does not reflect what is really at stake in healthcare settings. This is alarming, because the current discourse misrepresents medical practice in a way that actually contributes to bioethical self-delusion. (shrink)
Definiteness is commonly seen as the watershed between those noun phrases (NPs) that introduce new referents and those that refer to referents already familiar. Furthermore, for definite NPs, the anaphoric use is taken to be the paradigm case, while other, so-called first-mention uses are regarded as secondary. The aim of the present paper is to challenge this view, and to argue for a more complex picture of the role of definiteness in the processing of NPs. The paper consists of two (...) parts. The first part presents a corpus-based study of the co-referential properties of definite and indefinite NPs in natural, unrestricted texts. The data bring into light several issues with regard to co-referentiality in unrestricted discourse and the possible referential functions of indefinite and definite NPs. Particular attention is drawn to the fact that the most common function of definite NPs is not anaphoric but different types of first-mention uses. This is the point of departure for the second part of the paper, in which three different approaches to first-mention definities are discussed, and some preliminaries to an alternative model of the processing of first-mention definite NPs are presented. (shrink)
We introduce a new model of reduction inspired by Kemeny and Oppenheim’s model [Kemeny & Oppenheim 1956] and argue that this model is operative in a “ruthlessly reductive” part of current neuroscience. Kemeny and Oppenheim’s model was quickly rejected in mid-20th-century philosophy of science and replaced by models developed by Ernest Nagel and Kenneth Schaffner [Nagel 1961], [Schaffner 1967]. We think that Kemeny and Oppenheim’s model was correctly rejected, given what a “theory of reduction” was supposed to account for at (...) that time. But their guiding insights about what constitutes scientific reduction—increases in explanatory scope and systematization—reflect actual practices of current reductionistic neuroscience. The key rehabilitative step to make their insights fit current scientific details is to restate them using resources from recent work on causal-mechanistic explanation. We begin with a scientific case study, drawn from the relatively new field of “molecular and cellular cognition”. It provides an explanation of the well-known Ebbinghaus spacing effect on learning and memory in terms of interactions between a transcriptional enhancer protein and its inhibiting phosphatase in neurons recruited into the memory trace. Next we briefly describe some popular models of reduction from mid-20th-century philosophy of science. We point out how these models fail to illuminate key features of our scientific case study. Finally we present our causal-mechanistically updated Kemeny and Oppenheim-inspired model and argue that it nicely accounts for the details of our scientific case study. We close with a remark that will hopefully undercut the surprise many may feel to learn that a long-rejected philosophical account of reduction actually is at work in one of the most prominent reductionistic endeavors in current science. (shrink)
In The Varieties of Reference, Gareth Evans argues that the content of perceptual experience is nonconceptual, in a sense I shall explain momentarily. More recently, in his book Mind and World, John McDowell has argued that the reasons Evans gives for this claim are not compelling and, moreover, that Evans’s view is a version of “the Myth of the Given”: More precisely, Evans’s view is alleged to suffer from the same sorts of problems that plague sense-datum theories of perception. In (...) particular, McDowell argues that perceptual experience must be within “the space of reasons,” that perception must be able to give us reasons for, that is, to justify, our beliefs about the world: And, according to him, no state that does not have conceptual content can be a reason for a belief. Now, there are many ways in which Evans’s basic idea, that perceptual content is nonconceptual, might be developed; some of these, I shall argue, would be vulnerable to the objections McDowell brings against him. But I shall also argue that there is a way of developing it that is not vulnerable to these objections. (shrink)
Pain is an intensely subjective experience and one that is difficult for healthcare professionals to treat. Chronic pain, often diffuse, cyclical and involving many systems of the body, is often not well treated in a medical system that relies on discrete symptoms, identifiable causes, external pathogens and physician specialisation. Pain has its own problems specific to Somali diaspora populations, where chronic pain is prevalent but often undertreated, and where Somali patients face barriers of access to medicine. This study, conducted in (...) partnership with a Somali women’s health centre, seeks to understand Somali women’s use of informal and formal networks of healthcare. Drawing from qualitative interviews with Somali, refugee women, this article identifies four emerging frameworks through which participants experience chronic pain: pain as a symptom of exile; pain and the strength to bear pain as issues of faith; medicine as powerful, curative and fluid; medical discrimination and exclusion. (shrink)
The current antireductionist consensus rests in part on the indefensibility of the deductive-nomological model of explanation, on which classical reductionism depends. I argue that the DN model is inessential to the reductionist program and that mechanism provides a better framework for thinking about reductionism. This runs counter to the contemporary mechanists’ claim that mechanism is an alternative to reductionism. I demonstrate that mechanists are committed to reductionism, as evidenced by the historical roots of the contemporary mechanist program. This view shares (...) certain core commitments with reductionism. It is these shared commitments that constitute the essential elements of the reductionist program. (shrink)
Recently, some mechanists have embraced reductionism and some reductionists have endorsed mechanism. However, the two camps disagree sharply about the extent to which mechanistic explanation is a reductionistic enterprise. Reductionists maintain that cellular and molecular mechanisms can explain mental phenomena without necessary appeal to higher-level mechanisms. Mechanists deny this claim. I argue that this dispute turns on whether reduction is a transitive relation. I show that it is. Therefore, mechanistic explanations at the cellular and molecular level explain mental phenomena. I (...) make my case in part by noting that mechanisms at higher levels are composed of mechanisms at lower levels. Compositional relations are transitive. In addition, they are explanatory. I conclude that there are explanatory linkages from cellular and molecular mechanisms to mental phenomena within a hierarchy of nested mechanisms. (shrink)
Some ways of defending inequality against the charge that it is unjust require premises that egalitarians find easy to dismiss—statements, for example, about the contrasting deserts and/or entitlements of unequally placed people. But a defense of inequality suggested by John Rawls and elaborated by Brian Barry has often proved irresistible even to people of egalitarian outlook. The persuasive power of this defense of inequality has helped to drive authentic egalitarianism, of an old-fashioned, uncompromising kind, out of contemporary political philosophy. The (...) present essay is part of an attempt to bring it back in. (shrink)
1. The present paper is a continuation of my “Self-Ownership, World Ownership, and Equality,” which began with a description of the political philosophy of Robert Nozick. I contended in that essay that the foundational claim of Nozick's philosophy is the thesis of self-ownership, which says that each person is the morally rightful owner of his own person and powers, and, consequently, that each is free to use those powers as he wishes, provided that he does not deploy them aggressively against (...) others. To be sure, he may not harm others, and he may, if necessary, be forced not to harm them, but he should never be forced to help them, as people are in fact forced to help others, according to Nozick, by redistributive taxation. (shrink)
In recent years, many philosophers of science have attempted to articulate a theory of non-epistemic emergence that is compatible with mechanistic explanation and incompatible with reductionism. The 2005 account of Fred C. Boogerd et al. has been particularly influential. They argued that a systemic property was emergent if it could not be predicted from the behaviour of less complex systems. Here, I argue that Boogerd et al.'s attempt to ground emergence in complexity guarantees that we will see emergence, but at (...) the cost of rendering it either trivial or epistemic. There are three basic problems. First, neither the measures of complexity explicitly mentioned by Boogerd et al. nor the most popular measures in the literature can do the practical and theoretical work that they assign to complexity. Second, I argue that while the success of their view depends on restricting the base of information available to the reductionist, this cannot be done in a way that is metaphysically neutral with respect to emer.. (shrink)
Abstract G.A. Cohen has produced an influential criticism of libertarian?ism that posits joint ownership of everything in the world other than labor, with each joint owner having a veto right over any potential use of the world. According to Cohen, in that world rationality would require that wealth be divided equally, with no differential accorded to talent, ability, or effort. A closer examination shows that Cohen's argument rests on two central errors of reasoning and does not support his egalitarian conclusions, (...) even granting his assumption of joint ownership. That assumption was rejected by Locke, Pufendorf and other writers on property for reasons that Cohen does not rebut. (shrink)
Although Daniel Engster's “caring” human rights are, on the surface, a compelling way to bring the concept of care into the international political realm, I argue they actually serve to perpetuate some of the same problems of mainstream human-rights discourses. The problem is twofold. First, Engster's particular care theory relies on an uncritical acceptance of our dependence relations. It can, therefore, not only overlook how local and global institutions, norms, and the marketplace shape our relations of dependence, but also serve (...) to further naturalize our current dependence relations. Second, Engster's caring human rights are only minimally feminist, which means that they do not pay attention to the way in which women's full and equal political participation is a necessary component to challenging and overcoming the oppression, marginalization, and exploitation of women and their caring labor worldwide. Although I am sympathetic to Engster's goals and some of his proposed policy solutions, I argue that we should not abandon the critical, feminist lens of care ethics in favor of “caring” human rights that cannot overcome the care critique of mainstream human-rights discourses. (shrink)
Mechanistic explanation is at present the received view of scientific explanation. One of its central features is the idea that mechanistic explanations are both “downward looking” and “upward looking”: they explain by offering information about the internal constitution of the mechanism as well as the larger environment in which the mechanism is situated. That is, they offer both constitutive and contextual explanatory information. Adequate mechanistic explanations, on this view, accommodate the full range of explanatory factors both “above” and “below” the (...) target phenomenon. The aim of this paper is to demonstrate that mechanistic explanation cannot furnish both constitutive and contextual information simultaneously, because these are different types of explanation with distinctly different aims. Claims that they can, I argue, depend on several intertwined confusions concerning the nature of explanation. Particularly, such claims tend to conflate mechanistic and functional explanation, which I argue ought to be understood as distinct. Conflating them threatens to oversell the explanatory power of mechanisms and obscures the means by which they explain. I offer two broad reasons in favor of distinguishing mechanistic and functional explanation: the first concerns the direction of explanation of each, and the second concerns the type of questions to which these explanations offer answers. I suggest an alternative picture on which mechanistic explanation is understood as fundamentally constitutive, and according to which an adequate understanding of a phenomenon typically requires supplementing the mechanistic explanation with a functional explanation. (shrink)
Traditional approaches to computer ethics regard computers as tools, andfocus, therefore, on the ethics of their use. Alternatively, computer ethicsmight instead be understood as a study of the ethics of computationalagents, exploring, for example, the different characteristics and behaviorsthat might benefit such an agent in accomplishing its goals. In this paper,I identify a list of characteristics of computational agents that facilitatetheir pursuit of their end, and claim that these characteristics can beunderstood as virtues within a framework of virtue ethics. This (...) frameworkincludes four broad categories – agentive, social, environmental, and moral– each of which can be understood as a spectrum of virtues rangingbetween two extreme subcategories. Although the use of a virtue frameworkis metaphorical rather than literal, I argue that by providing a frameworkfor identifying and critiquing assumptions about what a `good' computer is,a study of android arete provides focus and direction to the developmentof future computational agents. (shrink)
Reminiscences of Peter, by P. Oppenheim.--Natural kinds, by W. V. Quine.--Inductive independence and the paradoxes of confirmation, by J. Hintikka.--Partial entailment as a basis for inductive logic, by W. C. Salmon.--Are there non-deductive logics?, by W. Sellars.--Statistical explanation vs. statistical inference, by R. C. Jeffre--Newcomb's problem and two principles of choice, by R. Nozick.--The meaning of time, by A. Grünbaum.--Lawfulness as mind-dependent, by N. Rescher.--Events and their descriptions: some considerations, by J. Kim.--The individuation of events, by D. Davidson.--On properties, by (...) H. Putnam.--A method for avoiding the Curry paradox, by F. B. Fitch.--Publications (1934-1969) by Carl G. Hempel (p. -270). (shrink)
Among the most outstanding discoveries of the last century is one that is not quite as momentous as the theory of relativity or cybernetics. It may even still be enigmatic. It has no one single author, it is not expressed in a single formula, conception, or invention. Nonetheless it is worth all the others combined.
Editor James Fetzer presents an analytical and historical introduction and a comprehensive bibliography together with selections of many of Carl G. Hempel's most important studies to give students and scholars an ideal opportunity to appreciate the enduring contributions of one of the most influential philosophers of science of the 20th century.