Objective: To determine whether a moral reasoning exercise can improve response quality to surveys of healthcare priorities Methods: A randomised internet survey focussing on patient age in healthcare allocation was repeated twice. From 2574 internet panel members from the USA and Canada, 2020 (79%) completed the baseline survey and 1247 (62%) completed the follow-up. We elicited respondent preferences for age via five allocation scenarios. In each scenario, a hypothetical health planner made a decision to fund one of two programmes identical (...) except for average patient age (35 vs 65 years). Half of the respondents (intervention group) were randomly assigned to receive an additional moral reasoning exercise. Responses were elicited again 7 weeks later. Numerical scores ranging from –5 (strongest preference for younger patients) to +5 (strongest preference for older patients); 0 indicates no age preference. Response quality was assessed by propensity to choose extreme or neutral values, internal consistency, temporal stability and appeal to prejudicial factors. Results: With the exception of a scenario offering palliative care, respondents preferred offering scarce resources to younger patients in all clinical contexts. This preference for younger patients was weaker in the intervention group. Indicators of response quality favoured the intervention group. Conclusions: Although people generally prefer allocating scarce resources to young patients over older ones, these preferences are significantly reduced when participants are encouraged to reflect carefully on a wide range of moral principles. A moral reasoning exercise is a promising strategy to improve response quality to surveys of healthcare priorities. (shrink)

We discuss our surgical philosophy concerning the subtle interplay between the size of the surgical margin taken and the resultant morbidity from ablative oncological. procedures, which is ever more evident in the treatment of head and neck malignancy. The extent of tissue resection is determined by the "trade off" between cancer control and the perioperative, functional and aesthetic morbidity and mortality of the surgery. We also discuss our dilemmas concerning recent minimally invasive endoscopic microsurgical. techniques for the trans-oral laser removal. (...) or co-ablation of aero-digestive tract tumours, which result in a minimal. surgical margin of oncological clearance. By a process of inductive argument as to the nature of the surgical margin, we consider whether the risks of taking a lesser margin with adjuvant therapy is justified by the attendant gain in reduced surgical morbidity and the possible costs in tumour control. (c) 2006 Elsevier Ltd. All rights reserved. (shrink)

Since Tversky argued that similarity judgments violate the three metric axioms, asymmetrical similarity judgments have been particularly challenging for standard, geometric models of similarity, such as multidimensional scaling. According to Tversky, asymmetrical similarity judgments are driven by differences in salience or extent of knowledge. However, the notion of salience has been difficult to operationalize, especially for perceptual stimuli for which there are no apparent differences in extent of knowledge. To investigate similarity judgments between perceptual stimuli, across three experiments, we collected (...) data where individuals would rate the similarity of a pair of temporally separated color patches. We identified several violations of symmetry in the empirical results, which the conventional multidimensional scaling model cannot readily capture. Pothos et al. proposed a quantum geometric model of similarity to account for Tversky's findings. In the present work, we extended this model to a more general framework that can be fit to similarity judgments. We fitted several variants of quantum and multidimensional scaling models to the behavioral data and concluded in favor of the quantum approach. Without further modifications of the model, the best-fit quantum model additionally predicted violations of the triangle inequality that we observed in the same data. Overall, by offering a different form of geometric representation, the quantum geometric framework of similarity provides a viable alternative to multidimensional scaling for modeling similarity judgments, while still allowing a convenient, spatial illustration of similarity. (shrink)

Background: Many people participating in dementia research may lack capacity to give informed consent and the relationship between cognitive function and capacity remains unclear. Recent changes in the law reinforce the need for robust and reproducible methods of assessing capacity when recruiting people for research.Aims: To identify numbers of capacitous participants in a pragmatic randomised trial of dementia treatment; to assess characteristics associated with capacity; to describe a legally acceptable consent process for research.Methods: As part of a pragmatic randomised controlled (...) trial of Ginkgo biloba for mild-moderate dementia, we used a consenting algorithm that met the requirements of existing case law and the exigencies of the new Mental Capacity Act. We decided who had capacity to give informed consent for participation in the trial using this algorithm and sought predictors of capacity.Results: Most participants with mild-moderate dementia in this trial were unable to give informed consent according to the legal criteria. When adjusted for confounding, the Mini Mental State examination did not predict the presence of capacity.Conclusion: Cognitive testing alone is insufficient to assess the presence of capacity. Researchers and clinicians need to be aware of the challenging processes regarding capacity assessment. We outline a procedure which we believe meets the ethical and legal requirements. (shrink)

In earlier work we have described how computer algebra may be used to derive composite rate laws for complete systems of equations, using the mathematical technique of Gröbner Bases (Bennett, Davenport and Sauro, 1988). Such composite rate laws may then be fitted to experimental data to yield estimates of kinetic parameters.Recently we have been investigating the practical application of this methodology to the estimation of kinetic parameters for the closed two enzyme system of aspartate aminotransferase (AAT) and malate dehydrogenase (MDH) (...) (Fisher 1990a; Fisher 1990b; Bennett and Fisher, 1990). (shrink)

Dr. R. Michael Fisher came across Ken Wilber's published work in 1982 and has ever since been a learner and critic of it. In this video he shares both his love of many aspects of Wilber's work and a few critiques that particularly focus on Conflict and Fear. He invites people to respond and also ask questions, and if enough of these are offered, he'll created another video on the topic and respond to your questions and concerns. If you'd (...) rather talk directly: r.michaelfisher52 [at] g[mail].com p.s. Phobos-Thanatos is what Wilber also articulates, again based on adaptation from Plotinus, as this never got into this video; likewise, it was missed that there are post-Integral levels of consciousness as well, beyond where Wilber writes from and where I work from... so, the "spectrum" is vast, at least 9-10 levels and "Integral" is only level 7 in this schema... (shrink)

Explores a postmodern criticism of P. S. Churchland's claims regarding materialism. Materialism is classically understood to be the philosophical position which holds that matter is the fundamental reality of the world, and so neurobiological explanations can be said to be materialistic. Neurobiological explanations of behavior are used increasingly in the place of psychological explanations. This trend is indicative of the rise in popularity of materialism. Churchland is one of the intellectual leaders in the modern manifestation of materialism. She is a (...) self-proclaimed materialist and "neurophilosopher." In order for Churchland to maintain her materialist position, she must assume a transparency in scientific method, an assumption which is a legacy of Enlightenment philosophy. However, many postmodern philosophers including M. Heidegger and H. G. Gadamer have questioned this assumed transparency of method. The implications of this postmodern philosophy for the current materialistic trends in psychology are discussed. 2012 APA, all rights reserved). (shrink)

In Marshall's Tendencies (Sutton, 2000), John Sutton poses some fairly deep questions for economists, especially for empirical work. In particular, when (if ever) is it safe to behave as though the applies? In that paradigm, we are attempting to extract and estimate the model from the data and are only kept from doing so because, while economic analysis captures the main , there are many small influences that we cannot exactly take into account. That paradigm, which Sutton traces to an (...) analogy of Marshall's likening economic predictions to predictions of the tides, leads to the econometric estimation of economic relationships, taking statistical account of the unincluded small influences by placing them in a random disturbance term. Sutton states (p. 5),. (shrink)

... 243-) INTRODUCTION §§243- constitute the eighth 'chapter' of the book. Its point of departure is a natural query with respect to the conclusion of the ...

Throughout its long history metaphysics has been variously conceived. At its most sublime, it has been taken to be the study of the super‐sensible, in particular of the existence of a god, the nature of the soul, and the possibility of an afterlife. When the young Ludwig Wittgenstein entered the lists, it was entirely reasonable to conceive of metaphysics in this manner. Its subject matter was held to be the language‐independent and thought‐independent de re necessities of the world. The Tractatus (...) is dominated by three problems: first, the nature of logic and logical necessity; secondly, the essence of the proposition and hence the characterization of the general propositional form; and thirdly, the intentionality of the proposition. Logical propositions are combinations of elementary propositions by means of truth‐functional logical connectives. The metaphysics adumbrated in the Tractatus, Wittgenstein thought, was required for the possibility of representation and for the possibility of logic. (shrink)

Throughout much of human history most people conceived of death as a transitional event. An alternative, secular, conception of death is as the permanent cessation of all life‐sustaining biological functions. The death of the physical organism is the death of the person or human being. However death be conceived, human beings are the only creatures that are aware of their mortality. The death penalty is often thought to be the most severe punishment of all, far worse than life imprisonment. Attitudes (...) towards death vary according to the acceptance or rejection of belief in an afterlife. Death in old age is generally held to be less deplorable than death in one's prime. Premature death, however, is commonly deemed to be tragic, but not because merely being alive is a good of one kind or another, let alone good in itself. Lucretius exaggerated the symmetry between prenatal and post‐ mortem events. (shrink)

Summary Long-standing claims have been made for nearly the entire twentieth century that the biometrician, Karl Pearson, and his colleague, W. F. R. Weldon, rejected Mendelism as a theory of inheritance. It is shown that at the end of the nineteenth century Pearson considered various theories of inheritance (including Francis Galton's law of ancestral heredity for characters underpinned by continuous variation), and by 1904 he ?accepted the fundamental idea of Mendel? as a theory of inheritance for discontinuous variation. Moreover, in (...) 1909, he suggested a synthesis of biometry and Mendelism. Despite the many attempts made by a number of geneticists (including R. A. Fisher in 1936) to use Pearson's chi-square (X 2, P) goodness-of-fit test on Mendel's data, which produced results that were ?too good to be true?, Weldon reached the same conclusion in 1902, but his results were never acknowledged. The geneticist and arch-rival of the biometricians, Williams Bateson, was instead exceptionally critical of this work and interpreted this as Weldon's rejection of Mendelism. Whilst scholarship on Mendel, by historians of science in the last 18 years, has led to a balanced perspective of Mendel, it is suggested that a better balanced and more rounded view of the hereditarian-statistical work of Pearson, Weldon, and the biometricians is long overdue. (shrink)

Entertainments and celebrations are meant to give audiences and participants pleasure. Pleasure and enjoyment are an integral part of flourishing human life, and the desire for pleasure and enjoyment is a distinctive aspect of human nature. Psychological hedonism is a descriptive doctrine concerned with giving an account of actual human motivation. Ethical hedonism is a prescriptive doctrine that advances the view that human beings ought to pursue pleasure and avoid pain, that prospective pleasure and pain are severally the only good (...) reasons for action. ‘Pleasure’, ‘enjoyment’, and ‘being pleased’ are three graces that stand at the intersection of psychology, axiology, and practical reasoning. The relation between pleasure and awareness or consciousness of pleasure is subtle and unlike the corresponding relation to having a pain. To live the life of a practical hedonist is to live a life guided by the pursuit of pleasure. (shrink)

The powers of intellect and will, possession of which is constitutive of having a mind, are not powers of the mind, but of the being that has a mind. The Platonic metaphysical conception of the soul is of great interest irrespective of its informing both ancient and Renaissance neo‐Platonist ideas about the soul and its immortality, and, via Augustine, ultimately moulding the misconceived Cartesian conception of the soul. The dividing line between the soul and the flesh is quite different from (...) that between the mind and the body. The soul is associated with aesthetic sensibility and with the appreciation of beauty and pathos, with which conscience has no connection. The evil‐doer commonly aims, explicitly or implicitly, to destroy the moral order of humanity and the moral restraints on behaviour that are constitutive of moral beings. Evil‐doers have to suppress the voice of conscience. (shrink)

Some of human evil is a function of the historical stage of society. The evils and wickednesses of bureaucracy are as old as well‐developed bureaucratic hierarchies. Evil‐doers have character traits that may form recognizable patterns with explanatory weight. Evil‐doers produce reasons for their evil‐doing and offer justifications for their evil deeds. Psychological experiments may indeed establish important correlations and statistical probabilities that may be crucial for the formation of intelligent social policy. The greatest students of the place of evil in (...) human life and of the subjective psychology of evil in a complex social setting are great novelists, dramatists, and poets. From the late eighteenth century onwards ideological beliefs played a major role in stimulating evil, not for the greater glory of God but for the future glory of man. The first major social movement that bent an ideology to wholly evil policies were the Jacobins during the French Revolution. (shrink)

Global fatalism is an attitude towards life, an attitude of resignation and acceptance of what happens. Global fatalism in the form of predestinarianism is typically, but not exclusively, associated with monotheism rather than with polytheism, and in particular with Christianity and Islam. An individual form of fatalism consists in the belief that specific incidents in a person's life are preordained. Local fatalism appears to be common to many different cultures and societies. Individual fatalism is associated with other important events in (...) human life, such as meeting the person with whom one is destined to fall in love. The ubiquity of the various forms of individual fatalism suggests that they have a deep appeal to human sentiment. Descartes's successors, lumbered with dualism but rejecting causal interaction, struggled to preserve human freedom while acknowledging nomological determinism. Global nomological determinism is a picture, a preconception of the nature of change in all its forms. (shrink)

Happiness has been at the centre of philosophical reflection ever since Plato and Aristotle. Epicureans thought of happiness as the satisfaction of one's minimal needs and the absence of further desires. True happiness may be the love of another, or successful and virtuous public service recognized by society, or successful engagement in a favoured activity. Youthful happiness involves intensity of feeling, engagement with the passing moment, the discovery of first love and of sexuality, and the joys of dedication to a (...) beloved. The different forms of human engagement involve different kinds of happiness. Physical normality and good health are patently preconditions of happiness inasmuch as physical abnormalities and persistent diseases are barriers to leading a healthy and normal human life. A person's social conditions are highly relevant to the possibility of happiness. Happiness can be marred or shattered by a multitude of accidents of fate and by human malice, political upheavals, and economic disasters. (shrink)

The most common form of determinism in the first quarter of the twenty‐first century is neuroscientific determinism. Global neuroscientific determinism is a blank cheque on a non‐existent bank. Neuroscientists have discovered the character of the neural activity in the premotor cortex immediately antecedent to movement, and the nature of the neural impulses from the brain to the muscles in the relevant limb that will make them severally contract or relax. Being rational, being free, and being responsible for our actions and (...) omissions are essential species characteristics of mankind. Various forms of responsibility have been distinguished by philosophers and lawyers: causal responsibility, capacity responsibility, act responsibility, liability responsibility, role responsibility, and responsibility as a character trait. At the heart of the very idea of responsibility lies the notion of a normal rational human agent with normal human faculties. (shrink)

A life devoid of meaning is a life without happiness. But one may find meaning in one's life and in one's activities without being happy. Like pleasure and happiness, goodness and beauty, the meaningfulness one may find in one's life comes in degrees. Many achievements may mean something to a person without being of sufficient significance to lend meaning to their life, such as winning in some competitive activity or passing an important examination. Forms of illusory meaning, that is meaning (...) that rests on false or misconceived beliefs, can impart meaning to a person's life and make it genuinely meaningful, as long as it involves neither evil doing nor evil beliefs. The human condition as language‐using, self‐conscious social animals with limited capacities for good and evil, with highly competitive and killer instincts is anything but ludicrous, farcical, silly, or ridiculous. (shrink)

The key to a perspicuous overview of axiology is the realization that all values arise from life. This chapter provides a brief overview of von Wright's categories, or ‘varieties’, of goodness. Medical goodness is the most elemental variety of natural value and disvalue. Any language‐using creature that has the skills to make and to use tools, instruments, and other artefacts is going to need the concepts of artefactual goodness and its subcategory of instrumental goodness. Morality is essentially a social phenomenon (...) – it is an aspect of the form of life of a community. In evolved societies, it overlaps with and fades into law, into social mores or small morals, and into individual critical morality. Virtue, or moral goodness, as well as the moral virtues, which are moral character traits, are attributes of social beings who are, and who identify themselves as being, members of a community, people, or nation. (shrink)

Von Wright argued that moral goodness is a derivative form of goodness. He proceeded to give an account of the moral goodness of an act, in terms of the good of man. Philosophical anthropology must render the phenomenon of morality intelligible. This chapter suggests that the roots of moral value lie in human sympathy, in maternal love, in intuitive recognition of the humanity of others, and in the nature of loving friendship. The sentiment of sympathy is virtually ubiquitous, but sympathetic (...) propensities vary from person to person, being partly a function of their imagination. Sympathy is an emotional tap‐root of moral reasons and a presupposition of moral reasoning. Kant's argument in support of a requirement of equal formal respect for human beings as moral agents is problematic. The explicit emergence of the idea of formal respect is one of the great advances in our evolving understanding of human nature and our conception of ourselves. (shrink)

Humans are caught – in their lives, in their thoughts, in their hungers and ambitions, in their avarice and cruelty, and in their kindness and generosity too – in a net of good and evil. Natural evils are simply natural catastrophes that destroy human life, property, crops, and means of livelihood such as earthquakes, tsunamis, volcanic eruptions, avalanches, floods, and droughts. Some people may never recover from such evils and be incapable of leading a normal human life. The evil of (...) evil‐doers can therefore be explained away by showing that they themselves are victims. The existence of human evil is explained by reference to the wickedness of those who choose of their own will to do evil. The idea that evil is privative, that is, it consists in the absence of good, stripped of its theological trappings, is unconvincing. (shrink)

Modern utilitarianism has its roots in the eighteenth century, its philosophical blossom in the works of Bentham and the Mills, and its practical fruit in the works of nineteenth‐century radical legal and political utilitarian reformers. Utilitarians held that pleasure, and hence too happiness, are sensations. Human beings are in effect mere pleasure or happiness receptacles or desire‐satisfying mechanisms. The idea of a science of happiness appealed to some economists and social theorists who rightly felt increasingly ill at ease about measuring (...) national welfare and progress in terms of growth in gross national product. The goal of profit maximization dominated economic science. One stimulus for the development of a putative science of happiness was dissatisfaction with economists’ attempts to evaluate the success of an economic system and the progress of a society by measuring gross national product. In a happy society alienation is minimal, and freedom and dignity are respected and preserved. (shrink)

The concept of normal is so familiar that it can be hard to imagine contemporary life without it. Yet the term entered everyday speech only in the mid-twentieth century. Before that, it was solely a scientific term used primarily in medicine to refer to a general state of health and the orderly function of organs. But beginning in the middle of the twentieth century, normal broke out of scientific usage, becoming less precise and coming to mean a balanced condition to (...) be maintained and an ideal to be achieved. In Normality, Peter Cryle and Elizabeth Stephens offer an intellectual and cultural history of what it means to be normal. They explore the history of how communities settle on any one definition of the norm, along the way analyzing a fascinating series of case studies in fields as remote as anatomy, statistics, criminal anthropology, sociology, and eugenics. Cryle and Stephens argue that since the idea of normality is so central to contemporary disability, gender, race, and sexuality studies, scholars in these fields must first have a better understanding of the context for normality. This pioneering book moves beyond binaries to explore for the first time what it does—and doesn’t—mean to be normal. (shrink)