Directional deep brain stimulation contacts provide greater spatial flexibility for therapy than traditional ring-shaped electrodes, but little is known about longitudinal changes of impedance and orientation. We measured monopolar and bipolar impedance of DBS contacts in 31 patients who underwent unilateral subthalamic nucleus deep brain stimulation as part of a randomized study. At different follow-up visits, patients were assigned new stimulation configurations and impedance was measured. Additionally, we measured the orientation of the directional lead during surgery, immediately after surgery, and (...) 1 year later. Here we contrast impedances in directional versus ring contacts with respect to local anatomy, active stimulation contact, and over time. Directional contacts display larger impedances than ring contacts. Impedances generally increase slightly over the first year of therapy, save for a transient decrease immediately post-surgery under general anesthesia during pulse generator placement. Local impedances decrease at active stimulation sites, and contacts in closest proximity to internal capsule display higher impedances than other anatomic sites. DBS leads rotate slightly in the immediate postoperative period but otherwise remain stable over the following year. These data provide useful information for setting clinical stimulation parameters over time. (shrink)

Introduction: Although deep brain stimulation often improves levodopa-responsive gait symptoms, robust therapies for gait dysfunction from Parkinson's disease remain a major unmet need. Walking speed could represent a simple, integrated tool to assess DBS efficacy but is often not examined systematically or quantitatively during DBS programming. Here we investigate the reliability and functional significance of changes in gait by directional DBS in the subthalamic nucleus.Methods: Nineteen patients underwent unilateral subthalamic nucleus DBS surgery with an eight-contact directional lead in the most (...) severely affected hemisphere. They arrived off dopaminergic medications >12 h preoperatively and for device activation 1 month after surgery. We measured a comfortable walking speed using an instrumented walkway with DBS off and at each of 10 stimulation configurations at the midpoint of the therapeutic window. Repeated measures of ANOVA contrasted preoperative vs. maximum and minimum walking speeds across DBS configurations during device activation. Intraclass correlation coefficients examined walking speed reliability across the four trials within each DBS configuration. We also investigated whether changes in walking speed related to modification of step length vs. cadence with a one-sample t-test.Results: Mean comfortable walking speed improved significantly with DBS on vs. both DBS off and minimum speeds with DBS on. Pairwise comparisons showed no significant difference between DBS off and minimum comfortable walking speed with DBS on. Intraclass correlations were ≥0.949 within each condition. Changes in comfortable walk speed were conferred primarily by changes in step length.Conclusion: Acute assessment of walking speed is a reliable, clinically meaningful measure of gait function during DBS activation. Directional and circular unilateral subthalamic DBS in appropriate configurations elicit acute and clinically significant improvements in gait dysfunction related to PD. Next-generation directional DBS technologies have significant potential to enhance gait by individually tailoring stimulation parameters to optimize efficacy. (shrink)

A crucial feature of Kant's critical-period writing on the sublime is its grounding in moral psychology. Whereas in the pre-critical writings, the sublime is viewed as an inherently exhausting state of mind, in the critical-period writings it is presented as one that gains strength the more it is sustained. I account for this in terms of Kantian moral psychology, and explain that, for Kant, sound moral disposition is conceived as a sublime state of mind.

This chapter contains sections titled: Playing the Blues Defining the Blues Wittgenstein to the Rescue Good Blues, Bad Blues, Walking Dead Blues Notes.

From 1945 on for two decades, Father William Wade was Chairman of the Department of Philosophy at St. Louis University. This volume, a recovery of his own 1935 Ph.D dissertation, was originally written under the direction of Vernon J. Bourke, later himself a renowned interpreter of both St. Augustine and St. Thomas Aquinas. In his dissertation, Wade displays deep understanding of relationships between Greek and medieval thought as well as of the different influences of Plato and Aristotle by (...) way of Augustine and Thomas. (shrink)

It has been insufficiently remarked that Murdoch deems “Kant’s ethical theory” to be “one of the most beautiful and exciting things in the whole of philosophy” in her 1959 essay “The Sublime and the Good”. Murdoch specifically has in mind the connection between Kant’s ethics and his theory of the sublime, which runs via the moral feeling of respect (Achtung). The chapter examines Murdoch’s interest in Kant on this point as a way to tease out the range of issues that (...) complicate Kant’s significance for the development of Murdoch’s distinctive conception of ethics as it is articulated in _The Sovereignty of Good_ and earlier essays. It focuses on her particular concerns about the moral dangers of consolation, and why this led her to propose reworking the Kantian theory of the sublime as a theory of art, and specifically of tragedy. (shrink)

This Element considers Kant's account of the sublime in the context of his predecessors both in the Anglophone and German rationalist traditions. Since Kant says with evident endorsement that 'we call sublime that which is absolutely great' and nothing in nature can in fact be absolutely great, Kant concludes that strictly speaking what is sublime can only be the human calling to perfect our rational capacity according to the standard of virtue that is thought through the moral law. The Element (...) takes account of the difference between respect and admiration as the two main varieties of sublime feeling, and concludes by considering the role of Stoicism in Kant's account of the sublime, particularly through the channel of Seneca. (shrink)

On a version of consent theory that tempts many, predatory sexual relations involving significant power imbalances (e.g. between professors and students, adults and teenagers, or employers and employees) are wrong because they violate consent-centric norms. In particular, the wronged party is said to have been _incapable_ of consenting to the predation, and the sexual wrong is located in the encounter’s nonconsensuality. Although we agree that these are sexual wrongs, we resist the idea that they are always nonconsensual. We argue instead (...) that it is possible for students, teenagers, employees, etc. to fully consent to sexually predatory encounters; denying as much renders survivors of predation vulnerable to compounding harms. Survivors face a dilemma: give up either their understanding of their experience as wrong, or their self-conception as an agent capable of consenting. We call the latter phenomenon _agential demotion_. (shrink)

A new reading of Plato’s political thought Plato famously defends the rule of knowledge. Knowledge, for him, is of the good. But what is rule? In this study, Melissa Lane reveals how political office and rule were woven together in Greek vocabulary and practices that both connected and distinguished between rule in general and office as a constitutionally limited kind of rule in particular. In doing so, Lane shows Plato to have been deeply concerned with the roles and relationships (...) between rulers and ruled. Adopting a longstanding Greek expectation that a ruler should serve the good of the ruled, Plato’s major political dialogues—the Republic, the Statesman, and Laws—explore how different kinds of rule might best serve that good. With this book, Lane offers the first account of the clearly marked vocabulary of offices at the heart of all three of these dialogues, explaining how such offices fit within the broader organization and theorizing of rule. Lane argues that taking Plato’s interest in rule and office seriously reveals tyranny as ultimately a kind of anarchy, lacking the order as well as the purpose of rule. When we think of tyranny in this way, we see how Plato invokes rule and office as underpinning freedom and friendship as political values, and how Greek slavery shaped Plato’s account of freedom. Reading Plato both in the Greek context and in dialogue with contemporary thinkers, Lane argues that rule and office belong at the center of Platonic, Greek, and contemporary political thought. (shrink)

The paper argues that existing interpretations of Kant's Critique of Pure Reason as an "analysis of experience" (e.g., those of Kitcher and Strawson) fail because they do not properly appreciate the method of the work. The author argues that the Critique provides an analysis of the faculty of reason, and counts as an analysis of experience only in a derivative sense.

‘War is definitely hell on earth’. All too often, we hope the hell will be short-lived, over in a few days, and yet, as we know from experience, hell can go on and on and on. For healthcare workers who provide care to victims of conflict, the work raises many ethical dilemmas. The stories showcased in this edition of NIB share the experiences of a handful of brave individuals and how they navigated their professional ethical obligations as well as their (...) personal convictions during times of conflict. Adeptly portrayed are various approaches to ethical dilemmas, such as adhering to the ethical imperative of medical impartiality, the limits of professional and personal responsibility, coping with moral distress, and the power of humanity, evident through the collective efforts of strangers to help others. This commentary reflects on the ethical grey zones of being a healthcare provider in conflict, as there is no single right way of fulfilling professional obligations, each context being different. As several stories highlight, whilst stressful, the solidarity and comradery of working in a healthcare team can provide great support, purpose, and motivation. (shrink)

Pezdek and Lam [Pezdek, K. & Lam, S. . What research paradigms have cognitive psychologists used to study “False memory,” and what are the implications of these choices? Consciousness and Cognition] claim that the majority of research into false memories has been misguided. Specifically, they charge that false memory scientists have been misusing the term “false memory,” relying on the wrong methodologies to study false memories, and misapplying false memory research to real world situations. We review each of these claims (...) and highlight the problems with them. We conclude that several types of false memory research have advanced our knowledge of autobiographical and recovered memories, and that future research will continue to make significant contributions to how we understand memory and memory errors. (shrink)

The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

This book explores the role and implications of responsibility for anthropology, asking how responsibility is recognised and invoked in the world, what relations it draws upon, and how it comes to define notions of the person, institutional practices, ways of knowing and modes of evaluation. The category of responsibility has a long genealogy within the discipline of anthropology and it surfaces in contemporary debates as well as in anthropologists' collaboration with other disciplines, including when anthropology is applied in fields such (...) as development, medicine, and humanitarian response. As a category that unsettles, challenges and critically engages with political, ethical and epistemological questions, responsibility is central to anthropological theory, ethnographic practice, collaborative research, and applied engagement. With chapters focused on a variety of cultural contexts, this volume considers how anthropology can contribute to a better understanding of responsibility, including the 'responsibility of anthropology' and the responsibility of anthropologists to specific others. (shrink)

This revolutionary book empowers its readers intellectually by providing a snapshot of perennial and timely philosophical topics. Written by twenty expert women in philosophy and representing a diverse and pluralistic approach to philosophy as a discipline, this book appeals to a wide audience. Individual readers, especially girls and women ages 16-24, as well as university and high school educators and students who want a change from standard anthologies that include few or no women will find value in these pages. This (...) volume contains several notable features: the book is divided into four sections that correspond to major fields in Philosophy-metaphysics, epistemology, social and political philosophy, and ethics-but the chapters within those sections provide fresh ways of understanding those fields. " Every chapter begins with a lively anecdote about a girl or woman in literature, myth, history, science, or art to introduce the chapter's specific topic." Chapters are dominated by women's voices, with nearly all primary and secondary sources used coming from women in the history of philosophy and a diverse set of contemporary women philosophers. "All chapters offer the authors' distinct philosophical perspectives written in their own voices and styles, representing diverse training, backgrounds, and interests." The Introduction and Prologue explicitly invite the book's readers to engage in philosophical conversation and reflection, thus setting the stage for continued contemplation and dialogue beyond the book itself. The result is a rigorous yet accessible entry-point into serious philosophical contemplation designed to embolden and strengthen its readers' own senses of philosophical inquiry and competence. The book's readers will feel confident in knowing that expert women affirm an equitable and just intellectual landscape for all and thus have lovingly collaborated to write this book. (shrink)

People frequently report that, at times, their thought has a vocal character. Thinking commonly appears to be accompanied or constituted by silently ‘talking’ to oneself in inner speech. In this paper, we explore the specifically epistemic role of inner speech in conscious reasoning. A plausible position—but one I argue is ultimately wrong—is that inner speech plays asolelyfacilitative role that is exhausted by (i) serving as the vehicle of representation for conscious reasoning, and/or (ii) allowing one to focus on certain types (...) of objects or relations, e.g., causal relations, abstracta, counterfactuals, etc., or to consciously entertain structured propositional contents that it would be hard (or impossible) to focus on or entertain with representations in other (e.g., imagistic) formats. According to this position, inner speech doesn't figure as a justificatory element in our reasoning or as the partial epistemic basis of our conclusions—it merely facilitates reasoning through (i) and/or (ii). In contrast to the view that inner speech is amerefacilitator, I establish that (outside of potentially playing roles (i) and/or (ii)) the language we use itself serves as a crucial source of information in reasoning. In other words, we reason from propositions about the language we use in inner speech as opposed to exclusively reasoning from the semantic contents of the speech. My conclusion follows from how we use language as a cognitive tool to keep track of information, e.g., the contents of premises, lemmas, previous reasoning results, etc., in reasoning. (shrink)

Stalnaker’s ‘Assertion’ (1978 [1999]) offers a classic account of diagonalization as an approach to the meaning of a declarative sentence in context. Here I explore the relationship between diagonalization and some puzzles in Mahtani’s book The Objects of Credence. Diagonalization can influence how we think about both credence and desirability, so it influences both components of a standard expected utility equation. In that vein, I touch on two of Mahtani’s case-studies, chance and the finite version of the Two Envelope Paradox.

The US populace appears to be increasingly polarized on partisan lines. Political fissures bifurcate the country even on empirical matters like vaccine safety and anthropogenic climate change. There now exists an ever-expanding interdisciplinary research program in which theorists attempt to explain increases in political polarization and myriad other phenomena collected under the “post-truth” heading by appeal to social-epistemic structures, like echo chambers and epistemic bubbles, that affect the flow and uptake of information in various communities. In this paper, I critically (...) analyze C. Thi Nguyen’s important and popular analysis of echo chambers and epistemic bubbles. As I demonstrate, the explanatory mechanisms on which Nguyen focuses are, arguably, overly cognitive and obscure significant effects of social-epistemic structures on our affective lives. The broader lesson to draw from my discussion is the following: commonly used expressions intended to refer to social-epistemic problems, like “political polarization”, possess no univocal definition across theorists, and various ways of making the terms precise are differentially successful in characterizing verifiable phenomena. Theorizing about social-epistemic structures should be responsive to relevant empirical work on various phenomena that we have good reason to believe constitute real and substantive problems that result from the flow and uptake of information. (shrink)

People frequently report that their thought has, at times, a vocal character. Thinking commonly appears to be accompanied or constituted by silently ‘talking’ to oneself in inner speech. In this paper, I argue that inner speech ‘utterances’ can constitute occurrent propositional attitudes, e.g., occurrent judgments, suppositions, etc., and, thereby, we can consciously reason through tokening a series of inner speech utterances in working memory. As I demonstrate, the functional role a mental state plays in working memory is determined in a (...) flexible and context sensitive manner by metacognitive monitoring and control procedures. An inner speech utterance functions as an occurrent judgment (and, thus, as a premise, lemma, or conclusion in a line of conscious reasoning) when it is experienced with a level of certainty that exceeds one’s threshold of confidence for acceptance. In virtue of an agent experiencing an inner speech utterance with a sufficient level of certainty, the utterance plays the functional role of an occurrent judgment through, e.g., terminating inquiry and causing overt actions (like overtly asserting the words rehearsed in inner speech). (shrink)

Is the debate over the existence of numbers unsolvable? Mario Gómez-Torrente presents a novel proposal to unclog the old discussion between the realist and the anti-realist about numbers. In this paper, the strategy is outlined, highlighting its results and showing how they determine the desiderata for a satisfactory theory of the reference of Arabic numerals, which should lead to a satisfactory explanation about numbers. It is argued here that the theory almost achieves its goals, yet it does not capture the (...) relevant association between how a number can be split up and the morphological property of Arabic numerals to be positional. This property seems to play a substantial role in providing a complete theory of Arabic numerals and numbers. (shrink)

Programs, policies, and technologies — particularly those concerned with health equity — are often designed with justice envisioned as the end goal. These policies or interventions, however, frequently fail to recognize how the beneficiaries have historically embodied the cumulative effects of marginalization, which undermines the effectiveness of the intended justice. These well-meaning attempts at justice are bounded by greater socio-historical constraints. Bounded justice suggests that it is impossible to attend to fairness, entitlement, and equity when the basic social and physical (...) infrastructures underlying them have been eroded by racism and other historically entrenched isms. Using the case of Brazil’s National Health Policy for the Black Population, this paper proposes that bounded justice can contribute to justice discourses by serving as a concept, a proffering to a multi-disciplinary conceptual framework, and a potential analytic for those interested in the design of policy, technology, and programmatic interventions towards health equity. (shrink)

Before we can resolve or avoid an ethical dilemma, we need to understand what makes something ethical. Practical and Professional Ethics : Key Concepts introduces us to a series of real cases where the stakes can be high, the situations complex, and the ethical issues often difficult to see. Drawing on examples from medicine, law and science, it offers a practical approach to thinking critically about the ethical problems that occur in our professions, teaching us how to: focus on the (...) ethical aspects of any situation distinguish between different kinds of ethical problems tailor our response to the kind of problem we face construct arguments we can plausibly attribute to those involved identify the role of power, discretion and moral blindness By guiding us through the concepts, issues and skills at play when we face an ethical problem, we learn how to find a solution. Ideal for students or professionals, this book provides the grounding required to become a more complex moral thinker, a quality that can be applied in a number of fields and jobs. (shrink)

In light of recent social psychological literature, I expand Miranda Fricker’s important notion of testimonial injustice. A fair portion of Fricker’s account rests on an older paradigm of stereotype and prejudice. Given recent empirical work, I argue for what I dub prescriptive credibility deficits in which a backlash effect leads to the assignment of a diminished level of credibility to persons who act in counter-stereotypic manners, thereby flouting prescriptive stereotypes. The notion of a prescriptive credibility deficit is not merely an (...) interesting conceptual addendum that can be appended to Fricker’s theory without need for further emendation. I develop the wider implications of prescriptive credibility deficits and argue that they pose a challenge to Fricker’s conception of the function of credibility assignments in conversational exchange and how a virtuous listener should respond to the potential threat of a prejudicial stereotype affecting her credibility assignments. (shrink)

Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or “incidental” features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to (...) distinguish clinical placebos from standard medical treatments. (shrink)

Journal of Philosophy of Education, EarlyView.

I propose a unified solution to two puzzles: Ross's puzzle and free choice permission. I begin with a pair of cases from the decision theory literature illustrating the phenomenon of act dependence, where what an agent ought to do depends on what she does. The notion of permissibility distilled from these cases forms the basis for my analysis of 'may' and 'ought'. This framework is then combined with a generalization of the classical semantics for disjunction — equivalent to Boolean disjunction (...) on the diagonal, but with a different two-dimensional character — that explains the puzzling facts in terms of semantic consequence. (shrink)

There can be no doubt that Kant thought we should be reflective: we ought to care to make up our own minds about how things are and what is worth doing. Philosophical objections to the Kantian reflective ideal have centred on concerns about the excessive control that the reflective person is supposed to exert over her own mental life, and Kantians who feel the force of these objections have recently drawn attention to Kant’s conception of moral virtue as it is (...) developed in his later work, chiefly the Metaphysics of Morals. Melissa Merritt’s book is a distinctive contribution to this recent turn to virtue in Kant scholarship. Merritt argues that we need a clearer, and textually more comprehensive, account of what reflection is, in order not only to understand Kant’s account of virtue, but also to appreciate how it effectively rebuts long-standing objections to the Kantian reflective ideal. (shrink)

Within the growing developmental literature on children's testimonial learning, the emphasis placed on children's evaluations of testimonial evidence has shielded from view some of the more collaborative dimensions of testimonial learning. Drawing on recent philosophical work on testimony and interpersonal trust, we argue for an alternative way of conceptualizing the social nature of testimonial learning. On this alternative, some testimonial learning is the result of a jointly collaborative epistemic activity, an activity that aims at the epistemic goal of true belief, (...) but that does so by means of an irreducibly social process. (shrink)

The relationship between truth and politics has rarely seemed more vexed. Worries about misinformation and disinformation abound, and the value of expertise for democratic decision-making dismissed. Whom can we trust to provide us with reliable testimony? In Truth and Evidence, the latest in the NOMOS series, Melissa Schwartzberg and Philip Kitcher present nine timely essays shedding light on practices of inquiry. These essays address urgent questions including what it means to #BelieveWomen; what factual knowledge we require to confront challenges (...) like COVID-19; and how white supremacy shapes the law of evidence. (shrink)

While readers of Euripides' Hippolytus have long regarded Phaedra's deltos as a mechanism of punitive revenge, I argue here that the tablet models itself on a judicial curse (defixio) and that its main function is to ensure victory for Phaedra in the upcoming “trial” over her reputation. In support of my thesis I examine three interrelated phenomena: first, Hippolytus' infamous assertion that his tongue swore an oath while his mind remains unsworn (612); second, Phaedra's status as a biaiothanatos; and third, (...) Phaedra's claim that Hippolytus “will learn sophrosune” (731), a speech act that, I conclude, anticipates the silencing effect on Hippolytus of Phaedra's death and her writing. (shrink)