A hypothetical scenario is presented in which a female patient is admitted to a private hospital to undergo a mastectomy and breast reconstruction. The surgeons and anaesthetists conducting the different procedures charge three times the medical aid rates. When the patient asks what the co-payments are likely to be, she is informed by the doctors’ accounts section that they can only provide this information after each procedure. The patient’s medical scheme also advises her that it cannot determine the likely co-payments (...) unless she completes the assessment form sent to her. The form requires her to include the costs reflected against the relevant ICD10 codes. The patient cannot complete the form because the doctors’ accounts sections have not informed her about the proposed procedures and the likely costs of each. This article builds on a previous article discussing doctors’ overarching responsibility to disclose medical treatment costs in advance. The present article outlines the legal requirements in the South African Constitution, the National Health Act and the Health Professions Act, and refers to the Promotion of Access to Information Act and Consumer Protection Act. Similar to the earlier article, this article addresses the ethical requirements of the Health Professions Council of South Africa and the internationally recognised biomedical ethical principles. Furthermore, it also refers to the National Patients Charter, the government’s policy document on health care services. (shrink)

Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed mechanism, Goal-Proximity Decision-making (GPD), is implemented within the ACT-R cognitive framework. GPD is found to be more efficient than RL in three maze-navigation simulations. GPD advantages over RL seem to grow as task difficulty is increased. (...) An experiment is presented where participants are asked to make choices in the absence of prior reward. GPD captures human performance in this experiment better than RL. (shrink)

Current debates about “Darwinizing culture” have typically focused on the validity of memetics. In this article we argue that meme-like inheritance is not a necessary requirement for descent with modification. We suggest that an alternative and more productive way of Darwinizing culture can be found in the application of phylogenetic methods. We review recent work on cultural phylogenetics and outline six fundamental questions that can be answered using the power and precision of quantitative phylogenetic methods. However, cultural evolution, like biological (...) evolution, is often far from treelike. We discuss the problems reticulate evolution can cause for phylogenetic analyses and suggest ways in which these problems can be overcome. Our solutions involve a combination of new methods for the study of cultural evolution , and the triangulation of different lines of historical evidence. Throughout we emphasize that most debates about cultural phylogenies can only be settled by empirical research rather than armchair speculation. (shrink)

On the ethics of extending human life: healthy people have a right to carry on livingHumanity has long demonstrated a paradoxical ambivalence concerning the extension of a healthy human lifespan. Modest health extension has been universally sought, whereas extreme health extension has been regarded as a snare and delusion—a dream beyond all others at first blush, but actually something we are better off without. The prevailing pace of biotechnological progress is bringing ever closer the day when humanity will be able (...) to act on the latter view by rejecting a clear and present opportunity for much longer healthy lives. Indeed, some biogerontologists contend that that day has already arrived, to the extent that our hesitation in embarking on a vigorous “war on ageing” is already delaying the point at which a cure for ageing will be developed. Here I consider whether our present caution concerning the wisdom of truly curing ageing is likely to survive the increased scrutiny that it will receive in coming years as a result of these technical advances. I conclude that it will not, because of its irreconcilability with values that are more deeply held by the large majority of humanity than any values that argue against the quest for a cure. I further conclude that all the major current reasons given for not curing ageing are mere crutches to help us cope with the immutability of ageing that we have been brought up to accept. Our failure to set aside such irrationality is already shortening potential longevity—quite probably of those already alive today—to a staggering degree. Once we realise this, our determination to consign human ageing to history will be second …. (shrink)

The nature/nurture debate is not dead. Dichotomous views of development still underlie many fundamental debates in the biological and social sciences. Developmental systems theory offers a new conceptual framework with which to resolve such debates. DST views ontogeny as contingent cycles of interaction among a varied set of developmental resources, no one of which controls the process. These factors include DNA, cellular and organismic structure, and social and ecological interactions. DST has excited interest from a wide range of researchers, from (...) molecular biologists to anthropologists, because of its ability to integrate evolutionary theory and other disciplines without falling into traditional oppositions. The book provides historical background to DST, recent theoretical findings on the mechanisms of heredity, applications of the DST framework to behavioral development, implications of DST for the philosophy of biology, and critical reactions to DST. (shrink)

The ability to learn complex tasks is fundamental to being human. Rahman and Gray examine this process in the context of learning to play a simple video game, using a tool called SpotLight to examine the low‐level process of skill and strategy improvements during this process. This paper was awarded the Allen Newell Best Student‐Led Paper Award at ICCM 2019.

What determines whether an action is right or wrong? Morality, Rules, and Consequences: A Critical Reader explores for students and researchers the relationship between consequentialist theory and moral rules. Most of the chapters focus on rule consequentialism or on the distinction between act and rule versions of consequentialism. Contributors, among them the leading philosophers in the discipline, suggest ways of assessing whether rule consequentialism could be a satisfactory moral theory. These essays, all of which are previously unpublished, provide students in (...) moral philosophy with essential material and ask key questions on just what the criteria for an adequate moral theory might be. (shrink)

The general thesis which I should wish to sustain on this topic is by no means new. It is, briefly, that even in the Republic , where the views on art which Plato propounds are notoriously unsatisfactory to the modern mind, this unsatisfactoriness is not due to any lack of aesthetic sympathy on Plato's part, but on the contrary to what is almost an excess of it. The position as far as I can understand it is this: the true artist (...) is the philosopher, and true artistic insight is episteme . The work of art par excellence is primarily the philosopher's own life-that is, the philosopher himself. (shrink)

The framework of plateaus, dips, and leaps shines light on periods when individuals may be inventing new methods of skilled performance. We begin with a review of the role performance plateaus have played in experimental psychology, human–computer interaction, and cognitive science. We then reanalyze two classic studies of individual performance to show plateaus and dips which resulted in performance leaps. For a third study, we show how the statistical methods of Changepoint Analysis plus a few simple heuristics may direct our (...) focus to periods of performance change for individuals. For the researcher, dips become the marker of exploration where performance suffers as new methods are invented and tested. Leaps mark the implementation of a successful new method and an incremental jump above the path plotted by smooth and steady log–log performance increments. The methods developed during these dips and leaps are the key to surpassing one's teachers and acquiring extreme expertise. (shrink)

The feasibility of reversing human aging within a matter of decades has traditionally been dismissed by all professional biogerontologists, on the grounds that not only is aging still poorly understood, but also many of those aspects that we do understand are not reversible by any current or foreseeable therapeutic regimen. This broad consensus has recently been challenged by the publication, by five respected experimentalists in diverse subfields of biogerontology together with three of the present authors, of an article (Ann NY (...) Acad Sci 959, 452–462) whose conclusion was that all the key components of mammalian aging are indeed amenable to substantial reversal (not merely retardation) in mice, with technology that has a reasonable prospect of being developed within about a decade. Translation of that panel of interventions to humans who are already alive, within a few decades thereafter, was deemed potentially feasible (though it was not claimed to be likely). If the prospect of controlling human aging within the foreseeable future cannot be categorically rejected, then it becomes a matter of personal significance to most people presently alive. Consequently, we suggest that serious public debate on this subject is now warranted, and we survey here several of the biological, social and political issues relating to it. BioEssays 24:667–676, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

Tasks, tools, and techniques that we perform, use, and acquire, define the elements of expertise which we value as the hallmarks of goal-driven behavior. Somehow, the creation of tools enables us to define new tasks, or is it that the envisioning of new tasks drives us to invent new tools? Or maybe it is that new tools engender new techniques which then result in new tasks? This jumble of issues will be explored and discussed in this diverse collection of papers. (...) Individually, few of the papers are related to each other by topic or by techniques of analysis. Collectively, all focus on tasks performed using tools and discuss the techniques of tool use which enable differences in performance and expertise across individuals, societies, and (even) species. -/- . (shrink)

Over recent years, evidence has been accumulating in favour of the free radical theory of aging, first proposed by Harman. Despite this, an understanding of the mechanism by which cells might succumb to the effects of free radicals has proved elusive. This paper proposes such a mechanism, based on a previously unexplored hypothesis for the proliferation of mutant mitochondrial DNA: that mitochondria with reduced respiratory function, due to a mutation or deletion affecting the respiratory chain, suffer less frequent lysosomal degradation, (...) because they inflict free radical damage more slowly on their own membranes. Once such a mutation occurs in a mitochondrion of a non‐dividing cell, therefore, mitochondria carrying it will rapidly populate that cell, thereby destroying the cell's respiratory capability. The accumulation of cells that have undergone this transition results in aging at the organismal level. The consistency of the hypothesis with known facts is discussed, and technically feasible tests are suggested, of both the proposed mechanism and its overall contribution to mammalian aging. (shrink)

Acquiring expertise in a task is often thought of as an automatic process that follows inevitably with practice according to the log‐log law (aka: power law) of learning. However, as Ericsson, Chase, and Faloon (1980) showed, this is not true for digit‐span experts and, as we show, it is certainly not true for Tetris players at any level of expertise. Although some people may simply “twitch” faster than others, the limit to Tetris expertise is not raw keypress time but the (...) techniques acquired by players that allow them to use the tools provided by the hardware and software to compensate for the game's relentlessly increasing drop speed. Unfortunately, these increases in drop speed between Tetris levels make performance plateaus very short and quickly followed by game death. Hence, a player's success at discovering, exploring, and practicing new techniques for the tasks of board preparation, board maintenance, optimal placement discovery, zoid rotation, lateral movement of zoids, and other tasks important to expertise in Tetris is limited. In this paper, we analyze data collected from 492 Tetris players to reveal the challenges they confronted while constructing expertise via the discovery of new techniques for gameplay at increasingly difficult levels of Tetris. (shrink)

Constraints and dependencies among the elements of embodied cognition form patterns or microstrategies of interactive behavior. Hard constraints determine which microstrategies are possible. Soft constraints determine which of the possible microstrategies are most likely to be selected. When selection is non‐deliberate or automatic the least effort microstrategy is chosen. In calculating the effort required to execute a microstrategy each of the three types of operations, memory retrieval, perception, and action, are given equal weight; that is, perceptual‐motor activity does not have (...) a privileged status with respect to memory. Soft constraints can work contrary to the designer's intentions by making the access of perfect knowledge in‐the‐world more effortful than the access of imperfect knowledge in‐the‐head. These implications of soft constraints are tested in two experiments. In experiment 1 we varied the perceptual‐motor effort of accessing knowledge in‐the‐world as well as the effort of retrieving items from memory. In experiment 2 we replicated one of the experiment 1 conditions to collect eye movement data. The results suggest that milliseconds matter. Soft constraints lead to a reliance on knowledge in‐the‐head even when the absolute difference in perceptual‐motor versus memory retrieval effort is small, and even when relying on memory leads to a higher error rate and lower performance. We discuss the implications of soft constraints for routine interactive behavior, accounts of embodied cognition, and tool and interface design. (shrink)