Training of resident physicians is essential for the care of future patients. While surgical trainee involvement is necessary, its disclosure to patients can often be omitted or underplayed by surgeons. The informed consent process and the underlying ethical principles make evident that patients should be informed of trainee involvement. In this review we explore the importance of disclosure, current themes in practice, and the optimal discussion for which we should strive.

In this paper, I begin by defending permissivism: the claim that, sometimes, there is more than one way to rationally respond to a given body of evidence. Then I argue that, if we accept permissivism, certain worries that arise as a result of learning that our beliefs were caused by the communities we grew up in, the schools we went to, or other irrelevant influences dissipate. The basic strategy is as follows: First, I try to pinpoint what makes irrelevant influences (...) worrying and I come up with two candidate principles. I then argue that one principle should be rejected because it is inconsistent with permissivism. The principle we should accept implies that it is sometimes rational to maintain our beliefs, even upon learning that they were caused by irrelevant influences. (shrink)

This article investigates the potential of fMRI to test assumptions about different components in models of complex cognitive tasks. If the components of a model can be associated with specific brain regions, one can make predictions for the temporal course of the BOLD response in these regions. An event‐locked procedure is described for dealing with temporal variability and bringing model runs and individual data trials into alignment. Statistical methods for testing the model are described that deal with the scan‐to‐scan correlations (...) in the errors of measurement of the BOLD signal. This approach is illustrated using a “sacrificial” ACT‐R model that involves mapping 6 modules onto 6 brain regions in an experiment from Ravizza, Anderson, and Carter (in press) concerned with equation solving. The model's visual encoding predicted the BOLD response in the fusiform gyrus, its controlled retrieval predicted the BOLD response in the lateral inferior prefrontal cortex, and its subgoal setting predicted the BOLD response in the anterior cingulate cortex. On the other hand, its motor programming failed to predict anticipatory activation in the motor cortex, its representational changes failed to predicted the pattern of activity in the posterior parietal cortex, and its procedural component failed to predict an initial spike in caudate. The results illustrate the power of such data to direct the development of a theory of complex problem solving, both at the level of a specific task model as well as at the level of the cognitive architecture. (shrink)

BackgroundBiobanks provide an important foundation for genomic and personalised medicine. In order to enhance their scientific power and scope, they are increasingly becoming part of national or international networks. Public trust is essential in fostering public engagement, encouraging donation to, and facilitating public funding for biobanks. Globalisation and networking of biobanking may challenge this trust.MethodsWe report the results of an Australian study examining public attitudes to the networking and globalisation of biobanks. The study used quantitative and qualitative methods in conjunction (...) with bioethical analysis in order to determine factors that may contribute to, and threaten, trust.ResultsOur results indicate a generally high level of trust in biobanks and in medical research more broadly. Key factors that can reduce perceived trustworthiness of biobanks are commercialisation and involvement in global networking.ConclusionsWe conclude that robust ethical oversight and governance standards can both promote trust in global biobanking and ensure that this trust is warranted. (shrink)

The literature addressing bias and fairness in AI models (fair-AI) is growing at a fast pace, making it difficult for novel researchers and practitioners to have a bird’s-eye view picture of the field. In particular, many policy initiatives, standards, and best practices in fair-AI have been proposed for setting principles, procedures, and knowledge bases to guide and operationalize the management of bias and fairness. The first objective of this paper is to concisely survey the state-of-the-art of fair-AI methods and resources, (...) and the main policies on bias in AI, with the aim of providing such a bird’s-eye guidance for both researchers and practitioners. The second objective of the paper is to contribute to the policy advice and best practices state-of-the-art by leveraging from the results of the NoBIAS research project. We present and discuss a few relevant topics organized around the NoBIAS architecture, which is made up of a Legal Layer, focusing on the European Union context, and a Bias Management Layer, focusing on understanding, mitigating, and accounting for bias. (shrink)

The aim of this essay is to argue that, if a robust form of moral realism is true, then moral vagueness is ontic vagueness. The argument is by elimination: I show that neither semantic nor epistemic approaches to moral vagueness are satisfactory.

Managing cardiac illness is not easy because it dramatically disrupts people’s daily life and both the patient and his/her spouse are at risk for experiencing distress, which, in turn, may affect the support provided by the partner as caregiver. The partner, in fact, is the main source of support, but his/her support may sometimes be inadequate. In addition, dyadic coping could likely be a moderating factor. The main aim of the present study was to examine the role that dyadic coping (...) plays in moderating the link between patient and partner cardiac illness-related distress and partner support. The study included 100 married couples faced with cardiac illness who completed a self-report questionnaire. We analyzed our data in PROCESS using multiple regressions in order to assess the moderating effects of DC responses in the relationship between the couple’s cardiac illness-related distress and partner support. With regard to patient distress, results showed that higher levels of patient anxiety and depression were linked with ineffective partner support. With regard to partner distress, higher levels of partner depression were linked with hostility; higher levels of partner depression and anxiety were associated with less partner support for patient engagement. Moreover, the association between distress and partner support was moderated by the quality of DC. In particular, low positive DC represented a risk factor for both the patient and the partner during a cardiac illness, as low positive DC exacerbated the link between patient and partner distress and less effective partner support styles. Also, higher levels of negative DC were risky for couples: The association between distress and less adequate partner supportive behaviors was stronger in the case of higher negative DC. These results imply a need for psychosocial interventions for couples in cardiac illness, especially for couples lacking relational competences, such as positive dyadic coping. (shrink)

The COVID-19 pandemic represents the most significant global challenge in a generation. Based on extant data from previous pandemics, demographic, occupational, and psychological factors have been linked to distress and for some vulnerable members of society. COVID-19 has added to the layers of grief and distress of existing trauma. Evidence-based frameworks exist to guide our individual and collective response to reduce the trauma associated with the experience of a pandemic. Pandemic and post-pandemic measures to ameliorate impacts require a multi-disciplined approach, (...) central to which is community connectedness, resilience, and access to support. We advocate for the acceptance and broader application of Dadirri, a healing practice held by the Ngan'gikurunggurr and Ngen'giwumirri Aboriginal people of the Daly River region in the Northern Territory, Australia. This modality engages therapeutic phases that are comparable with other practiced trauma therapies. The demonstrated therapeutic outcomes from Dadirri can be attained through an individualistic or in a relational engagement context. This practice is accessible to all ages, is non-specific to gender and is suitable for people constrained in their mobility or limited by resources, pertinent in pandemic affected settings. (shrink)

Últimamente, y en especial a partir del enfoque de capacidades y funcionamientos de Amartya Sen, se han cuestionado las mediciones de pobreza donde se tiene en cuenta sólo una dimensión del bienestar, como es el ingreso, y se ha dado creciente importancia a la medición de la pobreza desde una perspectiva multidimensional. La propuesta de medida de pobreza de tiempo e ingreso LIMTIP toma el trabajo no remunerado invisibilizado como punto de partida para establecer un umbral de requerimientos de tiempo. (...) Si el ingreso del hogar alcanza para compensar el valor de estos déficits de tiempo, entonces serán pobres de tiempo pero no de ingreso ajustado. Si el ingreso no alcanza para comprar sustitutos de este déficit de tiempo, entonces las personas y los hogares en que habitan serán pobres de tiempo e ingresos. La medida de pobreza de ingreso y tiempo LIMTIP corrige medidas de pobreza absoluta a las que estamos acostumbrados para hacerlas más fieles a sus supuestos. Este trabajo incorpora la dimensión temporal a la medición de pobreza utilizando la metodología LIMTIP sobre datos de la Encuesta de Uso de Tiempo y Voluntariado realizada en la ciudad de Rosario en 2010. (shrink)

To practice environmental awareness is to leave a legacy for a better world and this will be achieved with the support of students and society, for this reason the main objective of this research is to describe and analyze the perspectives of environmental awareness in university students, for which the methodology of quantitative approach is used, correlational between its elements and predictive, in which 1324 university students who responded to a survey of 17 questions divided into four dimensions participated.

Insofern entwickelt die Begriffslogik eine Epistemologie freien Denkens. Damit entscheidet sich Hegel in den nachkantischen Debatten für Kant und gegen den von Schelling in die Diskussion zurückgebrachten Spinozismus.

La técnica de reproducción asistida trae consigo un número de embriones sobrantes. Se propone una revisión del estado de la cuestión de estos embriones en el Perú. Se revisa desde las perspectivas biológica, ética y jurídica. Se profundiza en el ordenamiento jurídico peruano, sobre el estado de desprotección de estos embriones y se contrasta con una posible solución: la adopción embrionaria. Se constata el estado de incertidumbre de la situación de estos embriones y se concluye como ilegítima la práctica de (...) la adopción embrionaria, por vulnerar la dignidad y condición de sujeto de derecho del embrión sobrante. (shrink)

Ecological Immunology assumes that immunological defenses must be minimized in terms of cost (energy expenditure). To reach this goal, a complex and still largely unexplored strategy has evolved to assure survival. From invertebrates to vertebrates, an integrated immune–neuroendocrine response appears to be crucial for the hierarchical redistribution of resources within the body according to the specific ecological demands. Thus, on the basis of experimental data on the intimate relationship between stress and immune responses that has been maintained during evolution, we (...) argue that a broader perspective based on the integration of immune and neuroendocrine responses should be adopted to describe the comprehensive strategy that the body utilizes to adapt to dynamic environmental conditions. We discuss the hypothesis that a bow‐tie architecture might be suitable to describe the variety of immune–neuroendocrine inputs that continuously target cells and organs while, at the same time, fulfilling the basic requirement of minimizing the cost of immune–neuroendocrine responses. Bow‐tie architectures are able to convert a variety of stimuli (fan in) into a wide range of fine‐tuned responses (fan out) by passing through the integrating activity of a core (knot) constituted by a limited number of elements. Finally, we argue that the ecologically negotiated immune–neuroendocrine strategies may have deleterious effects in the post‐reproductive period of life when, at least in humans, chronic, low‐grade, systemic inflammation develops, in accordance with the antagonistic pleiotropy theory of aging. BioEssays 30:868–874, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

The aim of this paper is to apply the accuracy based approach to epistemology to the case of higher order evidence: evidence that bears on the rationality of one's beliefs. I proceed in two stages. First, I show that the accuracy based framework that is standardly used to motivate rational requirements supports steadfastness—a position according to which higher order evidence should have no impact on one's doxastic attitudes towards first order propositions. The argument for this will require a generalization of (...) an important result by Greaves and Wallace for the claim that conditionalization maximizes expected accuracy. The generalization I provide will, among other things, allow us to apply the result to cases of self-locating evidence. In the second stage, I develop an alternative framework. Very roughly, what distinguishes the traditional approach from the alternative one is that, on the traditional picture, we're interested in evaluating the expected accuracy of conforming to an update procedure. On the alternative picture that I develop, instead of considering how good an update procedure is as a plan to conform to, we consider how good it is as a plan to make. I show how, given the use of strictly proper scoring rules, the alternative picture vindicates calibrationism: a view according to which higher order evidence should have a significant impact on our beliefs. I conclude with some thoughts about why higher order evidence poses a serious challenge for standard ways of thinking about rationality. (shrink)

How is medical knowledge made? There have been radical changes in recent decades, through new methods such as consensus conferences, evidence-based medicine, translational medicine, and narrative medicine. Miriam Solomon explores their origins, aims, and epistemic strengths and weaknesses; and she offers a pluralistic approach for the future.

For the last forty years, two claims have been at the core of disputes about scientific change: that scientists reason rationally and that science is progressive. For most of this time discussions were polarized between philosophers, who defended traditional Enlightenment ideas about rationality and progress, and sociologists, who espoused relativism and constructivism. Recently, creative new ideas going beyond the polarized positions have come from the history of science, feminist criticism of science, psychology of science, and anthropology of science. Addressing the (...) traditional arguments as well as building on these new ideas, Miriam Solomon constructs a new epistemology of science. After discussions of the nature of empirical success and its relation to truth, Solomon offers a new, social account of scientific rationality. She shows that the pursuit of empirical success and truth can be consistent with both dissent and consensus, and that the distinction between dissent and consensus is of little epistemic significance. In building this social epistemology of science, she shows that scientific communities are not merely the locus of distributed expert knowledge and a resource for criticism but also the site of distributed decision making. Throughout, she illustrates her ideas with case studies from late-nineteenth- and twentieth-century physical and life sciences. Replacing the traditional focus on methods and heuristics to be applied by individual scientists, Solomon emphasizes science funding, administration, and policy. One of her goals is to have a positive influence on scientific decision making through practical social recommendations. (shrink)

: In this essay, Miriam argues for a phenomenological-hermeneutic approach to the radical feminist theory of sex-right and compulsory heterosexuality. Against critics of radical feminism, she argues that when understood from a phenomenological-hermeneutic perspective, such theory does not foreclose female sexual agency. On the contrary, men's right of sexual access to women and girls is part of our background understanding of heteronormativity, and thus integral to the lived experience of female sexual agency.

The question of whether it is ever permissible to believe on insufficient evidence has once again become a live question. Greater attention is now being paid to practical dimensions of belief, namely issues related to epistemic virtue, doxastic responsibility, and voluntarism. In this book, McCormick argues that the standards used to evaluate beliefs are not isolated from other evaluative domains. The ultimate criteria for assessing beliefs are the same as those for assessing action because beliefs and actions are both products (...) of agency. Two important implications of this thesis, both of which deviate from the dominant view in contemporary philosophy, are 1) it can be permissible to believe for non-evidential reasons, and 2) we have a robust control over many of our beliefs, a control sufficient to ground attributions of responsibility for belief. (shrink)

A defense of imprecise credences (and other imprecise doxastic attitudes).

Abstract: This paper defends a constraint that any satisfactory decision theory must satisfy. I show how this constraint is violated by all of the decision theories that have been endorsed in the literature that are designed to deal with cases in which opinions or values are represented by a set of functions rather than a single one. Such a decision theory is necessary to account for the existence of what Ruth Chang has called “parity” (as well as for cases in (...) which agents have incomplete preferences or imprecise credences). The problem with the all of the decision theories that have been defended to account for parity is that they are committed to a claim I call unanimity: when all of the functions in the set agree that an agent ought to do A, then an agent ought to do A. A decision theory committed to unanimity violates the constraint I defend in this paper. Thus, if parity exists, a new approach to decision theory is necessary. (shrink)

Had we grown up elsewhere or been educated differently, our view of the world would likely be radically different. What to make of this? This paper takes an accuracy-centered first-personal approach to the question of how to respond to the arbitrary nature in which many of our beliefs are formed. I show how considerations of accuracy motivate different responses to this sort of information depending on the type of attitude we take towards the belief in question upon subjecting the belief (...) to doubt. (shrink)

In this essay, Miriam argues for a phenomenological-hermeneutic approach to the radical feminist theory of sex-right and compulsory heterosexuality. Against critics of radical feminism, she argues that when understood from a phenomenological’ hermeneutic perspective, such theory does not foreclose female sexual agency. On the contrary, men's right of sexual access to women and girls is part of our background understanding of heteronormativity, and thus integral to the lived experience of female sexual agency.

Internalists face the following challenge: what is it about an agent's internal states that explains why only these states can play whatever role the internalist thinks these states are playing? Internalists have frequently appealed to a special kind of epistemic access that we have to these states. But such claims have been challenged on both empirical and philosophical grounds. I will argue that internalists needn't appeal to any kind of privileged access claims. Rather, internalist conditions are important because of the (...) way in which we expect them to act as causal mediators between states of the world, on the one hand, and our beliefs and actions on the other. (shrink)

The article deals with larger stretches of talk-in-interaction and argues in favor of a descriptive approach, which integrates the structural requirements of global organization, the special type of sequential orderliness within larger units as well as the genre-orientation of these units. Drawing on previous work in conversation analysis, discourse analysis and the sociological genre analysis, the article introduces GLOBE as an analytical tool which functionally links discourse units to conventionalized communicative purposes. GLOBE reconstructs the interactive achievement of genre-oriented discourse units (...) in a three-branch analysis of jobs, devices and forms. The analytical potential of GLOBE is demonstrated in the exemplary genre-contrastive analysis of a narrative, an explanative and an argumentative excerpt. On the basis of the analyses of the three genres, the overarching constitution of genre-oriented global units is then explicated. (shrink)

Embodied approaches in cognitive science hold that the body is crucial for cognition. What this claim amounts to, however, still remains unclear. This paper contributes to its clarification by confronting three ways of understanding embodiment—the sensorimotor approach, extended cognition and enactivism—with Locked-in syndrome. LIS is a case of severe global paralysis in which patients are unable to move and yet largely remain cognitively intact. We propose that LIS poses a challenge to embodied approaches to cognition requiring them to make explicit (...) the notion of embodiment they defend and its role for cognition. We argue that the sensorimotor and the extended functionalist approaches either fall short of accounting for cognition in LIS from an embodied perspective or do it too broadly by relegating the body only to a historical role. Enactivism conceives of the body as autonomous system and of cognition as sense-making. From this perspective embodiment is not equated with bodily movement but with forms of agency that do not disappear with body paralysis. Enactivism offers a clarifying perspective on embodiment and thus currently appears to be the framework in embodied cognition best suited to address the challenge posed by LIS. (shrink)

A new, social epistemology of science that addresses practical as well as theoretical concerns.

My main aim in this paper is to specify conditions that distinguish rational, or justified, hope from irrational, or unjustified hope. I begin by giving a brief characterization of hope and then turn to offering some criteria of rational hope. On my view both theoretical and practical norms are significant when assessing hope’s rationality. While others have recognized that there are theoretical and practical components to the state itself, when it comes to assessing its rationality, depending on the account, only (...) one of these dimensions matters. Either hope’s rationality is taken to be entirely derivative on the rationality of some belief that the hope entails, or the focus is entirely on the practical dimensions. If we take seriously the idea that both kinds of norms are at play, an account which treats these both as salient and as intertwining in important ways is preferable. I argue that as the practical importance of hope increases, the demand for the level of evidential support lessens and as the stakes get lower, the evidence for the likeliness of the hoped-for outcome coming to be must go up for the hope to be rational. This is so because a hope is rational insofar as it contributes to agential flourishing, but the different dimensions of hope each pick out different aspects of agency; to hope well requires agential competence in both the epistemic and practical realms. (shrink)

My main aim is to argue that most conceptions of doxastic agency do not respond to the skeptic’s challenge. I begin by considering some reasons for thinking that we are not doxastic agents. I then turn to a discussion of those who try to make sense of doxastic agency by appeal to belief’s reasons-responsive nature. What they end up calling agency is not robust enough to satisfy the challenge posed by the skeptics. To satisfy the skeptic, one needs to make (...) sense of the possibility of believing for nonevidential reasons. While this has been seen as an untenable view for both skeptics and anti-skeptics, I conclude by suggesting it is a position that has been too hastily dismissed. (shrink)

REVIEW ESSAY The minimal self needs a social update Self and other: Exploring subjectivity, empathy, and shame, by Dan Zahavi, Oxford, Oxford University Press, 2015, 304 pp.

I investigate what we mean when we hold people responsible for beliefs. I begin by outlining a puzzle concerning our ordinary judgments about beliefs and briefly survey and critique some common responses to the puzzle. I then present my response where I argue a sense needs to be articulated in which we do have a kind of control over our beliefs if our practice of attributing responsibility for beliefs is appropriate. In developing this notion of doxastic control, I draw from (...) John Fischer's discussions of “guidance control”. A central feature of this kind of control is the idea of “ownership”. I argue that we can own our beliefs and that we expect each other to do so. We take responsibility for our beliefs and taking responsibility includes taking control of them. I end by considering objections to my view as well as some implications of it. (shrink)

This paper takes a new look at an old question: what is the human self? It offers a proposal for theorizing the self from an enactive perspective as an autonomous system that is constituted through interpersonal relations. It addresses a prevalent issue in the philosophy of cognitive science: the body-social problem. Embodied and social approaches to cognitive identity are in mutual tension. On the one hand, embodied cognitive science risks a new form of methodological individualism, implying a dichotomy not between (...) the outside world of objects and the brain-bound individual but rather between body-bound individuals and the outside social world. On the other hand, approaches that emphasize the constitutive relevance of social interaction processes for cognitive identity run the risk of losing the individual in the interaction dynamics and of downplaying the role of embodiment. This paper adopts a middle way and outlines an enactive approach to individuation that is neither individualistic nor disembodied but integrates both approaches. Elaborating on Jonas’ notion of needful freedom it outlines an enactive proposal to understanding the self as co-generated in interactions and relations with others. I argue that the human self is a social existence that is organized in terms of a back and forth between social distinction and participation processes. On this view, the body, rather than being identical with the social self, becomes its mediator. (shrink)

Non-financial interests, and the conflicts of interest that may result from them, are frequently overlooked in biomedicine. This is partly due to the complex and varied nature of these interests, and the limited evidence available regarding their prevalence and impact on biomedical research and clinical practice. We suggest that there are no meaningful conceptual distinctions, and few practical differences, between financial and non-financial conflicts of interest, and accordingly, that both require careful consideration. Further, a better understanding of the complexities of (...) non-financial conflicts of interest, and their entanglement with financial conflicts of interest, may assist in the development of a more sophisticated approach to all forms of conflicts of interest. (shrink)

English summary: This book analyses the relationship between faith and love in terms of Aquinas' theology.

It is commonly held that (i) beliefs are revisable in the face of counter‐evidence and (ii) beliefs are connected to actions in reliable and predictable ways. Given such a view, many argue that if a mental state fails to respond to evidence or doesn't result in the kind of behavior typical or expected of belief, it is not a belief after all, but a different state. Yet, one finds seeming counter examples of resilient beliefs that fail to respond to evidence, (...) or that do not connect to action in the way that is expected. I offer a view of belief that does not force us to exclude states as realbeliefs that we pre‐reflectively think of as beliefs, and that does not require us to “outsource” the work belief seems to do to other mental states. I propose that we view belief as a type of emotion where emotions are understood a irreducibly blended states, containing representational, motivational and phenomenological elements. (shrink)

It has been argued that Extended Cognition (EXT), a recently much discussed framework in the philosophy of cognition, would serve as the theoretical basis to account for the impact of Brain Computer Interfaces (BCI) on the self and life of patients with Locked-in Syndrome (LIS). In this paper I will argue that this claim is unsubstantiated, EXT is not the appropriate theoretical background for understanding the role of BCI in LIS. I will critically assess what a theory of the extended (...) self would comprise and provide a list of desiderata for a theory of self that EXT fails to accommodate for. There is, however, an alternative framework in Cognitive Science, Enactivism, which entails the basis for an account of self that is able to accommodate for these desiderata. I will outline some first steps towards an Enactive approach to the self, suggesting that the self could be considered as a form of human autonomy. Understanding the self from an enactive point of view will allow to shed new light on the questions of whether and how BCIs affect or change the selves of patients with LIS. (shrink)