Background Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. Objective To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. Methods Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer an active role in clinical decision-making, (...) and (2) determine whether religious service attendance, the importance of religion, self-rated spirituality, Charlson Comorbidity Index, self-reported health, Vulnerable Elder Score and several demographic characteristics were associated with these preferences. Results Data were collected from 8308 of 11 620 possible participants. Ninety-seven per cent of respondents wanted doctors to offer them choices and to consider their opinions. However, two out of three (67%) preferred to leave medical decisions to the doctor. In multiple regression analyses, preferring to leave decisions to the doctor was associated with older age (per year, OR=1.019, 95% CI 1.003 to 1.036) and frequently attending religious services (OR=1.5, 95% CI 1.1 to 2.1, compared with never), and it was inversely associated with female sex (OR=0.6, 95% CI 0.5 to 0.8), university education (OR=0.6, 95% CI 0.4 to 0.9, compared with no high school diploma) and poor health (OR=0.6, 95% CI 0.3 to 0.9). Conclusions Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small. (shrink)

Although it originated in theological debates, the general will ultimately became one of the most celebrated and denigrated concepts emerging from early modern political thought. Jean-Jacques Rousseau made it the central element of his political theory, and it took on a life of its own during the French Revolution, before being subjected to generations of embrace or opprobrium. James Farr and David Lay Williams have collected for the first time a set of essays that track the evolving history (...) of the general will from its origins to recent times. The General Will: The Evolution of a Concept discusses the general will's theological, political, formal, and substantive dimensions with a careful eye toward the concept's virtues and limitations as understood by its expositors and critics, among them Arnauld, Pascal, Malebranche, Leibniz, Locke, Spinoza, Montesquieu, Kant, Constant, Tocqueville, Adam Smith and John Rawls. (shrink)

The traditional approach of the academy to research requires the practitioner to locate their inquiries in an academic discipline, inevitably restricting the study to a limited aspect of the challenges of practice and requiring an objectivity that removes the researcher from the action. This paper describes a fresh response to this question – a Post-graduate Programme in Professional Practice. The programme, offered by the Oxford Centre for Mission Studies, draws on work-based learning and reflective practice and facilitates a process of (...) critical inquiry and transformative action in the scholar-practioner's own context. (shrink)

Graphical displays of simple moving geometrical figures have been repeatedly used to study the attribution of animacy in human observers. Yet little is known about the relevant movement characteristics responsible for this experience. The present study introduces a novel parametric research paradigm, which allows for the experimental control of specific motion parameters and a predictable influence on the attribution of animacy. Two experiments were conducted using 3D computer animations of one or two objects systematically introducing variations in the following aspects (...) of motion: directionality, discontinuity and responsiveness. Both experiments further varied temporal kinematics. Results showed that animacy experience increased with the time a moving object paused in the vicinity of a second object and with increasing complexity of interaction between the objects . The experience of animacy could be successfully modulated in a parametric fashion by the systematic variation of comparably simple differential movement characteristics. (shrink)

Abordaré la crítica de Axel Honneth a la primera Escuela de Frankfurt y su aparente omisión de Herbert Marcuse. Defenderé a Marcuse contra algunas de las críticas hechas por Honneth a la teoría crítica temprana de la Escuela de Frankfurt. Luego argumentaré que Marcuse siempre estuvo en busca de una subjetividad radical, incluso cuando advirtió contra los mecanismos unidimensionales en curso de producción de sujetos. Finalmente, mostraré que Honneth también construye su proyecto en torno a la búsqueda de una subjetividad (...) radical, pero aborda el problema a través de una teoría de la intersubjetividad que complementa el proyecto de Marcuse. (shrink)

The insight a patient shares into their own psychosis is fundamental to their condition - it goes to the heart of what we understand 'madness' to be. Can a person be expected to accept treatment for a condition that they deny they have? Can a person be held responsible for their actions if those actions are inspired by their own unique perceptions and beliefs - beliefs that no-one else shares? The topic of insight in schizophrenia and related disorders has become (...) a major focus of research in psychiatry and psychology. It has important clinical implications in terms of outcome, treatment adherence, competence, and forensic issues. In order to study 'insight' a broad perspective is required. This involves applying knowledge from the cognitive and brain sciences, as well as from philosophy and the social sciences. Insight and Psychosis comprises a series of in-depth, well-referenced, scholarly overviews from each of these perspectives with a strong empirical foundation - including in some cases the presentation of new data and meta-analysis of the published literature. These are integrated and synthesised by the editors, both acknowledged experts in the field. The scope is truly international and spans theoretical perspectives, clinical practice, and consumer views. The book will act as a source for students and researchers interested in pursuing any number of questions and controversies around lack of insight and awareness, and will guide clinical psychologists and psychiatrists who seek a broader view of the many facets of insight that might arise during their day-to-day work. (shrink)

Erdelyi argues persuasively for his unified theory of repression. Beyond this, what can studying repression bring to our understanding of other aspects of emotional function? Here we consider ways in which work on repression might inform the study of, on one hand, emotional memory, and on the other, the emotional numbing seen in patients with chronic persistent depersonalization symptoms.

This study investigates the significant relationship between mental health and academic motivation among graduating students. Thus, the study employed a correlational design to determine if there is a significant relationship between mental health and academic motivation among 150 graduating college students. Hence, the Mental Health Inventory 38 (MHI-38) and Academic Motivation Scale (AMS-C28) were employed to measure the study variables. Moreover, statistical analysis reveals that the r coefficient of 0.35 indicates a low positive correlation between the variables. The p-value of (...) 0.00, which is less than 0.05, leads to the decision to reject the null hypothesis. (shrink)

This paper presents a series of 4 single subject experiments aimed to investigate whether children with autism show more social engagement when interacting with the Nao robot, compared to a human partner in a motor imitation task. The Nao robot imitates gross arm movements of the child in real-time. Different behavioral criteria (i.e. eye gaze, gaze shifting, free initiations and prompted initiations of arm movements, and smile/laughter) were analyzed based on the video data of the interaction. The results are mixed (...) and suggest a high variability in reactions to the Nao robot. The results are as follows: For Child2 and Child3, the results indicate no effect of the Nao robot in any of the target variables. Child1 and Child4 showed more eye gaze and smile/laughter in the interaction with the Nao robot compared to the human partner and Child1 showed a higher frequency of motor initiations in the interaction with the Nao robot compared to the baselines, but not with respect to the human-interaction. The robot proved to be a better facilitator of shared attention only for Child1. Keywords: human-robot interaction; assistive robotics; autism. (shrink)

This paper presents a series of 4 single subject experiments aimed to investigate whether children with autism show more social engagement when interacting with the Nao robot, compared to a human partner in a motor imitation task. The Nao robot imitates gross arm movements of the child in real-time. Different behavioral criteria were analyzed based on the video data of the interaction. The results are mixed and suggest a high variability in reactions to the Nao robot. The results are as (...) follows: For Child2 and Child3, the results indicate no effect of the Nao robot in any of the target variables. Child1 and Child4 showed more eye gaze and smile/laughter in the interaction with the Nao robot compared to the human partner and Child1 showed a higher frequency of motor initiations in the interaction with the Nao robot compared to the baselines, but not with respect to the human-interaction. The robot proved to be a better facilitator of shared attention only for Child1. Keywords: human-robot interaction; assistive robotics; autism. (shrink)

We propose a formal framework for interpretable machine learning. Combining elements from statistical learning, causal interventionism, and decision theory, we design an idealised explanation game in which players collaborate to find the best explanation for a given algorithmic prediction. Through an iterative procedure of questions and answers, the players establish a three-dimensional Pareto frontier that describes the optimal trade-offs between explanatory accuracy, simplicity, and relevance. Multiple rounds are played at different levels of abstraction, allowing the players to explore overlapping causal (...) patterns of variable granularity and scope. We characterise the conditions under which such a game is almost surely guaranteed to converge on a optimal explanation surface in polynomial time, and highlight obstacles that will tend to prevent the players from advancing beyond certain explanatory thresholds. The game serves a descriptive and a normative function, establishing a conceptual space in which to analyse and compare existing proposals, as well as design new and improved solutions. (shrink)

This paper presents a series of 4 single subject experiments aimed to investigate whether children with autism show more social engagement when interacting with the Nao robot, compared to a human partner in a motor imitation task. The Nao robot imitates gross arm movements of the child in real-time. Different behavioral criteria were analyzed based on the video data of the interaction. The results are mixed and suggest a high variability in reactions to the Nao robot. The results are as (...) follows: For Child2 and Child3, the results indicate no effect of the Nao robot in any of the target variables. Child1 and Child4 showed more eye gaze and smile/laughter in the interaction with the Nao robot compared to the human partner and Child1 showed a higher frequency of motor initiations in the interaction with the Nao robot compared to the baselines, but not with respect to the human-interaction. The robot proved to be a better facilitator of shared attention only for Child1. Keywords: human-robot interaction; assistive robotics; autism. (shrink)

Today's medicine is spiritually deflated and morally adrift; this book explains why and offers an ethical framework to renew and guide practitioners in fulfilling their profession to heal. What is medicine and what is it for? What does it mean to be a good doctor? Answers to these questions are essential both to the practice of medicine and to understanding the moral norms that shape that practice. The Way of Medicine articulates and defends an account of medicine and medical ethics (...) meant to challenge the reigning provider of services model, in which clinicians eschew any claim to know what is good for a patient and instead offer an array of "health care services" for the sake of the patient's subjective well-being. Against this trend, Farr Curlin and Christopher Tollefsen call for practitioners to recover what they call the Way of Medicine, which offers physicians both a path out of the provider of services model and also the moral resources necessary to resist the various political, institutional, and cultural forces that constantly push practitioners and patients into thinking of their relationship in terms of economic exchange. Curlin and Tollefsen offer an accessible account of the ancient ethical tradition from which contemporary medicine and bioethics has departed. Their investigation, drawing on the scholarship of Leon Kass, Alasdair MacIntyre, and John Finnis, leads them to explore the nature of medicine as a practice, health as the end of medicine, the doctor-patient relationship, the rule of double effect in medical practice, and a number of clinical ethical issues from the beginning of life to its end. In the final chapter, the authors take up debates about conscience in medicine, arguing that rather than pretending to not know what is good for patients, physicians should contend conscientiously for the patient's health and, in so doing, contend conscientiously for good medicine. The Way of Medicine is an intellectually serious yet accessible exploration of medical practice written for medical students, health care professionals, and students and scholars of bioethics and medical ethics. (shrink)

This paper describes differences in two perspectives on the idea of virtue as a theoretical foundation for positive organizational ethics (POE). The virtue ethics perspective is grounded in the philosophical tradition, has classical roots, and focuses attention on virtue as a property of character. The positive social science perspective is a recent movement (e.g., positive psychology and positive organizational scholarship) that has implications for POE. The positive social science movement operationalizes virtue through an empirical lens that emphasizes virtuous behaviors. From (...) a virtue ethics perspective, a behaviorally based account of virtue is a weak theory of virtue. Observations are suggested for integrating the two perspectives. First, virtue should always be understood as an excellence and is often an optimal point between extreme dysfunctions on continuum of potential states. Second, an empirical exploration of virtue needs to account for character and context. Finally, the properties of organization-level virtue need to be further specified and explored. Implications and directions for future research are discussed. (shrink)

This target article discusses the verbal working memory system used in sentence comprehension. We review the concept of working memory as a short-duration system in which small amounts of information are simultaneously stored and manipulated in the service of accomplishing a task. We summarize the argument that syntactic processing in sentence comprehension requires such a storage and computational system. We then ask whether the working memory system used in syntactic processing is the same as that used in verbally mediated tasks (...) that involve conscious controlled processing. Evidence is brought to bear from various sources: the relationship between individual differences in working memory and individual differences in the efficiency of syntactic processing; the effect of concurrent verbal memory load on syntactic processing; and syntactic processing in patients with poor short-term memory, patients with poor working memory, and patients with aphasia. Experimental results from these normal subjects and patients with various brain lesions converge on the conclusion that there is a specialization in the verbal working memory system for assigning the syntactic structure of a sentence and using that structure in determining sentence meaning that is separate from the working memory system underlying the use of sentence meaning to accomplish other functions. We present a theory of the divisions of the verbal working memory system and suggestions regarding its neural basis. (shrink)

Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to (...) explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed. (shrink)

In many ways, Ron Barnett’s academic oeuvre is unique. Without a doubt, he is one of the (if not the) most central founding academics of the research field ‘the philosophy of higher education’, whi...

This is a transcription of a debate on the concept of a person conducted in Moscow in 1983. David Bakhurst argues that Evald Ilyenkov's social constructivist conception of personhood, founded on Marx's thesis that the human essence is 'the ensemble of social relations', is either false or trivially true. F. T. Mikhailov, V. S. Bibler, V. A. Lektorsky and V. V. Davydov critically assess Bakhurst's arguments, elucidate and contextualize Ilyenkov's views, and defend, in contrasting ways, the claim that human (...) individuals are socially constituted beings. Issues discussed include: the concepts of activity and community and their relevance to the notions of mind and personhood; self-consciousness and its relation to personal identity; naturalism in Soviet thought. Translated from the Russian. (shrink)

_Real Essentialism_ presents a comprehensive defence of neo-Aristotelian essentialism. Do objects have essences? Must they be the kinds of things they are in spite of the changes they undergo? Can we know what things are really like – can we define and classify reality? Many, if not most, philosophers doubt this, influenced by centuries of empiricism, and by the anti-essentialism of Wittgenstein, Quine, Popper, and other thinkers. _Real Essentialism_ reinvigorates the tradition of realist, essentialist metaphysics, defending the reality and knowability (...) of essence, the possibility of objective, immutable definition, and its relevance to contemporary scientific and metaphysical issues such as whether essence transcends physics and chemistry, the essence of life, the nature of biological species, and the nature of the person. (shrink)

Virtuousness refers to the pursuit of the highest aspirations in the human condition. It is characterized by human impact, moral goodness, and unconditional societal betterment. Several writers have recently argued that corporations, in addition to being concerned with ethics, should also emphasize an ethos of virtuousness in corporate action. Virtuousness emphasizes actions that go beyond the “do no harm” assumption embedded in most ethical codes of conduct. Instead, it emphasizes the highest and best of the human condition. This research empirically (...) examines the buffering and amplifying effects of virtuousness in organizations. The study hypothesizes that virtuousness has a positive effect on organizations because amplifying dynamics make subsequent virtuous action more likely, and buffering dynamics reduce the harmful effects of downsizing. The study reveals that two types of virtuousness – tonic and phasic – are associated with these effects. (shrink)

BackgroundAs suggested by Shook and Giordano, understanding and therefore addressing the urgent international governance issues around globalizing bio-medical/technology research and applications is limited by the perception of the underlying science.MethodsA philosophical methodology is used, based on novel and classical philosophical reflection upon existent literature, clinical wisdoms and narrative theory to discover a meta-science and telos of humankind for the development of a relevant and defendable global biomedical bioethics.ResultsIn this article, through pondering an integrative systems approach, I propose a biomedical model (...) that may provide Western biomedicine with leadership and interesting insight into the unity beyond the artificial boundaries of its traditional divisions and the limit between physiological and pathological situations. A unified biomedicine, as scientific foundation, might then provide the basis for dissolution of similar reflected boundaries within bioethics. A principled and communitarian cosmopolitan bioethics may then be synonymous with a recently proposed principled and communitarian cosmopolitan neuroethics based on a novel objective meta-ethics. In an attempt to help facilitate equal and inclusive participation in inter-, multi-, and transdisciplinary intercultural discourse regarding the aforementioned international governance issues, I offer: a meta-science derived through considering the general behaviour of activity, plasticity and balance in biology and; a novel thought framework to encourage and enhance the ability for self-evaluation, self-criticism, and self-revision aimed at broadening perspective, as well as acknowledging and responding to the strengths and limitations of extant knowledge.ConclusionsThrough classical philosophical reflection, I evolve a theory of medicine to discover a telos of humankind which in turn provides an ‘internal’ moral grounding for a proposed global biomedical bioethics. (shrink)

It is often said that the world is explained by laws of nature together with initial conditions. But does that mean initial conditions don’t require further explanation? And does the explanatory role played by initial conditions entail or require that time has a preferred direction? This chapter looks at the use of the ‘initialness defence’ in physics, the idea that initial conditions are intrinsically special in that they don’t require further explanation, unlike the state of the world at other times. (...) Such defences commonly assume a primitive directionality of time to distinguish between initial and final conditions. Using the case study of the time-asymmetry of thermodynamics and the so-called ‘past hypothesis’ — the hypothesis that the early universe was in a state of very low entropy —, I outline and support a deflationary account of the initialness defence that does not pre- suppose a basic directionality of time, and argue that there is a relevant explanatory asymmetry between initial conditions and the state of systems at other times only if certain causal conditions are satisfied. Hence, the initialness defence is available to those who reject a fundamental direction of time. (shrink)

We propose a formal framework for interpretable machine learning. Combining elements from statistical learning, causal interventionism, and decision theory, we design an idealised explanation game in which players collaborate to find the best explanation for a given algorithmic prediction. Through an iterative procedure of questions and answers, the players establish a three-dimensional Pareto frontier that describes the optimal trade-offs between explanatory accuracy, simplicity, and relevance. Multiple rounds are played at different levels of abstraction, allowing the players to explore overlapping causal (...) patterns of variable granularity and scope. We characterise the conditions under which such a game is almost surely guaranteed to converge on a optimal explanation surface in polynomial time, and highlight obstacles that will tend to prevent the players from advancing beyond certain explanatory thresholds. The game serves a descriptive and a normative function, establishing a conceptual space in which to analyse and compare existing proposals, as well as design new and improved solutions. (shrink)

Machine learning algorithms may radically improve our ability to diagnose and treat disease. For moral, legal, and scientific reasons, it is essential that doctors and patients be able to understand and explain the predictions of these models. Scalable, customisable, and ethical solutions can be achieved by working together with relevant stakeholders, including patients, data scientists, and policy makers.

As machine learning has gradually entered into ever more sectors of public and private life, there has been a growing demand for algorithmic explainability. How can we make the predictions of complex statistical models more intelligible to end users? A subdiscipline of computer science known as interpretable machine learning (IML) has emerged to address this urgent question. Numerous influential methods have been proposed, from local linear approximations to rule lists and counterfactuals. In this article, I highlight three conceptual challenges that (...) are largely overlooked by authors in this area. I argue that the vast majority of IML algorithms are plagued by (1) ambiguity with respect to their true target; (2) a disregard for error rates and severe testing; and (3) an emphasis on product over process. Each point is developed at length, drawing on relevant debates in epistemology and philosophy of science. Examples and counterexamples from IML are considered, demonstrating how failure to acknowledge these problems can result in counterintuitive and potentially misleading explanations. Without greater care for the conceptual foundations of IML, future work in this area is doomed to repeat the same mistakes. (shrink)

We examine two different descriptions of the behavioral functions of the hippocampal system. One emphasizes spatially organized behaviors, especially those using cognitive maps. The other emphasizes memory, particularly working memory, a short-term memory that requires iexible stimulus-response associations and is highly susceptible to interference. The predictive value of the spatial and memory descriptions were evaluated by testing rats with damage to the hippocampal system in a series of experiments, independently manipulating the spatial and memory characteristics of a behavioral task. No (...) dissociations were found when the spatial characteristics of the stimuli to be remembered were changed; lesions produced a similar deficit in both spatial and nonspatial test procedures, indicating that the hippocampus was similarly involved regardless of the spatial nature of the task. In contrast, a marked dissociation was found when the memory requirements were altered. Rats with lesions were able to perform accurately in tasks that could be solved exclusively on the basis of reference memory. They performed at chance levels and showed no signs of recovery even with extensive postoperative training in tasks that required working memory. In one experiment all the characteristics of the reference memory and working memory procedures were identical except the type of memory required. Consequently, the behavioral dissociation cannot be explained by differences in attention, motivation, response inhibition, or the type of stimuli to be remembered. As a result of these experiments we propose that the hippocampus is selectively involved in behaviors that require working memory, irrespective of the type of material that is to be processed by that memory. (shrink)

We propose a formal framework for interpretable machine learning. Combining elements from statistical learning, causal interventionism, and decision theory, we design an idealisedexplanation gamein which players collaborate to find the best explanation(s) for a given algorithmic prediction. Through an iterative procedure of questions and answers, the players establish a three-dimensional Pareto frontier that describes the optimal trade-offs between explanatory accuracy, simplicity, and relevance. Multiple rounds are played at different levels of abstraction, allowing the players to explore overlapping causal patterns of (...) variable granularity and scope. We characterise the conditions under which such a game is almost surely guaranteed to converge on a (conditionally) optimal explanation surface in polynomial time, and highlight obstacles that will tend to prevent the players from advancing beyond certain explanatory thresholds. The game serves a descriptive and a normative function, establishing a conceptual space in which to analyse and compare existing proposals, as well as design new and improved solutions. (shrink)