Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

By combining normative philosophy and empirical social science, we craft a research framework for assessing differential expectations embodied in normative conceptions of the economic social contract in the United States. We argue that there are distinctviews of such a contract grounded in individualist and communitarian philosophical ideologies. We apply this framework to organizational downsizing, postulating that certain human resource practices, in combination with the respective ideological orientations, will affect perceptions of the justice of downsizing policies.Living up to one’s word is (...) a decisive measure of moral character. Within the microsocial realm of the family, promises and commitments derive their social force and cultural meaning from the idea that love or biology binds people together in an absolute way. But outside of this world, in the larger society, the only thing binding people together is a sense that there is a social contract, a set of common obligations held collectively by society as a whole. But today’s workers say no one seems to care whether these promises are kept. (shrink)

Abstract:By combining normative philosophy and empirical social science, we craft a research framework for assessing differential expectations embodied in normative conceptions of the economic social contract in the United States. We argue that there are distinct views of such a contract grounded in individualist and communitarian philosophical ideologies. We apply this framework to organizational downsizing, postulating that certain human resource practices, in combination with the respective ideological orientations, will affect perceptions of the justice of downsizing policies.

The Bible has influenced contemporary culture both positively and negatively. The present volume is a collection of papers that were discussed at an international colloquium on the use of the Bible in Ethics in the Department of Biblical Studies at the University of Sheffield in April 1995. Participants came from many parts of the world and from different backgrounds, and the papers reflect their varied interests and the contexts in which they work. The contributors, in addition to the three editors, (...) are John Barton, Bruce Birch, Mark Brett, Mark Chapman, David Clines, Philip Davies, Cheryl Exum, Stephen Fowl, Norman Gottwald, John Haldane, Walter Houston, Sharon Ringe, Chrisopher Rowland, Lisa Sowle Cahill and Gerald West. (shrink)

This article suggests a way to circumvent some of the problems that follow from the lack of consensus on a definition of emotion (Izard, 2010; Kleinginna & Kleinginna, 1981) and emotion regulation (Cole, Martin, & Dennis, 2004) by adopting a conceptual framework based on discrete emotions theory and focusing on specific emotions. Discrete emotions theories assume that neural, affective, and cognitive processes differ across specific emotions and that each emotion has particular motivational and regulatory functions. Thus, efforts at regulation should (...) target the specific dysregulated emotions. The positive effects of emotion regulation are more likely to be optimized when they result from or lead to emotion utilization—the constructive use of the energy of emotion arousal. Effective processes for regulation differ for basic emotions and emotion schemas. This article identifies neural systems that facilitate emotion experiences and emotion regulation processes. It considers the implications of the developmental change from basic emotions to emotion schemas, and also briefly discusses the effects of interventions on changes in emotion knowledge, emotion regulation, and social and emotional competence. (shrink)

In Spoils of War, a diverse group of distinguished contributors suggest that acts of aggression resulting from the racism and sexism inherent in social institutions can be viewed as a sort of "war," experienced daily by women of color.

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

Many emotion researchers would probably agree that at least some aspects of discrete emotions are evolutionarily conserved (e.g., the sensation/feeling component cannot be learned). Such agreement probably extends to the notion that aspects of emotions emerge in ontogeny as a function of developmental, learning, and cultural processes. Determining when and under what circumstances they emerge seems largely a matter for empirical research, though theories differ in their predictions and in the way they describe the relevant emotional-, cognitive-, and neuro-developmental processes.

I defend the extremist position that the fundamental ontology of the world consists of a vector in Hilbert space evolving according to the Schrödinger equation. The laws of physics are determined solely by the energy eigenspectrum of the Hamiltonian. The structure of our observed world, including space and fields living within it, should arise as a higher-level emergent description. I sketch how this might come about, although much work remains to be done.

Some modern cosmological models predict the appearance of Boltzmann Brains: observers who randomly fluctuate out of a thermal bath rather than naturally evolving from a low-entropy Big Bang. A theory in which most observers are of the Boltzmann Brain type is generally thought to be unacceptable, although opinions differ. I argue that such theories are indeed unacceptable: the real problem is with fluctuations into observers who are locally identical to ordinary observers, and their existence cannot be swept under the rug (...) by a choice of probability distributions over observers. The issue is not that the existence of such observers is ruled out by data, but that the theories that predict them are cognitively unstable: they cannot simultaneously be true and justifiably believed. (shrink)

A longstanding issue in attempts to understand the Everett (Many-Worlds) approach to quantum mechanics is the origin of the Born rule: why is the probability given by the square of the amplitude? Following Vaidman, we note that observers are in a position of self-locating uncertainty during the period between the branches of the wave function splitting via decoherence and the observer registering the outcome of the measurement. In this period it is tempting to regard each branch as equiprobable, but we (...) argue that the temptation should be resisted. Applying lessons from this analysis, we demonstrate (using methods similar to those of Zurek's envariance-based derivation) that the Born rule is the uniquely rational way of apportioning credence in Everettian quantum mechanics. In doing so, we rely on a single key principle: changes purely to the environment do not affect the probabilities one ought to assign to measurement outcomes in a local subsystem. We arrive at a method for assigning probabilities in cases that involve both classical and quantum self-locating uncertainty. This method provides unique answers to quantum Sleeping Beauty problems, as well as a well-defined procedure for calculating probabilities in quantum cosmological multiverses with multiple similar observers. (shrink)

We have a much better understanding of physics than we do of consciousness. I consider ways in which intrinsically mental aspects of fundamental ontology might induce modifications of the known laws of physics, or whether they could be relevant to accounting for consciousness if no such modifications exist. I suggest that our current knowledge of physics should make us skeptical of hypothetical modifications of the known rules, and that without such modifications it’s hard to imagine how intrinsically mental aspects could (...) play a useful explanatory role. Draft version of a paper submitted to Journal of Consciousness Studies, special issue responding to Philip Goff’s Galileo’s Error: Foundations for a New Science of Consciousness. (shrink)

Cosmological models that invoke a multiverse - a collection of unobservable regions of space where conditions are very different from the region around us - are controversial, on the grounds that unobservable phenomena shouldn't play a crucial role in legitimate scientific theories. I argue that the way we evaluate multiverse models is precisely the same as the way we evaluate any other models, on the basis of abduction, Bayesian inference, and empirical success. There is no scientifically respectable way to do (...) cosmology without taking into account different possibilities for what the universe might be like outside our horizon. Multiverse theories are utterly conventionally scientific, even if evaluating them can be difficult in practice. (shrink)

It is commonplace in discussions of modern cosmology to assert that the early universe began in a special state. Conventionally, cosmologists characterize this fine-tuning in terms of the horizon and flatness problems. I argue that the fine-tuning is real, but these problems aren't the best way to think about it: causal disconnection of separated regions isn't the real problem, and flatness isn't a problem at all. Fine-tuning is better understood in terms of a measure on the space of trajectories: given (...) reasonable conditions in the late universe, the fraction of cosmological histories that were smooth at early times is incredibly tiny. This discussion helps clarify what is required by a complete theory of cosmological initial conditions. (shrink)

To the best of our current understanding, quantum mechanics is part of the most fundamental picture of the universe. It is natural to ask how pure and minimal this fundamental quantum description can be. The simplest quantum ontology is that of the Everett or Many-Worlds interpretation, based on a vector in Hilbert space and a Hamiltonian. Typically one also relies on some classical structure, such as space and local configuration variables within it, which then gets promoted to an algebra of (...) preferred observables. We argue that even such an algebra is unnecessary, and the most basic description of the world is given by the spectrum of the Hamiltonian and the components of some particular vector in Hilbert space. Everything else—including space and fields propagating on it—is emergent from these minimal elements. (shrink)

We argue that, under certain plausible assumptions, de Sitter space settles into a quiescent vacuum in which there are no dynamical quantum fluctuations. Such fluctuations require either an evolving microstate, or time-dependent histories of out-of-equilibrium recording devices, which we argue are absent in stationary states. For a massive scalar field in a fixed de Sitter background, the cosmic no-hair theorem implies that the state of the patch approaches the vacuum, where there are no fluctuations. We argue that an analogous conclusion (...) holds whenever a patch of de Sitter is embedded in a larger theory with an infinite-dimensional Hilbert space, including semiclassical quantum gravity with false vacua or complementarity in theories with at least one Minkowski vacuum. This reasoning provides an escape from the Boltzmann brain problem in such theories. It also implies that vacuum states do not uptunnel to higher-energy vacua and that perturbations do not decohere while slow-roll inflation occurs, suggesting that eternal inflation is much less common than often supposed. On the other hand, if a de Sitter patch is a closed system with a finite-dimensional Hilbert space, there will be Poincaré recurrences and dynamical Boltzmann fluctuations into lower-entropy states. Our analysis does not alter the conventional understanding of the origin of density fluctuations from primordial inflation, since reheating naturally generates a high-entropy environment and leads to decoherence, nor does it affect the existence of non-dynamical vacuum fluctuations such as those that give rise to the Casimir effect. (shrink)

In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (...) (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. (shrink)

We study the conservation of energy, or lack thereof, when measurements are performed in quantum mechanics. The expectation value of the Hamiltonian of a system changes when wave functions collapse in accordance with the standard textbook treatment of quantum measurement, but one might imagine that the change in energy is compensated by the measuring apparatus or environment. We show that this is not true; the change in the energy of a state after measurement can be arbitrarily large, independent of the (...) physical measurement process. In Everettian quantum theory, while the expectation value of the Hamiltonian is conserved for the wave function of the universe, it is not constant within individual worlds. It should therefore be possible to experimentally measure violations of conservation of energy, and we suggest an experimental protocol for doing so. (shrink)

It seems natural to ask why the universe exists at all. Modern physics suggests that the universe can exist all by itself as a self-contained system, without anything external to create or sustain it. But there might not be an absolute answer to why it exists. I argue that any attempt to account for the existence of something rather than nothing must ultimately bottom out in a set of brute facts; the universe simply is, without ultimate cause or explanation.

We study the question of how to decompose Hilbert space into a preferred tensor-product factorization without any pre-existing structure other than a Hamiltonian operator, in particular the case of a bipartite decomposition into "system" and "environment." Such a decomposition can be defined by looking for subsystems that exhibit quasi-classical behavior. The correct decomposition is one in which pointer states of the system are relatively robust against environmental monitoring (their entanglement with the environment does not continually and dramatically increase) and remain (...) localized around approximately-classical trajectories. We present an in-principle algorithm for finding such a decomposition by minimizing a combination of entanglement growth and internal spreading of the system. Both of these properties are related to locality in different ways. This formalism could be relevant to the emergence of spacetime from quantum entanglement. (shrink)

I propose a version of quantum mechanics featuring a discrete and finite number of states that is plausibly a model of the real world. The model is based on standard unitary quantum theory of a closed system with a finite-dimensional Hilbert space. Given certain simple conditions on the spectrum of the Hamiltonian, Schrödinger evolution is periodic, and it is straightforward to replace continuous time with a discrete version, with the result that the system only visits a discrete and finite set (...) of state vectors. The biggest challenges to the viability of such a model come from cosmological considerations. The theory may have implications for questions of mathematical realism and finitism. (shrink)

We provide a derivation of the Born Rule in the context of the Everett (Many-Worlds) approach to quantum mechanics. Our argument is based on the idea of self-locating uncertainty: in the period between the wave function branching via decoherence and an observer registering the outcome of the measurement, that observer can know the state of the universe precisely without knowing which branch they are on. We show that there is a uniquely rational way to apportion credence in such cases, which (...) leads directly to the Born Rule. Our analysis generalizes straightforwardly to cases of combined classical and quantum self-locating uncertainty, as in the cosmological multiverse. (shrink)

This article presents a three-stage model of how isomorphic mechanisms have shaped corporate social responsibility reporting practices over time. In the first stage, defensive reporting, companies fail to meet stakeholder expectations due to a deficiency in firm performance. In this stage, the decision to report is driven by coercive isomorphism as firms sense pressure to close the expectational gap. In the second stage, proactive reporting, knowledge of CSR reporting spreads and the practice of CSR reporting becomes normatively sanctioned. In this (...) stage, normative isomorphism leads other organizations to look to CSR reporting as a potential new opportunity for achieving the firm’s goals. In the third stage, imitative diffusion, the defensive reporters together with the proactive reporters create a critical mass of CSR reporters that reaches a threshold at which the benefits of CSR reporting begin to outweigh any costs due to mimetic isomorphism. The study finds support for the model in an examination of Fortune 500 firms from 1997 to 2006. (shrink)

Effective Field Theory (EFT) is the successful paradigm underlying modern theoretical physics, including the "Core Theory" of the Standard Model of particle physics plus Einstein's general relativity. I will argue that EFT grants us a unique insight: each EFT model comes with a built-in specification of its domain of applicability. Hence, once a model is tested within some domain (of energies and interaction strengths), we can be confident that it will continue to be accurate within that domain. Currently, the Core (...) Theory has been tested in regimes that include all of the energy scales relevant to the physics of everyday life (biology, chemistry, technology, etc.). Therefore, we have reason to be confident that the laws of physics underlying the phenomena of everyday life are completely known. (shrink)

In Morality & Mathematics, Justin Clarke-Doane argues that it is hard to imagine being "a realist about, for example, the standard model of particle physics, but not about mathematics." I try to explain how that seems very possible from the perspective of a physicist. What is real is the physical world; mathematics starts from descriptions of the natural world and extrapolates from there, but that extrapolation does not imply any independent reality. -/- Submitted to an Analysis Reviews symposium on Clarke-Doane's (...) Morality & Mathematics. (shrink)

This chapter contains sections titled: Notes.

Clark and Fischer analyze social robots as interactive depictions, presenting characters that people can interact with in social settings. Unlike other types of depictions, the props for social robot depictions depend on emerging interactive technologies. This raises questions about how such depictions depict: They conflate character and prop in ways that delight, confuse, mistreat, and may become ordinary human–technology interactions.

Traditional theistic proofs are often understood as evidence intended to compel belief in a divinity. John Clayton explores the surprisingly varied applications of such proofs in the work of philosophers and theologians from several periods and traditions, thinkers as varied as Ramanuja, al-Ghazali, Anselm, and Jefferson. He shows how the gradual disembedding of theistic proofs from their diverse and local religious contexts is concurrent with the development of natural theologies and atheism as social and intellectual options in early modern Europe (...) and America. Clayton offers a fresh reading of the early modern history of philosophy and theology, arguing that awareness of such history, and the local uses of theistic argument, offer important ways of managing religious and cultural difference in the public sphere. He argues for the importance of historically grounded philosophy of religion to the field of religious studies and public debate on religious pluralism and cultural diversity. (shrink)

Throughout the Old Testament, the stories, laws, and songs not only teach a way of life that requires individuals to be moral, but they demonstrate how. In biblical studies, character ethics has been one of the fastest-growing areas of interest. Whereas ethics usually studies rules of behavior, character ethics focuses on how people are formed to be moral agents in the world. This book presents the most up-to-date academic work in Old Testament character ethics, covering topics throughout the Torah, the (...) Prophets, and the Writings, in addition to the use of the Bible in the modern world. In addition to Carroll and Lapsley, contributors are Denise M. Ackermann, Cheryl B. Anderson, Samuel E. Balentine, William P. Brown, Walter Brueggemann, Thomas B. Dozeman, Bob Ekblad, Jose Rafael Escobar R., Theodore Hiebert, Kathleen O'Connor, Dennis T. Olson, J. David Pleins, Luis R. Rivera Rodriguez, J. J. M. Roberts, and Daniel L. Smith-Christopher. (shrink)

Proper names often have shorter variants, e.g., the Boston Common the Common, New York City New York. A description of this phenomenon is proposed that decomposes it into four sub‐processes: Category Ellipsis, Location Ellipsis, Appellation Formation, and Explicit Metonomy. Discussion focusses principally on the former two processes, which produce “nameheods”—briefer alternations of proper names that preserve the naming function. It is argued that the name shortening processes (a) operate in a lexical domain; but (b) are non‐grammatical. An extra‐grammatical analysis of (...) the processes is outlined. (shrink)

En posant avec clarté des questions de philosophie de l’esprit, d’ontologie et d’épistémologie, ce livre témoigne à la fois de l’intérêt réel de la danse comme objet philosophique et du rôle unique que peut jouer la philosophie dans une meilleure compréhension de cet art. Qu’est-ce que danser ? Que nous apprend le mouvement dansé sur la nature humaine et la relation entre le corps et l’esprit ? À quelles conditions une œuvre est-elle correctement interprétée par les danseurs et bien identifiée (...) par les spectateurs ? (shrink)

Some children living with life-shortening medical conditions may wish to attend school without the threat of having resuscitation attempted in the event of cardiopulmonary arrest on the school premises. Despite recent attention to in-school do-not-attempt-resuscitation (DNAR) orders, no assessment of state laws or school policies has yet been made. We therefore sought to survey a national sample of prominent school districts and situate their policies in the context of relevant state laws. Most (80%) school districts sampled did not have policies, (...) regulations, or protocols for dealing with student DNARs. A similar majority (76%) either would not honor student DNARs or were uncertain about whether they could. Frequent contradictions between school policies and state laws also exist. Consequently, children living with life-shortening conditions who have DNARs may not have these orders honored if cardiopulmonary arrest were to occur on school premises. Coordinated efforts are needed to harmonize school district, state, and federal approaches in order to support children and families' right to have important medical decisions honored. (shrink)

Abstract:This paper contends that rationality is more properly evaluated as a property of an organization’s relationships with its stakeholders than of the organization itself. We predicate our approach on the observation that stakeholders can hold goals quite distinct from those of owners and top managers, and these too can be rationally pursued. We build upon stakeholder theory and Weber’s classic distinction betweenwertrationalitatandzweckrationalitat, adding to them the “new institutionalist” concept of the organization field (1983, 1991). Stakeholders employ a variety of direct (...) and indirect mechanisms to rationalize relations with the firm. We discuss four: internal subunits, legislated stakeholder participation, legislated access to information, and direct stakeholder activism. These developments are blurring the distinction between the environment and the organization by importing the values and goals of external stakeholders into the internal organization. They are also precipitating a more structured set of relationships among the actors who comprise the field. To the extent that thezweckrationalitatvalues of managers and owners as well as thewertrationalitatconcerns of stakeholders are met, the firm is more rational. (shrink)

A comparison of the literatures on how infants represent generic object classes, gender and race information in faces, and emotional expressions reveals both common and distinctive developments in the three domains. In addition, the review indicates that some very basic questions remain to be answered regarding how infants represent facial displays of emotion, including (a) whether infants form category representations for discrete classes of emotion, (b) when and how such representations come to incorporate affective meaning, (c) the developmental trajectory for (...) representation of emotional expression at different levels of inclusiveness (i.e., from broad to narrow or narrow to broad?), and (d) whether there is superior discrimination ability operating within more frequently experienced emotion categories. (shrink)

A comparison of the literatures on how infants represent generic object classes, gender and race information in faces, and emotional expressions reveals both common and distinctive developments in the three domains. In addition, the review indicates that some very basic questions remain to be answered regarding how infants represent facial displays of emotion, including (a) whether infants form category representations for discrete classes of emotion, (b) when and how such representations come to incorporate affective meaning, (c) the developmental trajectory for (...) representation of emotional expression at different levels of inclusiveness (i.e., from broad to narrow or narrow to broad?), and (d) whether there is superior discrimination ability operating within more frequently experienced emotion categories. (shrink)