Despite growing scientific interest in the placebo effect and increasing understanding of neurobiological mechanisms (Finniss et al. 2010), theoretical conceptualization of the placebo effect remains primitive (Miller, Colloca, and Kaptchuk 2009). Mechanistic research on this phenomenon appears largely free-floating, with little guidance by any systematic theoretical paradigm. A partial explanation is the pervasive conceptual confusion that characterizes thinking about the placebo effect. The philosopher of science Adolf Grunbaum noted that "the medical and psychiatric literature on placebos and their effects (...) is conceptually bewildering, to the point of being a veritable Tower of Babel" (Grunbaum 1994, p. 286). .. (shrink)

Vi sono varie forme di impossibilità normativa. Una prima forma si incontra quando un fatto naturale al quale il diritto attribuisce un significato normativo è impossibile. Una seconda consiste nell’impossibilità di un atto o fatto la quale derivi dalla presenza o assenza di una norma. Vi è poi una terza forma di impossibilità normativa che si incontra quando si afferma che da una certa realtà oggetto di normazione derivano necessariamente limiti all’attività di normazione stessa. Di una quarta forma si può (...) parlare quando ci si riferisce a un’impossibilità derivante dalle specifiche relazioni che intercorrono tra norme di un sistema normativo dinamico. Le forme di impossibilità normativa sono indagate, nei contributi raccolti in questo volume, da diverse angolazioni: la filosofia del diritto, la filosofia morale, la logica, la filosofia della conoscenza, la scienza del diritto penale. (shrink)

It has been presumed within bioethics that the benefits and risks of treatments can be assessed independently of information disclosure to patients as part of the informed consent process. Research on placebo and nocebo effects indicates that this is not true for symptomatic treatments. The benefits and risks that patients experience from symptomatic treatments can be shaped powerfully by information about these treatments provided by clinicians. In this paper we discuss the implications of placebo and nocebo research for risk–benefit assessment (...) and informed consent. (shrink)

The doctor-patient relationship is built on an implicit covenant of trust, yet it was not until the post-World War Two era that respect for patient autonomy emerged as an article of mainstream medical ethics. Unlike their medical forebears, physicians today are expected to furnish patients with adequate information about diagnoses, prognoses and treatments. Against these dicta there has been ongoing debate over whether placebos pose a threat to patient autonomy. A key premise underlying medical ethics discussion is the notion that (...) the placebo effect necessitates patient deception. Indeed, the American Medical Association guidelines imply that placebo treatment necessary entails a form of deception. As a consequence of this assumption, the fulcrum of debate on the use of placebo treatment has hinged on whether that deception is ever justified. Recently performed experiments with open-label transparently prescribed placebos have begun to challenge the notion that deception is necessary in eliciting the placebo effect and such effects necessarily involve a binary distinction between autonomy and beneficence. In this article we focus on the content of disclosures in distinctive open-label, transparently disclosed placebo studies and inquire whether they might be said to invoke deception in clinical contexts, and if so, whether the deception is unethical. We find that open placebos may be said to involve equivocation over how placebos work. However, drawing on surveys of patient attitudes we suggest that this equivocation appears to be acceptable to patients. We conclude that open placebos fulfil current American Medical Association guidelines for placebo use, and propose future research directions for harnessing the placebo effect ethically. (shrink)

Physicians commonly recommend ?placebo treatments?, which are not believed to have specific efficacy for the patient's condition. Motivations for placebo treatments include complying with patient expectations and promoting a placebo effect. In this article, we focus on two key empirical questions that must be addressed in order to assess the ethical legitimacy of placebo treatments in clinical practice: 1) do placebo treatments have the potential to produce clinically significant benefit? and 2) can placebo treatments be effective in promoting a therapeutic (...) placebo response without the use of deception? We examine evidence from clinical trials and laboratory experiments bearing on these two questions. The conclusion is reached that based on currently available evidence, it is premature to judge whether placebo treatments are ethically justifiable, with the possible exception of acupuncture for pain relief. (shrink)

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire medication-like (...) effects. We found a total of 22studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Importantly, provided that nondisclosure is pre-authorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated. (shrink)

A commentary on “What's Not Being Shared in Shared Decision‐Making?” from the July‐August 2013.

The paper concerns the following two questions: (i) is the general exclusive norm a proper legal norm? (ii) if the general exclusive norm is a proper legal norm, is it universally valid? It will be held that the general exclusive norm is a proper legal norm and not a logical principle. Therefore, as a legal norm, it can be said to be valid or invalid. The answer to the second question will be negative: the general exclusive norm, as a proper (...) legal norm, is valid only in those legal systems in which it is positively established. (shrink)

The incredible achievements of modern scientific theories lead most of us to embrace scientific realism: the view that our best theories offer us at least roughly accurate descriptions of otherwise inaccessible parts of the world like genes, atoms, and the big bang. In Exceeding Our Grasp, Stanford argues that careful attention to the history of scientific investigation invites a challenge to this view that is not well represented in contemporary debates about the nature of the scientific enterprise. The historical record (...) of scientific inquiry, Stanford suggests, is characterized by what he calls the problem of unconceived alternatives. Past scientists have routinely failed even to conceive of alternatives to their own theories and lines of theoretical investigation, alternatives that were both well-confirmed by the evidence available at the time and sufficiently serious as to be ultimately accepted by later scientific communities. Stanford supports this claim with a detailed investigation of the mid-to-late 19th century theories of inheritance and generation proposed in turn by Charles Darwin, Francis Galton, and August Weismann. He goes on to argue that this historical pattern strongly suggests that there are equally well-confirmed and scientifically serious alternatives to our own best theories that remain currently unconceived. Moreover, this challenge is more serious than those rooted in either the so-called pessimistic induction or the underdetermination of theories by evidence, in part because existing realist responses to these latter challenges offer no relief from the problem of unconceived alternatives itself. Stanford concludes by investigating what positive account of the spectacularly successful edifice of modern theoretical science remains open to us if we accept that our best scientific theories are powerful conceptual tools for accomplishing our practical goals, but abandon the view that the descriptions of the world around us that they offer are therefore even probably or approximately true. (shrink)

The place of the emotions among the passions -- The analytic of the emotions I -- The analytic of the emotions II -- The dialectic of the emotions -- Pride, arrogance, and humility -- Shame, embarrassment, and guilt -- Envy -- Jealousy -- Anger -- Love -- Friendship -- Sympathy and empathy.

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)

An Interdisciplinary Approach to Cognitive Modelling presents a new approach to cognition that challenges long-held views. It systematically develops a broad-based framework to model cognition, which is mathematically equivalent to the emerging 'quantum-like modelling' of the human mind. The book argues that a satisfactory physical and philosophical basis of such an approach is missing, a particular issue being the application of quantization to the mind for which there is no empirical evidence as yet. In response to this issue, the book (...) adopts a COM (classical optical modelling) approach, broad-based but mathematically equivalent to quantum-like modelling while avoiding its problematic features. It presents a philosophically informed and empirically motivated mathematical model of cognition, mainly concerning decision making processes. It also deals with applications to different areas of the social sciences. It will be of interest to scholars and research students interested in the mathematical modelling of cognition and decision making, and also interdisciplinary researchers interested in broader issues of cognition. (shrink)

This study concerns the ideas of one particular philosopher, Henri Bergson, whose views of time, intuition, and creativity have had a significant impact on art, literature, and the humanities, both in his time and in our own. Although it is generally recognized that Bergson's ideas have significantly impacted the arts and the humanities, it has not been recognized how they have also had a creative influence on the sciences as well. Nor has it been realized that this was one of (...) his most basic contentions. Bergson's conception of intuition--his fundamental insight into reality--was not limited to fugitive insights into human existence. By realizing previously unsuspected possibilities for research and discovery, his endeavors were also meant to make possible new advances in the sciences. If it enabled his cousin by marriage, Marcel Proust, to explore human memory in depth, it also inspired psychologists like Daniel Schachter to use Bergson's ideas to make real contributions to contemporary memory science. If his notion of creative evolution brought many thinkers to a belief in human creative freedom, it brought others (notably Alexis Carrel and Pierre Lecomte de Noüy) to a scientific study of biological time. Among his successful speculations was the theory of the Big Bang cosmology. 'Getting Bergson Straight' shows many points at which Bergson's ideas anticipated future developments in the sciences. This was seen clearly by the Nobel Prize-winning physicist Luis de Broglie who viewed Bergson's physics as presaging quantum physics. Thus, the text is well situated for arts, humanities, social science, and natural science classrooms studying creative thinking and/or intellectual history. (shrink)

Profoundly important ethical and political controversies turn on the question of whether biological life is an essential aspect of a human person, or only an extrinsic instrument. Lee and George argue that human beings are physical, animal organisms - albeit essentially rational and free - and examine the implications of this understanding of human beings for some of the most controversial issues in contemporary ethics and politics. The authors argue that human beings are animal organisms and that their personal identity (...) across time consists in the persistence of the animal organisms they are; they also argue that human beings are essentially rational and free and that there is a radical difference between human beings and other animals; criticize hedonism and hedonistic drug-taking; present detailed defenses of the prolife positions on abortion and euthanasia; and defend the traditional moral position on marriage and sexual acts. (shrink)

Do the ethical features of an artwork bear on its aesthetic value? This movie endorses misogyny, that song is a civil rights anthem, the clay constituting this statue was extracted with underpaid labor—are facts like these the proper bases for aesthetic evaluation? I argue that this debate has suffered from a false presupposition: that if the answer is yes (for at least some such ethical features), such considerations feature as pro tanto contributions to an artwork's overall aesthetic value, i.e., as (...) merits or flaws which make something have more or less overall aesthetic value. As the case of ethically laden, aesthetic evaluation makes clear, however, good aesthetic judgement is irreducibly multi-dimensional, e.g., "the movie has an engaging soundtrack, tasteful camera work, and takes a misogynistically prurient perspective on its female lead.'' Such a "non-summative" judgement refuses to reduce those various dimensions of aesthetic value to a single aggregate aesthetic evaluation, like "it's a 6/10" or "it's a pretty good movie!" I defend both the modest claim that such non-summative evaluations are not mistaken and the extremist claim that summative (i.e., unidimensional) aesthetic evaluation is defective by considering other domains of normative assessment in which summing seems inappropriate, notably including evaluations of people's character. (shrink)

This practical and essential text, co-authored by an engineer and an ethicist, covers ethical dilemmas that any engineer might encounter on the job, emphasizing the responsibility of a practicing engineer to act in an ethical manner. To illustrate the complexities involved, the authors present characters who encounter situations that test the engineering code of ethics. The dialogue between the characters highlights different perspectives of each dilemma. As they proceed through the book, students see how the code of ethics can help (...) in decision making, as well as the implications of various decisions. The philosophical theory that supports the ethical situations encountered is presented as boxed material following each section. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

In worlds that lack life, there is no value. For all that, there is no mystery about 'the existence of values in a world of facts'. The world does not consist of facts, rather true descriptions of the world consist of statements of fact. It is as much a fact concerning the world that there are things that are of value to living things, that human beings value things and possess valuable characteristics, perform valuable deeds, stand in valuable relationships to (...) others, as it is a fact that there is life on earth. (shrink)

A critical note on Christopher Bartel and Jack M. C. Kwong, ‘Pluralism, Eliminativism, and the Definition of Art’, Estetika 58 (2021): 100–113. Art pluralism is the view that there is no single, correct account of what art is. Instead, art is understood through a plurality of art concepts and with considerations that are different for particular arts. Although avowed pluralists have retained the word ‘art’ in their discussions, it is natural to ask whether the considerations that motivate pluralism should lead (...) us to abandon art talk altogether; that is, should pluralism lead to eliminativism? This paper addresses arguments both for and against this move. We ultimately argue that pluralism allows one to retain the word ‘art’, if one wants it, but only in a loose, conversational sense. The upshot of pluralism is that talk of art in general cannot be asked to do theoretical and philosophical work. (shrink)

Some scientific categories seem to correspond to genuine features of the world and are indispensable for successful science in some domain; in short, they are natural kinds. This book gives a general account of what it is to be a natural kind and puts the account to work illuminating numerous specific examples.

" In a book that seeks to shift the ground of debate within theory of knowledge, William P. Alston finds that the century-lo.

In lieu of an abstract, here is a brief excerpt of the content:Burma’s Healthcare Under Fire: My Experience as an Exiled Medical ProfessionalP. P. KyawI used to work as a medical doctor in a less developed state than many big cities in Burma1 that experienced prolonged civil wars and current similar atrocities decades before the urban areas of the country experienced them. Before everything started, I was responsible for the medical management of the most vulnerable communities and had been struggling (...) with pandemic-related medical activities. Those were the happiest years of my life. I was with one of the best international organizations, where every effort I made was directly delivered to the patients with no unnecessary paperwork. The system was efficient, my colleagues were supportive, and I had a good work-life balance. I supported my family and whoever needed temporary financial support, played music weekly, met good friends who I hung out with every weekend, and [End Page 164] found hobbies like gardening and crocheting. I was content and happy. I even postponed my plans to get registered as a doctor in the Western world.Before moving to this beautiful ethnic state in 2019, I previously worked as a government medical doctor in Yangon, the capital. As much as I loved working in those civilian hospitals, I could not support myself with a monthly pay of $100-$150 USD. It was a hard decision to leave the service because it meant I could not pursue the medical specialty that I had always longed for and had to leave like-minded supportive colleagues. In Myanmar, unless you are a civil servant, you cannot pursue further clinical specialties. However, after leaving the government’s service to work in humanitarian medical assistance in hard-to-reach areas of Burma, I learned that life is still beautiful outside my comfort zone, until February 2021 when the coup began. Democratically elected members of the country’s ruling party were overthrown by the military, which then bestowed power in a military junta.I expected the election prior to the coup in November 2020 to be an uphill battle for Burma, but nothing more. I was still in denial when I first heard the news from one of the town’s NGO staff. The person had to travel on a motorbike to inform everyone that the junta had staged the coup. No telephone or internet was working at that time. My colleagues and I cried in our office, saying, “We are so young, and the future is still ahead. I don’t think this is going to last long. Maybe it will be over in a few days or, at most, a few weeks.” Once the peaceful protests started nationwide, my friends and I provided medical cover for the protesters, initially for minor medical problems such as low sugar, low blood pressure, injuries from accidental minor slips and falls, etc. Never in my life had I imagined that I would be taking care of bullet wounds and people injured by live rounds. While learning about gunshot wounds in forensic medicine, I thought, “Oh, this is not going to be very useful because Burma is not America, and I am not going there.” Then suddenly, it became too real and more useful than I would’ve liked it to be.I always think back to one especially bloody day when many people in the town were shot with live rounds. We assisted many patients. Usually, we would go around with the protest groups until they were over in the late afternoon. The protesters were always peaceful. There were no riots, no harmful acts, or vandalism. Only when the protesters were cruelly dispersed with tear gas, high-pressure pumps, rubber bullets, and live rounds (to the head) did they decide to defend themselves while still making their voices heard. The only defenses people had to counteract the live rounds were things like metal covers, firecrackers, and slingshots.One afternoon in March 2021, my team and I took an early break for lunch—unaware that some people would lose their lives that afternoon. We followed the local protests through Facebook Live while having lunch and started to hear firecracker sounds. A few seconds later, we knew... (shrink)

Writing from a scientifically and philosophically informed perspective, the authors provide a critical overview of the conceptual difficulties encountered in many current neuroscientific and psychological theories.

This book examines the relationship between law and scientific advancement, with a particular focus on the theory of evolution and medical innovation. Historically, the law has struggled to keep pace with modern medical advances. The authors demonstrate that the laws that govern human behaviour must evolve in response to such advances."--Provided by publisher.

The author asks to what extent a knowledge of the concepts of yoga may prepare the way to a better understanding of Indian archaeology. The yoga at the basis of this study is that which forms the core of the Tantras. In the first chapter the author surveys the system of Tantrik yoga. He then continues with a discussion of the various forms of yantras, that is all the means employed by yogis in their meditational exercises as aids to the (...) concentration of thought. The author provides in-depth studies of ritual objects of the Lamaistic cult in Tibet and Nepal, the sacred cemeteries of Nepal, and pantheons in Java and Bali. (shrink)