With their comprehensive categorization of “ambivalence-related phenomena,” Moore et al. helpfully clarify and contextualize these decisional states as they arise in patient care. Given the...

Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, in which the evidence for the drug is assumed to be established, are often prioritised over research use. In this manuscript, we present a case of (...) a phase II investigational trial of intravenous thiamine for delirium prevention in patients undergoing haematopoietic stem cell transplantation to emphasise several shortcomings in the overarching prioritisation of clinical over research uses of scarce drugs. Specifically, we present the following considerations: clinical use may not have stronger evidence than research use; a strong scientific rationale for research use may outweigh the claim for clinical indications in which there is weak evidence; treatment within the context of a clinical trial may be the standard of care; and research use may not only benefit patients receiving the treatment but also offers the prospect of improving future clinical care. In summary, we argue against allocation schemes that prohibit all research uses of scarce drugs and instead recommend that allocation schemes include a balanced approach that weighs risks and benefits of access to scarce drugs irrespective of the research versus clinical use designation. (shrink)

In two studies, we used the Ethics Position Questionnaire (EPQ) to investigate the relationship between individual differences in moral philosophy, involvement in the animal rights movement, and attitudes toward the treatment of animals. In the first, 600 animal rights activists attending a national demonstration and 266 nonactivist college students were given the EPQ. Analysis of the returns from 157 activists and 198 students indicated that the activists were more likely than the students to hold an "absolutist" moral orientation (high idealism, (...) low relativism). In the second study, 169 students were given the EPQ with a scale designed to measure attitudes toward the treatment of animals. Multiple regression showed that gender and the EPQ dimension of idealism were related to attitudes toward animal use. (shrink)

The major competing statistical paradigms share a common remarkable but unremarked thread: in many of their inferential applications, different probability interpretations are combined. How this plays out in different theories of inference depends on the type of question asked. We distinguish four question types: confirmation, evidence, decision, and prediction. We show that Bayesian confirmation theory mixes what are intuitively “subjective” and “objective” interpretations of probability, whereas the likelihood-based account of evidence melds three conceptions of what constitutes an “objective” probability.

_Addresses of the Mississippi Philosophical Association_ is a collection of presidential and invited addresses from the members of the Mississippi Philosophical Association (MPA). Papers date from the inception of the association in the mid-1940s and continue through 1999. The common thread in these addresses is the authors' service to or leadership in the MPA. The content and methods in the chapters are diverse, including addresses on ethics, political philosophy, history of philosophy, epistemology, aesthetics, philosophy of language, philosophy of religion, philosophy (...) of science, and philosophical theology. Some unique features of this book are a history of the MPA, biographical sketches and photographs of each contributor, and the inclusion of the unpublished 1988 Dunbar Lectures from Millsaps College and the unpublished 1992 Akin Lecture from Mississippi College. These essays and lectures reveal the vitality of philosophy in the colleges and universities of Mississippi. As part of the special series, Histories and Addresses of Philosophical Societies in the larger Value Inquiry Book Series, this book documents - in a unique historical format - the value and vitality of a state philosophical organization. “There has been no attempt to mold these addresses into a unity; rather, the addresses offer a glimpse of the pluralistic philosophical reflection among the philosophical faculties of the private colleges and public universities in the state of Mississippi. To the surprise of some people, philosophy is alive, well, diverse, and flourishing in Mississippi!” (from the Preface). (shrink)

THE CENTRALITY OF "SYMPATHY" to Adam Smith's Theory of Moral Sentiments points to the centrality of love in the book. While Smith delineates a somewhat unusual, technical sense of "sympathy", his actual use of the term frequently slips into its more ordinary sense of "compassion" or affectionate fellow feeling. This no doubt intentional equivocation on Smith's part helps suffuse the book with these themes, to the point that, without much exaggeration, one could say that the Theory of Moral Sentiments is (...) generally about love: our need for love and sympathy, love as friendship, self-love, the love of praise and praiseworthiness, the love of beauty. Even in the Wealth of Nations, our loves are thought to be very important in explaining our behavior. Smith is unusual among modern moral philosophers in according so central a place to love in this broad sense, although of course Christianity made love a central theme in reflection on ethical life, and philosophers such as Hutcheson made benevolence a key virtue in their ethical systems. However, it is not our purpose to examine Smith's critique of Hutcheson or indeed of any of his predecessors. Rather we aim in this paper to reflect on his treatment of this topic. We shall do so in part by means of comparisons with Aristotle and Plato, first with respect to friendship and then with respect to love generally. Smith's writing is replete with classical references, raising the issue of the degree to which his thought is "ancient" or "modern." Friendship is arguably the pinnacle of social relations for the ancients, and thus it provides us with a useful device for determining the degree to which Smith's thought embodies classical moral and philosophical principles. The subtlety of Smith's interweaving of traditions will become visible as we reflect not just on the ways Smith's thought exhibits classical conceptions of friendship and love, but also on the ways he departs from them. For in at least one important respect, love is a closed book from Smith's standpoint, and thus, as it turns out, also at odds with classical friendship. (shrink)

Today’s medical training environment exposes medical trainees to many aspects of what has been called “the hidden curriculum.” In this article, we examine the relationship between two aspects of the hidden curriculum, the performance of emotional labor and the characterization of patients and proxies as “bad,” by analyzing clinical ethics discussions with resident trainees at an academic medical center. We argue that clinicians’ characterization of certain patients and proxies as “bad,” when they are not, can take an unnecessary toll on (...) trainees’ emotions. We conclude with a discussion of how training in ethics may help uncover and examine these aspects of the hidden curriculum. (shrink)

Henrich et al.'s critical review demonstrating that psychology research is over-reliant on WEIRD samples is an important contribution to the field. Their stronger claim that is less convincing, however. We argue that WEIRD people's apparent distinct weirdness is a methodological side-effect of psychology's over-reliance on WEIRD populations for developing its methods and theoretical constructs.

Mouse embryonic stem cell lines offer an attractive route for introducing rare genetic alternations into the gene pool since the cells can be pre‐screened in culture and the mutations then transmitted into the germline through chimera production. Two applications of this technique seem ideally suited for a genetic analysis of development are enhancer and gene trap screens for loci expressed during gastrulation and production of targeted mutations using homologous recombination. These approaches should greatly increase the number of mouse developmental mutants (...) available and help to elucidate the genetic hierarchy controlling embryogenesis. (shrink)

Interpreting Figurative Meaning critically evaluates the recent empirical work from psycholinguistics and neuroscience examining the successes and difficulties associated with interpreting figurative language. There is now a huge, often contradictory literature on how people understand figures of speech. Gibbs and Colston argue that there may not be a single theory or model that adequately explains both the processes and products of figurative meaning experience. Experimental research may ultimately be unable to simply adjudicate between current models in psychology, linguistics and philosophy (...) of how figurative meaning is interpreted. Alternatively, the authors advance a broad theoretical framework, motivated by ideas from 'dynamical systems theory', that describes the multiple, interacting influences which shape people's experiences of figurative meaning in discourse. This book details past research and theory, offers a critical assessment of this work and sets the stage for a new vision of figurative experience in human life. (shrink)

This Article examines the influence of the Americans with Disabilities Act (ADA) on affective attitudes toward children with disabilities and on the incidence of disability-selective abortion. Applying regression analysis to U.S. natality data, we find that the birthrate of children with Down syndrome declined significantly in the years following the ADA's passage. Controlling for technological, demographic, and cultural variables suggests that the ADA may have encouraged prospective parents to prevent the existence of the very class of people the Act was (...) designed to protect. We explain this paradox by showing how specific ADA provisions could have given rise to demeaning media depictions and social conditions that reinforced negative understandings and expectations among prospective parents about what it means to have a child with a disability. We discuss implications for reproduction law and antidiscrimination policy. (shrink)

Examination of the target article for its relevance to the analysis of private behavior leads to three concerns: the absence of a new methodology for studying private behavior, the undisclosed possibility of interactions, and insufficient attention to the social context of idea generation. Regardless of these concerns, a larger issue remains: Can a science of n = 1 be credible?

Open peer commentary on the article ““Black Box” Theatre: Second-Order Cybernetics and Naturalism in Rehearsal and Performance” by Tom Scholte. Upshot: What von Foerster accomplished in raising the specter of second-order cybernetics now requires experimental design and the heavy lifting of theory to complete his quest for new ways of thinking. Scholte’s “black box theatre” points to research into non-trivial systems as a formal means of grasping living systems.

Copyright © 2015 by the Society of Criti. Objective: Global lung stress varies considerably with low tidal volume ventilation for acute respiratory distress syndrome. High stress despite low tidal volumes may worsen lung injury and increase risk of death. No widely available parameter exists to assess global lung stress. We aimed to determine whether the volume delivered during a recruitment maneuver is inversely associated with lung stress and mortality in acute respiratory distress syndrome. Design: Substudy of an acute respiratory distress (...) syndrome clinical trial on esophageal pressure-guided positive end-expiratory pressure titration. Setting: U.S. academic medical center. Patients: Forty-two patients with acute respiratory distress syndrome in whom airflow, airway pressure, and esophageal pressure were recorded during the recruitment maneuver. Interventions: A single recruitment maneuver was performed before initiating protocol-directed ventilator management. Recruitment maneuvers consisted of a 30-second breath hold at 40 cm H2O airway pressure under heavy sedation or paralysis. VRM was calculated by integrating the flow-time waveform during the maneuver. End-inspiratory stress was defined as the transpulmonary pressure during end-inspiratory pause of a tidal breath and tidal stress as the transpulmonary pressure difference between end-inspiratory and end-expiratory pauses. Measurements and Main Results: VRM ranged between 7.4 and 34.7 mL/kg predicted body weight. Lower VRM predicted high end-inspiratory and tidal lung stress. After adjusting for Pao2/Fio2 and either driving pressure, tidal volume, or plateau pressure and positive end-expiratory pressure, VRM remained independently associated with both end-inspiratory and tidal stress. In unadjusted analysis, low VRM predicted increased risk of death. VRM remained significantly associated with mortality after adjusting for study arm. Conclusions: Low VRM independently predicts high lung stress and may predict risk of death in patients with acute respiratory distress syndrome. (shrink)

This paper argues that the mode of statesmanship recommended in Utopia provides the framework for the Epigrams. While Utopia demonstrates the need for artful indirection by exposing the vices of a man too proud to adopt it, the Epigrams exhibit More's preparation for and practice of a tactfully philosophic statesmanship.