Deep brain stimulation — a novel surgical procedure — is emerging as a treatment of last resort for people diagnosed with neuropsychiatric disorders such as severe obsessive-compulsive disorder. The US Food and Drug Administration granted a so-called humanitarian device exemption to allow patients to access this intervention, thereby removing the requirement for a clinical trial of the appropriate size and statistical power. Bypassing the rigors of such trials puts patients at risk, limits opportunities for scientific discovery, and gives device manufacturers (...) unique marketing opportunities. We argue that Congress and federal regulators should revisit the humanitarian device exemption to ensure that it is not used to sidestep careful research that can offer valuable data with appropriate patient safeguards. (shrink)

There is a New Idea in epistemology. It goes by the name of ‘knowledge first,’ and it is particularly associated with Timothy Williamson’s book Knowledge and Its Limits. In slogan form, to put knowledge first is to treat knowledge as basic or fundamental, and to explain other states—belief, justification, maybe even content itself—in terms of knowledge, instead of vice versa. The idea has proven enormously interesting, and equally controversial. But deep foundational questions about its actual content remain relatively unexplored. We (...) think that a wide variety of views travel under the banner of ‘knowledge first’ (and that the slogan doesn’t help much with differentiating them). Furthermore, we think it is far from straightforward to draw connections between certain of these views; they are more independent than they are often assumed to be. Our project here is exploratory and clarificatory. We mean to tease apart various ‘knowledge first’ claims, and explore what connections they do or do not have with one another. Our taxonomy is offered in §2, and connections are explored in §3. The result, we hope, will be a clearer understanding of just what the knowledge first theses are. We conclude, in §4, with some brief suggestions as to how we think the various theses might be evaluated. (shrink)

Background: We aimed to determine the smallest changes in health-related quality of life (HRQoL) scores in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire core 30 and the Brain Cancer Module (QLQ-BN20), which could be considered as clinically meaningful in brain cancer patients. Materials and methods: World Health Organisation performance status (PS) and mini-mental state examination (MMSE) were used as clinical anchors appropriate to related subscales to determine the minimal clinically important differences (MCIDs) in HRQoL (...) change scores (range 0-100) in the QLQ-C30 and QLQ-BN20. A threshold of 0.2 standard deviation (SD) (small effect) was used to exclude anchor-based MCID estimates considered too small to inform interpretation. Results: Based on PS, our findings support the following integer estimates of the MCID for improvement and deterioration, respectively: physical (6, 9), role (14, 12), and cognitive functioning (8, 8); global health status (7, 4(star)), fatigue (12, 9), and motor dysfunction (4(star), 5). Anchoring with MMSE, cognitive functioning MCID estimates for improvement and deterioration were (11, 2(star)) and for communication deficit were (9, 7). Estimates with asterisks were <0.2 SD and were excluded from our MCID range of 5-14. Conclusion: These estimates can help clinicians evaluate changes in HRQoL over time, assess the value of a health care intervention and can be useful in determining sample sizes in designing future clinical trials. (shrink)

This is one of the seminal articles of the pragmatist tradition where C.S. Peirce sets out his doctrine of doubt and belief --and their relationship to inquiry and clarity of our concepts. Originally published in the Popular Science Monthly; and widely available in reprints and collections of Peirce's writings.

“Probably Peirce’s best-known works are the first two articles in a series of six that originally were collectively entitled Illustrations of the Logic of Science and published in Popular Science Monthly from November 1877 through August 1878. The first is entitled ‘The Fixation of Belief’ and the second is entitled ‘How to Make Our Ideas Clear.’ In the first of these papers Peirce defended, in a manner consistent with not accepting naive realism, the superiority of the scientific method over other (...) methods of overcoming doubt and ‘fixing belief.’” — Robert Burch, “Charles Sanders Peirce,” entry in the Stanford Encyclopedia of Philosophy (2021 revision) -/- “Pragmatist epistemologies often explore how we can carry out inquiries in a self-controlled and fruitful way. (Where much analytic epistemology centres around the concept of knowledge, considered as an idealised end-point of human thought, pragmatist epistemology centres around the concept of inquiry, considered as the process of knowledge-seeking and how we can improve it.) So pragmatists often provide rich accounts of the capacities or virtues that we must possess in order to inquire well, and the rules or guiding principles that we should adopt. A canonical account is Peirce’s classic early paper ‘The Fixation of Belief‘. Here Peirce states that inquiry is a struggle to replace doubt with “settled belief“, and that the only method of inquiry that can make sense of the fact that at least some of us are disturbed by inconsistent beliefs, and will subsequently reflect upon which methods of fixing belief are correct is the Method of Science, which draws on the Pragmatic Maxim described above. This contrasts with three other methods of fixing belief: i) refusing to consider evidence contrary to one’s favored beliefs (the Method of Tenacity), ii) accepting an institution’s dictates (the Method of Authority), iii) developing the most rationally coherent or elegant-seeming belief-set (the A Priori Method).“ — Catherine Legg, “Pragmatism,” entry in the Stanford Encyclopedia of Philosophy (2021 revision). (shrink)

An able and clear defense of Bradley's principal theses and the underlying conception of metaphysical enterprise. "This is a book about a metaphysician, about metaphysics, and, most importantly, it attempts to develop elements of a metaphysical position long the lines of what is called Absolute Idealism." The Introduction takes up the Verificationists [[sic]] argument and two recent accounts of metaphysics. Part I devotes ten Chapters to the elucidation and defense of Bradley's conception of reality. It culminates in examining three alternative (...) accounts of "Real". Part II considers "the major philosophical theories of the self in order to defend Bradley's Theory of the self within his metaphysical scheme."--A. S. C. (shrink)

C. S. Lewis sets out to disentangle this knotty issue but wisely adds that in the end no intellectual solution can dispense with the necessity for patience and ...

A repackaged edition of the revered author's classic work that examines the four types of human love: affection, friendship, erotic love, and the love of God—part of the C. S. Lewis Signature Classics series. C.S. Lewis—the great British writer, scholar, lay theologian, broadcaster, Christian apologist, and bestselling author of Mere Christianity, The Screwtape Letters, The Great Divorce, The Chronicles of Narnia, and many other beloved classics—contemplates the essence of love and how it works in our daily lives in one of (...) his most famous works of nonfiction. Lewis examines four varieties of human love: affection, the most basic form; friendship, the rarest and perhaps most insightful; Eros, passionate love; charity, the greatest and least selfish. Throughout this compassionate and reasoned study, he encourages readers to open themselves to all forms of love—the key to understanding that brings us closer to God. (shrink)

On the occasion of the 50th anniversary of C. S. Lewis’s death, a special annotated edition of his Christian classic, The Screwtape Letters, with notes and excerpts from his other works that help illuminate this diabolical masterpiece. Since its publication in 1942, The Screwtape Letters has sold millions of copies worldwide and is recognized as a milestone in the history of popular theology. A masterpiece of satire, it offers a sly and ironic portrayal of human life and foibles from the (...) vantage point of Screwtape, a highly placed assistant to “Our Father Below.” At once wildly comic, deadly serious, and strikingly original, The Screwtape Letters comprises the correspondence of the worldly-wise devil Screwtape and his nephew Wormwood, a novice demon in charge of securing the damnation of an ordinary young man. For the first time, The Screwtape Letters will be presented in full-text accompanied by helpful annotations in a striking two-color format. These annotations will give fans a deeper, more nuanced understanding of the popular book, providing background information, explanations of terms, historical significance, and excerpts from Lewis’s other works that more fully explain the ideas in this volume. For both expert Lewis fans and casual readers, The Screwtape Letters: Annotated Edition will be a beautiful and insightful guide to a beloved classic. (shrink)