In Aaron and Bachalo's work, Doctor Stephen Strange exemplifies the characteristics and methods of the natural philosophers in clashes with his mystical enemies, Lord Imperator and the Empirikul. It's easy to be distracted by Doctor Strange's fancy spells, unique job title, or flashy cape, but we should also recognize that he is a Sorcerer Supreme, who demonstrates both discipline and intellect. Like the historical philosopher‐scientists, Doctor Strange studies metaphysics and its relationship to the physical world. When intellectuals began to challenge (...) Aristotle's teleological world‐view, they faced opposition from both the Catholic Church, who found Aristotle's views consistent with scripture, and the scientific community. Historian Peter Dear's book Revolutionizing the Sciences helps situate the work of ancient philosophers, like Aristotle, in the context of the history of the scientific revolution. (shrink)

Lex Luthor despises Superman. He obsesses about Superman. He tries to kill Superman. Luthor takes existentialism to the extreme, though, rejecting ethics and becoming an anti‐hero. In Superman: Secret Origin, Luthor is presented as self‐directed from an early age. Friedrich Nietzsche can help us understand Luthor as an iconoclast, literally one who breaks sacred images. Luthor also explains why he is so obsessed with bringing down Superman. Luthor thinks that Superman interferes with people viewing their lives as an existential project. (...) Lex Luthor underscores the complexities of existentialist philosophy. While he is creative, self‐determined, and autonomous, he is also completely immoral. His willingness to sacrifice anything or anyone takes existentialism to an extreme that Nietzsche, Sartre, and Kierkegaard would reject. And so, we are left to wonder: is Lex Luthor an evil genius and an abomination to existentialism, or might he be a true evolution of what existentialism can become. (shrink)

We investigated spectral resting-state EEG in persons with chronic stroke-induced aphasia to determine its reliability, sensitivity, and relationship to functional behaviors. Resting-state EEG has not yet been characterized in this population and was selected given the demonstrated potential of resting-state investigations using other neuroimaging techniques to guide clinical decision-making. Controls and persons with chronic stroke-induced aphasia completed two EEG recording sessions, separated by approximately 1 month, as well as behavioral assessments of language, sensorimotor, and cognitive domains. Power in the classic (...) frequency bands was examined via spectral analysis of resting-state EEG data. Results suggest that power in the theta, alpha, and beta bands is reliable for use as a repeated measure. Significantly greater theta and lower beta power was observed in persons with aphasia than controls. Finally, in PWAs theta power negatively correlated with performance on a discourse informativeness measure, while alpha and beta power positively correlated with performance on the same measure. This indicates that spectral rsEEG slowing observed in PWAs in the chronic stage is pathological and suggests a possible avenue for directly altering brain activation to improve behavioral function. Taken together, these results suggest that spectral resting-state EEG holds promise for sensitive measurement of functioning and change in persons with chronic aphasia. Future studies investigating the utility of these measures as biomarkers of frank or latent aphasic deficits and treatment response in chronic stroke-induced aphasia are warranted. (shrink)

Vernae—often but not exclusively taken to be home-born slaves—are usually thought to have had a privileged role within the ancient Roman household. While previous studies have highlighted how these individuals were represented with affection or as surrogate members of the freeborn family, this article uses epigraphic evidence from Pompeii to argue that the reality for at least some vernae was much more grim. A full examination of Pompeian attestations of the word verna reveals that there was a connection to prostitution (...) in over seventy per cent of extant appearances of the noun. Furthermore, contextualizing this phenomenon within the corpus of prostitution-related graffiti more broadly reveals that verna was the single most commonly used descriptor in advertisements for sexual services at Pompeii. Ultimately, the epigraphic evidence from Pompeii suggests that vernae were not safe from sexual exploitation, and it may have been their status as vernae that made them attractive to those wishing to purchase sex. (shrink)

The difficulty of making reliable interpretation from a dense cloud of unreliable correlations means that the grounds for making a testable or brain-based, theory of intelligence remain very shaky. We briefly discuss the conceptual and methodological problems that arise and suggest one possible alternative interpretation of the data.

Ten years after the Human Genome Project’s completion the life sciences stand in a moment of uncertainty, transition, and contestation. The postgenomic era has seen rapid shifts in research methodology, funding, scientific labor, and disciplinary structures. Postgenomics is transforming our understanding of disease and health, our environment, and the categories of race, class, and gender. At the same time, the gene retains its centrality and power in biological and popular discourse. The contributors to Postgenomics analyze these ruptures and continuities and (...) place them in historical, social, and political context. Postgenomics, they argue, forces a rethinking of the genome itself, and opens new territory for conversations between the social sciences, humanities, and life sciences. Contributors. Russ Altman, Rachel A. Ankeny, Catherine Bliss, John Dupré, Michael Fortun, Evelyn Fox Keller, Sabina Leonelli, Adrian Mackenzie, Margot Moinester, Aaron Panofsky, Sarah S. Richardson, Sara Shostak, Hallam Stevens. (shrink)

Feminist philosophy of science has led to improvements in the practices and products of scientific knowledge-making, and in this way it exemplifies socially relevant philosophy of science. It has also yielded important insights and original research questions for philosophy. Feminist scholarship on science thus presents a worthy thought-model for considering how we might build a more socially relevant philosophy of science—the question posed by the editors of this special issue. In this analysis of the history, contributions, and challenges faced by (...) feminist philosophy of science, I argue that engaged case study work and interdisciplinarity have been central to the success of feminist philosophy of science in producing socially relevant scholarship, and that its future lies in the continued development of robust and dynamic philosophical frameworks for modeling social values in science. Feminist philosophers of science, however, have often encountered marginalization and persistent misunderstandings, challenges that must be addressed within the institutional and intellectual culture of American philosophy. (shrink)

This paper develops the conceptual framework of ’sex contextualism’ for the study of sex-related variables in biomedical research. Sex contextualism offers an alternative to binary sex essentialist approaches to the study of sex as a biological variable. Specifically, sex contextualism recognizes the pluralism and context-specificity of operationalizations of ’sex’ across experimental laboratory research. In light of recent policy mandates to consider sex as a biological variable, sex contextualism offers constructive guidance to biomedical researchers for attending to sex-related biological variation. As (...) an alternative to and critique of biological binary sex essentialism, sex contextualism contributes to current debates in philosophy of biology, feminist science studies, and social ontology on the construction of categories of gender/sex differences in scientific research. (shrink)

Although the dynamic field model predicts infants' perseverative behavior in the context of the A-not-B manual search task, it does not account for infant perseveration in other contexts. An alternative cognitive capacity explanation for perseveration is more parsimonious. It accounts for the graded nature of perseverative responses and perseveration in different contexts.

Recent scholarship resuscitates the history and philosophy of a ‘left wing’ in the Vienna Circle, offering a counterhistory to the conventional image of analytic philosophy as politically conformist. This paper disputes the historical claim that early logical empiricists developed a political philosophy of science. Though some individuals in the Vienna Circle, including Rudolf Carnap and Otto Neurath, believed strongly in the importance of science to social progress, they did not construct a political philosophy of science. Both Carnap and Neurath were (...) committed to forms of political neutralism that run strongly against a political reading of their logical empiricism. In addition, Carnap and Neurath sharply differ on precisely the subject of the place of politics in logical empiricism, throwing into question the construct of the ‘Left Vienna Circle’ as a coherent, sociohistorical, programmatic unit within the Vienna Circle.Keywords: Vienna Circle; Rudolf Carnap; Otto Neurath; Logical empiricism; History of philosophy of science; Political philosophy of science. (shrink)

This paper analyzes the claim that the Left Vienna Circle offers a theoretical and historical precedent for a politically engaged philosophy of science today. I describe the model for a political philosophy of science advanced by LVC historians. They offer this model as a moderate, properly philosophical approach to political philosophy of science that is rooted in the analytic tradition. This disciplinary-historical framing leads to weaknesses in LVC scholars’ conception of the history of the LVC and its contemporary relevance. In (...) this light, I examine the claim that there are productive enrichments to be gained from the engagement of feminist philosophy of science with the LVC, finding this claim ill-formulated. The case of LVC historiography and feminist philosophy of science presents a revealing study in the uses and ethics of disciplinary history, showing how feminist and other perspectives are misconceived and marginalized by forms of disciplinary self-narrativizing.Keywords: Vienna Circle; Logical empiricism; Political philosophy of science; Disciplinary history; Feminist philosophy of science. (shrink)

This paper describes, analyzes, and critiques the construction of separate “male” and “female” genomes in current human genome research. Comparative genomic work on human sex differences conceives of the sexes as like different species, with different genomes. I argue that this construct is empirically unsound, distortive to research, and ethically questionable. I propose a conceptual model of biological sex that clarifies the distinction between species and sexes as genetic classes. The dynamic interdependence of the sexes makes them “dyadic kinds” that (...) are not like species, which are “individual kinds.” The concept of sex as a “dyadic kind” may be fruitful as a remedy to the tendency to conceive of the sexes as distinct, binary classes in biological research on sex more generally. (shrink)

In “Analyzing COVID-19 Sex Difference Claims: The Harvard GenderSci Lab,” Marion Boulicault and Sarah Richardson summarize some of the groundbreaking work that they’re doing at the Harvard GenderSci Lab. Since March 2020, their lab has been analyzing, interrogating, and critiquing sex essentialist explanations of COVID-19 outcome disparities that are fairly ubiquitous in news media. Using interdisciplinary tools from feminist philosophy, science studies, and critical public health, they work collaboratively with two goals: (i) to critically examine COVID-19 sex difference (...) research and (ii) to explore and elevate the role of social variables in driving biological disparities. They argue that in public health research, media, and messaging, data on sex disparities must be contextualized both to avoid reinforcing harmful sex essentialist assumptions and also to help the public understand the complex ways in which social factors influence these patterns. They argue that within the context of COVID-19, doing so can both clarify risks and save lives. Their contribution to this issue describes their methods and shares some of their findings. (shrink)

Is the feminist project to bring about parity for women and men in traditionally male fields doomed? Recent headlines trumpet that "The more gender equality, the fewer women in STEM." The American Enterprise Institute proposes that it is futile to fund efforts to increase women in STEM fields, given that, “as paradoxical and counter-intuitive as it seems, female underrepresentation in STEM may actually be the result of the great advances in female empowerment, progress, and advancement that have taken place in (...) recent decades, and not the result of systemic gender discrimination.” Meanwhile, men's rights activists exalt new findings as evidence that women just naturally don’t prefer science. These bold claims stem from the “Gender Equality Paradox” hypothesis, which is simply this: Some of the countries with the highest gender equity scores on internationally-comparable indices also show the largest average sex differences in prefrences for STEM careers. In other words, in countries with more gender equality, like Norway and Sweden, fewer women choose to enter STEM fields than in countries like Algeria or Turkey. Over the past year, the GenderSci Lab has been engaged in a critical analysis of the “Gender Equality Paradox” hypothesis and its accompanying assumptions and implications. In this paper, we share our reanalysis of some of the data used by Stoet and Geary (2018) and argue that their findings are likely spurious. (shrink)

In the past, work on racial and ethnic variation in brain and behavior was marginalized within genetics. Against the backdrop of genetics’ eugenic legacy, wide consensus held such research to be both ethically problematic and methodologically controversial. But today it is finding new opportunistic venues in a global, transdisciplinary, data‐rich postgenomic research environment in which such a consensus is increasingly strained. The postgenomic sciences display worrisome deficits in their ability to govern and negotiate standards for making postgenomic claims in the (...) transdisciplinary space between human population variation research, studies of intelligence, neuroscience, and evolutionary biology.Today some researchers are pursuing the genomics of intelligence on a newly grand scale. They are sequencing large numbers of whole genomes of people considered highly intelligent (by varying empirical and social measures) in the hope of finding gene variants predictive of intelligence. Troubling and at times outlandish futurist claims accompany this research. Scientists involved in this research have openly discussed the possibility of marketing prenatal tests for intelligence, of genetic engineering or selective embryo implantation to increase the likelihood of a high‐IQ child, and of genotyping children to guide their education. In this permissive and contested environment, what would trustworthy research on the genomics of high intelligence look like? (shrink)

Dlg (Discs large), Scrib (Scribble) and Lgl (Lethal giant larvae) are evolutionarily conserved components of a common genetic pathway that link the seemingly disparate functions of cell polarity and cell proliferation in epithelial cells. dlg, scrib and lgl have been identified as tumour suppressor genes in Drosophila, mutations of which cause similar phenotypes, involving disruption of cell polarity and neoplastic overgrowth of tissues. The molecular mechanisms by which Dlg, Scrib and Lgl proteins regulate cell proliferation are not clear, but there (...) is some evidence that epithelial polarisation is required for this regulation. Dlg, Scrib and Lgl are highly conserved between human and Drosophila, and we discuss evidence that these proteins also play a role in cancer progression in humans. BioEssays 25:542–553, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

En este artículo se desarrolla el marco conceptual del “contextualismo sexual” para el estudio de las variables relacionadas con el sexo en la investigación biomédica. El contextualismo sexual ofrece una alternativa a los enfoques sexuales binarios y esencialistas del estudio del sexo como variable biológica. Específicamente, el contextualismo sexual reconoce el pluralismo y la especificidad contextual que tienen las operacionalizaciones de “sexo” a través de la investigación experimental de laboratorio. A la luz de recientes normativas para la consideración del sexo (...) como variable biológica, el contextualismo sexual ofrece una guía constructiva a los/as investigadores/as biomédicos/as para abordar la variación biológica relacionada con el sexo. En tanto alternativa y crítica al esencialismo binario del sexo biológico, el contextualismo sexual contribuye a los debates actuales en filosofía de la biología, estudios feministas de la ciencia y ontología social en torno a la construcción de categorías de la diferencia sexual/genérica en la investigación científica. (shrink)

Observational learning can enhance the acquisition and performance quality of complex motor skills. While an extensive body of research has focused on the benefits of synchronous (i.e., concurrent physical practice) and non-synchronous (i.e., delayed physical practice) observational learning strategies, the question remains as to whether these approaches differentially influence performance outcomes. Accordingly, we investigate the differential outcomes of synchronous and non-synchronous observational training contexts using a novel dance sequence. Using multidimensional cross-recurrence quantification analysis, movement time-series were recorded for novice dancers (...) who either synchronised with (n = 22) or observed and then imitated (n = 20) an expert dancer. Participants performed a 16-count choreographed dance sequence for 20 trials assisted by the expert, followed by one final, unassisted performance trial. Although end-state performance did not significantly differ between synchronous and non-synchronous learners, a significant decline in performance quality from imitation to independent replication was shown for synchronous learners. A non-significant positive trend in performance accuracy was shown for non-synchronous learners. For all participants, better imitative performance across training trials led to better end-state performance, but only for the accuracy (and not timing) of movement reproduction. Collectively, the results suggest that synchronous learners came to rely on a realtime mapping process between visual input from the expert and their own visual and proprioceptive intrinsic feedback, to the detriment of learning. Thus, the act of synchronising alone does not ensure an appropriate training context for advanced sequence learning. (shrink)

With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global researchers were confronted with major challenges. The German National Pandemic Cohort Network (NAPKON) was launched in fall 2020 to effectively leverage resources and bundle research activities in the fight against the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the setup phase of NAPKON as an example for multicenter studies in Germany, highlighting challenges and optimization potential in connecting 59 university and nonuniversity study sites. We examined the ethics application (...) process of 121 ethics submissions considering durations, annotations, and outcomes. Study site activation and recruitment processes were investigated and related to the incidence of SARS-CoV-2 infections. For all initial ethics applications, the median time to a positive ethics vote was less than two weeks and 30 of these study sites (65%) joined NAPKON within less than three weeks each. Electronic instead of postal ethics submission (9.5 days (Q1: 5.75, Q3: 17) vs. 14 days (Q1: 11, Q3: 26), p value = 0.01) and adoption of the primary ethics vote significantly accelerated the ethics application process. Each study center enrolled a median of 37 patients during the 14-month observation period, with large differences depending on the health sector. We found a positive correlation between recruitment performance and COVID-19 incidence as well as hospitalization incidence. Our analysis highlighted the challenges and opportunities of the federated system in Germany. Digital ethics application tools, adoption of a primary ethics vote and standardized formal requirements lead to harmonized and thus faster study initiation processes during a pandemic. (shrink)

Cook et al. reported a 97% scientific consensus on anthropogenic global warming (AGW), based on a study of 11,944 abstracts in peer-reviewed science journals. Powell claims that the Cook et al. methodology was flawed and that the true consensus is virtually unanimous at 99.99%. Powell’s method underestimates the level of disagreement because it relies on finding explicit rejection statements as well as the assumption that abstracts without a stated position endorse the consensus. Cook et al.’s survey of the papers’ authors (...) revealed that papers may express disagreement with AGW despite the absence of a rejection statement in the abstract. Surveys reveal a large gap between the public perception of the degree of scientific consensus on AGW and reality. We argue that it is the size of this gap, rather than the small difference between 97% and 99.99%, that matters in communicating the true state of scientific opinion to the public. (shrink)

We describe the design and evaluation of a sub-clinical digital assessment tool that integrates digital biomarkers of depression. Based on three standard cognitive tasks on which people with depression have been known to perform differently than a control group, we iteratively designed a digital assessment tool that could be deployed outside of laboratory contexts, in uncontrolled home environments on computer systems with widely varying system characteristics. We conducted two online studies, in which participants used the assessment tool in their own (...) homes, and completed subjective questionnaires including the Patient Health Questionnaire —a standard self-report tool for assessing depression in clinical contexts. In a first study, we demonstrate that each task can be used in isolation to significantly predict PHQ-9 scores. In a second study, we replicate these results and further demonstrate that when used in combination, behavioral metrics from the three tasks significantly predicted PHQ-9 scores, even when taking into account demographic factors known to influence depression such as age and gender. A multiple regression model explained 34.4% of variance in PHQ-9 scores with behavioral metrics from each task providing unique and significant contributions to the prediction. (shrink)

A cultural icon of the fin de siècle, the New Woman was not one figure, but several. In the guise of a bicycling, cigarette-smoking Amazon, the New Woman romped through the pages of Punch and popular fiction; as a neurasthenic victim of social oppression, she suffered in the pages of New Woman novels such as Sarah Grand's hugely successful The Heavenly Twins. The New Woman in Fiction and Fact marks a radically new departure in nineteenth-century scholarship to explore the (...) polyvocal nature of the late Victorian debates around gender, motherhood, class, race and imperialism which converged in the name of the New Woman. (shrink)

The short experimental film Shifting Perspectives stems from a collaborative research project initiated in 2019 in Sydney, Australia, during the 'Choreographic Hack Lab-a week-long laboratory co-presented by Critical Path and Sydney Festival in partnership with the Museum of Applied Arts and Sciences (MAAS), which asked artists and academics to rethink and respond to the idea of the Anthropocene (Pini & George, 2019). The film was later developed in 2020 during a Responsive Residency at Critical Path, Sydney, awarded to anthropologist and (...) choreographer Sarah Pini in collaboration with Jestin George, biotechnologist and visual artist, and Melissa Ramos, visual artist and filmmaker. This work aims to open a multivocal interdisciplinary dialogue across screendance, performance and synthetic biology. Inspired by a recent conversation between two leaders in the field of synthetic biology (Sarah Richardson and Tom Knight) and their divergent approaches to working with microbial life (Agapakis, 2019), the film invites to consider how collaborating with microorganisms can reshape our future in a more-than-human world. (shrink)

Following the tradition of feminist philosophers and scholars of science from the 1980s onward such as Evelyn Fox-Keller, Helen Longino, Anne Fausto-Sterling, and others who revealed how popular notions of masculinity and femininity infiltrated and shaped the content of scientific knowledge, Sarah S. Richardson's book Sex Itself: The Search for Male and Female in the Human Genome deserves a place on the shelf with this canonical literature. It addresses one of the most celebrated symbols of biological sex binary: (...) the X and Y chromosomes. The X and Y chromosomes, we learn, were not given the role of "sex chromosomes" upon their discovery in 1890 and 1905, respectively. Their transformation into the ultimate... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021) by Sarah RichardsonQuill KuklaQuill Kukla, review of Sarah Richardson's The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021)I had been eagerly anticipating the release of Sarah Richardson's meticulously researched The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021) for several years, and I was not disappointed. A leading feminist scholar of (...) the history and philosophy of science, Richardson traces the scientific history of the idea that pregnant people's bodies control the future health, character, and well-being of their offspring. She also explores how this science is translated into social messaging and shaped by social ideology. Richardson delves into the details of the methodology, motivations, results, and communication of the science of maternal influences. She reveals a history of shaky results, contested methods, and socially loaded messaging, unified by a sustained interest in framing maternal bodies as sites of risk and responsibility for birth outcomes.A central narrative of the book is that the perceived location and mechanism through which pregnant bodies control fetal development keeps shifting around; over time, scientists have located this maternal influence in the uterine environment, the cytoplasm, the methylation of DNA, maternal nutrition, and even in the emotions, thoughts, and imagination of the mother, among other locations.1 Each time a version of the maternal influence hypothesis re-emerges, targeting a different bodily location and mechanism, it comes along with similar social messaging: pregnant people are distinctively responsible for the 'quality' of their children; their bodies are distinctive sites of risk, in need of social management; and their influence can be understood and controlled independent of the context in which they live. Given how many times this scientific hypothesis and its accompanying social messaging has died and been reborn, it is hard not to conclude, with Richardson, that background ideology compels us to keep searching for new stories that take this same form. The idea that pregnant people's bodies are understood as decontextualized and heightened sites of risk and responsibility for birth outcomes, in need of systematic discipline (both self-discipline and social discipline) in order to ensure their production of proper offspring, is one that has been explored [End Page e-1] in quite a bit of depth within feminist theory and reproductive ethics over the last thirty years. To name just a few, Barbara Duden's Disembodying Women: Perspectives on Pregnancy and the Unborn (1993), Deborah Lupton's "Risk and the Ontology of Pregnant Embodiment" (1999), Lisa Mitchell's Baby's First Picture: Ultrasound and the Politics of Fetal Subjects (2001), and my own Mass Hysteria: Medicine, Culture, and Mothers' Bodies (2005) are all works firmly within this tradition. What is new about Richardson's book is not the development and exploration of this cultural narrative and imaginary, but rather her rigorous and skillful analysis of the science that has grown out of and undergirded it. Richardson is a masterful writer, who makes scientific details comprehensible and fascinating. Her historical and epistemological analyses of exactly what shaped the science at each stage, what each scientific iteration did and didn't manage to show, and how these different scientific movements were translated into public messaging, is sharp and compelling. Richardson shows us the inner workings of how scientific programs build momentum; how scientists make methodological decisions; and how results feed into ongoing research programs. From this book, we also develop a rich sense of just how much uncertainty is baked into the science of human development, and how both scientific and public excitement about a given research program are mostly independent of the success and security of the science that comes out of it. The book traces 150 years of the history of the science of maternal influences, culminating in the current focus on epigenetics—which, like various past maternal influence theories, has ignited our broader social imagination. Epigenetics, roughly, is the study of molecular changes outside our DNA that control how genes express themselves. Environmental stimuli (such as stress) can cause changes in methylation, and thereby influence the expression of the genome: "Epigenetic markers that help determine whether a... (shrink)

Le livre de Sarah Gutsche-Miller, issu d’une thèse soutenue en 2010, explore l’histoire et l’esthétique du ballet de music-hall dans les trois principaux établissements parisiens, les Folies-Bergère, le Casino de Paris et l’Olympia, entre 1871 et 1913. D’une grande qualité, il va assurément contribuer à combler des lacunes importantes dans l’histoire de la danse et dans celle des music-halls, plus largement dans l’histoire culturelle de Paris à la fin du xixe siècle. Les études sur le music-h...

BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. Most (...) physicians were male (66%) and of Southeast Asian descent (66%). All physicians explained the plan of care to the patients; most believed that their patient understood. However, many patients did not. Physicians rarely asked the patient for their opinion. In all those cases, the decision had been made previously by the doctors. No decisions were made with the patient. Patients sometimes disagreed. CONCLUSIONS: Shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict. PRACTICE IMPLICATIONS: Some hospitalized patients are interested in discussing treatment. Improving hospital communication can foster patient autonomy. (shrink)