Until recently, the medical community assumed that placebos required either concealment in randomized controlled trials or deception in clinical practice to elicit placebo effects. Henry Beecher emphasized this orthodoxy, when he stated that placebo pills only work "as long as it is not detected as a placebo by the subject or the observer" and therefore, patients "believe it [is a drug] and consequently the expected results occurs". The time was ripe for such ideas: Norman Vincent Peale's The Power of Positive (...) Thinking was already in its fourth year on the bestseller list when Beecher published his landmark paper. As time went on, the use of placebo pills became trapped in an... (shrink)

Reviewing works by James Alison, Alistair McFadyen, Andrew Sung Park, Ted Peters, and Solomon Schimmel, the author suggests that the status and function of the discourse/doctrine of sin highlight tensions between theology and ethics in ways that suggest the character, limits, and promise of religious ethics. This literature commends attention to sin-talk because it helps religious ethicists to render more adequately the dynamics of human agency, sociality, and culture and because it raises questions about the nature and task of (...) theology, faith, and morality. Yet these volumes also indicate that religious ethics should pay more attention to particular sins. (shrink)

Research has shown that it requires less time to process information that is part of an objective causal relation describing states of affairs in the world (She was out of breath because she was running), than information that is part of a subjective relation (She must have been in a hurry because she was running) expressing a claim or conclusion and a supporting argument. Representing subjectivity seems to require extra cognitive operations. In Mental Spaces Theory (MST; Fauconnier, Gilles. 1994. Mental (...) spaces: Aspects of meaning construction in natural language. Cambridge: MIT Press) the difference between these two relation types can be described in terms of an extra mental space in the discourse representation of subjective relations: representing the Subject of Consciousness (SoC). In processing terms, this might imply that the processing difference is not present if this SoC has already been established in the discourse. We tested this prediction in two eye tracking experiments. The results of Experiment 1 showed that signaling the subjectivity of the relation by introducing a subject of consciousness beforehand did not diminish the processing asymmetry compared to a neutral context. However, the relative complexity of subjective relations was diminished in the context of Free Indirect Speech (No! He was absolutely sure. There was no doubt about it. She was running so she was in hurry; Experiment 2). In terms of MST and the representation of subjectivity in general, this implies that not only creating a representation of a thinking subject, but also assigning a claim to this thinking subject requires extra processing effort. (shrink)

Within many animal taxa there is a trend for the species of larger body size to eat food of lower caloric value. For example, most large extant lizards are herbivorous. Reasonable arguments based on energetic considerations are often invoked to explain this trend, yet, while these factors set limits to feasible body size, they do not in themselves mathematically produce optimum body sizes. A simple optimization model is developed here which considers food search, capture, and eating rates and the metabolic (...) cost of these activities for animals of different sizes. The optimization criterion is defined as the net caloric gain a consumer accrues per day. This model does produce an optimum intermediate body size which increases with food quality - not the reverse. This discrepancy is accounted for, however, because the model also predicts that body size should be even more sensitive to increases in food abundance. In nature, many poor quality foods are also relatively abundant foods, hence the consumers eating them may maximize their daily energetic profit by evolving a relatively large body size. Optimum consumer body size also decreases with increases in consumer metabolic rate and prey speed. (shrink)

The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (shrink)

In Daubert v. Merrell Dow Pharmaceuticals, Inc., the U.S. Supreme Court made its first major pronouncement on the evaluation of scientific evidence, calling on judges to act as gatekeepers for scientific knowledge and validity, despite lack of scientific training among judges. Daubert offers the science studies community a case study for examining how judges engage in boundary-work and construct scientific validity. In constructing scientific validity under Daubert, judges must evaluate the scientific method behind a particular scientific claim, and will look (...) to the parties' experts and the relevant scientific community for assistance. To combat the oft-cited problem of the battle of the experts, judges may be tempted to obtain assistance from court-appointed neutral experts, an inquisitorial system in the civil law tradition of many European countries. The judicial evaluation of scientific evidence, the resulting construction of scientific validity, and the push for a greater use of court-appointed experts reveal judges' desire to segregate "objective" scientific facts from aspects of the legal process that are infused with adversaries' values. Yet the scientific and judicial construction of validity mixes empirical results and research methods with the personal, political, and institutional values of judges and scientists. (shrink)

Richard M Weaver, a thinker and writer celebrated for his unsparing diagnoses and realistic remedies for the ills of our age, is known largely through a few of his works that remain in print. This new collection of Weaver's shorter writings, assembled by Ted J Smith III, Weaver's leading biographer, presents many long-out-of-print and never-before-published works that give new range and depth to Weaver's sweeping thought. Included are eleven previously unpublished essays and speeches that were left in near-final form at (...) the time of Weaver's death in 1963. In all, there are some one hundred and twenty-six essays, speeches, book reviews, and editorials. (shrink)

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

Providing a concise definition of hope is challenging. Psychologists alone have proposed 26 theories of hope and 54 definitions thereof. The difficulty of finding a universal definition of hope was summed up by the philosopher Joseph Godfrey who admitted, "I'd rather have hope than be able to define it". Part of the problem is that the concept is the object of scrutiny across many different scholarly disciplines, each of which have their own, sometimes divergent, methodologies and interests in the concept. (...) Notwithstanding these idiosyncrasies, many of the respective disciplines, if not all, have the potential to improve the understanding of... (shrink)

We define our conscious experience by constructing narratives about ourselves and the people with whom we interact. Narrative pervades our lives--conscious experience is not merely linked to the number and variety of personal stories we construct with each other within a cultural frame, but is subsumed by them. The claim, however, that narrative constructions are essential to conscious experience is not useful or informative unless we can also begin to provide a distinct, organized, and empirically consistent explanation for narrative in (...) relation to consciousness. Understanding the role of narrative in determining individual and collective consciousness has been elusive from within traditional academic frameworks. This volume argues that addressing so broad and complex a problem requires an examination from outside our insular disciplinary framework. Such an open examination would be informed by the inquiries and approaches of multiple disciplines. Recognition of the different approaches to examining personal stories will allow for the coordination of how narrative seems, with what mental labor it does, and how it is realized. Only by overcoming the boundaries erected by multiple theoretical and discursive traditions can we begin to comprehend the nature and function of narrative in consciousness. Narrative and Consciousness brings together essays by exceptional scholars and scientists in the disciplines of literary theory, psychology, and neuroscience to examine how stories are constructed, how stories structure lived experience, and how stories are rooted in material reality. The specific topics addressed include narrative in the development of conscious awareness; autobiographical narrative, fiction and the construction of self; trauma and narrative disruptions; narrative, memory and identity; and the physiological and neural substrate of narrative. It is the editors' hope that the multidisciplinary nature of this collection will challenge the reader to move beyond disciplinary confines and toward a coherent interdisciplinary dialogue. (shrink)

Originally published in 1948, at the height of post–World War II optimism and confidence in collective security, _Ideas Have Consequences_ uses “words hard as cannonballs” to present an unsparing diagnosis of the ills of the modern age. Widely read and debated at the time of its first publication,the book is now seen asone of the foundational texts of the modern conservative movement. In its pages, Richard M. Weaver argues that the decline of Western civilization resulted from the rising acceptance of (...) relativism over absolute reality. In spite of increased knowledge, this retreat from the realist intellectual tradition has weakened the Western capacity to reason, with catastrophic consequences for social order and individual rights. But Weaver also offers a realistic remedy. These difficulties are the product not of necessity, but of intelligent choice. And, today, as decades ago, the remedy lies in the renewed acceptance of absolute reality and the recognition that ideas—like actions—have consequences. This expanded edition of the classic work contains a foreword by _New Criterion _editor Roger Kimball that offers insight into the rich intellectual and historical contexts of Weaver and his work and an afterword by Ted J. Smith III that relates the remarkable story of the book’s writing and publication. (shrink)

At the onset of the COVID-19 pandemic in the United States, stay-at-home orders disrupted normal research operations. Principal investigators (PIs) had to make decisions about conducting and staffing essential research under unprecedented, rapidly changing conditions. These decisions also had to be made amid other substantial work and life stressors, like pressures to be productive and staying healthy. Using survey methods, we asked PIs funded by the National Institutes of Health and the National Science Foundation (N = 930) to rate how (...) they prioritized different considerations, such as personal risks, risks to research personnel, and career consequences, when making decisions. They also reported how difficult they found these choices and associated symptoms of stress. Using a checklist, PIs indicated those factors in their research environments that made their decisions easier (i.e., facilitators) or more difficult (i.e., barriers) to make. Finally, PIs also indicated how satisfied they were with their decisions and management of research during the disruption. Descriptive statistics summarize PIs’ responses and inferential tests explore whether responses varied by academic rank or gender. PIs overall reported prioritizing the well-being and perspectives of research personnel, and they perceived more facilitators than barriers. Early-career faculty, however, rated concerns about their careers and productivity as higher priorities compared to their senior counterparts. Early-career faculty also perceived greater difficulty and stress, more barriers, fewer facilitators, and had less satisfaction with their decisions. Women rated several interpersonal concerns about their research personnel more highly than men and reported greater stress. The experience and perceptions of researchers during the COVID-19 pandemic can inform policies and practices when planning for future crises and recovering from the pandemic. (shrink)

Evidence that placebo acupuncture is an effective treatment for chronic pain presents a puzzle: how do placebo needles appearing to patients to penetrate the body, but instead sitting on the skin’s surface in the manner of a tactile stimulus, evoke a healing response? Previous accounts of ritual touch healing in which patients often described enhanced touch sensations suggest an embodied healing mechanism. In this qualitative study, we asked a subset of patients in a singleblind randomized trial in irritable bowel syndrome (...) to describe their treatment experiences while undergoing placebo treament. Analysis focused on patients’ unprompted descriptions of any enhanced touch sensations and any significance patients assigned to the sensations. We found in 5/6 cases, patients associated sensations including “warmth” and “tingling” with treatment efficacy. The conclusion offers a “neurophenomenological” account of the placebo effect by considering dynamic effects of attentional filtering on early sensory cortices, possibly underlying the phenomenology of placebo acupuncture. (shrink)

This article aims to further test the cognitive claims of the so-called subjectivity account of causal events and their linguistic markers, causal connectives. We took Mandarin Chinese, a language that is typologically completely different from the usual western languages, as a case to provide evidence for this subjectivity account. Complementary to the commonly used corpora analyses, we employed crowdsourcing to tap native speakers’ intuitions about causal coherence, focusing on four result connectives kějiàn ‘therefore’, suǒyǐ ‘so’, yīncǐ ‘so/for this reason’ and (...) yúshì ‘thereupon/as a result’. The analysis shows systematic differences regarding the use of connectives in relations that differ in terms of subjectivity, demonstrating that native speakers make use of subjectivity to encode and decode different types of causal relations in discourse. Moreover, our study evidences that a comprehensive model of subjectivity should include the epistemic dimension of certainty about the subjectivity scale that might be indicated by other linguistic elements. In-depth analyses of the test items revealed that the presence/absence of modality words in the result segments are related to different preferential patterns for the connectives. There is a trade-off between the epistemic dimension of certainty and the expression of subjectivity in the four connectives involved. (shrink)

We know facts, but we also know how to do things. To know a fact is to know that a proposition is true. But does knowing how to ride a bike amount to knowledge of propositions? This is a challenging question and one that deeply divides the contemporary landscape. A Critical Introduction to Knowledge-How introduces, outlines, and critically evaluates various contemporary debates surrounding the nature of knowledge-how. Carter and Poston show that situating the debate over the nature of knowledge-how in (...) other epistemological debates provides new ways to make progress. In particular, Carter and Poston explore the question of what knowledge-how involves, and how it might come apart from propositional knowledge, by engaging with key epistemological topics including epistemic luck, knowledge of language, epistemic value, virtue epistemology and social epistemology. New frontiers for research on knowledge-how are also explored relating to the internalism - externalism debate as well as embodied and extended knowledge. A Critical Introduction to Knowledge-How provides an accessible introduction to the main arguments in this important and thriving debate suited for undergraduates and postgraduates in philosophy and related areas. A strength of the book is its methodology which places a premium on placing the debates over knowledge-how in a broader conversation over the nature of knowledge. This book also offers an opinionated discussion of various lines of argument which will be of interest to professional philosophers as well. (shrink)

Connectives and cue phrases are the most prototypical linguistic elements that signal coherence relations, but by limiting our attention to connectives, we are likely missing out on important other cues readers and listeners use when establishing coherence relations. However, defining the role of other types of linguistic elements in the signaling of coherence relations is not straightforward, and it is also not obvious why and how non-connective elements function as signals for coherence relations. In this paper, we aim to develop (...) a systematic way of categorizing segment-internal elements as signals of coherence relations on the basis of a literature review and evidence from parallel corpora. We propose a three-way distinction betweendivision of labor, agreement, andgeneral collocationto categorize the different ways in which elements inside discourse segments interact with connectives in the marking of coherence relations. In each type of interaction, segment-internal elements can function as signals for coherence relations, but the mechanism behind it is slightly different for each type. (shrink)

This book posits an interconnection between the ways in which contemporary television serials cue cognitive operations, solicit emotional responses, and elicit aesthetic appreciation. The chapters explore a number of questions including: How do the particularities of form and style in contemporary serial television engage us cognitively, emotionally, and aesthetically? How do they foster cognitive and emotional effects such as feeling suspense, anticipation, surprise, satisfaction, and disappointment? Why and how do we value some serials while disliking others? What is it about (...) the particularities of serial television form and style, in conjunction with our common cognitive, emotional, and aesthetic capacities, that accounts for serial television's cognitive, socio-political, and aesthetic value, and its current ubiquity in popular culture? This book will appeal to postgraduates and scholars working in television studies as well as film studies, cognitive media theory, media psychology, and the philosophy of art. (shrink)

In meeting the challenges of fashioning a new health care system, South Africa stands poised to contribute to a better future for its own citizens and the subcontinent.

In meeting the challenges of fashioning a new health care system, South Africa stands poised to contribute to a better future for its own citizens and the subcontinent.

A quarter of a century ago, a group of scientists and conservationists introduced ‘biodiversity’ as a media buzzword with the explicit intent of galvanizing public and political support for environ...

In this paper, we extend Michel Foucault’s final works on the ‘care of the self’ to an empirical examination of research practice in community-based research (CBR). We use Foucault’s ‘morality of behaviors’ to analyze interview data from a national sample of Canadian CBR practitioners working with communities affected by HIV. Despite claims in the literature that ethics review is overly burdensome for non-traditional forms of research, our findings suggest that many researchers using CBR have an ambivalent but ultimately productive relationship (...) with institutional research ethics review requirements. They understand and use prescribed codes, but adapt them in practice to account for the needs of participating community members, members of their research teams and the larger communities with whom they work. Complying with ethics protocols was seen as only the beginning, a minimum standard; our research suggests that the real ethical work happens in the field, where CBR practitioners encounter community members in diverse public roles and must forge ethical consensus across communities. CBR represents an ethical terrain in which practitioners challenge themselves to work differently, and as a result they care for themselves—and others—in ways that often resist the propensity for domination through public health research.‘…there are different ways to “conduct oneself” morally, different ways for the acting individual to operate, not just as an agent, but as an ethical subject of action.’ (Foucault, 1985: 26). (shrink)