Rules of thumb are simple instructions, used to guide actions toward a specific result, without need of advanced knowledge. Knowing adequate rules of thumb is a common form of technological knowledge. It differs both from science-based and intuitive (or tacit) technological knowledge, although it may have its origin in experience, scientific knowledge, trial and error, or a combination thereof. One of the major advantages of rules of thumb is the ease with which they can be learned. One of (...) their major disadvantages is that they cannot easily be adjusted to new situations or conditions. (shrink)

Objective The objective of this article is to provide an ethical analysis of a high-risk, advanced treatment case where the patient received transcatheter aortic valve insertion, for aortic valve stenosis. Particular emphasis will be placed upon the significance of evidence and the implications for priority setting. Method One paradigmatic case involving a TAVI patient from a large university hospital in Norway is described and analysed. The method used was ethical case analysis modified after Kymlicka by Miljeteig et al. (...) Perioperative mortality risk was estimated using the Euroscore risk-logarithm and the Society of Thoracic Surgeons’ risk model, STS. These predict the risk of operative mortality and morbidity associated with adult cardiac surgery. GRADE, the Grading of Recommendations Assessment, Development and Evaluation, was used to evaluate the evidence. Results In the case analysis, we found that it would be ethically justifiable not to recommend TAVI treatment for this patient. Although the patient had a severe condition in need of treatment, the expected improvement was marginal, the quality of evidence was low and the opportunity costs for other patients and society were higher than usually deemed appropriate. Conclusions Decision-making in the absence of high quality evidence from randomized trials is a complex process involving difficult ethical judgments. Novel high-risk devices often enter the European market with limited clinical evidence. Transparency and improved clinical evaluation are required so patient safety is not jeopardized. We argue that implementation of high risk, high cost interventions should be better regulated at a national level. Background All clinical decisions imply priority setting and therefore indirectly affect other patients and other patient groups. The use of expensive, innovative health technologies has an affect on individual patients as well as on other patient groups competing for the same resources. (shrink)

The studies of mind and language have traditionally been linked to one another. Indeed, theories of reference have over time brought more and more mind into meaning. Here I argue that the links must be made far stronger still if we are to understand either. I offer some criticism of the causal-functionalist theories of reference on this ground, and present some ideas for improvements. The upshot will be that intentionality is largely internal and very real indeed, that it provides a (...) genuine distinction between systems that have it and ones that do not, and that it hinges on internal complexities of a specifiable sort, ones that are tied to the detection of error. What is meaning, what is it good for, and what is a naturalist account of how it works? In this paper. I will argue that first two of these questions should be answered primarily in terms of processes inside the mind/brain, contrary to most recent thinking on this. In the sequel paper, I will argue that a key aspect of this is the physical body of the meaning agent, and propose a way in which this might work and how an external notion of reference can be recaptured from internal processes. (shrink)

The purpose of the present thesis is to apply philosophical methods to the ongoing debate of the precautionary principle, in order to illuminate this debate. The thesis consists of an Introduction and five papers. Paper I con-cerns an objection to the method of conceptual analysis, the Charge from Psychology. After a brief characterisation of conceptual analysis, I argue that the Charge from Psychology is misdirected. In Paper II, the method of conceptual analysis is applied to the concept of (...) precaution which is ana-lysed in terms of precautionary actions. The purpose is explicatory. A definition involving three necessary and jointly sufficient conditions is proposed, and the implications of this analysis for the debate on the pre-cautionary principle are discussed. Paper III attempts to provide an ana-lytical apparatus which may be used for finding improved formulations of the precautionary principle. The approach is lexicographical. Several exist-ing and possible formulations of the precautionary principle are examined, and four common elements and a common structure of the precautionary principle are identified. It is suggested that the analytical apparatus pre-sented can be used in negotiations of the precautionary principle. Paper IV questions the soundness of some arguments against the precautionary prin-ciple. Five common arguments are discussed and rejected. In Paper V, two of these arguments are further discussed. I argue that an attempt at rejec-tion of the precautionary principle delivered by John Harris and Søren Holm is unwarranted, because their arguments against it are based on in-terpretations of the precautionary principle that ignore context. Paper VI deals with the idea of de minimis risk. After a discussion of the distinction between disregarding a risk and accepting it, I examine one way of deter-mining how small a risk ought to be in order to be disregarded, namely the use of natural risk levels as benchmarks. I argue that this approach fails, even if the distinction between what is natural and what is not natural can be upheld. (shrink)

Introduction: The concept of ” work ability” is central for many sciences, especially for those related to working life and to rehabilitation. It is one of the important concepts in legislation regulating sickness insurance. How the concept is defined therefore has important normative implications. The concept is, however, often not sufficiently well defined. Aim and Method: The objective of this paper is to clarify, through conceptual analysis, what the concept can and should mean, and to propose a useful definition (...) for scientific and practical work. Results: Several of the defining characteristics found in the literature are critically scrutinized and discussed, namely health, basic standard competence, occupational competence, occupational virtues, and motivation. These characteristics are related to the work tasks and the work environment. One conclusion is that we need two definitions of work ability, one for specific jobs that require special training or education, and one for jobs that most people can manage given a short period of practice. Having work ability, in the first sense, means having the occupational competence, the health required for the competence, and the occupational virtues that are required for managing the work tasks, assuming that the tasks are reasonable and that the work environment is acceptable. In the second sense, having work ability is having the health, the basic standard competence and the relevant occupational virtues required for managing some kind of job, assuming that the work tasks are reasonable and that the work environment is acceptable. Conclusion: These definitions give us tools for understanding and discussing the complex, holistic and dynamic aspects of work ability, and they can lay the foundations for the creation of instruments for evaluating work ability, as well as help formulate strategies for rehabilitation. (shrink)

I argue that consciousness is an aspect of an agent's intelligence, hence of its ability to deal adaptively with the world. In particular, it allows for the possibility of noting and correcting the agent's errors, as actions performed by itself. This in turn requires a robust self-concept as part of the agent's world model; the appropriate notion of self here is a special one, allowing for a very strong kind of self-reference. It also requires the capability to come to see (...) that world model as residing in its belief base , while then representing the actual world as possibly different, i.e., forming a new world-model. This suggests particular computational mechanisms by which consciousness occurs, ones that conceivably could be discovered by neuroscientists, as well as built into artificial systems that may need such capabilities. Consciousness, then, is not an epiphenomenon at all, but rather a key part of the functional architecture of suitably intelligent agents, hence amenable to study as much as any other architectural feature. I also argue that ignorance of how subjective states could be essentially functional does not itself lend credibility to the view that such states are not essentially functional; the strong self-reference proposal here is one possible functional explanation of consciousness. (shrink)

The studies of mind and language have traditionally been linked to one another. Indeed, theories of reference (meaning, intentionality, content) have over time brought more and more mind into meaning. Here I argue that the links must be made far stronger still if we are to understand either. I offer some criticism of the causal-functionalist theories of reference on this ground, and present some ideas for improvements. The upshot will be that intentionality is largely internal and very real indeed, that (...) it provides a genuine distinction between systems that have it and ones that do not, and that it hinges on internal complexities of a specifiable sort, ones that are tied to the detection of error. What is meaning, what is it good for, and what is a naturalist (non-intentional) account of how it works? In this paper (part I of a two-part work). I will argue that first two of these questions should be answered primarily in terms of processes inside the mind/brain, contrary to most recent thinking on this. In the sequel paper (part II), I will argue that a key aspect of this is the physical body of the meaning agent, and propose a way in which this might work and how an external notion of reference can be recaptured from internal processes. (shrink)

In 2015, observers argued that the fourth agricultural revolution had been initiated. This article focuses on one part of this high-tech revolution: the origin, development, applications, and user value of unmanned aerial systems (UAS). Institutional changes connected to the UAS innovation are analyzed, based on a Swedish case study. The methods included autoethnography. The theoretical frame was composed by four perspectives: innovation, institutions, sustainability, and ethics. UAS can help farmers cut costs and produce higher quantity with better quality, and also (...) has environmental benefits. However, this promising innovation was exposed to institutional forces and suddenly became subordinated the Act of Camera Surveillance. This study illuminates how legislative institutions can inhibit responsible innovation. The study shows that different ethical perspectives can collide with each other. (shrink)

In 2015, observers argued that the fourth agricultural revolution had been initiated. This article focuses on one part of this high-tech revolution: the origin, development, applications, and user value of unmanned aerial systems. Institutional changes connected to the UAS innovation are analyzed, based on a Swedish case study. The methods included autoethnography. The theoretical frame was composed by four perspectives: innovation, institutions, sustainability, and ethics. UAS can help farmers cut costs and produce higher quantity with better quality, and also has (...) environmental benefits. However, this promising innovation was exposed to institutional forces and suddenly became subordinated the Act of Camera Surveillance. This study illuminates how legislative institutions can inhibit responsible innovation. The study shows that different ethical perspectives can collide with each other. (shrink)

Stuttering is a disorder characterized by intermittent loss of volitional control of speech movements. This hypothesis and theory article focuses on the proposal that stuttering may be related to an impairment of the energy supply to neurons. Findings from electroencephalography, brain imaging, genetics, and biochemistry are reviewed: Analyses of the EEG spectra at rest have repeatedly reported reduced power in the beta band, which is compatible with indications of reduced metabolism. Studies of the absolute level of regional cerebral blood flow (...) show conflicting findings, with two studies reporting reduced rCBF in the frontal lobe, and two studies, based on a different method, reporting no group differences. This contradiction has not yet been resolved. The pattern of reduction in the studies reporting reduced rCBF corresponds to the regional pattern of the glycolytic index. High regional GI indicates high reliance on non-oxidative metabolism, i.e., glycolysis. Variants of the gene ARNT2 have been associated with stuttering. This gene is primarily expressed in the brain, with a pattern roughly corresponding to the pattern of regional GI. A central function of the ARNT2 protein is to act as one part of a sensor system indicating low levels of oxygen in brain tissue and to activate appropriate responses, including activation of glycolysis. It has been established that genes related to the functions of the lysosomes are implicated in some cases of stuttering. It is possible that these gene variants result in a reduced peak rate of energy supply to neurons. Lastly, there are indications of interactions between the metabolic system and the dopamine system: for example, it is known that acute hypoxia results in an elevated tonic level of dopamine in the synapses. Will mild chronic limitations of energy supply also result in elevated levels of dopamine? The indications of such interaction effects suggest that the metabolic theory of stuttering should be explored in parallel with the exploration of the dopaminergic theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.1 (2002) 43-56 [Access article in PDF] Jack London's Medusa of Truth Per Serritslev Petersen FROM THE VERY START of his literary career, Jack London believed that a good fiction writer must also be a good thinker—that fictional authenticity and integrity must somehow be imbedded in philosophical authenticity and integrity. In his early essay "On the Writer's Philosophy of Life," and in his early letters to (...) Cloudsley Johns, his intellectually "slovenly" friend (who also happened to share his literary ambitions and interests), London insists, again and again, on the proper philosophical foundation of the successful writer. This is how poor Cloudsley, who had previously been told to "get in and systematically ground [himself] in history, economics, biology and the kindred branches" 1 gets browbeaten by his self-appointed mentor and master, a veritable Jack of all trades, in a letter dated March 15, 1900: "To be well fitted for the tragedy of existence (intellectual existence), one must have a working philosophy, a synthesis of things. Have you a synthesis of things? Do you write, and talk, and build upon a foundation which you know is securely laid? Or do you not rather build with a hazy idea of 'to hell with the foundation.'" London then proceeds to catechize his friend on scientific principles such as the indestructibility of Matter, the persistence of Force, and the overall "dynamic principle, true of the metamorphosis of the universe"—principles that Cloudsley is urged to study "carefully and painstakingly" before he can ever claim to have "a firm foundation for [his] philosophy of life" (Letters, pp. 170-71).In London's admittedly heavy-handed ad hominem argument, one recognizes the philosophical sledgehammer of Ernest Everhard, the revolutionary hero of The Iron Heel and one of the fictional exponents of "that cold forbidding philosophy, materialistic monism," 2 which also [End Page 43] served as the scientific foundation of London's own philosophy of life. There are, however, not one, but two components to London's philosophy, which, as I shall argue in this essay, together constitute an essentially dialectical construction, a dynamic juxtaposition of and negotiation with, on the one hand, the "cold forbidding" Medusa of Truth and, on the other hand, the life-enhancing Aphrodite of Romance, the second of which is one of several versions of the vital Maia-Lie (Maia being the Buddhist term for the power that creates or re-creates the world as cosmic illusion).Two points need to be stressed from the outset. First, London's work is implicitly aligned with literary naturalism—the "Zolaistic Movement" of modern American fiction that the genteel writer and editor Thomas Bailey Aldrich famously condemned for its "miasmatic breath" 3 —even though London himself would always qualify his own naturalism by insisting that, artistically, he was "an emotional materialist" (Letters, p. 329), and that his realism was, in the words of Martin Eden, one of his fictional alter egos, "an impassioned realism, shot through with human aspiration and faith." 4 Second, London's work is explicitly aligned with philosophical naturalism (as distinct from supernaturalism)—that is, naturalism as the philosophical or epistemological view that, to quote The Oxford Companion to Philosophy (1995), "everything is natural, i.e. that everything there is belongs to the world of nature, and so can be studied by the methods appropriate for studying that world." In philosophical practice, naturalism and materialism have tended to coalesce, materialism being basically understood as the view that everything is made of matter, which can be studied by the methods of natural science. Like London's philosophical alter ego Ernest Everhard (and also like fictional protagonists such as Wolf Larsen and Martin Eden), London declared himself "a materialistic monist," although, as he admitted to Cloudsley Johns, "there is dam little satisfaction in it." Rhetorically impersonating, as it were, Wolf Larsen, London, in the same letter, asks himself and his correspondent, "what squirming anywhere, damned or otherwise, means anything? That's the question I am always prone to put: What's this chemical ferment called life about? Small wonder that small men... (shrink)

The article presents and discusses an ongoing fellowship project entitled ‘Space for Interference’, conducted under the Norwegian Programme for Research Fellowships in the Arts. Two concrete site-specific art projects produced under Space for Interference serve as a point of departure for an investigation into methods of interference and the forms of address that artists use when intervening in other specialized fields in society. The institutions that provide the site for an art project have different social functions. We ask what may (...) be their motivation for allowing artists access to their physical environments, apparatuses, procedures, systems and discourses. The fact that the artists’ projects in these contexts function as a means of self-observation for the institutions seems obvious. Nevertheless, we seek to investigate the various economic and political factors that allow these institutions to include potentially critical activities, which aim to modify or transgress their systems, and thereby displaying how they are malleable and mobile bodies. One assertion we make is that by doing so the involved institutions prove to be modern, self-critical and flexible, thus complying with political requirements to adapt to the rapidly changing environments of the information and communication age. The perspective from systems theory in the Luhmannian tradition has proved useful since it shows how the issues of art may also be the problems of science, business, politics and the law in the complex and decentered social universe of today. The issues of contingency, insecurity, paradox and autoreflexivity, surplus meanings and the complexity and decentering of the subject are at the heart of contemporary art. Systems theory provides a way to link such practices theoretically with scientific discourse and with the advanced problem solving and criticality of other social domains, like politics, business and the media industries. (shrink)

Exactly when Philosophy of Psychiatry started as a subfield of Philosophy is hard to say. There are several different estimates of how old psychiatry itself is, from one hundred to three hundred years, and of course there has been discussion and treatment of mental illness for at least a couple of thousand years. A host of issues which could count as belonging to the field have been discussed just within the last hundred years. For instance, a large literature on the (...) philosophy of psychoanalysis dates back to the beginning of the century, and in the last thirty years there has been discussion of amnesia and multiple personality in the philosophy of mind, bioethical debate about involuntary hospitalization and the ability of the mentally ill to give informed consent to drug trials, and recent continental philosophy has shown much interest in madness, civilization, capitalism and schizophrenia. However, I suggest that Philosophy of Psychiatry reached a sense of itself as a separate field only in the 1990s. In this time, it has gained its own association, journal, and a book series with a prestigious press. I refer to the American Association for Philosophy and Psychiatry, the associated journal, Philosophy, Psychiatry, and Psychology, and the MIT Press series, Philosophical Psychopathology: Disorders of Mind, edited by Owen Flanagan and George Graham. Jennifer Radden's Divided Minds and Successive Selves is the first book in that series. (shrink)

Objective To examine medical students’ views on conscientious objection and controversial medical procedures.Methods Questionnaire study among Norwegian 5th and 6th year medical students.Results Five hundred and thirty-one of 893 students responded. Respondents object to a range of procedures not limited to abortion —notably euthanasia, ritual circumcision for boys, assisted reproduction for same-sex couples and ultrasound in the setting of prenatal diagnosis. A small minority would object to referrals for abortion. In the case of abortion, up to 55% would tolerate conscientious (...) refusals, whereas 42% would not. Higher proportions would tolerate refusals for euthanasia or ritual circumcision for boys.Discussion A majority of Norwegian medical students would object to participation in euthanasia or ritual circumcision for boys. However, in most settings, many medical students think doctors should not be able to refuse participation on grounds of conscience. A minority would accept conscientious refusals for procedures they themselves do not object to personally. Most students would not accept conscientious refusals for referrals.Conclusions Conscientious objection remains a live issue in the context of several medical procedures not limited to abortion. Although most would want a right to object to participation in euthanasia, tolerance towards conscientious objectors in general was moderate or low. (shrink)

Background: Perfectionism is increasing over time and associated with various mental health problems. Recent research indicates adverse childhood experiences may play a role in the development of perfectionism. In addition, perfectionism is marked by interpersonal problems with implications for treatment outcome.Aim: This study aimed to fill an important gap in the predominantly quantitative literature field by exploring how individuals with perfectionism understand the relationship between painful experiences and how they relate to others.Method: Nine individuals with perfectionism were interviewed using (...) McAdam's life-story interview. Thematic analysis was used to analyze the interviews.Results: Four themes emerged: “A childhood with big responsibilities,” “I am still the responsible one,” “Keeping others at a distance to protect the inner self,” and “Achieving physical distance to get a fresh start.” These themes are grouped into two overarching themes: “You can't always trust people” and “A distancing from others.”Conclusion: Findings highlight taking responsibility and social distancing serve an important function for perfectionistic individuals in response to painful relational events. We discuss how themes of control and agency impact individuals' relationship to mental health and turning toward others for help. The findings provide greater complexity to understanding perfectionism as a “barrier to treatment.”. (shrink)

During multiple testing, researchers often adjust their alpha level to control the familywise error rate for a statistical inference about a joint union alternative hypothesis (e.g., “H1,1 or H1,2”). However, in some cases, they do not make this inference. Instead, they make separate inferences about each of the individual hypotheses that comprise the joint hypothesis (e.g., H1,1 and H1,2). For example, a researcher might use a Bonferroni correction to adjust their alpha level from the conventional level of 0.050 to (...) 0.025 when testing H1,1 and H1,2, find a significant result for H1,1 (p < 0.025) and not for H1,2 (p > .0.025), and so claim support for H1,1 and not for H1,2. However, these separate individual inferences do not require an alpha adjustment. Only a statistical inference about the union alternative hypothesis “H1,1 or H1,2” requires an alpha adjustment because it is based on “at least one” significant result among the two tests, and so it refers to the familywise error rate. Hence, an inconsistent correction occurs when a researcher corrects their alpha level during multiple testing but does not make an inference about a union alternative hypothesis. In the present article, I discuss this inconsistent correction problem, including its reduction in statistical power for tests of individual hypotheses and its potential causes vis-à-vis error rate confusions and the alpha adjustment ritual. I also provide three illustrations of inconsistent corrections from recent psychology studies. I conclude that inconsistent corrections represent a symptom of statisticism, and I call for a more nuanced inference-based approach to multiple testing corrections. (shrink)

Enrico Opocher, one of the most important Italian legal philosophers in the last century, died on March 3, 2004. For almost four decades, he was Director of the prestigious Insitute of Philosophy of Law and Comparative Law in the University of Padua. Together with Norberto Bobbio, Sergio Cotta, Uberto Scarpelli and few others, he represented a generation as well as a season of deep renewal in Italian philosophy of law and politics. In the legal thought of the postwar period, Opocher (...) became the point of reference for all those who neither wanted to join the old tradition (substantially neo-scholastic) of natural law thinking, nor believed in Kelsen’s triumphant legalistic normativism. My contribution is devoted to focusing on that part of Opocher’s thought in which the Paduan philosopher defines “justice” as “a value which makes the law count” (in the sense of its “duration”) and puts in contact this peculiar concept of justice with the problem of the verification of truth in trials and lawsuits. My thesis comes from the analysis of the Opocher’s conception of “judicial truth” as a truth obtained by reflecting facts which are relevant to norms. In the course of my analysis, I criticize all interpretations which reduce judicial truth-seeking to the empirical method. My aim is to move it from the level of mere factual description to the one of “logical demonstration according to the circumstances”. This movement from the descriptive niveau to the argumentative one, will be justified through the adoption of the perspective of classical rethorics, based on Aristotle and Cicero, which shows how judicial truth (intended in the sense of entymematic demonstration) was much more coherent with the very idea of Opocher’s conception of justice. (shrink)

Creativity may be a trait, a state or just a process defined by its products. It can be contrasted with certain cognitive activities that are not ordinarily creative, such as problem solving, deduction, induction, learning, imitation, trial and error, heuristics and "abduction," however, all of these can be done creatively too. There are four kinds of theories, attributing creativity respectively to (1) method, (2) "memory" (innate structure), (3) magic or (4) mutation. These theories variously emphasize the role (...) of an unconscious mind, innate constraints, analogy, aesthetics, anomalies, formal constraints, serendipity, mental analogs, heuristic strategies, improvisatory performance and cumulative collaboration. There is some virtue in each, but the best model is still the one implicit in Pasteur's dictum: "Chance favors the prepared mind." And because the exercise and even the definition of creativity requires constraints, it is unlikely that "creativity training" or an emphasis on freedom in education can play a productive role in this preparation. (shrink)

Randomized controlled clinical trials play an important role in the development of new medical therapies. There is, however, an ethical issue surrounding the use of randomized treatment allocation when the patient is suffering from a life threatening condition and requires immediate treatment. Such patients can only benefit from the treatment they actually receive and not from the alternative therapy, even if it ultimately proves to be superior. We discuss a novel new way to analyse data from such clinical trials based (...) on the use of the recently developed theory of imprecise probabilities. This work draws an explicit distinction between the related but nevertheless distinct questions of inference and decision in clinical trials. The traditional question of scientific interest asks 'Which treatment offers the greater chance of success?' and is the primary reason for conducting the clinical trial. The question of decision concerns the welfare of the patients in the clinical trial, asking whether the accumulated evidence favours one treatment over the other to such an extent that the next patient should decline randomization and instead express a preference for one treatment. Consideration of the decision question within the framework of imprecise probabilities leads to a mathematical definition of equipoise and a method for governing the randomization protocol of a clinical trial. This paper describes in detail the protocol for the conduct of clinical trials based on this new method of analysis, which is illustrated in a retrospective analysis of data from a clinical trial comparing the anti-emetic drugs ondansetron and droperidol in the treatment of postoperative nausea and vomiting. The proposed methodology is compared quantitatively using computer simulation studies with conventional clinical trial designs and is shown to maintain high statistical power with reduced sample sizes, at the expense of a high type I error rate that we argue is irrelevant in some specific circumstances. Particular emphasis is placed on describing the type of medical conditions and treatment comparisons where the new methodology is expected to provide the greatest benefit. (shrink)

Building a meaningful model of biological regulatory network is usually done by specifying the components and their interactions, by guessing the values of parameters, by comparing the predicted behaviors to the observed ones, and by modifying in a trial-error process both architecture and parameters in order to reach an optimal fitness. We propose here a different approach to construct and analyze biological models avoiding the trial-error part, where structure and dynamics are represented as formal constraints. We (...) apply the method to Hopfield-like networks, a formalism often used in both neural and regulatory networks modeling. The aim is to characterize automatically the set of all models consistent with all the available knowledge. The available knowledge is formalized into formal constraints. The latter are compiled into Boolean formula in conjunctive normal form and then submitted to a Boolean satisfiability solver. This approach allows to formulate a wide range of queries, expressed in a high level language, and possibly integrating formalized intuitions. In order to explore its potential, we use it to find cycles for 3-nodes networks and to determine the flower morphogenesis regulatory network of Arabidopsis thaliana. Applications of this technique are numerous and concern the building of models from data as well as the design of biological networks possessing specified behaviors. (shrink)

In 1966 the U.S. Supreme Court wrote, “The basic purpose of a trial is the determination of truth.” This is Larry Laudan's guiding premise in his “essay on legal epistemology.” Without ascertaining the facts about a crime, he writes, it is impossible to achieve justice, since a just resolution crucially depends on correctly figuring out who did what to whom. Thus, he continues, “it is entirely fitting to ask whether the procedures and rules that govern a trial are (...) genuinely truth-conducive.” In chapter 1 of the book, Laudan identifies one of the most important and legitimate methods for finding truth, namely, ensuring that the jury hears all and only relevant evidence. Laudan bemoans the fact, however, that “legal texts and the practices of courts routinely flout” this principle. Much of the rest of the book is devoted to the other tests for admissibility that the system imposes, tests that Laudan often regards as misguided. (shrink)

In their recent book, Is Inequality Bad for Our Health?, Daniels, Kennedy, and Kawachi claim that to “act justly in health policy, we must have knowledge about the causal pathways through which socioeconomic (and other) inequalities work to produce differential health outcomes.” One of the central problems with this approach is its dependency on “knowledge about the causal pathways.” A widely held belief is that the randomized clinical trial (RCT) is, and ought to be the “gold standard” of evaluating (...) the causal efficacy of interventions. However, often the only data available are non-experimental, observational data. For such data, the necessary randomization is missing. Because the randomization is missing, it seems to follow that it is not possible to make epistemically warranted claims about the causal pathways. Although we are not sanguine about the difficulty in using observational data to make warranted causal claims, we are not as pessimistic as those who believe that the only warranted causal claims are claims based on data from (idealized) RCTs. We argue that careful, thoughtful study design, informed by expert knowledge, that incorporates propensity score matching methods in conjunction with instrumental variable analyses, provides the possibility of warranted causal claims using observational data. (shrink)

It is commonly thought that Dioscorides’s view on medicine is purely pragmatic, focused entirely on the effectiveness of medicines, and derived from trial and error. One reason for this interpretation is that Dioscorides himself wrote little about his theory of medicine. In this article, however, we argue that he would have arranged De Materia Medica in a way that would have been useful only to a skilled practitioner. This argument implies that Dioscorides had a medical theory, as the (...) arrangement of the content could not have followed a trial-and-error approach. It is only in the sense of having a theory that he is able to claim that his text is more “complete” than others. This article provides a historical overview of the text from its genesis to its reception and, ultimately, to its falling out of use. This article concludes with a series of hypotheses on the correspondence between theory and arrangement of the treatise, with the aim of narrowing scholarly conjectures about both. In the final analysis, we argue that an arrangement by family resemblance most closely corresponds to the theory that animates Dioscorides’s text. (shrink)

BackgroundPost-stroke depression is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine, such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. Thus, this trial aims (...) to assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation. Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale, Self-Rating Depression Scale, and Activity of Daily Living Scale. And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment Scale, and the Pittsburgh Sleep Quality Index. All outcome measures will be evaluated at baseline, week 4, and week 8. Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975. (shrink)

This paper sets forth a familiar theme, that science essentially consists of two interdependent episodes, one imaginative, the other critical. Hypotheses and other imaginative conjectures are the initial stage of scientific inquiry because they provide the incentive to seek the truth and a clue as to where to find it. But scientific conjectures must be subject to critical examination and empirical testing. There is a dialogue between the two episodes; observations made to test a hypothesis are the inspiration for new (...) conjectures. Inductive generalizations may also inspire hypotheses, but cannot validate them. A hypothesis is empirically tested by ascertaining whether or not predictions about the world of experience deduced from the hypothesis agree with what is actually observed. This has been appropriately considered the 'criterion of demarcation' that distinguishes science from other knowledge. But scientific hypotheses must satisfy other tests as well, e.g., whether they have explanatory value and further understanding. I briefly explore such issues as verifiability and falsifiability, empirical content and truthfulness, contingency and certainty, fact and theory, error and fraud. Science like any human activity is subject to error and to the foibles and other failings of human beings. But severe attempts of empirical falsification and other trials yield knowledge that stands the test of time and provides a foothold for further knowledge. Moreover, scientists have developed social mechanisms, such as peer review and publication, to evaluate their work. Because the research of scientists depends on the validity of previous knowledge, it is of great consequence that they discern valid from invalid knowledge and thus scientists are inclined to transcend ideology, nationality, friendship, monetary interest and other prejudices when the mettle of scientific knowledge is at stake. I use historical examples to illustrate some relevant aspects of scientific practice: its success (Mendel), misrepresentation (Darwin), ideological abuse (Lysenko), arrogant violation of the requirement of testing (Koch), theory replacement (Priestly and Lavoisier, Newton and Einstein), and the indispensability of context (Oswald Avery and Alfred Wegener). (shrink)

This chapter talks about the power of music, how characters in South Park use it in telling stories, and how music conveys ideas in the context of Western philosophy. But South Park does raise questions about music that philosophers— particularly Plato—have dealt with again and again. Despite their flaws, these Greek thinkers' views were instrumental to asking questions about music's impact (often referred to as ethos), its mathematical properties in relation to the universe, and how these two aspects interact with (...) one another. Phil Collins and Asia may not survive history's merciless aesthetic filter, just as the aulos instrument vanished long ago, but where the underlying philosophy is concerned, the issues are timeless. (shrink)

When we forgive, we do so for reasons. One challenge for forgiveness theorists is to explain which reasons are reasons to forgive and which are not. This paper argues that we forgive in response to a perceived change of heart on the part of the offender. The argument proceeds in four steps. First, I show that we forgive for reasons. Second, I argue that forgiveness requires the right kind of reason. Third, I show that these two points explain a common (...) distinction between forgiving and letting go and, in doing so, solve a problem facing many accounts of forgiveness. Finally, I consider candidate reasons to forgive and argue that all of them are either the wrong kind of reason or are instances of a more general reason of the right kind, namely, a perceived change of heart. (shrink)

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the (...) paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use. (shrink)

This article contends that an ethics of care has a particular moral ontology that makes it suitable to argue for the normative significance of relational responsibilities within professional health care. This ontology is relational. It means that moral choices always have to account for the web of relationships, the relational networks and responsibilities that are an essential part of particular moral circumstances. Given this ontology, the article investigates the conditions for health care professionals to be partial and to act on (...) the basis of particular responsibilities to their patients. We will argue that priorities could be partial in three ways: first, because there may be exceptional circumstances that allow for giving priority to one patient over another; second, because the integrity of the patient and a health care worker may be connected in special ways; and, finally, even if impartiality is essential, the institutional basis of health care must always give ample space for an ethically qualified individual and personal care for patients. Even if difficult priorities may be necessary, the conditions of institutional health care should always seek to create the prerequisites for nurses and doctors to administer proper care. (shrink)

It is often claimed both that forgiveness is elective and that forgiveness is something that we do for reasons. However, there is a tension between these two central claims about the nature of forgiveness. If forgiving is something one does for reasons, then, at least sometimes, those reasons may generate a requirement to forgive or withhold forgiveness. While not strictly inconsistent with electivity, the idea of required forgiveness strikes some as antithetical to the spirit of the concept. They argue that (...) forgiveness is essentially elective. In this paper, I dispute these arguments. I argue that the intuitive plausibility of the position diminishes upon reflection and that the best arguments fail to explain why reasons to forgive, unlike most other reasons for action, cannot generate requirements. (shrink)

Abolitionism is the view that if no one is responsible, we ought to abandon the reactive attitudes. This paper defends abolitionism against the claim, made by P.F. Strawson and others, that abandoning these attitudes precludes the formation and maintenance of valuable personal relationships. These anti-abolitionists claim that one who abandons the reactive attitudes is unable to take personally others’ attitudes and actions regarding her, and that taking personally is necessary for certain valuable relationships. I dispute both claims and argue that (...) this objection exaggerates the role of the reactive attitudes and underestimates the importance of non-reactive moral emotions. (shrink)

The starting point for the contemporary debate about theories of health should be the holistic theory of Lennart Nordenfelt, claims George Khushf, not the refuted theory of Christopher Boorse. The present paper is an attempt to challenge Nordenfelt and to present an alternative theory to his and other theories, including Boorse’s. The main problems with Nordenfelt’s theory are that it is relativistic, that it leads to counter-intuitive results as to what goals can count as healthy, that it focuses on the (...) wrong kind of abilities, that it makes measuring health extra difficult, and that it does not give us a sufficient account of health, at most a necessary one. The alternative theory proposed is two-dimensional. First, health is to have developed the abilities and dispositions that members of one’s culture typically develop, and be able to use them, in acceptable circumstances; and second, health is to experience positive moods and sensations, the kinds that have internal causes. The theory solves the problems attached to Nordenfelt’s theory by not being individual relativistic, by eliminating the goals in the definition, by giving an alternative interpretation of “ability,” by making health easier to measure, and by adding the dimension of well-being that, together with health as ability, not only gives us a necessary, but also a sufficient, account of health. (shrink)

This thesis in an invistigation into the concept of "harm" and its moral relevance. A common view is that an analysis of harm should include a counterfactual condition: an act harms a person iff it makes that person worse off. A common objection to the moral relevance of harm, thus understood, is the non-identity problem. -/- This thesis criticises the counterfactual condition, argues for an alternative analysis and that harm plays two important normative roles. -/- The main ground for rejecting (...) the counterfactual condition is that it has unacceptable consequences in cases of overdetermination and pre-emption. Several modifications to the condition are considered but all fail to solve this problem. -/- According to the alternative analysis to do harm is to perform an act which is responsible for the obtaining of a state of affairs which makes a person’s life go worse. It is argued that should be understood in terms of counterfactual dependence. This claim is defended against counterexamples based on redundant causation. An analysis of is also provided using the notion of a well-being function. It is argued that by introducing this notion it is possible to analyse contributive value without making use of counterfactual comparisons and to solve the non-identity problem. -/- Regarding the normative importance of harm, a popular intuition is that there is an asymmetry in our obligations to future people: that a person would have a life worth living were she to exist is not a reason in favour of creating that person while that a person would have a life not worth living is a reason against creating that person. It is argued that the asymmetry can be classified as a moral option grounded in autonomy. Central to this defence is the suggestion that harm is relevant to understanding autonomy. Autonomy involves partly the freedom to pursue one’s own aims as long as one does no harm. (shrink)

One important ethical issue for health promotion and public health work is to determine what the goals for these practices should be. This paper will try to clarify what some of these goals are thought to be, and what they ought to be. It will specifically discuss two different approaches to health promotion, such as, behavior change and empowerment. The general aim of this paper is, thus, to compare the behavior-change approach and the empowerment approach, concerning their immediate goals or (...) aims, and to morally evaluate the strengths and weaknesses of these two goal models, in relation to the ultimate goal of health promotion. The investigation shows that the behavior-change approach has several moral problems. First of all, it is overly paternalistic and often disregards the individual’s or group’s own perception of what is important—something that also increases the risk of failed interventions. Furthermore, it risks leading to ‘victim blaming’ and stigmatization, and to increased inequalities in health, and it puts focus on the ‘wrong’ problems, i.e., behavior instead of the ‘causes of the causes’. It is thereafter shown that the empowerment approach does not have any of these problems. Finally, some specific problems for the empowerment approach are discussed and resolved, such as, the idea that empowering some groups might lead to power over others, the objection that the focus is not primarily on health, and the fact that empowered people might choose to live lives that risk reducing their health. (shrink)

In this paper we distinguish two versions of the non-identity problem: one involving positive well-being and one involving negative well-being. Intuitively, there seems to be a difference between the two versions of the problem. In the negative case it is clear that one ought to cause the better off person to exist. However, it has recently been suggested that this is not so in the positive case. We argue that such an asymmetrical treatment of the two versions should be rejected (...) and that this is evidence against views according to which it is permissible to cause the less well off person to exist in the positive non-identity case. (shrink)

Vol.:The Journal of Value Inquiryhttps://doi.org/10.1007/s10790-018-9660-y1 3Bad Art and Good TastePer Algander1© The Author 2018Aesthetic value and good taste usually go hand in hand. A person with good taste is, typically, someone who appreciates things which exhibit some aesthetic quality or excellence. However, in ordinary life it is commonplace that we indulge in things which are lacking in aesthetic value. For example, we might prefer to watch Days of Our Lives rather than The Wire, or to read a bad crime novel (...) rather than good poetry.It is tempting to draw the conclusion that we are making a mistake, and lacking good taste, when our aesthetic attitudes do not match up against the aesthetic value of the things we prefer. However, this conclusion may be too quick. It has recently been argued by John Dyck and Matt Johnson1 that appreciating bad art—art which lack aesthetically good making features or whose bad making features clearly out-weigh its good making ones—isn’t always inappropriate. In this paper I will argue that while there might be a case to be made for this claim, the problem which Dyck and Johnson identify is much more general and that their proposed solution can at best be a partial one. (shrink)

It is an imperative within health care, medicine, and public health to restore, preserve, and enhance health. Therefore, it is important to determine what kinds of enhancement are increases in health and what kinds are not. Taking as its point of departure two conceptions of health, namely, “manifest health” and “fundamental health,” the paper discusses various means used to enhance ability and well-being, and if those means, such as wheelchairs, implants, medicines, stimulants, or narcotics, enhance health. The fact that some (...) means that enhance ability or well-being are not usually considered health enhancing, for example, narcotics, constitutes a problem. The paper ends with a discussion of some suggestions about how to distinguish between those enhancements that are health related and those that are not. One plausible idea holds that an enhancement is health related when the substance, or aid, increases ability or well-being, is integrated into the body, and does not harm the individual’s fundamental health. (shrink)

The discussion about theories of health has recently had an important new input through the work of Sridhar Venkatapuram. He proposes a combination of Lennart Nordenfelt's holistic theory of health and Martha Nussbaum's version of the capability approach. The aim of the present article is to discuss and evaluate this proposal. The article starts with a discussion of Nordenfelt's theory and evaluates Venkatapuram’ critique of it, that is, of its relativism, both regarding goals and environment, and of the subjectivist theory (...) of happiness used. Then the article explains why Nordenfelt's idea of a reasonable environment is not a problem for the theory, and it critiques Venkatapuram's own incorporation of the environment into the concept of health, suggesting that this makes the concept too wide. It contends, moreover, that Venkatapuram's alternative theory retains a problem inherent in Nordenfelt's theory, namely, that health is conceived of as a second-order ability. It is argued that health should, instead, be defined as first-order abilities. This means that health cannot be seen as a capability, and also that health cannot be seen as a meta-capability of the kind envisioned by Venkatapuram. It is, furthermore, argued that the theory lacks one crucial aspect of health, namely, subjective wellbeing. Finally, the article tries to illustrate how health, in the suggested alternative sense, as first-order abilities, fits into Nussbaum's capability theory, since health as an ‘actuality’ is part of all the ‘combined capabilities’ suggested by Nussbaum. (shrink)

Anthropocentrism—the idea that humans are the most important beings there are—comes in many guises. One version of anthropocentrism states that only humans have full moral status. Those who argue for such a position usually refer to some trait that confers moral status and that only humans have. Suggestions include linguistic ability, self-awareness or rationality. However, regardless of what trait one picks it will not track the line between Homo sapiens and other species. You will always be able to find some (...) non-human animal that possesses the trait to a greater degree than some human does— even potentially. Koplin and Wilkinson1 adopt a broadly sentientist position: moral status is conferred by some mental or cognitive function. They discuss two sources of moral uncertainty related to this. In cases of moral uncertainty of the first type, it is uncertain whether Property X confers moral status. In cases of uncertainty of the second type, we assume it to be true that moral status is conferred by X, but it is uncertain whether a particular entity possesses the property. There are reasons to believe …. (shrink)

Abolitionism is the view that if no one is responsible, then we ought to abandon the reactive attitudes. Proponents suggest that reactive attitudes can be replaced in our emotional repertoire by non-reactive analogues. In this paper, I dispute and reject a common challenge to abolitionism according to which the reactive attitudes are necessary for protesting unfairness and maintaining social harmony. While other abolitionists dispute the empirical basis of this objection, I focus on its implications. I argue that even if non-reactive (...) analogues cannot perform the interpersonal and social functions of reactive attitudes, it does not follow that the losses of abandoning them outweigh the gains of retaining them. The force of the challenge rests on a mistake, identified by John Stuart Mill among others, that is common when evaluating entrenched social practices. (shrink)

The idea of self-forgiveness poses a serious challenge to any philosopher interested in giving a general account of forgiveness. On the one hand, it is an uncontroversial part of our common psychological and moral discourse. On the other, any account of self-forgiveness is inconsistent with any general account of forgiveness which implies that only the victim of an offense can forgive. To avoid this conclusion, one must either challenge the particular claims that preclude self-forgiveness or offer an independently plausible account (...) of self-forgiveness. I deploy both strategies in this article, explaining what self-forgiveness is and how it is possible. (shrink)

A wide variety of skills, abilities and knowledge are used in technological activities such as engineering design. Together, they enable problem solving and artefact creation. Gilbert Ryle’s division of knowledge into knowing how and knowing that is often referred to when discussing this technological knowledge. Ryle’s view has been questioned and criticised by those who claim that there is only one type, for instance, Jason Stanley and Timothy Williamson who claim that knowing how is really a form of knowing that (...) and Stephen Hetherington who claims that knowing that is knowing how. Neither Ryle himself nor any of his critics have discussed technological knowledge. Exposing both Ryle’s and his critics’ ideas to technological knowledge show that there are strong reasons to keep the knowing how–knowing that dichotomy in technological contexts. The main reasons are that they are justified in different ways, that Stanley’s and Williamson’s ideas have great difficulties to account for learning of technological knowing how through training, and that knowing that is susceptible to Gettier problems, which technological knowing how is not. (shrink)

In this article two problems with the recently developed "practice or virtue approach" to business ethics are discussed. The first problem concerns an alleged harmony between common demands of morality (generally understood) and the internal goods of actual business practice. The claimed harmony is strong in essence since it holds that the role expectations a good manager has to live up to, do in fact coincide with what morality demands. The second problem is related to the first and concerns the (...) alleged relevance of a virtue perspective for business ethics. According to the virtue perspective discussed in this article, moral reasoning should take actual practice, and only actual practice, as a point of departure. In so doing ethics is claimed to become insulated from e.g. putting irrelevant demands on practitioners. Such demands are understood as based on abstract principles alien to the practice in question. The thesis of this article is that neither of the above mentioned two claims are plausible. This is so basically because one needs to turn elsewhere than to actual business practice in order to detect a morally laden notion of managerial goodness. (shrink)

This is the first book in welfare economics to be primarily intended for undergraduates and non-specialists. Concepts such as Pareto optimality in a market economy, the compensation criterion, and the social welfare function are explored in detail. Market failures are analysed by using different ways of measuring welfare changes. The book also examines public choice, and the issues of provision of public goods, median voter equilibrium, government failures, efficient and optimal taxation, and intergenerational equity. The three final chapters are devoted (...) to applied welfare economics: methods for revealing people's preferences, cost-benefit analysis, and project evaluation in a risky world. The book is intended for introductory and intermediate courses in welfare economics, microeconomics, and public economics. It will also be suitable for courses in health economics, environmental economics, and cost-benefit analysis, as well as those undertaking project evaluations in government agencies and private firms. (shrink)

This paper discusses the application of the supreme emergency doctrine from just-war theory to non-antagonistic threats. Two versions of the doctrine are considered: Michael Walzer’s communitarian version and Brian Orend’s prudential one. I investigate first whether the doctrines are applicable to non-antagonistic threats, and second whether they are defensible. I argue that a version of Walzer’s doctrine seems to be applicable to non-antagonistic threats, but that it is very doubtful whether the doctrine is defensible. I also argue that Orend’s version (...) of the doctrine is applicable to non-antagonistic threats, but that his account is not defensible, regardless of whether the threats are antagonistic or not. (shrink)