The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in (...) other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. (shrink)

Crespi & Badcock (C&B) provide a novel hypothesis outlining a role for imprinted genes in mediating brain functions underlying social behaviours. The basic premise is that maternally expressed genes are predicted to promote hypermentalistic behaviours, and paternally expressed genes hypomentalistic behaviours. The authors provide a detailed overview of data supporting their ideas, but as we discuss, caution should be applied in interpreting these data.

In fall 1844, a party of colonists led by William Keil arrived at what was to become their new home, a gentle slope rising from the bank of the North River in Shelby County, Missouri, about forty-five miles west of Hannibal. One year later the utopian Bethel Colony had been laid out, houses were being added as fast as they could be built, and construction of a steam-powered gristmill was under way.The Bethel colonists were Bible Communists who found the (...) inspiration for their communal life in the book of Acts, which records that in the Early Church "as many as were possessors of lands or houses sold them and brought the proceeds and laid them at the apostles' feet; and distribution was made to each as any had need"... (shrink)

This essay results from a common interest in the history of emotions shared by an academic with appointments in philosophy and psychiatry (Charland) and a literary historian (White). Where our interests converge is in the early modern concept of 'the passions,' as explanatory of what we now call mental illness. The task we have set ourselves is to see how this might: (a) be exemplified in a 'case study' of the dramatic revelation of Leontes's jealousy in the first half (...) of William Shakespeare's The Winter's Tale, and his 'cure' which takes sixteen years. Both events have troubled literary critics as implausible, lacking in realistic motivation, and clumsy as narrative devices, but can be explained in terms of theories of the passions ; and (b) open up a greater, modern understanding of irrational, pathological states, their onset and termination, by using as an explanatory model the early modern understanding of passions as revived and refined in the nineteenth century by Théodule Ribot. Janus-like, this chapter faces into the past and the future (our present) via a play written in 1610 that is still performed to receptive audiences today. We hope to show that the theory can illuminate a playtext, and that the play can revivify the theory, and to contend that historical analysis can shed light on modern clinical problems. The particular historical distinction which lies at the heart of our approach derives from early modern terminology offered by Thomas Wright in his book, The Passions of the Minde in Generall (first published in 1601; corrected, enlarged and augmented in 1604), and presented in more modern fashion in the nineteenth century by Théodule Ribot, in his La Psycholgie des sentiments * We dedicate this essay to Philippa Maddern, whose inspiration has generated so much inter-disciplinary research in the history of emotions and has brought so many like-minded scholars into fertile contact—in our cases, linking Western Ontario and Western Australia. (shrink)

Eight essays in honor of political philosopher Fred Dallmays explore issues of subjectivity and inter-subjectivity, elucidating the implications of postmodernism and the phenomenological tradition for contemporary ethics and political theory. The contributors include Dallmays, William E. Connolly, and Jean Bethke Elshtain. Annotation copyrighted by Book News, Inc., Portland, OR.

I. INTRODUCTION: THE PROBLEMAkrasia (or, weakness of the will), often defined as “the moral state of agents who act against their better judgment”—a definition first given by Aristotle in the Nicomachean Ethics, depicts one of the most human of predicaments.Risto Sarrinen, Weakness of the Will in Medieval Thought: From Augustine to Buridan (New York: E. J. Brill, 1994), p. 1. Similar definitions can be found in, e.g., Aristotle, Nicomachean Ethics VII, 1045b10–15; Donald Davidson, “How is Weakness of the Will Possible?” (...) in Moral Concepts, ed. J. Feinberg (Oxford: Oxford University Press, 1970) p. 93; William Charlton, Weakness of Will (Oxford: Basil Blackwell, 1988), p. 1. We know what we ought to do, and we try. But, for one reason or other, we sometimes choose to act contrary to our better judgment.Being influenced by Socratic reasoning, some philosophers have argued that, in principle, one cannot freely and intentionally choose to act against one’s better judgment, if (1) one rationally judges what is best for oneself, (2) one prefers to act according to one’s rational judgment, and (3) one is free to make one’s own choice. See, e.g., Davidson, “How is Weakness,” pp. 93–113; and R. M. Hare, Freedom and Reason (Oxford: Oxford University Press, 1963), pp. 78–79. Despite the logical difficulty, many believe that weakness of the will is a fact. (shrink)

Contents: Stephen White: Opuscula and Opera in the Catalogue of Theophrastus' Works Han Baltussen: Theophrastean Echoes? The De Sensibus in the Platonic and Aristotelian Tradition Pamela M. Huby: Arabic Evidence about Theophrastus' De Sensibus Todd Ganson: A Puzzle Concerning the Aristotelian Notion of a Medium of Sense-Perception Istvan M. Bodnar: Theophrastus' De igne: Orthodoxy, Reform and Readjustment in the Doctrine of Elements Georg Wohrle: Ps-Aristoteles De Coloribus -aA Theophrastean Opusculum? David Sider: On On Signs - R.A.H. King: Nutrition and (...) Fatigue Amneris Roselli: Greek Medical Theories of Fatigue Sabine Vogt: Theophrast, De Vertigine Armelle Debru: La sueur des corps: le De sudore de Theophraste face a la tradition medicale John Dillon: Theophrastus' Critique of the Old Academy in the Metaphysics H. Takahashi: Syriac Fragments of Theophrastean Meteorology and Mineralogy Index Contributors and Editors. (Franz Steiner 2002). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:56~ BOOK REVIEWS of the problem of free will and God's omnipotence- not a problem peculiar to evolution, to be sure, but one that nonetheless arises within the context of the emergence of living things, especially man, on earth and how that process relates to divine intervention; and Francisco J. Ayola starts everything off with a biologist's hardline defense of evolutionary theory. It may be asking too much to (...) expect original thinking on a topic that has been subjected to so much investigation and controversy over the past century. But it is reasonable to expect, in a book such as Evolution and Crea.tion, ways of approaching the topic which spark the reader's interest and furnish him with a competent and sometimes brilliant overview to it. The book fulfills this.expectation. I think it would be particularly useful as a source book and catalyst in graduate level seminars. University of San Francisco San Francisco, California RAYMOND DENNEHY God and Nature: Historical Essays on the Encounter Between Chris·tianity and Science. Edited by DAVID C. LINDBERG and RONALD L. NUMBERS. Berkeley and Los Angeles: University of California Press, 1986. Pp. xi + 516. $50.00 (cloth), $17.95 (paper). The editors tell us at the outset of this important volume that it is the outcome of two convictions that they share: (1) "that the interaction of science and Christianity has been of profound imp@tance in the shaping of Western civilization" and (2) that the results of extensive specialist work by historians of science and religion in recent decades belie widelyheld stereotypes and ought to be made generally available. The most familiar of the stereotypes is of course the Draper-White 66 warfare" thesis, the origins and continuing influence of which the editors trace in the first part of their helpful introduction. The eighteen contributors to the volume find plenty of controversies-sometimes rising to the level of conflicts-among individuals, among theological schools of thought, among scientific schools of thought, and among social groups, but at no period do they find anything that could be called an overall conflict of science and theology. They find many instances of smallerand larger-scale influences of theological developments on scientific ones, of scientific developments on theological ones, and of social developments on both. But no grand overall interpretative scheme appears in this respect either. Stanley L. Jaki's thesis, for instance, that modern science BOOK REVIEWS 563 was born of Christian theology and has prospered just insofar as it has remained faithful to its parentage, fares no better than the warfare thesis. No sweeping unitary interpretation can be expected to emerge, Lindberg and Numbers sugg.est, from historical work that " shows the respect for the particularity, individuality and value of each people and age that the canons of historical scholarship demand" (p. 10; i:r).ternal quotation from Donald Kagan). Accordingly, each essay is devoted to a particular period-some longer than others, to be sure. Nearly all are by professional historians. One author is primarily a philosopher, and several have at least secondary philosophical interests ; none are primarily scientists or theologians. Nearly all were trained and teach at secular universities, though a few have formal training from religious institutions as well. The coverage by periods is comprehensive, from Lindberg on " Science and the Early Church" to Numbers on "The Creationists" and Keith Yandell (the philosopher) on "Protestant Theology and Natural Science in the Twentieth Century." The last title calls attention, however, to one oddity in the coverage. Whereas in the essays on the sixteenth through eighteenth centuries both Protestant and Catholic figures and movements are treated, in those on the nineteenth and twentieth centuries attention is focused almost exclusively on the Protestant scene. Clearly, eighteen substantial essays cannot be analyzed in detail in a review of reasonable length. I shall indicate the main topics and theses of each with a few comments where these can be made briefly. First, however, I should stress that the book is treasure-trove of information and ideas. All the essays are good; several are superb. Each should be highly instructive for readers who are not specialists in the topic and period it deals with... (shrink)

In lieu of an abstract, here is a brief excerpt of the content: Choice and Virtue in the Nicomachean Ethics ALFRED R. MELE COM~rNTATORS ON THr Nicomachean Ethics (NE) have long been laboring under the influence of a serious misunderstanding of one of the key terms in Aristotle's moral philosophy and theory of action. This term is prohairesis (choice), the importance of which is indicated by Aristotle's assertions that choice is the proximate efficient cause of action (NE 6. 1139a31--32) and (...) that in which "the essential elements of virtue and character" lie (NE 8. x163a2'~-23). The accepted view is that Aristotle employs two importantly different notions of choice in the NE, one on which the term refers exclusively to means or things which are pros (toward, related to)' ends and another on which it does not have this reference? This "two notion" interpretation is motivated by the following three considerations: i. Aristotle's good or virtuous agent is said (NE 2. 11o5a28-33, cf. NE 6. 1144ax8-2o ) to choose actions for their own sakes; but, according to the This paper is derived in part from a chapter of my doctoral dissertation, which was submitted to the University of Michigan in January of 1979. 1 would like to express my gratitttde to the chairman of my dissertation committee, Nicholas P. White, for his comments and criticisms on the relevant sections during the preparation of my dissertation and to theJHP's anonymous reviewers for their helpful criticisms and queries. ' It has often been pointed out that things which are pros an end are not necessarily "means," in the ordinary sense of the word. E.g., constituents of an end are pros the end, but they are not means to it. See, e.g., Nicomachean Ethics, Book 6, trans. Leonard H. G. Greenwood (Cambridge: Cambridge University Press, 19o9), pp. 46-47, 53ff.: and John M. Cooper, Reason and Human Good in Aristotle (Cambridge: Harvard University Press, 1975), pp. 1o-22. ' Among the many proponents of this "two notion" interpretation are William D. Ross and Donald J. Allan. See Ross, Aristotle, 5th ed. (London: Methuen, t953), p. 2oo. See Allan, The Philosophy of Aristotle, 2nd ed. (London: Oxford University Press, 197o), p. 132; idem, "Aristotle 's Account of the Origin of Moral Principles," Xlth International Congress of Philosophy 12 (1953):124; idem, "The Practical Syllogism," in Autour d'Aristote, Studies for A. Mansion (Louvain : Publications Universitaires, 1955). Richard Sorabji, in "Aristotle on the Role of Intellect in Virtue" (Proceedings of the Aristotelian Society 74 l t973-74]:t t6), says that he has noticed sixteen commentators who take this view. [4o5] 406 HISTORY OF PHILOSOPHY so-called formal account of prohairesis (NE 3. 2-3, 6. 2), the object of choice is what has been decided upon by deliberation (bouleuais), and what is decided upon by deliberation is a "means" to an end. 2. Aristotle says that choice is "closely bound up with virtue" and "discriminates characters better than actions do" (1 1t lb5; cf. t i lob3t, 1117a 5, 1163a22, 1t64bi); but commentators argue that these claims about choice are false unless choice is "of ends." 3. Though Aristotle holds that the impetuous akrat~s (incontinent agent) does not deliberate (e.g., t 152a 18-19), he says that the akrat~s' choice is good (1152ax5--17; cf. l l51a5-- 7, 29--32); and this appears to contradict his position in Book 3 that the object of choice is what is decided upon by deliberation, s In this paper I shall show that only one (philosophically significant) notion ofprohairesis is employed in the NE, namely, the notion developed in the "formal account" of deliberation and choice (3- 2-3, 6. 2), according to which choice is specifically of things which are pros ends. This point has several interesting applications. For example, it makes it easier to find in Aristotle (as I shall briefly explain) a comprehensive theory of practical reasoning or inference rather than several unconnected accounts of what practical inference is like in different types of cases; and it is helpful in clarifying what is involved in the evaluation of character on Aristotle's view (see Sec. ~). However, though I do think that the main point to be made... (shrink)

During the past few decades a growing interest in what is often called the ‘Kyoto School’ of philosophy has evidenced itself here and there in the West, especially in discussions of comparative religious thought and in the pages of journals which are sensitive, in the post-colonial world, to the value of giving attention to contemporary thought that originates outside the Anglo-American and continental contexts. What has made the so-called Kyoto School especially interesting is the fact that those thinkers identified with (...) it obviously possess a wide acquaintance with Western thought but also have a programme of clarifying points at which they, as Japanese philosophers, find Western philosophy either in sum or in its parts inadequate or objectionable. Moreover, inasmuch as the philosophers of the Kyoto School have deliberately reached back into the Mahayana Buddhist component in Japanese civilization in order to find terms, perspectives, and even foundations for their own analyses and constructions, Western students of comparative religion and comparative thought have in the study of this school a unique aperture for observing how a group of thinkers, while sharing modernity and its problems with us, reates both of these to a religious tradition which is in many ways strikingly different from that of the West. (shrink)

Despite the fact that psychedelics were proscribed from medical research half a century ago, recent, early-phase trials on psychedelics have suggested that they bring novel benefits to patients in the treatment of several mental and substance use disorders. When beneficial, the psychedelic experience is characterized by features unlike those of other psychiatric and medical treatments. These include senses of losing self-importance, ineffable knowledge, feelings of unity and connection with others and encountering ‘deep’ reality or God. In addition to symptom relief, (...) psychedelic experiences often lead to significant changes in a patient’s personality and worldview. Focusing on the case of psilocybin, we argue that the peculiar features of psychedelics pose certain novel risks, which warrant an enhanced informed consent process–one that is more comprehensive than what may be typical for other psychiatric medications. We highlight key issues that should be focused on during the consent process and suggest discussion prompts for enhanced consent in psychedelic psychiatry. Finally, we respond to potential objections before concluding with a discussion of ethical considerations that will arise as psychedelics proceed from highly controlled research environments into mainstream clinical psychiatry. (shrink)

William Uttal is concerned that in an effort to prove itself a hard science, psychology may have thrown away one of its most important methodological tools—a critical analysis of the fundamental assumptions that underlie day-to-day empirical research. In this book Uttal addresses the question of localization: whether psychological processes can be defined and isolated in a way that permits them to be associated with particular brain regions. New, noninvasive imaging technologies allow us to observe the brain while it is (...) actively engaged in mental activities. Uttal cautions, however, that the excitement of these new research tools can lead to a neuroreductionist wild goose chase. With more and more cognitive neuroscientific data forthcoming, it becomes critical to question their limitations as well as their potential. Uttal reviews the history of localization theory, presents the difficulties of defining cognitive processes, and examines the conceptual and technical difficulties that should make us cautious about falling victim to what may be a "neo-phrenological" fad. (shrink)

Why would a country strongly influenced by Buddhism's reverence for life allow legalized, widely used abortion? Equally puzzling to many Westerners is the Japanese practice of mizuko rites, in which the parents of aborted fetuses pray for the well-being of these rejected "lives." In this provocative investigation, William LaFleur examines abortion as a window on the culture and ethics of Japan. At the same time he contributes to the Western debate on abortion, exploring how the Japanese resolve their conflicting (...) emotions privately and avoid the pro-life/pro-choice politics that sharply divide Americans on the issue. (shrink)

Skepticism about ethical expertise has grown common, raising concerns that bioethicists’ roles are inappropriate or depend on something other than expertise in ethics. While these roles may depend on skills other than those of expertise, overlooking the role of expertise in ethics distorts our conception of moral advising. This paper argues that motivations to reject ethical expertise often stem from concerns about elitism: either an intellectualist elitism, where some privileged elite have supposedly special access in virtue of expertise in moral (...) theory; or an authoritarian elitism, where our reliance on experts in ethics risks violation of autonomy and democracy. The paper sketches an anti-elitist conception of ethics expertise in bioethics as continuous with an anti-elitist conception of ethics expertise in common moral practice, undercutting the intellectualism, and then uses this anti-elitist conception to reject arguments that ethical expertise violates autonomy or democracy. An anti-elitist picture of ethical expertise both renders it consistent with our general moral practice and allows us to resist skeptical concerns. (shrink)

In a recent essay review of William R. Newman, Atoms and Alchemy (2006), Ursula Klein defends her position that philosophically informed corpuscularian theories of matter contributed little to the growing knowledge of "reversible reactions" and robust chemical species in the early modern period. Newman responds here by providing further evidence that an experimental, scholastic tradition of alchemy extending well into the Middle Ages had already argued extensively for the persistence of ingredients during processes of "mixture" (e.g. chemical reactions), and (...) that this corpuscular alchemical tradition bore important fruit in the work of early modern chymists such as Daniel Sennert and Robert Boyle. (shrink)

Sections include: experiments and generalised causal inference; statistical conclusion validity and internal validity; construct validity and external validity; quasi-experimental designs that either lack a control group or lack pretest observations on the outcome; quasi-experimental designs that use both control groups and pretests; quasi-experiments: interrupted time-series designs; regresssion discontinuity designs; randomised experiments: rationale, designs, and conditions conducive to doing them; practical problems 1: ethics, participation recruitment and random assignment; practical problems 2: treatment implementation and attrition; generalised causal inference: a grounded theory; (...) generalised causal inference: methods for single studies; generalised causal inference: methods for multiple studies; a critical assessment of our assumptions. (shrink)

It no longer is true in a metaphorical sense only that a person can have a change of heart. We might grant this much — allow that a person may have one heart at one time and have another heart at still another time — and also resist the idea that a person can have a change of mind in anything other than a qualitative sense. In the discussion that follows, this standard view of the matter is called into question. (...) If the argument presented here is sound, it can happen both that one person has numerically different minds at different times and that different people have the same mind at different times. These possibilities, as I take them to be, call for reassessment of some well entrenched assumptions concerning personal identity and responsibility. In particular, they suggest that it may not be true that person A bears responsibility for making decisions person B previously made only on the condition that A is the same person as B. (shrink)

Several prominent writers including Norman Daniels, James Sabin, Amy Gutmann, Dennis Thompson and Leonard Fleck advance a view of legitimacy according to which, roughly, policies are legitimate if and only if they result from democratic deliberation, which employs only public reasons that are publicised to stakeholders. Yet, the process described by this view contrasts with the actual processes involved in creating the Affordable Care Act and in attempting to pass the Health Securities Act. Since the ACA seems to be legitimate, (...) as the HSA would have been had it passed, there seem to be counterexamples to this view. In this essay, I clarify the concept of legitimacy as employed in bioethics discourse. I then use that clarification to develop these examples into a criticism of the orthodox view–that it implies that legitimacy requires counterintuitively large sacrifices of justice in cases where important advancement of healthcare rights depends on violations of publicity. Finally, I reply to three responses to this challenge: that some revision to the orthodox view salvages its core commitments, that its views of publicity and substantive considerations do not have the implications that I claim and that arguments for it are strong enough to support even counterintuitive results. My arguments suggest a greater role for substantive considerations than the orthodox view allows. (shrink)

This essay argues that Japan's resistance to the practice of transplanting organs from persons deemed “brain dead” may not be the result, as some claim, of that society's religions being not yet sufficiently expressive of love and altruism. The violence to the body necessary for the excision of transplantable organs seems to have been made acceptable to American Christians at a unique historical “window of opportunity” for acceptance of that new form of medical technology. Traditional reserve about corpse mutilation had (...) weakened and, especially as presented by the theologian Joseph Fletcher, organ donation was touted as both expressive of agape and a way of “updating” Christianity via the ethics of Utilitarianism. Many Japanese, largely Buddhist and Confucian in their orientation, view these changed valorizations as neither necessary nor patently more ethical than those of their own traditions. (shrink)