Built-in decision thresholds for AI diagnostics are ethically problematic, as patients may differ in their attitudes about the risk of false-positive and false-negative results, which will require that clinicians assess patient values.

Gathers fragments of the writings of early Greek philosophers, including Hesiod, Anaximander, Pythagoras, and Zeno.

Exceptionalism is the view that one group is better than other groups and, by virtue of its alleged superiority, is not subject to the same constraints. Here we identify national exceptionalism in the responses made by political leaders in the United States and the United Kingdom to the covid-19 pandemic in early 2020. First, we observe that responses appealed to national values and national character and were marked by a denial of the severity of the situation. Second, we suggest an (...) analogy between national exceptionalism and unrealistic optimism, i.e., people’s tendency to make rosier predictions about their future than is warranted by the evidence due to illusions of superiority and control. Finally, we argue that, at the national level, exceptionalism gave rise to an assumption of invulnerability that made for slow responses to the pandemic, and at the individual level, it served as a justification of people’s failures to adopt safety behaviors. (shrink)

We present a computational model of dialectical argumentation that could serve as a basis for legal reasoning. The legal domain is an instance of a domain in which knowledge is incomplete, uncertain, and inconsistent. Argumentation is well suited for reasoning in such weak theory domains. We model argument both as information structure, i.e., argument units connecting claims with supporting data, and as dialectical process, i.e., an alternating series of moves by opposing sides. Our model includes burden of proof as a (...) key element, indicating what level of support must be achieved by one side to win the argument. Burden of proof acts as move filter, turntaking mechanism, and termination criterion, eventually determining the winner of an argument. Our model has been implemented in a computer program. We demonstrate the model by considering program output for two examples previously discussed in the artificial intelligence and legal reasoning literature. (shrink)

The nature of authority is shifting in online scholarly communication. This examination of the history and future of peer review argues that effective online communication requires the development of an open, community?oriented, post?publication system of peer?to?peer review, transforming peer review from a process focused on gatekeeping to one concerned with filtering the wealth of scholarly material made available via the Internet.

Healthcare organizations and workers are under pressure to produce increasingly complete and accurate data for multiple data-intensive endeavors. However, little research has examined the emerging occupations arising to carry out the data work necessary to produce “improved” data sets, or the specific work activities of these emerging data occupations. We describe the work of Clinical Documentation Integrity Specialists, an emerging occupation that focuses on improving clinical documentation to produce more detailed and accurate administrative datasets crucial for evolving data-intensive forms of (...) healthcare accountability, management, and research. Using ethnographic methods, we describe the core of CDIS’ work as a translation practice in which the language, interests, and concerns of clinicians and clinical documentation are translated via real-time “nudging” and ongoing education of clinicians into the language, interests, and concerns of medical coders, structured administrative datasets, and the various stakeholders of these datasets. Further, we show how the institutional context of CDIS’ work shapes the occupational virtues that guide CDIS’ translation practice, including financial reimbursement, quality measures, clinical accuracy, and protecting clinician’s time. Despite the existence of these multiple virtues, financial reimbursement is the most prominent virtue guiding CDIS’ limited attention. Thus, overall clinical documentation is “improved” in specific, partial ways. This research provides one of the first studies of the emergent data work occupations arising in the wake of digitization and big data opportunities, and shows how local data settings shape large scale data in specific ways and thus may influence outcomes of analyses based on such data. (shrink)

The development of the philosophy of science in the twentieth century has created a framework where issues concerning funding dynamics can be easily accommodated. It combines the historical-philosophical approach of Thomas Kuhn. The University of Chicago Press, Chicago, [1962] ) with the sociological approach of Robert K. Merton The sociology of science. Theoretical and empirical investigations. The University of Chicago Press, Chicago, pp 267–278, [1942] ), linking the ‘exact’ sciences to economy and politics. Out of this came a new domain, (...) namely the study of scientific practices : Science as practice and culture. The University of Chicago Press, Chicago, 1992). Given this broad theoretical framework, we will specify by looking at the case of STEM education and its variant Science, Technology, Engineering and Mathematics with Art education as an example par excellence. Without going into the technical details of the financial support of the projects, we prefer to open a philosophical debate on the way how policies on academic subjects influence a whole society and the personal life of both researchers and people/pupils involved in education. (shrink)

This article reviews the phenomena of disordered discourse often manifested in schizophrenia. It argues that the Structure Building Framework, a model of the general cognitive processes and mechanisms underlying discourse, can be used to account for these phenomena. According to the Structure Building Framework, the goal of comprehension is to build coherent mental representations or structures. Building a mental structure involves several component subprocesses: laying a foundation, mapping relevant information onto that foundation, and shifting to initiate a new substructure. Building (...) a mental structure also involves at least two general cognitive mechanisms: enhancement of relevant activation and suppression of irrelevant or inappropriate activation. We suggest that schizophrenics who exhibit verbose disordered discourse have inefficient suppression mechanisms, are impaired in laying a foundation, and tend to shift too often. We also speculate that schizophrenics who exhibit impoverished disordered discourse have inefficient enhancement mechanisms and are impaired with the cognitive process of mapping. (shrink)

Some authors argue that the ethics of medical care and the ethics of research differ, and that it is a mistake to conflate the two. They propose “that medical research and medical treatment are two distinct forms of activities, governed by different ethical principles.” This raises the question of whether physicians who are also clinical investigators may separate their role as physician from that of researcher when they are involved in clinical trials, thereby avoiding the obligations required in the physician-patient (...) relationship. Miller and Brody suggest that medical training is to blame for what they believe is the physicians’ tendency to confound the obligations of research and practice. “Physician-investigators, after all, went to medical school” they explain. They believe that considering research with patients outside the ethical framework of the physician-patient relationship may be “difficult and threatening” to physicians who have “psychological needs” to consider the ethical obligations flowing from their relationship with their patients. (shrink)

Advances in medicine depend not only on the generation of information but also on its dissemination. Clinically relevant data must be transmitted to the practitioners who will use it. Health care professionals in North America are aware of their ethical and legal obligations to inform patients adequately concerning interventions and treatments so that they may make informed choices about medical care. This obligation has been well described and defined by the courts and in the literature of medicine, ethics, and law. (...) But do investigators and others who are responsible for disseminating information have any obligation to divulge adequately the results of clinical trials to practitioners so that the latter might offer the choice of appropriate care to their patients? Can incomplete disclosure of trial outcomes result in harm to patients? If this is the case, what possible avenues are available to avoid such harm? (shrink)

This article reviews four areas of pediatric research in which we have identified questionable levels of allowable risk, exceeding those foreseen by the Commission. They are the following: the categorization of increasingly risky interventions as minimal risk in a variety of protocols; the increasing number of applications for federal panel review of research not otherwise approvable because of higher projected risk levels; research on asymptomatic at risk children; and the inclusion of children and adolescents in placebo-controlled trials for participants of (...) all ages without performing subgroup analysis. While embracing the imperative to include children in research is an encouraging step towards providing the pediatric population with effective medical care and finally eradicating the therapeutic orphan, we must ensure that this research does not become overly permissive. (shrink)

ABSTRACT The aim of this article is to bring philosophical thinking closer to practice-based empirical work. Using Martin Heidegger’s philosophy, it offers a bridge between these two worlds, attempting to provide philosophical depth to the findings of a hermeneutic phenomenological study. This process unfolded through the appearance of three intertwined, potential, meaningful modes of being in the lifeworld: space as a condition for being and being for worlding the world; temporal and spatial self-being, the existence of multiple selves in time (...) and space; and suffering and thriving as modes of being. The article extends the dialogue and concludes with key reflections and insight for research practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Rita Gross as Teacher, Mentor, FriendKathleen M. ErndlI have been asked to speak about the work of Rita Gross from the point of view of someone who was once her student. Not only was I her student, I was one of her very first students. She was my first teacher of religious studies during my first semester of college in the first semester of her first full-time academic position. (...) The year was 1971; the place was New College, a small, alternative liberal arts college in Sarasota, Florida. As the eldest child in the second generation of a working-class immigrant family, I was the first person in my family to pursue higher education. While none of my grandparents had completed high school, both of my parents were high school graduates and my father had risen to a professional level as an engineer through on-the-job training and his own diligence, so my attending college was perhaps the next logical step in achieving the "American dream." However, my choice of college was a bit unusual.New College, as might be expected by its name (though I later discovered was named after a college at Oxford), was new and relatively unknown, lacking a football team and an engineering school, which my parents, with their limited knowledge of higher education, considered essential. But by this time I was somewhat of an educational radical, having been influenced by Angela Davis and Paolo Freire.1 A local newspaper article of the time described New College students as "rich, radical, and hedonistic" (I can only attest to ever having been one of the above). The Underground Guide to the College of Your Choice2 described New College as a place where students taught the classes and where "chicks suffer from underwear famine." While this was somewhat of an overstatement, it was the kind of place where students initiated courses, were largely free from required courses, conducted unusual independent research, came to class barefoot, and sat on the floor. In any case, as the first in my working-class immigrant family to attend college and as an idealist who had chafed against a system that I felt, to paraphrase Henry David Thoreau, allowed schooling to interfere with education, I was excited to be in any college and especially in one with a reputation for experimental modes of learning.When I went to meet my assigned faculty advisor to figure out my schedule and negotiate a "contract" of study, I was told that I had been reassigned to a new faculty member who was "young and full of energy." This, of course, was Rita Gross. Asian religious and cultural traditions place a strong significance on the first meeting with [End Page 57] one's teacher. To be honest, I do not remember much about our first meeting, but I can say in retrospect that it was life changing. After meeting with her, I decided to take her course, Indian Religions I, as well as courses in philosophy, literature, and constitutional law. On my first day of college, my initial plan had been to major in philosophy, with a focus on legal philosophy, with the eventual goal of law school and practicing constitutional, civil rights, or public interest law. But my experience in that Indian Religions I course changed that plan forever. I subsequently took Indian Religions II, then Indian Religious III, and by that time I was hooked. I took several other courses with Rita, including East Asian Religions and a tutorial on Primal Religions. In January of my second year, at Rita's encouragement, I went to Sri Lanka on a study program, doing a project under Rita's direction on lay Buddhist practices. By the time I returned to New College for my third and final year, Rita had already left for the University of Wisconsin-Eau Claire, but that was not the end of our association. We have stayed in contact for almost forty years now, meeting at the AAR, visiting each other's homes, and talking about each other's work and lives. I have hosted lectures or workshops by Rita at all three institutions where I have taught. I... (shrink)

Josh Cohen _Spectacular Allegories: Postmodern American Writing and the Politics of Seeing_ London: Pluto Press, 1998 ISBN 0-7453-1212-8 169 pp.

Wilkins & Wakefield fall short of solving the language origin puzzle because they underestimate the cognitive and linguistic capacities of great apes. A focus on ape capacities leads to the recognition of varied levels of cognition and language and to a gradualistic model of language emergence in which early hominid language skills exceed those of the apes but fall far short of those of modern humans or later fossil hominid groups.

Under certain circumstances the act of apologizing has moral import. It requires a commitment to truth, adherence to moral standards, and a willingness to acknowledge and regret one's own moral failures. In this paper I examine the moral import of apologizing within the U.S. legal system and as a response to historical acts of injustice. In both of these contexts apologies are expressed in a public forum, which adds an interesting dynamic to their moral significance. Within the legal system the (...) judge, representing the interests of the community, may use apologizing to directly address the harm done to victims, as an indicator of recidivism on the part of offenders, and to help create an atmosphere of respect for law in the community at large. Different moral aspects of apologizing come to the fore in the context of historical acts of injustice. Interesting philosophical questions arise, e.g. the legitimacy of moral judgments across time and culture and the very possibility of group action. And skepticism is commonly expressed about the value of such apologies: aren't they empty words that provide no real benefit to victims or the descendants of victims? Aren't they irrelevant to the future? I identify what I hope are convincing reasons to believe that historical apologies can in fact have considerable moral value and a significant impact on the future. (shrink)

Understanding people's experience of skin ageing as it is lived can enable sensitive approaches to promoting healthy skin and to care in general. By understanding the insider perspective, what it is like for individuals, a way to sensitise practice for more humanly sensitive care is offered. Through interviews with seventeen community‐dwelling older people, the essential meaning of living within ageing skin was illuminated as a state of managed inevitability. The skin is inevitably changing, and ageing skin is a marker of (...) change over time but the person within remains. Constituents of the phenomenon comprise the experience of unfamiliar sights and sensations given by ageing skin; facing and accepting bodily changes and seeing this back and forth in family connections; taking care of the skin “to face” the world; and to present oneself to others and a different place in the world, same person, changed body. Findings point to why and how nurses can treat older people as persons by not over emphasising a view on ageing bodies or bodies with aged skin alone, but in tempering this view with deeper existential insights, meeting the older person with a skin care need as a person and not just as a physical entity. (shrink)

An engaging history of the philosophy of pardons, this volume offers special insight into presidential pardons, revealing how, over and over again, controveries about pardons have arisen at times when circumstance prevented people from thinking dispassionately about them.