The aim of this paper is to examine the usefulness of the Machamer, Darden, and Craver (2000) mechanism approach to gaining an understanding of explanation in cognitive neuroscience. We argue that although the mechanism approach can capture many aspects of explanation in cognitive neuroscience, it cannot capture everything. In particular, it cannot completely capture all aspects of the content and significance of mental representations or the evaluative features constitutive of psychopathology.

In Explaining Attitudes, Lynne Rudder Baker considers two views of what it is to have a propositional attitude, the Standard View and Pragmatic Realism, and attempts to argue for Pragmatic Realism. The Standard View is, roughly, the view that “the attitudes, if there are any, are particular brain states”. In contrast, Pragmatic Realism that a person has a propositional attitude if and only if there are certain counterfactuals true of that person.Baker’s case against the Standard View is a complex one. (...) One aspect of that case is that there are no good general arguments for the Standard View. We argue that one of the three she considers, an argument from causal explanation, can be defended. The problematic premise, according to Baker, is the claim that unless beliefs are [identical to, constituted by, or realized by] brain states, they cannot causally explain behavior. Baker tackles this premise in two ways: in Chapter 4, she attempts to undermine the brain-explain thesis by taking issue with the conception of causal explanation that she believes supports it; in Chapter 5, she argues against the brain-explain thesis directly, by attempting to show that it is false, whether or not the Standard View is true. Neither of these attempts are successful, on our view.The alternative version of the causal argument we develop uses the doctrine of physicalism as a supplementary premise rather than appeal to a reductive conception of causal explanation. After presenting this alternative version, we consider how Baker might respond to it by drawing on her discussion of materialism. We conclude that Baker’s argument against materialism does not generalize to physicalism as we construe it. (shrink)

Summary Leading scholars offer perspectives from the philosophy of science on the crisis in psychiatric research that exploded after the publication of DSM-5. -/- Psychiatry and mental health research is in crisis, with tensions between psychiatry's clinical and research aims and controversies over diagnosis, treatment, and scientific constructs for studying mental disorders. At the center of these controversies is the Diagnostic and Statistical Manual of Mental Disorders (DSM), which—especially after the publication of DSM-5—many have found seriously flawed as a guide (...) for research. This book addresses the crisis and the associated “extraordinary science” (Thomas Kuhn's term for scientific research during a state of crisis) from the perspective of philosophy of science. The goal is to help reconcile the competing claims of science and phenomenology within psychiatry and to offer new insights for the philosophy of science. -/- The contributors discuss the epistemological origins of the current crisis, the nature of evidence in psychiatric research, and the National Institute for Mental Health's Research Domain Criteria project. They consider particular research practices in psychiatry—computational, personalized, mechanistic, and user-led—and the specific categories of schizophrenia, depressive disorder, and bipolar disorder. Finally, they examine the DSM's dubious practice of pathologizing normality. (shrink)

In vitro fertilization technology has been in use in Poland for over 25 years with success and social approval, but it is still not regulated under Polish law. The current debate over different non-medical aspects of reproductive technologies in Poland is extremely heated and highly politicized. Politicians on the right, Catholic clergy and some journalists use very radical language and criticize IVF as a technique that plays with the lives and deaths of thousands and thousands of children. The aim of (...) this article is to follow the Polish debate on IVF in the context of Poland’s transition, which is marked primarily by two events: the collapse of communism in 1989 and access to the European Union in 2004. The article shows that the IVF debate concerns not only moral choices or legal regulation, but also citizenship, nation, state, and the role of the Catholic Church within. Moreover, it creates new citizens: frozen embryos, which being independent persons, have the right to life, ‘dignity’ and care. The history of IVF in Poland reveals the different tensions in the Polish transition to liberal democracy and it can be used to view a ‘big’ history of the Polish transition. It is one of the micro-histories which make this big story about Poland after 1989. Analyses of both the abortion debate and the IVF debate in Poland show that the process of democratization is very much connected with limiting women’s reproductive rights, including the right to choose infertility treatment. (shrink)

This chapter contains section titled: Introduction Chomsky's Challenge Methodological Physicalism.

The article deals with relations between the individual and human rights on the one hand, and the State on the other, in the context of the Constitution of the Republic of Poland. The author poses the question whether the idea of subordination of the State to the individual is really a central idea of that constitution. He puts forward many arguments against such suggestion. These arguments relate, above all, to the arrangement of the constitution: a chapter concerning human rights is (...) chapter II, while chapter I deals with foundation of the State; the goals of the State are specified in the preamble including the following initial phrase “the existence and future of Poland as our Homeland” and in Article 5 where human rights are as subject of protection by the State is mentioned after independence and integrity of [its] territory; a general concept of human rights protection adopted in the constitution is dominated by the structures typical of law in its objective sense; the way of regulation admissible limitations on human rights differs from international standards; possibility of claiming human rights is constitutionally guaranteed, mostly by constitutional complaint which is above all aimed at correction of legal system, rather than claiming of rights by the individual; Article 1 (“The Republic of Poland shall be the common good of all its citizens”) interpreted as referring to Article 1 paragraph 1 of the April Constitution of 1935, one of the main ideas of which was precedence of the State over the individual. He also analyses the arguments in favour of the recognition of the idea of subordination of the State. Nevertheless, they cannot be accepted as resolving the question of whether it is a central idea of the constitution. These arguments include in particular: the principle of subsidiarity contained in the preamble, even if it has not been appropriately emphasized there; recognition of inherent and inalienable dignity of the person, but it was not until Article 30 that this provision has been contained and it does not determine the relations between the human dignity and rights and the State. The author suggests that the only conclusive way to justify the subordination of the State in relation to the individual as a central idea of the constitution is by means of Article 1. Taking into account, above all, preparatory work, we should reject the interpretation of that article referring to the April (1935) Constitution. Essential interpretative context may be found in preparatory work and social teachings of the Catholic Church, referred to therein. In that case, the common good means the entirety of the conditions of social life which favour the human development. These conditions include above all the respect for human dignity. Such interpretation of Article 1 gives priority to proposals on what the State should be to serve the individual rather than to safeguard obligations of citizens in relation to the State. (shrink)

Addictive behavior threatens not just the addict's happiness and health but also the welfare and well-being of others. It represents a loss of self-control and a variety of other cognitive impairments and behavioral deficits. An addict may say, "I couldn't help myself." But questions arise: are we responsible for our addictions? And what responsibilities do others have to help us? This volume offers a range of perspectives on addiction and responsibility and how the two are bound together. Distinguished contributors -- (...) from theorists to clinicians, from neuroscientists and psychologists to philosophers and legal scholars -- discuss these questions in essays using a variety of conceptual and investigative tools. Some contributors offer models of addiction-related phenomena, including theories of incentive sensitization, ego-depletion, and pathological affect; others address such traditional philosophical questions as free will and agency, mind-body, and other minds. Two essays, written by scholars who were themselves addicts, attempt to integrate first-person phenomenological accounts with the third-person perspective of the sciences. Contributors distinguish among moral responsibility, legal responsibility, and the ethical responsibility of clinicians and researchers. Taken together, the essays offer a forceful argument that we cannot fully understand addiction if we do not also understand responsibility. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Landmark Legal Cases in BioethicsSusan Cartier Poland (bio)Only a few decades old, the interdisciplinary field of bioethics has developed surrounded by centuries of legal tradition and moral philosophy. Bioethics and the law have weaved back and forth over time influencing each field. Sometimes ethics leads the debate on problematical issues; for example, the Recombinant DNA Advisory Committee at the National Institutes of Health established regulations prior to initiating human (...) gene therapy. At other times, law takes over; Roe v. Wade, for example, has polarized and closed public discussion on abortion. Most frequently, however, scientific developments initiate discussion in both fields, as when the announcement of the birth of Dolly—the first cloned mammal—sparked President Clinton to ask the National Bioethics Advisory Commission for a report on cloning.A back-and-forth pattern also exists within the law itself, this time between legislator and judge. Legislators enact statutes, which apply universally to regulate conduct in society. Judges, on the other hand, interpret statutes and apply them to particular cases to resolve disputes between parties. Case law, as judge-made law is called, that grows in the absence of legislation becomes the common law. Legislatures can change the course of common law development by enacting more law, usually as amendments, but sometimes as repeals. A judge who sees the facts of a case or the law differently may also change the common law. And so the counterpoint between legislator and judge goes.A legal case becomes a landmark in bioethics because of its historical or precedential value to the field. Historical cases reflect judicial reasoning or rationalization that lays the conceptual foundation for a bioethical principle. Perhaps the best known example of this is the focus on the right to self-determination in Schloendorff that led to the development of informed consent. The principle of autonomy in bioethics derives its legal impetus from this line of cases.A case that acquires landmark status because of its precedential value does so for one of two reasons based on legal precedents. First, the case may be one of “first impression.” In the legal sense, that means that the particular case with its [End Page 191] facts or issues is the first one that a particular court has confronted within that court’s jurisdiction or area of decision-making authority. To be a landmark in bioethics, however, the ordinary sense of “first impression” applies. The first time that a particular bioethical topic has appeared in court for legal resolution makes a case one of “first impression” for bioethics. The case of Baby M on surrogacy contracts illustrates this.The second way in which a case can achieve landmark status based on precedents involves legal precedent and the jurisdictional basis of the court system. Under the common law system, a preceding case that involves the same or similar facts or issues as a current case must be followed by lower—i.e., less authoritative—courts in the same jurisdiction. That judicial rule of decision making is called stare decisis. It creates an institution of continuity, yet allows for change due to differences in judicial interpretation of facts and issues, which is called distinguishing the case.All courts under United States jurisdiction must follow the U.S. Supreme Court. By its sheer power of authority, the Court issues opinions that, if they concern bioethical topics, make cases landmarks in bioethics. For example, Roe v. Wade made abortion legal and set off the debate between maternal and fetal rights. Casey later refined, or to some redefined with a discussion of stare decisis, the bioethical underpinnings of Roe by framing the debate as one between maternal rights and state interests.In law, precedents concern only appellate cases. Trial courts, like that in McFall v. Shimp, handle questions of both fact and law. Appellate courts, like that in Brotherton, hear appeals from the lower trial courts and address legal issues only. Trial judges apply the law to facts, and appellate judges reason about the trial judge’s legal interpretation.Appellate court decisions are the ones most frequently published, either in print or electronically online, for citation. Consequently they are the easiest to locate and retrieve. “Reporters” as... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 12.3 (2002) 305-323 [Access article in PDF] Scope Note 41 Bioethics and Cloning, Part I Susan Cartier Poland and Laura Jane Bishop This is Part One of a two part Scope Note on Bioethics and Cloning. Part Two will be published in the December 2002 issue of the Kennedy Institute of Ethics Journal and as a separate reprint. Contents For Parts 1 And 2 (...) Part 1Part 2I.History of the ScienceI.Ethical PerspectivesII.Historical CommentaryII.Religious PerspectivesIII.Animal WelfareIII.Fiction and FilmIV.Laws and Legal Literature"Clone" is a collective noun (I, Stewart 1997, p. 771). A collective noun names a group and is composed of individual members, such as "herd" or "flock." Derived from the Greek kl¯on for twig or slip, "clone" was first used in biology to describe the aggregate of asexually produced progeny of an individual, either naturally occurring or man-made; the definition later expanded to mean a group of genetically identical members who originate from a single ancestor. Thus, a clone is a group that results from the process of asexual reproduction.In nature, cloning occurs either by parthenogenesis (reproduction without fertilization) or by fission (embryo splitting). In a pioneering experiment in 1952, Robert Briggs and Thomas J. King (I, 1952), cancer researchers at the Institute for Cancer Research (today part of the Fox Chase Cancer Center) in Philadelphia, demonstrated on frogs another method of cloning by transplanting nuclei into enucleated cells, a technique called "nuclear transplantation," which John B. Gurdon and colleagues (I, 1958, 1975) used to create clones of frogs.Then, in the late 1970s and early 1980s, two back-to-back frauds in cloning occurred. First, the cloning of a human described by American science journalist David Rorvik in the 1978 book In His Image was called a hoax by a court in [End Page 305] 1982. Second, the cloning of three mice, announced by German wunderkind Karl Illmensee to scientific circles in 1979 (and to the public in 1981), could not be proven to be true, according to convincing evidence by McGrath and Solter (I) published in 1984.With their pronouncement that mammalian cloning was impossible, McGrath and Solter essentially stopped cloning research and funding for such biological research. So by the mid-1980s, instead of further investigating cloning, developmental biologists studied embryology related to in vitro fertilization, while molecular biologists studied recombinant DNA under the newly relaxed NIH guidelines. These two strands of scientific investigation came together in the work of Ian Wilmut, who created in vitro embryos using nuclear transplantation to reproduce genetically engineered cattle. Wilmut was seeking a way to increase the successful birth rate when, in the 1990s, he produced identical twin sheep, Megan and Morag, cloned from an embryonic cell, followed by another sheep, Dolly, cloned from an adult cell. The birth of a mammal from an embryo whose genetic material came from an adult cell firmly re-established the possibility of cloning from adults. Prior to Dolly's birth, scientists believed that adult cells lost the ability to dedifferentiate—i.e., to become unspecialized—and so could not direct the development of an embryo through to birth.The 1997 announcement of Dolly's birth initiated the present widespread discussion of cloning. Because of its potentially vast applications across human health, medicine, agriculture, and business/economics, cloning raises a host of issues including those concerning: genetics and genetic engineering, patenting, animal rights and/or animal welfare (especially for transgenic, research, or cloned animals), organ transplantation, reproduction, eugenics, pharmacology (drug production using transgenic animals), research practices, informed consent, stem cell research, women's rights, children's rights, parental rights and responsibilities, and theology and philosophy. It fosters questions about the meaning and purpose of life, the limits of human powers to intervene in research and therapy, and what it means to be human or animal. In addition, environmentalists and organic farmers raise concerns about the effect of novel animals and plants on the environment, while nutritionists and the lay public wonder... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 15.2 (2005) 211-218 [Access article in PDF] Bioethics, Biolaw, and Western Legal Heritage Susan Cartier Poland Bioethics and biolaw are two philosophical approaches that address social tension and conflict caused by emerging bioscientific and biomedical research and application. Both reflect their respective, yet different, heritages in Western law. Bioethics can be defined as "the research and practice, generally interdisciplinary in nature, which aims to (...) clarify or resolve ethical questions raised by the advances and application of biomedical and biological sciences" (II, Miller 2000, p. 246). Biolaw, on the other hand, is a legal philosophical concept that can be defined as "the taking of agreed upon principles and practices of bioethics into law with the sanctions that law engenders" (p. 246). Some see biolaw as hierarchical, either evolving from or devolving into bioethics (p. 245), while others think of bioethics and biolaw as a continuum or gradation (p. 246). Whichever view one takes, bioethics and biolaw are, at the least, intertwined (II, Loureiro 2000, p. 71).Although bioethics came out of the U.S. in the 1970s, the field is now considered Anglo-American (II, Kemp 2000a, p. 67). Biolaw emerged in the 1990s from the French biodroit and has become associated with continental Europe (p. 68). These distinctions, however, are based on geopolitical entities. Another way to distinguish bioethics from biolaw is to look at their legal heritage and understand the differences between the common law and the civil law.Bioethics and biolaw share a Western legal heritage, specifically roots in Roman law. When the Roman empire in the West fell to Germanic tribes in 476 A.D., the Romans had developed a sophisticated system of law that included flexible standards and abstract, rather than concrete, modes of thought. In 528, Justinian, emperor of the surviving Roman empire in the East at Constantinople, ordered a compilation and consolidation of Roman law. Despite the rise of seventh century Islam, the split of the Christian church into eastern and western branches in 1054, and the Norman conquest of England in 1066, Roman law survived through the courts of canon law and was revived later in the twelfth century at the University of Bologna in Italy. By 1500, what would later become France and Germany had [End Page 211] "received" or recognized Roman law, albeit in varying degrees. Not a single event, the Reception, or "direct acceptance of Roman law as a principal source of law," is the definitive turning point in Western legal history that eventually produced the common law and civil law strands (I, Von Mehren 1957, p. 10).England, however, did not participate in the Reception, although its influence was felt at Oxford University, where Vacarious taught its precepts in 1151, and in the courts of canon law (I, Von Mehren 1957, p. 10). William the Conqueror already essentially had established the common law tradition when he merged Anglo-Saxon law with Norman law and created a centralized system of justice administration for the single fiefdom known as England.Aside from historical development, the common law and the civil law differ from other legal families in terms of their modes of thought, institutions, sources, and ideology (I, Zweigert and Kotz 1977, p. 62). In the common law, Roman legal concepts were shaped by Christian ethics through the canon law courts. In the civil law, Roman law became the basis for a legal science centered in the universities and interpreted by various schools, such as the commentators, the glossators, and the humanists. The civil law uses a central text as the starting point for legal reasoning and analysis. The common law develops over time through case law, that is, by judges applying principles from preceding cases to resolve the issue at hand. One writer describes the common law as "anything that is not prohibited is permitted" and the civil law as "anything that is not permitted is prohibited" (I, Karambelas 2005, p. 28).The common law and the civil law are only two of the three traditions in Western law. The third is socialist law. All three are... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics Commissions: Town Meetings with a “Blue, Blue Ribbon”Susan Cartier Poland (bio)Town meetings are characteristic of New England. In theory, a quorum of registered voters in a small municipality meets annually to decide local public policy. In fact, special interests and the town bureaucracy control the meeting.Like a town meeting, a commission (or committee or council) comes into being, whether on an ad hoc or permanent basis, to direct (...) a government function. Bioethics commissions specialize in one area: the intersection of public policy with developments, either real or anticipated, in the basic and applied sciences.That specialization of commissions carries over into the selection of the members. More often than not commission members are appointed on the basis of expertise in a specific area. Although some commissions are still made up entirely of one kind of expert, usually medical, the majority of these government bodies seek breadth between the fields of law, religion, ethics, and science (including medicine and the social sciences).In the words of Mrs. Rigenbach, the law clerk to Chief Judge Carl B. Rubin of the United States District Court for the Southern District of Ohio, selection of persons “knowledgeable in the field” constitutes a “blue, blue ribbon” jury. In contrast, a “blue ribbon” jury is composed of those persons having “the greatest amount of formal education” (In re Richardson-Merrill, Inc. (Bendectin litigation), 624 Federal Supplement 1212 at 1217 (1985)). The problem with persons knowledgeable in the field is that their minds may have already been made up. For a jury, this is a disaster; for a bioethics commission, this directs and shapes the research, investigation, and discussion, or, in short, it makes for more efficient decision making.For this Scope Note, the definition of commission begins with the Bioethicsline description of its index term “advisory committees” as committees or commissions set up to advise government bodies on public policy. Furthermore, a commission [End Page 91] (or committee) receives government funding and support in exchange for its expertise in research, investigation, reporting, and recommendations.Six functions served by bioethics commissions have been clearly and succinctly described by LeRoy Walters (Commissions and Bioethics. Journal of Medicine and Philosophy 14 (4): 363–68, August 1989). The functions are: (1) to legitimize action; (2) to delay action or resolution; (3) to identify duplication; (4) to be representative; (5) to do research and find facts; and (6) to provide education and support (pp. 364–65). Since 1989, however, another government function has moved to the forefront. Instead of remaining within the legislative arena, government commissions serve the judiciary as well, in cases involving complex and technical questions. The now defunct Law Reform Commission of Canada recognized this use when it included in its annual reports a section on its “Influence on Law Reform through Judicial Decisions.”In mid-1997, the United States Supreme Court in its consolidated cases on assisted suicide used extensively the writings from a state commission, the New York State Task Force on Life and the Law, to support its rationale. Not only did the Court make use of the Task Force’s work, but in so doing the Court extended the efforts of the commission beyond its jurisdiction of New York into another jurisdiction on the opposite coast, Washington state. Furthermore, although the commission was chartered by one state, through the federal court system, its influence became national.Outside the U.S., the United Nations recently adopted its first bioethics text on the ethics of genetic research, and Canada is reworking its human research guidelines into a single set of guidelines that will apply to research in both the natural sciences and the social sciences.This Scope Note attempts to compile for the researcher and the reference librarian those commissions, existing and defunct, that have addressed bioethics issues. Only one other such attempt is known to the author, an Office of Technology Assessment [OTA] Background Paper, Biomedical Ethics in U.S. Public Policy (1993). Due to space limitations, not all publications could be listed; the selections included represent the range of topics from a particular group or the more frequently cited sources. Future updates of this compilation are planned, so please notify the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.3 (2000) 265-281 [Access article in PDF] Scope Note 39 Genes, Patents, and Bioethics-Will History Repeat Itself? Susan Cartier Poland Gene patenting--the very notion sounds absurd! How can anyone claim to have invented the genes with which one is born? To make matters worse, genetic makeup precedes birth, meaning the existence of the invention predates the existence of the inventor. So, do we really (...) own our genes, or do they belong to our parents, or our governments, or a Supreme Being? Ownership is only one bioethical issue involved in gene patenting. But before looking at the issues, some essential and basic terms must be understood, namely genes and patents. Genes In his book On the Origin of Species, published in 1859, the biologist Charles Darwin proposed a theory called "natural selection," whereby living things changed over time or evolved through generations due to competition and variation. By experimenting with the garden pea in the 1860s, Gregor Mendel, a monk and accomplished horticulturalist, provided the mechanism of inheritance supporting the natural selection theory of his contemporary Darwin. That mechanism is the gene, or, as Mendel described it, a discrete "factor." The gene has also been defined as "the fundamental unit of heredity" (United States 1987, p. 157). Each individual has two copies of a gene, one from each parent, but that individual passes down to offspring only one of the two copies. Because of Mendel, the gene has become a scientific concept and the basis of a new scientific field: genetics.David C. Page (2000) of the Whitehead Institute for Biomedical Research at the Massachusetts Institute of Technology explained today's terms for genetics structures using an analogy taken from the home. In his view, the cell is a kitchen, the genome is a shelf in the kitchen, the chromosome is a cookbook on the shelf, the gene is a recipe in the cookbook, and a base-pair (either adenine with thymine or guanine with cytosine) is a single letter in the recipe. A protein, the [End Page 265] working molecule blueprinted by a gene, is a dish ready to eat, and an ingredient in the dish is an amino acid, which is a building block of the protein as specified by a string of base-pairs.Colin Tudge (1993), a British science journalist, would disagree with Page's description of the gene as a recipe. A recipe is like a blueprint: both are directions that precede the work. But a gene is not passive according to Tudge; it actively administers the cell's work, and it also responds to cellular events (Aldridge 1996).The current focus of scientific research and funding is on the gene and the completion of the sequencing of all the genes that comprise the human genome, portrayed in the press as a race between the U.S. government's Human Genome Project and the private corporation Celera Genomics. The real action, however, is at the protein level. The gene only holds the information to produce a protein; it is the three-dimensional shaped protein that does the work. In order to produce energy, eliminate waste, and perform other functions specific to a cell or tissue, proteins must bind, thus creating "biological pathways." Proteins bind (or not) and detach as a function of their shapes, which are determined by their precise chemical composition as spelled out in their genetic code. IBM will spend the next five years making one computer, Blue Gene, that will then take an entire year to come up with the chemical map for only one protein (Gillis 2000). It is estimated that there are about 40,000 proteins in the human body.Despite these overwhelming numbers, modern biology has been able to achieve significant results within the Human Genome Project's 15-year time frame, from 1990 to 2005. The genetic map was completed in 1993; the physical map was completed in 1995; and the genetic sequence is expected to be completed in 2002, with 97 to 99 percent completed as of 26 June 2000. This... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to those (...) with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 16.4 (2006) 379-396MuseSearchJournalsThis JournalContents[Access article in PDF]Pharmacists and Conscientious Objection *In March 2005, a Wisconsin pharmacist's act of conscience garnered headlines across the United States. After a married woman with four children submitted a prescription for the morning-after pill, the pharmacist, Neil Noesen, not only refused to fill it, but also refused to transfer the prescription to another pharmacist or to return the prescription (...) to the customer. As more such incidents occurred, many states "... decided to consider and enact laws setting the bounds of pharmacists' and other health care workers' professional obligations" (III, Grady 2006, p. 327). Discussions of objector legislation, also referred to as "conscience clauses," "refusal clauses," and "abandonment laws" (III, Appel 2005, p. 279), are not limited to professional ethics, but also draw from philosophical, theological, and legal perspectives. The purpose of this Scope Note is to present a wide variety of viewpoints on the health provider's right to conscience.More than 40 years ago the development of "The Pill" as the first reliable method of birth control not only ushered in a feminist revolution, but also provided a new focus for concerns of conscience for those who were part of the anti-abortion movement based on religious belief in the sanctity of life. Similarly, in the past ten years, worldwide, and seven years (1999) since the emergency contraception "morning after" pill first became available as a prescription item, there has been an upsurge in the number of medical personnel who refuse to prescribe or dispense it on grounds of personal conscience, whether for religious reasons or not. Their actions bring into play issues of power and control for health care personnel and for patients—in this case women, which also raises women's rights issues. Ironically, studies in France, Sweden, and the United Kingdom have shown that emergency contraception does not reduce the abortion rate—it is too infrequently used (II, Glasier 2006).It is important to underline the difference between the "morning-after" pill or "Plan B," which is made up of two progestin pills containing levonorgestrel (a synthetic derivative of the female hormone progesterone), and RU-486 (Mifiprex [End Page 379] or mifipristone with misoprostol). Plan B, if taken within 72 hours post-coitus prevents implantation, and therefore pregnancy, by suppressing the output of luteinizing hormone, the hormone that triggers the ovulation process. Scientists have been unable to determine whether this action could destroy already fertilized eggs, but even if it does, it uses the same mechanism as occurs with the birth-control pill, that was developed some 45 years ago. By contrast, RU-486 acts up to 49 days after implantation by blocking the action of progesterone in order to terminate the pregnancy and as such is an abortifacient (II, US FDA 1).On 24 August 2006, the U.S. Food and Drug Administration announced approval of the Plan B pill for over-the-counter (OTC ) sales (II, US FDA 2). Although this action makes the drug more widely available, it remains to be seen whether pharmacists who are conscientious objectors and who refuse to dispense it also will refuse to provide it OTC.A survey article by Rebecca Dresser (II, 2005, p. 9) succinctly sums up the problem for conscientious objectors: "Because emergency contraception can act to block implantation of a fertilized egg, people who believe in protection of human life after conception find it morally objectionable."When conscientious objections are raised over abortion or birth control services performed, prescribed, or dispensed, they affect not only the health professionals—physicians, pharmacists, nurses, and health technicians—who may object, as well as their colleagues and/or managers, but also the consumers: the female patients who are then forced to reconsider or to seek an alternative supplier, as well as their spouses or partners. Alta Charo (II, 2005, p. 2473) makes the point that the patient needs to have access to a system of counseling and referral "so... (shrink)

In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often (...) used to explicitly or implicitly reference interventions that do not fall under the standard account. The authors offer an alternative ‘schematic’ definition of invasiveness, whereby medical interventions entail an underlying context-independent property of ‘basic invasiveness’ and may be understood both relative to each other and to a context-specific threshold of what is ‘invasive’.1 We propose that the meaning of terms such as ‘invasiveness’ is necessarily heterogeneous, and that what is implied by its usage will certainly depend on context, particularly in medical settings. Hence, the creation of a unifying definition is less critical than clarification of the implied and intended meanings of each instance of the term’s use. We further argue that interpreting the use of terms like ‘invasiveness’ in medical practice is complicated by the embedding of each use of this term in a different ‘language game’, whereby words and their meanings are understood by an in-group familiar with …. (shrink)

As these opening quotes acknowledge, the Prisoner’s Dilemma (PD) represents a core puzzle within the formal mathematics of game theory.3 Its rise in conspicuity is evident figure 2.1 above demonstrating a relatively steady rise in incidences of the phrase’s usage between 1960 to 1995, with a stable presence persisting into the twenty first century. This famous two-person “game,” with a stock narrative cast in terms of two prisoners who each independently must choose whether to remain silent or speak, each advancing (...) self-interest at the expense of the other and thereby achieving a mutually suboptimal outcome, mires any social interaction it is applied to into perplexity. The logic of this game proves the inverse of Adam Smith’s invisible hand: individuals acting on self interest will achieve a mutually suboptimal outcome. However, as this chapter illuminates, the assumptions underlying game theory drive this conclusion. (shrink)

This essay takes a synthetic and critical approach to the scattered pieces of art criticism and aesthetic theory authored by Louis Althusser. Connecting these texts to his larger philosophical and political project, we argue that these reflections make an independent contribution to its worth and that they offer different perspectives on lingering theoretical problems. We piece together the insights that form the core of the Althusserian approach to aesthetics and show how these are formulated and trace how their formulations take (...) shape in relation to the work of different authors and artists. In addition to helping us better understand his overall project, Althusser’s aesthetic theory is, we argue, a powerful and original contribution to Marxist aesthetics. Specifically, it points us to the idea that we need to take aesthetic production seriously as a practice with its own specificity – one that has its own logics of determination, rituals of production, circulation, and consumption, one that commands effects that need to be theorized on their own terms. (shrink)

Subjects classified visible 2-digit numbers as larger or smaller than 55. Target numbers were preceded by masked 2-digit primes that were either congruent (same relation to 55) or incongruent. Experiments 1 and 2 showed prime congruency effects for stimuli never included in the set of classified visible targets, indicating subliminal priming based on long-term semantic memory. Experiments 2 and 3 went further to demonstrate paradoxical unconscious priming effects resulting from task context. For example, after repeated practice classifying 73 as larger (...) than 55, the novel masked prime 37 paradoxically facilitated the “larger” response. In these experiments task context could induce subjects to unconsciously process only the leftmost masked prime digit, only the rightmost digit, or both independently. Across 3 experiments, subliminal priming was governed by both task context and long-term semantic memory. (shrink)

This essay represents a novel contribution to Nietzschean studies by combining an assessment of Friedrich Nietzsche’s challenging uses of “truth” and the “eternal return” with his insights drawn from Indian philosophies. Specifically, drawing on Martin Heidegger’s Nietzsche, I argue that Nietzsche’s critique of a static philosophy of being underpinning conceptual truth is best understood in line with the Theravada Buddhist critique of “self ” and “ego” as transitory. In conclusion, I find that Nietzsche’s “eternal return” can be understood as a (...) direct inversion of “nirvana”: Nietzsche celebrates profound attachment to each and every moment, independent from its pleasurable or distasteful registry. (shrink)

Philosophers of science are divided over the interpretations of scientific normativity. Larry Laudan defends a sort of goal-directed rules for scientific methodology. In contrast, Gerard Doppelt thinks methodological rules are a mixed batch of rules in that some are goal-oriented hypothetical rules and others are goal-independent categorical rules. David Resnik thinks that the debate between them is at a standstill now. He further thinks there are certain rules, such as the rule of consistency which is goal independent. However, he proposes (...) a holistic understanding of the scientific methodology. Taking a thread from Resnik, the present paper also advocates a holistic understanding of the scientific methodology. Given that many scientific practices deal with systems, the focus will be given to the systems by assuming each as a constellation of methodological norms. By taking each system as a set of mutually supportive methodological rules whose instrumental values underwrite the coherence relation among them, the paper aims to provide what could be a viable holistic epistemological account that can explain scientific normativity at work in a scientific system. The paper will lay down specific holistic criteria for understanding the scientific methodology. They will be used to show how a holistic account could satisfactorily account for the success of the Compact Muon Solenoid (CMS) experiment in discovering the Higgs boson and how the holistic account can account for the instrumental error behind the apparent faster-than-light neutrino anomaly of the Oscillation Project with Emulsion-t Racking Apparatus (OPERA) experiments respectively. (shrink)

This fourth edition of one of the classic logic textbooks has been thoroughly revised by John Burgess. The aim is to increase the pedagogical value of the book for the core market of students of philosophy and for students of mathematics and computer science as well. This book has become a classic because of its accessibility to students without a mathematical background, and because it covers not simply the staple topics of an intermediate logic course such as Godel's Incompleteness Theorems, (...) but also a large number of optional topics from Turing's theory of computability to Ramsey's theorem. John Burgess has now enhanced the book by adding a selection of problems at the end of each chapter, and by reorganising and rewriting chapters to make them more independent of each other and thus to increase the range of options available to instructors as to what to cover and what to defer. (shrink)

The intensive process of differentiation of knowledge that has in the past decade come to include philosophy has had the results, inter alia, that ethics, esthetics, and empirical sociology have undergone a kind of secondary "branching off" from the philosophy of society and culture . On the level of teaching this had the consequence that a department of esthetics and ethics was carved out of the department of historical materialism at the Philosophical Faculty of Moscow University, and was subsequently divided (...) into departments of esthetics and ethics, respectively. It was thus that the independent department of ethics made its appearance for the first time in the history of Moscow University. This occurred in 1969, and recently the department of Marxist- Leninist ethics marked its modest first decade. (shrink)

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)

Just as some types of philosophical analysis are more useful than others to historians or political scientists, so, I find, are some sorts of historical research more useful to philosophers than are other sorts. Sommerville makes history useful to non-historians by clarifying the large-scale historical background against which his investigative questions are posed, and then separating out crucial figures, ideas, and events from arcana of interest primarily to specialist historians. His interpretations are relatively neutral, striking a welcome balance between mere (...) reporting of events or textual ideas on the one hand, and on the other, accounts so theoretically laden that they prejudge or foreclose promising interpretive possibilities. (shrink)

In spite of its everyday connotations, the term independence as republicans understand it is not a celebration of individualism or self-reliance but embodies an acknowledgement of the importance of personal and social relationships in people’s lives. It reflects our connectedness rather than separateness and is in this regard a relational ideal. Properly understood, independence is a useful concept in addressing a fundamental problem in social philosophy that has preoccupied theorists of relational autonomy, namely how to reconcile the idea (...) of individual human agency with the inevitable and necessary influence of other people, both directly and indirectly. I derive my account from the work of Mary Wollstonecraft and Catharine Macaulay, whose contributions have remained largely overlooked by current republican theorists. I have three purposes in this chapter. First, I set out the relational character of independence. Secondly, I outline a republican approach to the problem of structural social threats to agency. Finally, I hope to establish the basis for a fruitful dialogue between republicans and relational autonomy theorists on the requirements and dynamics of individual agency and freedom in oppressive social situations. I identify three distinctive features of the internal logic of freedom as independence that give it a relational character: it always locates the person within a community; there is a mediating role played by the notion of arbitrariness in connecting individual and collective perspectives; a causal relationship exists linking each person’s freedom as independence such that that the dependence of one class of persons jeopardizes the independence of the whole community. (shrink)

Is a phenomenal pain a conscious primitive or composed of more primitive phenomenal states? Are pain experiences necessarily or only contingently unpleasant? Here, I sketch how to answer such questions concerning intra-phenomenal metaphysics using the example of pain and unpleasantness. Arguments for a symmetrical metaphysical independence of phenomenal pain and unpleasant affect are presented, rejecting a composite view like the IASP definition and dimensional views. The motivating intuition of these views is explained by common binding mechanisms in consciousness and (...) characterized as fallacious if generalized. There are, however, underlying commonalities between pain perception and unpleasant affect, e.g. formal content or evolutionary ancestry. (shrink)

Independence is a central and recurring theme in Mary Wollstonecraft's work. Independence should not be understood as an individualistic ideal that is in tension with the value of community but as an essential ingredient in successful and flourishing social relationships. I examine three aspects of this rich and complex concept that Wollstonecraft draws on as she develops her own notion of independence as a powerful feminist tool. First, independence is an egalitarian ideal that requires that all (...) individuals, regardless of sex, be protected to a comparable extent in all areas of social, political, and economic life, no matter whether this is in the public or private sphere. Second, so long as this egalitarian condition is not compromised, independence allows for individuals to perform differentiated social roles, including along gendered lines. Finally, the ongoing and collective input of both women and men is required to ensure that the conditions necessary for social independence are maintained. In Wollstonecraft's hands, then, independence is a powerful ideal that allows her to argue that women must be able to act on their own terms as social and political equals, doing so as women whose perspectives and interests may differ from men's. (shrink)

Context: Radical constructivism claims that we have no final truth criteria for establishing one ontology over another. This leaves us with the question of how we can come to know anything in a viable manner. According to von Glasersfeld, radical constructivism is a theory of knowledge rather than a philosophy of the world in itself because we do not have access to a human-independent world. He considers knowledge as the ordering of experience to cope with situations in a satisfactory way. (...) Problem: Von Foerster and Krippendorff show that the central goal of a constructivist theory of knowing must be to find a way of putting the knower into a known that is constructed so as to keep the knower, as well as the knowing process, viable in practice. Method: The conceptual and philosophical analysis of present theories and their necessary prerequisites suggests that such foundation for viable knowing can be built on the analysis of what the ontological prerequisites are for establishing viable observing, cognition, communication and observer-communicators, and communication media and vehicles. Results: The moment an observer chooses to accept his/her own embodied conscious presence in this world as well as language, he/she must accept other humans as partly independently existing conversation partners; if knowledge and knowing has to make sense, he/she must also accept as prerequisites for our observation and conversation a pre-linguistic reality from which our bodies come and which our conversation is often about. Furthermore, we can no longer claim that there is a reality that we do not know anything about: From being here in conversation, we know that the world can produce more or less stable embodied consciousnesses that can exchange and construct conceptual meanings through embodied conversations and actions that last over time and exist in space-time and mind, and are correlated to our embodied practices. We can also see that our communication works through signs for all living systems as well as in human language, understood as a structured and progressively developed system of communication. The prerequisite for this social semiotic production of meaning is the fourfold “semiotic star of cybersemiotics,” which includes at least four different worlds: our bodies, the combination of society, culture and language, our consciousness, and also an outer nature. Implications: The semiotic star in cybersemiotics claims that the internal subjective, the intersubjective linguistic, our living bodies, and nature are irreducible and equally necessary as epistemological prerequisites for knowing. The viable reality of any of them cannot be denied without self-refuting paradoxes. There is an obvious connectedness between the four worlds, which Peirce called “synechism.” It also points to Peirce’s conclusion that logic and rationality are part of the process of semiosis, and that meaning in the form of semiosis is a fundamental aspect of reality, not just a construction in our heads. Erratum: The paper erroneously refers to “pleroma.” The correct term is “plemora.” . (shrink)

We show that the join of two classical [respectively, regular, normal] modal logics employing distinct modal operators is a conservative extension of each of them.

Independence is a central and recurring theme in Wollstonecraft’s work. Independence should not be understood as an individualistic ideal that is in tension with the value of community but as an essential ingredient in successful and flourishing social relationships. I examine three aspects of this rich and complex concept that Wollstonecraft draws on as she develops her own notion of independence as a powerful feminist tool. First, independence is an egalitarian ideal that requires that all individuals, (...) regardless of sex, are protected to a comparable extent in all areas of social, political and economic life, no matter whether this is in the public or private sphere. Secondly, so long as this egalitarian condition is not compromised, independence allows for individuals to perform differentiated social roles, including along gendered lines. Finally, the on-going and collective input of both women and men is required to ensure that the conditions necessary for social independence are maintained. In Wollstonecraft’s hands, then, independence is a powerful ideal that allows her to argue that women must be able to act on their own terms as social and political equals, doing so as women whose perspectives and interests may differ from men’s. (shrink)

One of the most learned men of his day and called -the philosopher- by contemporaries, George Amiroutzes (c. 1400-c. 1469) attended the Council of Florence (1438-39) as a lay scholar in the Greek delegation. As a high government official in his native Trebizond, he helped to negotiate the surrender of this last independent Greek state to Mehmed the Conqueror in 1461. He eventually entered the Sultan's household as someone with whom Mehmed enjoyed having intellectual discussions. Despite his contemporary fame, however, (...) almost no philosophical writings of his survive. The present work offers an edition of fifteen previously unknown philosophical tractates. Although they are unpublished drafts in a fragmentary state, the tractaes reveal Amiroutzes to be an Aristotelian philosopher influenced by Thomas Aquinas and firmly intent upon refuting Platonism. He also shows himself to be an original thinker in discussing ethics and metaphysics.". (shrink)

Anydomainofscientificresearchhasitssustainingorthodoxy. Thatis, research on a problem, whether in astronomy, physics, or biology, is con- ducted against a backdrop of broadly shared assumptions. It is these as- sumptionsthatguideinquiryandprovidethecanonofwhatisreasonable-- of what "makes sense." And it is these shared assumptions that constitute a framework for the interpretation of research results. Research on the problem of how we see is likewise sustained by broadly shared assump- tions, where the current orthodoxy embraces the very general idea that the business of the visual system is to (...) create a detailed replica of the visual world, and that it accomplishes its business via hierarchical organization and by operatingessentiallyindependently of other sensorymodalitiesas well as independently of previous learning, goals, motor planning, and motor execution. (shrink)