For decades, health information has been collected and shared for health care delivery and public health purposes. While the “primary use” of patient data for providing direct health care services is the cornerstone of health care practice, health departments rely on data sharing for research and analysis to support disease prevention and health promotion in the population. As the U.S. health system undergoes a digital revolution, health information that was previously captured in paper form now can be captured electronically. Electronic (...) health information has transformed the efficiency, capacity, and functions of the U.S. health system. For this reason, there is increased attention to the “secondary use” of electronic patient data for public health uses, including disease reporting and investigation, syndromic surveillance, and patient-specific or population-level communications about health conditions and their associated risk factors. Secondary uses may also encompass clinical research, licensure, and payment for services. (shrink)

Phase transitions are an important instance of putatively emergent behavior. Unlike many things claimed emergent by philosophers, the alleged emergence of phase transitions stems from both philosophical and scientific arguments. Here we focus on the case for emergence built from physics, in particular, arguments based upon the infinite idealization invoked in the statistical mechanical treatment of phase transitions. After teasing apart several challenges, we defend the idea that phase transitions are best thought of as conceptually novel, but not ontologically or (...) explanatorily irreducible to finite physics; indeed, by looking at ongoing work on “smooth phase transitions” we even suggest that they’re not even conceptually novel. In the case of renormalization group theory, consideration of infinite systems and their singular behavior provides a central theoretical tool, but this is compatible with an explanatory reduction. Phase transitions may be “emergent” in some sense of this protean term, but not in a sense that is incompatible with the reductionist project broadly construed. (shrink)

For Knox, ‘spacetime’ is to be defined functionally, as that which picks out a structure of local inertial frames. Assuming that Knox is motivated to construct this functional definition of spacetime on the grounds that it appears to identify that structure which plays the operational role of spacetime—i.e., that structure which is actually surveyed by physical rods and clocks built from matter fields—we identify in this paper important limitations of her approach: these limitations are based upon the fact that there (...) is a gap between inertial frame structure and that which is operationally significant in the above sense. We present five concrete cases in which these two notions come apart, before considering various ways in which Knox’s spacetime functionalism might be amended in light of these issues. (shrink)

The value-free ideal in science has been criticised as both unattainable and undesirable. We argue that it can be defended as a practical principle guiding scientific research even if the unattainability and undesirability of a value-free end-state are granted. If a goal is unattainable, then one can separate the desirability of accomplishing the goal from the desirability of pursuing it. We articulate a novel value-free ideal, which holds that scientists should act as if science should be value-free, and we argue (...) that even if a purely value-free science is undesirable, this value-free ideal is desirable to pursue. (shrink)

Brown and Pooley’s ‘dynamical approach’ to physical theories asserts, in opposition to the orthodox position on physical geometry, that facts about physical geometry are grounded in, or explained by, facts about dynamical fields, not the other way round. John Norton has claimed that the proponent of the dynamical approach is illicitly committed to spatiotemporal presumptions in ‘constructing’ space-time from facts about dynamical symmetries. In this article, I present an abstract, algebraic formulation of field theories and demonstrate that the proponent of (...) the dynamical approach is not committed, in special relativity, to the illicit presumptions to which Norton refers. (shrink)

Abstract The word ‘meme’ was first used by Richard Dawkins (Dawkins, 1976)1 in the sense of a replicator to introduce the idea of cultural transmission through the process of imitation, just as genes are responsible for the evolution of organisms. Following Dawkins several writers came forth to have a closer look at ‘meme’. The consensus was that this was a fascinating way of explaining cultural evolution and transmission; that meme is the basic unit of (cultural) information whose existence influences events (...) so as to make more copies of itself (Brodie, 1996).2 The book which got most attention in this line of literature wasThe Meme Machine (Blackmore, 1993),3 which favours the idea that culture, like biology, evolves through the process of variation, selection and replication. Something striking in Blackmore’s thesis is that emotions and attitudes do not count as memes since they are subjective and never get passed on. http://link.springer.com/article/10.1007%2FBF02780405?LI=true. (shrink)

Supersymmetry (SUSY) is a proposed symmetry between bosons and fermions. The structure of the space of SUSY generators is such that the distinction between internal and spacetime symmetries is blurred. As a result, there are two viable candidates for the correct spacetime setting for a flat supersymmetric field theory---Minkowski spacetime and superspace. an extension of four- dimensional Minkowski spacetime to include (at least) four new dimensions, coordinatised by mathematical objects known as supernumbers. These objects are, in one significant way, quite (...) different from real or complex number---some of them have the property that their order of multiplication makes a difference; in mathematical terms, they are said to have nontrivial commutation properties. This paper argues for two theses: first, that one standard set of arguments, related to universality of symmetry behaviour, that motivate a particular choice of spacetime structure in familiar spacetime theories motivates the choice of superspace as the appropriate spacetime for SUSY field theories. And second, that the metaphysical utility of the concept of spacetime requires more than just the satisfaction of this universality condition; in supersymmetric theories, the spacetime concept is not as useful as in special relativity. (shrink)

Este texto pretende-se um ensaio sobre a questão do Espiritual na teoria pictórica de Kandinsky. Nele busco evidenciar a idéia de que as concepções do pintor russo, em grande parte construída em consonância com o pensamento esotérico do fim do século XIX, aproximam-se bastante de um tipo de cosmologia mágica, que abriga uma perspectiva análoga àquela das categorias do pensamento mágico segundo Marcel Mauss. No centro desta cosmologia encontra-se a arte, síntese do Espiritual, cuja noção central é a de gênio (...) que creio ser herdada em grande medida de Kant. (shrink)

Recent work in the physics literature demonstrates that, in particular classes of rotating spacetimes, physical light rays in general do not traverse null geodesics. Having presented this result, we discuss its philosophical significance, both for the clock hypothesis (and, in particular, a recent purported proof thereof for light clocks), and for the operational meaning of the metric field. 1. Introduction2. Fletcher's Theorem2.1. Maudlin on the clock hypothesis in special relativity2.2. Fletcher’s result in special relativity2.3. Fletcher’s theorem in general relativity3. Electromagnetism (...) and the Geometrical-Optical Limit 3.1. Maxwell’s equations in curved spacetime3.2. The geometrical-optical limit3.3. Rotating spacetimes3.4. Aren’t Gödel spacetimes unphysical?4. The Clock Hypothesis and Chronogeometry 4.1. Natural and mathematical observations4.2. Clock registry discord4.3. Chronogeometry5. Conclusion. (shrink)

Phase transitions are an important instance of putatively emergent behavior. Unlike many things claimed emergent by philosophers (e.g., tables and chairs), the alleged emergence of phase transitions stems from both philosophical and scientific arguments. Here we focus on the case for emergence built from physics, in particular, arguments based upon the infinite idealization invoked in the statistical mechanical treatment of phase transitions. After teasing apart several challenges, we defend the idea that phase transitions are best thought of as conceptually novel, (...) but not ontologically or explanatorily irreducible to finite physics; indeed, by looking at ongoing work on “smooth phase transitions” we even suggest that they’re not even conceptually novel. In the case of renormalization group theory, consideration of infinite systems and their singular behavior provides a central theoretical tool, but this is compatible with an explanatory reduction. Phase transitions may be “emergent” in some sense of this protean term, but not in a sense that is incompatible with the reductionist project broadly construed. (shrink)

Contributed articles presented at the National Conference on "Consciousness, Experience, and Ways of Knowing: Perspectives from Science, Philosophy, and the Arts" held at National Institute for Advanced Studies, Bangalore from 6-7 Feb. 2006.

Contributed seminar papers organized by National Institute of Advanced Studies in June 2001.

If we cannot directly empirically test the claims of particular scientific theory, then it would be nice to have some other criteria with which to assess its viability. In his 2013 book, String Theory and the Scientific Method, Richard Dawid aims to develop such criteria, with an eye to vindicating research programs in disciplines where direct empirical data is scant or non-existent. In an accompanying paper, Dawid, Hartmann and Sprenger formalise Dawid’s so-called ‘No Alternatives Argument’ using a generalised Bayesian framework, (...) as a first step towards formalising Dawid’s entire re- search programme. In this paper, I argue that the formalisation of the NAA cannot play the central role in Dawid’s programme as intended. This is based on the observation that not all confirmation is non-negligible confirmation. For Dawid’s programme to be useful, it must demonstrate the viability not just of non-empirical theory confirmation, but of non-negligible non-empirical theory confirmation. I argue that Dawid et al.’s appeal to Bayesian confirmation theory to formalise his NAA cannot guarantee non-negligible confirmation. As a result, I conclude that if Dawid’s overall project is to succeed, it must do so without the NAA formalised in this way. (shrink)

Objective To document the legal guardian-related barriers to consent procurement, and their stated reasons for non-participation in a paediatric critical care research study.Study design A multicentre, prospective, cohort study.Participants Legal guardians of children who participated in a multicentre study on adrenal insufficiency in paediatric critical illness. Data were collected on all consent encounters in the main study.Methods Screening data, reasons for consent not being obtained, paediatric risk of mortality scores and age were collected on all 1707 patients eligible for participation (...) in the Adrenal Insufficiency Study.Results The main barriers to approaching legal guardians for consent were lack of availability of the legal guardians and language barriers . Legal guardians of 917 patients were approached with an overall consent rate of 42% . 81% of the 528 legal guardians who declined consent provided an unsolicited reason for refusal. The three most commonly stated reasons were: being overwhelmed , not wanting anything else done to their child and not wanting an additional medication . In addition, 14.2% cited research-related concerns as the reason for their non-participation.Conclusions Barriers to consent procurement in a non-therapeutic paediatric critical care study appear to occur at many levels with lack of availability of legal guardians, and legal guardians feeling overwhelmed, being the most commonly recorded reasons. Further research into the impact of these findings on the validity and generalisability of the results of such studies is necessary prior to the development and study of future consent models. (shrink)

Family involvement in healthcare decision-making for competent patients occurs to varying degrees in many communities around the world. There are different attitudes about who should make treatment decisions, how and why. Legal and professional ethics codes in most jurisdictions reflect and support the idea that competent patients should be enabled to make their own treatment decisions, even if others, including their healthcare professionals, disagree with them. This way of thinking contrasts with some cultural norms that put more emphasis on the (...) family as a decision-making entity, in some circumstances to the exclusion of a competent patient. Possible tensions may arise between various combinations of patient, family members and healthcare professionals, and healthcare professionals must tread a careful path in navigating family involvement in the decision-making process. These tensions may be about differences of opinion about which treatment option is best and/or on who should have a say or influence in the decision-making process. While some relevant cultural, legal and policy considerations vary from community to community, there are ethical issues that healthcare professionals need to grapple with in balancing the laws and professional codes on decision-making and the ethical principle of respecting patients and their autonomy. This paper will highlight and propose that a partial resolution to these issues may lie in relational understandings of autonomy, which in principle justify interventions by healthcare professionals and family that support patients in decision-making. (shrink)

This book discusses consciousness from the perspectives of neuroscience, neuropsychiatry and philosophy. The author argues that the central issue in brain studies is to explain the unity, continuity, and adherence of experience, whether it is sensory or mental awareness, phenomenal- or self-consciousness. The fascinating discussion that this book presents is: How do the brain and the self create the conspiracy of experience where the physicality of the brain is lost in the subjectivity of the self?

Most of the large-scale violence in the world will continue to occur within societies rather than between or among states. Yet the international community still has not developed the ethical-legal consensus or the institutions required to manage this terrible problem.

Therapeutic privilege is a defence that may be available to doctors who fail to disclose to the patient relevant information when seeking informed consent for treatment if they have a reasonable belief that providing that information would likely cause the patient concerned serious physical or mental harm. In a landmark judgement, the Singapore Court of Appeal introduced a novel interpretation of TP, identifying circumstances in which it might be used with patients who did not strictly lack capacity but might be (...) inclined to refuse recommended treatments. In this paper, we explore the conceptual and practical challenges of this novel interpretation of TP. We propose that more emphasis should be placed on forms of shared and supported decision-making that foster the autonomy of patients with compromised mental capacity while being mindful of the need to safeguard their well-being. The kind of privilege that doctors might need to invoke is one of time and supportive expertise to ensure a flexible, responsive approach calibrated to the individual patients’ needs. The provision of such service would extinguish the need for the novel TP proposed by the Singapore Court of Appeal. (shrink)

In current trends in cognitive sciences, the discussion on body crosses the classical divide between the body and the self in terms of nature and function. Embodiment theories have helped to bring in the importance of the role of subjective experiences to understand cognition, and place the process of knowing in a cultural and social context. This article is a critique of the growing trend in cognitive sciences, particularly in affective neurosciences, and approaches, to reduce the experiential self to a (...) nonentity. It is shown that though the apparent goal is to highlight the inner qualitative nature of experience, what is happening in the background is a role reversal. The outer body becomes the inner self. The inner self becomes the outer body. The nature and functions of the self are founded on the body by theorizing embodiment as an alternate to neural reductionism. This article argues that one of the negative consequences of embodiment theories is that age-old concepts of freewill, character and moral choices become flimsy and fleeting in the process of embodying cognition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Legal CommentarySumy Menon, Senior Associate in ResearchThis case involves the balancing of a young person’s right to autonomy and the desire to protect her from harm. No Singapore court decision has determined whether the doctor owes a duty to the parents of the doctor’s 16-year-old patient, to warn them that their child is engaging in sexual activities, and who subsequently has had an abortion. Similarly, the issue of (...) whether the doctor has a duty to protect the minor in such circumstances has also not been tested in the Singapore courts. Nonetheless, it is very unlikely that either duty will be found in this case.The general rule is that doctors owe a duty of confidentiality to their patients. This duty extends to children, and although no Singapore court has ruled on the matter, the law in England is clear.1 It is enshrined in section 4.2.3.1 of the Ethical Code & Ethical Guidelines of the Singapore Medical Council. It is not absolute and a number of exceptions have been carved out. The confidentiality duty can be overridden by legislation, court order, the public interest, or other justifiable circumstances that the doctor believes warrants disclosure.The age of consent for non-commercial consensual sexual activities in Singapore is 16.2 Therefore, there is no statutory responsibility on Dr. C under the criminal law to report the patients’ sexual activities to the authorities or anyone else. There is no other legislation or court order that compels disclosure. It is highly unlikely that the public interest would be served by disclosure. The consequences of such disclosure to the public interest were aptly put in a recent English case, when J. Silber held that if a confidentiality duty was not imposed, it “would probably or might well deter young people [End Page 262] from seeking advice and treatment on contraception, sexually transmitted diseases and abortion, and this would have undesirable and troubled consequences”.3 The last exception offers the greatest latitude for doctors to disclose if they believe there are other justifiable circumstances that would shift the balance in favour of disclosure. There are strong reasons to maintain confidentiality in Miss M’s case and although an argument can be made for disclosure, that argument is relatively weak.Miss M’s parents are understandably worried about her but Dr. C should not breach the duty of confidentiality owed to the patient even though she is only 16 years old. It is irrelevant that Miss M’s parents are paying for their daughter’s treatment. The doctor-patient relationship is between Dr. C and Miss M, and her parents have never been involved in the consultations or treatment decision-making process. They have not insisted on attending the consultations with their daughter, nor did they appear to object to Miss M consenting to treatment. Prior to their complaint, they had not sought any update or information about their daughter’s condition from Dr. C. Miss M specifically asked Dr. C not to reveal the contents of their conversations to her parents at the first consultation and the doctor agreed after attempting to convince her that it would be preferable to include her parents in the consultations. Miss M was obviously concerned about confidentiality and sought clarification from Dr. C. It appears as though Dr. C determined that Miss M had the capacity to exclude her parents from the consultations, and later to make her own treatment decisions, as a mature minor, and their doctor-patient relationship proceeded on that basis.It may be in the public interest for Dr. C to disclose confidential information about Miss M, even if she refuses to consent to it, if the doctor believes it is necessary to protect her from serious harm. Any such decision must be made with the patient’s best interests in mind. Examples of such harm include situations where the patient is at risk of serious physical abuse or has voiced a desire to commit suicide. Engaging in sexual activity with an older boy is unlikely to result in such serious harm, although harm may result. In this case, that harm manifested itself in an unwanted pregnancy... (shrink)

Accession Number: ATLA0001712100; Hosting Book Page Citation: p 7-23.; Language(s): English; General Note: Bibliography: p 22-23.; Issued by ATLA: 20130825; Publication Type: Essay.