ABSTRACT The expansion of health research to low and middle income countries has increased the likelihood of exploitation and undue influence in economically vulnerable populations. In behavioral research, “reasonable availability”, which was originally developed for biomedical research and advocates for the equitable provision of any product developed during the research process, cannot always prevent exploitation. In such cases and settings, the informed consent process may lack cross-cultural validity and therapeutic misconceptions may arise. This article advocates for a mutual learning framework (...) where international researchers can gain cultural competence while training and empowering local partners, increasing community ownership of health research. (shrink)

In this paper, we explore the idea of digital technologies as truth‐bearers in health care and argue that devices like SenseCam, which facilitate reflection and memory recall, have a potentially vital role in healthcare situations when questions of veracity are at stake (e.g., when best interest decisions are being made). We discuss the role of digital technologies as truth‐bearers in the context of nursing people with dementia, as this is one area of health care in which the topic of truth‐telling (...) has been hotly debated. People with dementia have been excluded from research studies and decisions that affect their lives because they are not regarded as truth‐bearers—that is, as being capable of giving truthful accounts of their experiences. Also, considerable research has focused on the ethics of lying to and deceiving people with dementia. Given their increasing prominence in healthcare settings, there has been surprisingly little discussion of what role digital technologies might play in relation to these questions of truth and deception. Drawing on theories from science and technology studies (STS), we explore their possible future role in some of the truth‐making processes of health care. In particular, we discuss the potential value of constraints on use of SenseCam to support the accounts of people with dementia as part of their care. (shrink)

I give an analysis of how empirical terms do their work in communication and the gathering of knowledge that is fully externalist and that covers the full range of empirical terms. It rests on claims about ontology. A result is that armchair analysis fails as a tool for examining meanings of ‘basic’ empirical terms because their meanings are not determined by common methods or criteria of application passed from old to new users, by conventionally determined ‘intensions’. Nor do methods of (...) application used by individual speakers constitute definitive reference-determining intensions for their idiolect terms or associated concepts. Conventional intensions of non-basic empirical terms ultimately rest on basic empirical concepts, so no empirical meaning is found merely ‘in the head’. I discuss the nature of lexical definition, why empirical meanings cannot ultimately be modelled as functions from possible worlds to extensions, and traps into which armchair analysis of meaning can lead us. A coda explains how ‘Swampman’ examples, as used against teleosemantic theories of content, illustrate such traps. (shrink)

"Paleontologists like to say that to a first approximation, all species are extinct (ninety- nine percent is the usual estimate). The organisms we see around us are distant cousins, not great grandparents; they are a few scattered twig-tips of an enormous tree whose branches and trunk are no longer with us." (p. 343-44). The historical life bush consists mainly in dead ends.

I try to focus our differences by examining the relation between what Dennett has termed "the intentional stance" and "the design stance." Dennett takes the intentional stance to be more basic than the design stance. Ultimately it is through the eyes of the intentional stance that both human and natural design are interpreted, hence there is always a degree of interpretive freedom in reading the mind, the purposes, both of Nature and of her children. The reason, or at least a (...) reason, is that intentional interpretation is holistic, hence indeterminate, for the kinds of reasons given by Davidson and Quine. In contrast, I take the design stance to be more basic than the intentional stance. Intentional attributions express our best guesses about the locations of effects of certain kinds of natural design. And although there is often indeterminacy, ambiguity, or vagueness concerning what it is that natural selection (or learning) has selected for, these indeterminacies and vaguenesses are local, not holistic. There is reason to suppose that the better portion of Nature's purposes and the intentional states of her children are determinate in content within quite closely defined limits. I propose to defend this position as well as I can, so as to call from Dennett his own views on precisely where our paths separate (if they really do). (shrink)

On Reading Signs; Some Differences between Us and The Others If there are certain kinds of signs that an animal cannot learn to interpret, that might be for any of a number of reasons. It might be, first, because the animal cannot discriminate the signs from one another. For example, although human babies learn to discriminate human speech sounds according to the phonological structures of their native languages very easily, it may be that few if any other animals are capable (...) of fully grasping the phonological structures of human languages. If an animal cannot learn to interpret certain signs it might be, second, because the decoding is too difficult for it. It could be, for example, that some animals are incapable of decoding signs that exhibit syntactic embedding, or signs that are spread out over time as opposed to over space. Problems of these various kinds might be solved by using another sign system, say, gestures rather than noises, or visual icons laid out in spatial order, or by separating out embedded propositions and presenting each separately. But a more interesting reason that an animal might be incapable of understanding a sign would be that it lacked mental representations of the necessary kind. It might be incapable of representing mentally what the sign conveys. When discussing what signs animals can understand or. (shrink)

Brentano was surely mistaken, however, in thinking that bearing a relation to something nonexistent marks only the mental. Given any sort of purpose, it might not get fulfilled, hence might exhibit Brentano's relation, and there are many natural purposes, such as the purpose of one's stomach to digest food or the purpose of one's protective eye blink reflex to keep out the sand, that are not mental, nor derived from anything mental. Nor are stomachs and reflexes "of" or"about" anything. A (...) reply might be, I suppose, that natural purposes are "purposes" only in an analogical sense hence "fail to be fulfilled" only in an analogical way. They bear an analogy to things that have been intentionally designed by purposive minds, hence can fail to accomplish the purposes they analogically have. As such they also have only analogical "intentionality". Such a response begs the question, however, for it assumes that natural purposes are not purposes in the full sense exactly because they are not. (shrink)

I sketch in miniature the whole of my work on the relation between language and thought. Previously I have offered closeups of this terrain in various papers and books, and I reference them freely. But my main purpose here is to explain the relations among the parts, hoping this can serve as a short introduction to my work on language and thought for some, and for others as a clarification of the larger plan.

Philosophers and laymen alike have traditionally assumed that whether you can reason well, make valid inferences, avoid logical mistakes and so forth is entirely a matter of how well the cogs in your head are fashioned and oiled. Partner to this is the assumption that careful reflection is always the method by which we discover whether an inference or reasoning process is correct. Against this, I argue that good reasoning needs constant empirical support; conceptual clarity is not an a priori, (...) but a deeply empirical matter. Moreover, clear thinking is possible only as embedded in a cooperative external world. (shrink)

This interview deals with the major themes in the work of Ruth Millikan. Her most fundamental idea is that the intentionality of inner and outer representations can be understood in analogy to biological functions. Another innovative feature is the view that thought and language stand parallel to each other. Thirdly, the basic ideas concerning the ontology and the epistemology of concepts are explained. Millikan aims at clarifying her position by contrasting it with Dretske, Fodor, Sellars, and Brandom. Finally, the (...) interview addresses topics that pose problems for her account as well as questions she does not treat in her work. (shrink)

Professor Elder has, I believe, misunderstood my position on the ontology of individuals, for I am not any kind of stage theorist. I do indeed believe, however, that there is a sense in which many different things can be in the same place at once, though it is not a sense in which “thing” is a count noun. To explain this, I briefly describe what I call “substances”, a category that includes both individuals and real kinds.

Low birth rates in developed societies reflect women’s difficulties in combining work and motherhood. While demographic research has focused on the role of formal childcare in easing this dilemma, evolutionary theory points to the importance of kin. The cooperative breeding hypothesis states that the wider kin group has facilitated women’s reproduction during our evolutionary history. This mechanism has been demonstrated in pre-industrial societies, but there is no direct evidence of beneficial effects of kin’s support on parents’ reproduction in modern societies. (...) Using three-generation longitudinal data anchored in a sample of grandparents aged 55 and over in 1992 in the Netherlands, we show that childcare support from grandparents increases the probability that parents have additional children in the next 8 to 10 years. Grandparental childcare provided to a nephew or niece of childless children did not significantly increase the probability that those children started a family. These results suggest that childcare support by grandparents can enhance their children’s reproductive success in modern societies and is an important factor in people’s fertility decisions, along with the availability of formal childcare. (shrink)

BackgroundThe past 10 years have witnessed a significant growth in sharing of health data for secondary uses. Alongside this there has been growing interest in the public acceptability of data sharing and data linkage practices. Public acceptance is recognised as crucial for ensuring the legitimacy of current practices and systems of governance. Given the growing international interest in this area this systematic review and thematic synthesis represents a timely review of current evidence. It highlights the key factors influencing public responses (...) as well as important areas for further research.MethodsThis paper reports a systematic review and thematic synthesis of qualitative studies examining public attitudes towards the sharing or linkage of health data for research purposes. Twenty-five studies were included in the review. The included studies were conducted primarily in the UK and North America, with one study set in Japan, another in Sweden and one in multiple countries. The included studies were conducted between 1999 and 2013. The qualitative methods represented in the studies included focus groups, interviews, deliberative events, dialogue workshops and asynchronous online interviews.ResultsKey themes identified across the corpus of studies related to the conditions necessary for public support/acceptability, areas of public concern and implications for future research. The results identify a growing body of evidence pointing towards widespread general—though conditional—support for data linkage and data sharing for research purposes. Whilst a variety of concerns were raised in cases where participants perceived there to be actual or potential public benefits from research and had trust in the individuals or organisations conducting and/or overseeing data linkage/sharing, they were generally supportive. The studies also find current low levels of awareness about existing practices and uses of data.ConclusionsWhilst the results indicate widespread public support for data sharing and linkage for research purposes, a range of concerns exist. In order to ensure public support for future research uses of data greater awareness raising combined with opportunities for public engagement and deliberation are needed. This will be essential for ensuring the legitimacy of future health informatics research and avoiding further public controversy. (shrink)

Construction of the trunk/caudal region of the vertebrate embryo involves a set of distinct molecules and processes whose relationships are just coming into focus. In addition to the subdivision of the embryo into head and trunk domains, this “caudalisation” process requires the establishment and maintenance of a stem zone. This sequentially generates caudal tissues over a long period which then undergo differentiation and patterning in the extending body axis. Here we review recent studies that show that changes in the signalling (...) properties of the paraxial mesoderm act as a switch that controls onset of differentiation and pattern in the spinal cord. These findings identify distinct roles for different caudalising factors; in particular, Fibroblast Growth Factor (FGF) inhibits differentiation in the caudal stem zone, while Retinoic acid (RA) provided rostrally by somitic mesoderm is required for neuronal differentiation and establishment of ventral neural pattern. Furthermore, the mutual opposition of FGF and RA pathways controls not only neural differentiation but also mesoderm segmentation and might also underlie the progressive assignment of rostrocaudal identity by regulating Hox gene availability and activation. BioEssays 26:857–869, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Background: Despite procedural innovations and increasing numbers of uterus transplant attempts worldwide, the perspectives of uterus transplant (UTx) trial participants are lacking. Methods: We conducted a mixed-methods study with women with absolute uterine factor infertility (AUFI). Participants included women who had previously contacted the Cleveland Clinic regarding the Uterine Transplant Trial and met the initial eligibility criteria for participation. In-depth interviews were conducted in conjunction with FertiQoL, a validated and widely used tool to measure the impact of infertility on the (...) quality of life of infertility patients. Results: All (n = 19) rated their overall health as good; some experienced grief and social isolation. AUFI is a life-framing experience that influences acceptance by family, partners, peers, and one’s self. UTx is a means to gain control of reproductive autonomy. UTx allows family-building and the ability to play an active role in prenatal health and well-being. Establishing and maintaining a supportive relationship is a key issue of AUFI and when considering UTx. Risks of UTx are perceived relative to risks to self/child/family posed by adoption/surrogacy. Participants had no overall preference regarding living or deceased donor. Conclusions: The ways in which women with AUFI conceptualize this condition in their lives and choices around UTx and participating in a study of the procedure are multifaceted and textured. These perspectives are critical to understanding its ethical, legal, and social implications. (shrink)