Evidence-based medicine has been the subject of much controversy within and outside the field of medicine, with its detractors characterizing it as reductionist and authoritarian, and its proponents rejecting such characterization as a caricature of the actual practice. At the heart of this controversy is a complex linguistic and social process that cannot be illuminated by appealing to the semantics of the modifier evidence-based. The complexity lies in the nature of evidence as a basic concept that circulates in both expert (...) and non-expert spheres of communication, supports different interpretations in different contexts, and is inherently open to contestation. We outline a new methodology that combines a social epistemological perspective with advanced methods of corpus linguistics and elements of conceptual history to investigate this and other basic concepts that underpin the practice and ethos of modern medicine. The potential of this methodology to offer new insights into controversies such as those surrounding EBM is demonstrated through a case study of the various meanings supported by evidence and based, as attested in a large electronic corpus of online material written by non-experts as well as a variety of experts in different fields, including medicine. (shrink)

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

Many accept the following three theses in animal ethics. First, although animal welfare should not be—or at least, need not be—our top moral priority, it is not a trivial one either. Second, if an animal is sentient, then it is a moral patient. Third, the extinction of an animal species is a tragic outcome that we have moral reason to prevent. I argue that a traditional (i.e., pre-modern) Buddhist perspective pushes against the first thesis and that a naturalized Buddhist perspective (...) is inconsistent with the latter two. (shrink)

Maximize Expected Choiceworthiness (MEC) is a theory of decision-making under moral uncertainty. It says that we ought to handle moral uncertainty in the way that Expected Value Theory (EVT) handles descriptive uncertainty. MEC inherits from EVT the problem of fanaticism. Roughly, a decision theory is fanatical when it requires our decision-making to be dominated by low-probability, high-payoff options. Proponents of MEC have offered two main lines of response. The first is that MEC should simply import whatever are the best solutions (...) to fanaticism on offer in decision theory. The second is to propose statistical normalization as a novel solution on behalf of MEC. This paper argues that the first response is open to serious doubt and that the second response fails. As a result, MEC appears significantly less plausible when compared to competing accounts of decision-making under moral uncertainty, which are not fanatical. (shrink)

Assertion is the central vehicle for the sharing of knowledge. Whether knowledge is shared successfully often depends on the quality of assertions: good assertions lead to successful knowledge sharing, while bad ones don't. In Sharing Knowledge, Christoph Kelp and Mona Simion investigate the relation between knowledge sharing and assertion, and develop an account of what it is to assert well. More specifically, they argue that the function of assertion is to share knowledge with others. It is this function that (...) supports a central norm of assertion according to which a good assertion is one that has the disposition to generate knowledge in others. The book uses this functionalist approach to motivate further norms of assertion on both the speaker and the hearer side and investigates ramifications of this view for other questions about assertion. (shrink)

Cloud computing (ClC) has become a more popular computer paradigm in the preceding few years. Quality of Service (QoS) is becoming a crucial issue in service alteration because of the rapid growth in the number of cloud services. When evaluating cloud service functioning using several performance measures, the issue becomes more complex and non-trivial. It is therefore quite difficult and crucial for consumers to choose the best cloud service. The user's choices are provided in a quantifiable manner in the current (...) methods for choosing cloud services. Hence, this study attempts to achieve this objective through construction. decision-making framework so-called cloud services evaluator (CSsEv). The main indicator and its sub-indicators are formed as nodes at levels(n) in tree soft sets (TSSs). Thereafter Single Value Neutrosophic Sets (SVNSs) as branch of neutrosophic sets which conjunction with the Multi-Criteria Decision Making (MCDM) technique to facilitate analysis and evaluation process for the available Cloud services providers. Hence, entropy is employed to obtain indicators and sub_indicators weights and Complex Proportional Assessment utilizes these weights to facilitate the decision process of selecting optimal ClSPs. (shrink)

This paper discusses varieties of normative phenomena, ranging from morality, to epistemic justification, to the rules of chess. It canvases a number of distinctions among these different normative phenomena. The most significant distinction is between formal and authoritative normativity. The prior is the normativity exhibited by any standard one can meet or fail to meet. The latter is the sort of normativity associated with phenomena like the "all-things-considered" ought. The paper ends with a brief discussion of reasons for skepticism about (...) authoritative normativity. (shrink)

The Cambridge World History of Medical Ethics is the first comprehensive scholarly account of the global history of medical ethics. Offering original interpretations of the field by leading bioethicists and historians of medicine, it will serve as the essential point of departure for future scholarship in the field. The volumes reconceptualize the history of medical ethics through the creation of new categories, including the life cycle; discourses of religion, philosophy, and bioethics; and the relationship between medical ethics and the state, (...) which includes a historical reexamination of the ethics of apartheid, colonialism, communism, health policy, imperialism, militarism, Nazi medicine, Nazi "medical ethics," and research ethics. Also included are the first global chronology of persons and texts; the first concise biographies of major figures in medical ethics; and the first comprehensive bibliography of the history of medical ethics. An extensive index guides readers to topics, texts, and proper names. (shrink)

The main goal of this paper is to introduce the notion of stabilizers in \(L\)-algebras and develop stabilizer theory in \(L\)-algebras. In this paper, we introduced the notions of left and right stabilizers and investigated some related properties of them. Then, we discussed the relations among stabilizers, ideal and co-annihilators. Also, we obtained that the set of all ideals of a \(CKL\)-algebra forms a relative pseudo-complemented lattice. In addition, we proved that right stabilizers in \(CKL\)-algebra are ideals. Then by using (...) the right stabilizers we produced a basis for a topology on \(L\)-algebra. We showed that the generated topology by this basis is Baire, connected, locally connected and separable and we investigated the other properties of this topology. (shrink)

The Representational Theory of the Mind (RTM) has been forcefully and subtly developed by Jerry A. Fodor. According to the RTM, psychological states that explain behavior involve tokenings of mental representations. Since the RTM is distinguished from other approaches by its appeal to the meaning or "content" of mental representations, a question immediately arises: by virtue of what does a mental representation express or represent an environmental property like coto or shoe? This question asks for a general account of the (...) semantics of mental representation. Fodor places two conditions on the requisite theory: it must be physi calistic (that is, it must be couched in nonsemantic and nonintentional terms, free of expressions like "refers to" or "denotes" or "means that"), and it must be atomistic (that is, it must allow that the thinker can have a single intentional state without having any others). What is wanted, then, is a reductive theory that "naturalizes" content by specifying sufficient conditions, in physicalistic and atomistic terms, for a mental symbol to represent or express a certain property. (shrink)

Considers observation as it is enacted in the home, nursery or classroom. Drawing on a range of theories including feminist new materialism, social semiotics, and sociocultural and multimodal approaches to early childhood, the chapters cover a range of areas, from early childhood art and observational literacy tools to intergenerational research, and using photography and video in observations.

Machine generated contents note: 1. Spoken, intended and problematic divorce in Hanafi Fiqh; 2. Between person and property - slavery in Qudūrī's Mukhtasar; 3. Pig, purity and permission in Mālikī slaughter; 4. Islamic and other perspectives on evil; 5. The language of love in the Qur'ān; 6. Virtue and limits in the ethics of friendship 7. Drinking and drunkenness in Ibn Rushd.

This chapter develops a novel Neo-Moorean view. The view falls squarely within the Radical Neo-Moorean camp, in that it holds that closure holds unrestrictedly, warrant transmits through Moore’s inference, and that there is nothing wrong – epistemically or dialectically – with Moore’s argument. Nevertheless, the account is superior to extant Radical Neo-Mooreanisms in explanatory power: it explains both the precise variety of epistemic failure exhibited by the sceptic, and the intuition of reasonableness when it comes to the sceptic’s resistance to (...) Moore’s argument. It does so in terms of epistemic functions and contrary-to-duty obligations. (shrink)

No single theory so far proposed gives a wholly satisfactory account of the origin and maintenance of bird-song dialects. This failure is the consequence of a weak comparative literature that precludes careful comparisons among species or studies, and of the complexity of the issues involved. Complexity arises because dialects seem to bear upon a wide range of features in the life history of bird species. We give an account of the principal issues in bird-song dialects: evolution of vocal learning, experimental (...) findings on song ontogeny, dialect descriptions, female and male reactions to differences in dialect, and population genetics and dispersal.We present a synthetic theory of the origin and maintenance of song dialects, one that accommodates most of the different systems reported in the literature. The few data available suggest that large, regional dialect populations are genetically differentiated; this pattern is correlated with reduced dispersal between dialects, assortative mating by females, and male-male exclusion. At the same time, “subdialects” may be formed within regional dialects. Subdialect clusters are usually small and may represent vocal mimicry among a few adjacent territorial males. The relative importance of genetic and social adaptation may contribute to the emergence of subdialects; their distinctiveness may be correlated with the degree of polygyny, for example. Thus, subdialect formation is linked to one theory of the evolution of repertoire size, but data are too fragmentary to examine this idea critically. (shrink)

DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge. Ethical competence can be (...) developed through experience, communication and education, and a supportive environment is necessary for maintaining a high ethical competence. The aim of the present study was to investigate how nurses and physicians in oncology and hematology care understand the concept of ethical competence in order to make, or be involved in, DNR decisions and how such skills can be learned and developed. A further aim was to investigate the role of guidelines in relation to the development of ethical competence in DNR decisions. Individual interviews were conducted with fifteen nurses and sixteen physicians. The interviews were analyzed using thematic content analysis. Physicians and nurses in the study reflected on their ethical competence in relation to DNR decisions, on what it should comprise and how it could be developed. The ethical competence described by the respondents related to the concepts being, doing and knowing. In order to make ethically sound DNR decisions in oncology and hematology care, physicians and nurses need to develop appropriate virtues, improve their knowledge of ethical theories and relevant clinical guidelines. Ethical competence also includes the ability to act upon ethical judgements. Continued ethical education and discussions for further development of a common ethical language and a good ethical working climate can improve ethical competence and help nurses and physicians cooperate better with regard to patients in relation to DNR decisions, in their efforts to act in the best interest of the patient. (shrink)

Le projet révolutionnaire s'est largement identifié à un projet pédagogique, qui déborde de beaucoup les dispositifs scolaires pour s'attacher à une véritable conversion : du sujet au citoyen, de l'homme enchaîné à l'homme libre, du vieil homme à l'homme régénéré. Au coeur de cet ouvrage, on trouvera l'essai consacré à cette entreprise, dont Saint-Just a défini l'ambition ("faire des hommes ce qu'on veut qu'ils soient") et Mirabeau le possible délire : "Avec des moyens appropriés, on pourrait passionner les hommes pour (...) une organisation sociale entièrement absurde, injuste et cruelle". Toutes les études qui accompagnent ce texte central éclairent à leur manière la tentative utopique, magnifique et désespérée, de maîtriser à la fois l'événement et la durée, l'individu et le collectif, l'opinion réfléchie et l'opinion spontanée. Se dessine ainsi le vrai sujet de cet ensemble, que traitaient déjà La Fête révolutionnaire (1976) et L'École de la France (1984) : l'entrée, avec la volonté d'instituer l'homme aussi bien que le citoyen, dans notre culture démocratique. (shrink)

BackgroundIn cancer care, do not resuscitate orders are common in the terminal phase of the illness, which implies that the responsible physician in advance decides that in case of a cardiac arrest neither basic nor advanced Coronary Pulmonary Rescue should be performed. Swedish regulations prescribe that DNR decisions should be made by the responsible physician, preferably in co-operation with members of the team. If possible, the patient should consent, and significant others should be informed of the decision. Previous studies have (...) shown that physicians and nurses can experience ethical dilemmas in relation to DNR decisions, but knowledge about what ethical reasoning they perform is lacking. Therefore, the aim was to describe and explore what ethical reasoning physicians and nurses apply in relation to DNR-decisions in oncology and hematology care.MethodsA qualitative, descriptive and explorative design was used, based on 287 free-text comments in a study-specific questionnaire, answered by 216 physicians and nurses working in 16 oncology and hematology wards in Sweden. Comments were given by 89 participants.ResultsThe participants applied a situation-based ethical reasoning in relation to DNR-decisions. The reasons given for this were both deontological and utilitarian in kind. Also, expressions of care ethics were found in the material. Universal rules or guidelines were seen as problematic. Concerning the importance of the subject, nurses to a higher extent underlined the importance of discussing DNR-situations, while physicians described DNR-decisions as over-investigated and not such a big issue in their daily work.ConclusionThe study revealed that DNR-decisions in oncology and hematology care gave rise to ethical considerations. Important ethical values described by the participants were to avoid doing harm and to secure a peaceful and “natural” death with dignity for their dying patients. A preference for the expression “allow for natural death” instead of the traditional term “do not resuscitate” was found in the material. (shrink)

La France a longtemps passé pour le pays des femmes. Elle a pourtant la réputation d'être aussi celui d'un féminisme timoré qui a tardé plus qu'ailleurs à asseoir ses conquêtes. D'où vient cette timidité? C'est ce paradoxe qu'explore le livre de Mona Ozouf, en donnant à entendre "les mots des femmes", ceux qu'elles ont choisis elles-mêmes pour décrire la féminité.

I argue against pessimistic readings of the Buddhist tradition on which unawakened beings invariably have lives not worth living due to a preponderance of suffering (duḥkha) over well-being.

This chapter examines two different views of universal grammar. Most linguists assume that universal grammar is underspecified — providing us with an incomplete grammar to be elaborated by learning. But the alternative is that it is overspecified — providing us with a full range of possible grammars from which we select one on the basis of environmental input. Underspecification is now the dominant view in the developmental sciences, and is often treated as the null hypothesis on grounds of greater possibility, (...) parsimony, and simplicity. The chapter questions whether the underspecification view is really feasible and whether it is more parsimonious than the overspecification view, drawing on examples from certain African languages. It also shows that the perplexity evoked by overspecification theories disappears if language has a concealing purpose as well as a communicating purpose, similar to a code. (shrink)

An innovative approach to rethinking sciences of mind at the turn of the twenty-first century via the texts of philosopher and psychologist William James.

The ethics of hospitality – the welcome of the foreigner – is implied in all moral debate in international relations ranging from questions of asylum to those of humanitarian intervention. Why then has there been so little reflection on hospitality in the study of international relations to date? Seeking to correct this striking omission, and making an important and original contribution to debates about ethics in international relations in the process, Baker outlines a theory of cosmopolitanism as hospitality which (...) goes beyond existing cosmopolitanisms. He argues that we must understand cosmopolitanism not as the pursuit of a world in which there are no more foreigners but as the welcome of the foreigner. However, though hospitality calls for a welcome, there is always a decision on the welcome to be made. Cosmopolitanism as hospitality is therefore always as much a politics as it is an ethics. Addressing issues of central concern for those who seek to understand our obligations to strangers, this book will be of interest to students and scholars of international relations, security studies, ethics, and political and international theory. (shrink)

It is no exaggeration to say that there has been an explosion of activity in the field of philosophical enquiry that is known as natural theology. Having been smothered in the early part of the twentieth century due to the dominance of the anti-metaphysical doctrine of logical positivism, natural theology began to make a comeback in the late 1950s as logical positivism collapsed and analytic philosophers took a newfound interest in metaphysical topics such as possibility and necessity, causation, time, the (...) mind-body problem, and God. This chapter begins by considering how we might characterise natural theology as a field of enquiry. It then proceeds to survey the landscape of contemporary natural theology, which has spawned a large and at times highly technical body of literature. Finally, consideration is given to two epistemological issues confronting the theist who wishes to appeal to natural theology, which could be termed the problem of the gap(s) and the problem of accessibility. (shrink)

Background:Within oncology and hematology care, patients are sometimes considered to have such a poor prognosis that they can receive a do not resuscitate order from the physician responsible, stipulating that neither basic nor advanced coronary pulmonary rescue be performed in the event of a cardiac arrest. Studies on do not resuscitate decisions within oncology and hematology units, focusing on the specific role of the nurse in relation to these decisions, are scarce.Objective:The aim of this study was to investigate hematology and (...) oncology nurses’ experiences and perceptions of do not resuscitate orders, in order to achieve a deeper understanding of the nurses’ specific role in these decisions.Research design:A qualitative, descriptive methodology with individual semi-structured interviews was used.Participants and research context:A total of 15 nurses from eight hematology/oncology wards in four hospitals in Sweden were interviewed individually.Ethical considerations:In accordance with national regulations, an ethical review was not required for this study. The research followed international guidelines for empirical research, as outlined in the Helsinki Declaration.Findings:The nurses strived for good nursing care through balancing harms and goods and observing integrity and quality of life as important values. Experienced hindrances for good care were unclear and poorly documented decisions, uninformed patients and relatives, and disagreements among the caregivers and family. The nurses expressed a need for an ongoing discussion on do not resuscitate decisions, including all concerned parties.Conclusion:In order to provide good nursing care, nurses need clear and well-documented do not resuscitate orders, and patients and relatives need to be well informed and included in the decisions. To increase the understanding for each other’s opinions within the medical team, regular ethical discussions are required. (shrink)

The papers in this volume question how perceptions of space influenced understandings of the body and its functions, illness and treatment, and the surrounding natural and built environments in relation to health in the classical and ...

According to the World Health Organization, female genital cutting affects millions of girls and women worldwide, particularly on the African continent and in the Middle East. This paper presents a plausible, albeit hypothetical, clinical vignette and then explores the legal landscape as well as the ethical landscape physicians should use to evaluate the adult patient who requests re-infibulation. The principles of non-maleficence, beneficence, justice, and autonomy are considered for guidance, and physician conscientious objection to this procedure is discussed as well. (...) Analyses of law and predominant principles of bioethics fail to yield a clear answer regarding performing female genital cutting or re-infibulation on an adult in the United States. Physicians should consider the patient’s physical, mental, and social health when thinking about female genital cutting and should understand the deep-rooted cultural significance of the practice. (shrink)

When Ron Giere introduced perspectivism into philosophy of science, he provided a perspectivist analysis of both scientific instruments and scientific theorizing. Today, there is a burgeoning literature that extends Giere’s analysis of theorizing, with many philosophers examining the perspectivist approach to aspects of theorizing such as models, laws, explanations, and so on. However, relatively little attention has been paid to Giere’s analysis of instruments. In this article, I hope to fill this gap. I argue that the perspectivist analysis of instruments (...) should be rejected. First, I give a general account of the kind of instrumentation relevant to instrumental perspectivism, drawing on Cartwright’s notion of nomological machines, which forms the basis of my criticism of Giere’s argument for instrumental perspectivism. Next, I present the case against instrumental perspectivism. I argue that instrumental perspectivism is dependent on theoretical perspectivism in a way that robs it of philosophical significance, and that it introduces new puzzles while adding little to our understanding of instruments. (shrink)

One central debate in recent literature on epistemic normativity concerns the epistemic norm for action. This paper argues that this debate is afflicted by a category mistake: strictly speaking, there is no such thing as an epistemic norm for action. To this effect, I introduce a distinction between epistemic norms and norms with epistemic content; I argue that while it is plausible that norms of the latter type will govern action in general, epistemic norms will only govern actions characteristically associated (...) with delivering epistemic goods. (shrink)

The desire to minimize the number of individual new entities postulated is often referred to as quantitative parsimony. Its influence on the default hypotheses formulated by scientists seems undeniable. I argue that there is a wide class of cases for which the preference for quantitatively parsimonious hypotheses is demonstrably rational. The justification, in a nutshell, is that such hypotheses have greater explanatory power than less parsimonious alternatives. My analysis is restricted to a class of cases I shall refer to as (...) additive. Such cases involve the postulation of a collection of qualitatively identical individual objects which collectively explain some particular observed phenomenon. Especially clear examples of this sort occur in particle physics. 1 Introduction 2 Particle physics: a case study 3 Three kinds of simplicity 4 Explanatory power 5 Explanation and non-observation 6 Parsimony and scientific methodology 7 Conclusions. (shrink)

Stop trying to become "better" by suppressing or hiding parts of yourself, and learn what it means to be fully human with this accessible guide to the core ethical teachings of Zen Buddhism. In Opening to Oneness, Zen teacher Nancy Baker offers a detailed path of practice for Zen students planning to take the precepts and for anyone, Buddhist or non-Buddhist, interested in deepening their personal study of ethical living. She reveals that there are three levels of each precept: (...) a literal level (don't kill, not even a bug), a relative level that takes moral ambiguity into account (what if it's a malaria-spreading mosquito?), and an ultimate level-the paradoxical level of nonduality, in which the precepts are naturally expressed from a state of oneness. Full of nuance, skepticism, intelligence, and compassion, ten chapters addressing the grave precepts approach them mostly from the literal and relative levels, including instructions for how to practice these precepts individually and in pairs or groups. The next part of the book takes a deep dive into looking at the precepts from the ultimate perspective, largely through an exploration of the precept writings of Dogen, the thirteenth-century religious genius who founded the Soto Zen school. At once comprehensive and innovative, Opening to Oneness will take its place alongside classics like The Mind of Clover, The Heart of Being, and Being Upright as a cherished guide to Zen Buddhist ethics. (shrink)

This study deals specifically with one of the most relevant issues in neuro-ethics, namely the philosophical classification of so-called memory dampening, which refers to the attenuation of traumatic memories with the help of medication. Numerous neuroethical questions emerge from this issue. For example, how is a person’s identity affected by using such drugs? Does one still remain the same person? Would propranolol, for example, as a memory-dampening agent lead to a fundamental change in one’s identity? Are not a person’s negative (...) memories also part of their identity and present personality? These questions are examined from the perspective of the seventeenth-century Islamic philosopher, Mullā Ṣadrā. The goal is to shed light on the neuroethical foundations of memory dampening and personal identity from an Islamic philosophical perspective. (shrink)

Can war be morally justified? What is the philosophy behind armed conflict? How do you conduct an ethical war? And what guides military action as the nature of conflict changes over time? Based on a MOOC (Massive Open Online Course) designed for both military personnel and non-specialists across the globe, Key Concepts in Military Ethics is structured as a series of 'mini-chapters' that cover a huge range of topics and issues: moral dilemmas, military and civilian interactions, freedom of the press, (...) peacekeeping, terrorism, and humanitarian intervention. Written by a team of academic experts, many with military experience, the book contains scenarios and case studies, including the Gulf War, the Falklands War, 'Ground Zero' in New York City and more conventional theatres of war through history, as well as cyber-terrorism, the role of military contractors and unmanned weapons systems. (shrink)