During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

An alternative to objectifying approaches to understanding Post-traumatic Stress Disorder grounded in hermeneutic phenomenology is presented. Nurses who provided care for soldiers injured in the Iraq and Afghanistan wars, and sixty-seven wounded male servicemen in the rehabilitation phase of their recovery were interviewed. PTSD is the one major psychiatric diagnosis where social causation is established, yet PTSD is predominantly viewed in terms of the usual neuro-physiological causal models with traumatic social events viewed as pathogens with dose related effects. Biologic models (...) of causation are applied reductively to both predisposing personal vulnerabilities and strengths that prevent PTSD, such as resiliency. However, framing PTSD as an objective disease state separates it from narrative historical details of the trauma. Personal stories and cultural meanings of the traumatic events are seen as epiphenomenal, unrelated to the understanding of, and ultimately, the therapeutic treatment of PTSD. Most wounded service members described classic symptoms of PTSD: flashbacks, insomnia, anxiety etc. All experienced disturbance in their sense of time and place. Rather than see the occurrence of these symptoms as decontextualized mechanistic reverberations of war, we consider how these symptoms meaningfully reflect actual war experiences and sense of displacement experienced by service members. (shrink)

Intervening on causal systems can illuminate their underlying structures. Past work has shown that, relative to adults, young children often make intervention decisions that appear to confirm a single hypothesis rather than those that optimally discriminate alternative hypotheses. Here, we investigated how the ability to make informative causal interventions changes across development. Ninety participants between the ages of 7 and 25 completed 40 different puzzles in which they had to intervene on various causal systems to determine their underlying structures. Each (...) puzzle comprised a three‐ or four‐node computer chip with hidden wires. On each trial, participants viewed two possible arrangements of the chip's hidden wires and had to select a single node to activate. After observing the outcome of their intervention, participants selected a wire configuration and rated their confidence in their selection. We characterized participant choices with a Bayesian measurement model that indexed the extent to which participants selected nodes that would best disambiguate the two possible causal structures versus those that had high causal centrality in one of the two causal hypotheses but did not necessarily discriminate between them. Our model estimates revealed that the use of a discriminatory strategy increased through early adolescence. Further, developmental improvements in intervention strategy were related to changes in the ability to accurately judge the strength of evidence that interventions revealed, as indexed by participants' confidence in their selections. Our results suggest that improvements in causal information‐seeking extend into adolescence and may be driven by metacognitive sensitivity to the efficacy of previous interventions in discriminating competing ideas. (shrink)

We propose a new definition of actual causes, using structural equations to model counterfactuals. We show that the definition yields a plausible and elegant account of causation that handles well examples which have caused problems for other definitions and resolves major difficulties in the traditional account.

We propose new definitions of (causal) explanation, using structural equations to model counterfactuals. The definition is based on the notion of actual cause, as defined and motivated in a companion article. Essentially, an explanation is a fact that is not known for certain but, if found to be true, would constitute an actual cause of the fact to be explained, regardless of the agent's initial uncertainty. We show that the definition handles well a number of problematic examples from the literature.

Using formal systems to represent and reason about uncertainty.

Recent work in psychology and experimental philosophy has shown that judgments of actual causation are often influenced by consideration of defaults, typicality, and normality. A number of philosophers and computer scientists have also suggested that an appeal to such factors can help deal with problems facing existing accounts of actual causation. This article develops a flexible formal framework for incorporating defaults, typicality, and normality into an account of actual causation. The resulting account takes actual causation to be both graded and (...) comparative. We then show how our account would handle a number of standard cases. 1 Introduction2 Causal Models3 The HP Definition of Actual Causation4 The Problem of Isomorphism5 Defaults, Typicality, and Normality6 Extended Causal Models7 Examples7.1 Omissions7.2 Knobe effects7.3 Causes versus background conditions7.4 Bogus prevention7.5 Causal chains7.6 Legal doctrines of intervening causes7.7 Pre-emption and short circuits8 Conclusion. (shrink)

In response to the article by Baum-Baicker and Sisti, I will consider the kind of wisdom involved in therapeutic listening; the role of life wisdom; and the challenge of imparting clinical wisdom to young health professionals’ education.

Sufficient conditions are given under which ratifiable acts exist.

More than 40 years ago, Gilbert Gottlieb and like-minded scholars argued for the philosophical necessity of approaching genetic contributions to development through a multilevel, bidirectional systems perspective. Charney's target article builds on this heritage in significant ways, offering more recent examples of the interactions of biology and context, as well as the diversity of developmental mechanisms, and reaffirming a way forward for genetic research.

There is an important gap in philosophical, clinical and bioethical conceptions of decision-making capacity. These fields recognize that when traumatic life circumstances occur, people not only feel afraid and demoralized, but may develop catastrophic thinking and other beliefs that can lead to poor judgment. Yet there has been no articulation of the ways in which such beliefs may actually derail decision-making capacity. In particular, certain emotionally grounded beliefs are systematically unresponsive to evidence, and this can block the ability to deliberate (...) about alternatives. People who meet medico-legal criteria for decision-making capacity can react to health and personal crises with such capacity-derailing reactions. One aspect of this is that a person who is otherwise cognitively intact may be unable to appreciate her own future quality of life while in this complex state of mind. This raises troubling ethical challenges. We cannot rely on the current standard assessment of cognition to determine decisional rights in medical and other settings. We need to understand better how emotionally grounded beliefs interfere with decision-making capacity, in order to identify when caregivers have an obligation to intervene. (shrink)

The appropriateness of S5 as a logic of knowledge has been attacked at some length in the philosophical literature. Here one particular attack based on the interplay between knowledge and belief is considered: Suppose that knowledge satisfies S5, belief satisfies KD45, and both the entailment property (knowledge implies belief) and positive certainty (if the agent believes something, she believes she knows it) hold. Then it can be shown that belief reduces to knowledge: it is impossible to have false beliefs. While (...) the entailment property has typically been viewed as perhaps the least controversial of these assumptions, an argument is presented that it can plausibly be viewed as the culprit. More precisely, it is shown that this attack fails if we weaken the entailment property so that it applies only to objective (nonmodal) formulas, rather than to arbitrary formulas. Since the standard arguments in favor of the entailment property are typically given only for objective formulas, this observation suggests that care must be taken in applying intuitions that seem reasonable in the case of objective formulas to arbitrary formulas. (shrink)

Unrealistic therapeutic beliefs are very common—the majority of patient-subjects (up to 94%) enrol in phase 1 trials seeking and expecting significant medical benefit, even though the likelihood of such benefit has historically proven very low. The high prevalence of therapeutic misestimation and unrealistic optimism in particular has stimulated debate about whether unrealistic therapeutic beliefs in early-phase clinical trials preclude adequate informed consent. We seek here to help resolve this controversy by showing that a crucial determination of when such therapeutic beliefs (...) are ethically problematic turns on whether they are causally linked and instrumental to the motivation to participate in the trial. Thus, in practice, it is ethically incumbent on researchers to determine which understanding and beliefs lead to the participant’s primary motivation for enrolling, not to simply assess understanding, beliefs and motivations independently. We further contend that assessing patient-subjects’ appreciation as a component of informed consent—it is already an established component of decision-making capacity assessments—can help elucidate the link between understanding-beliefs and motivation; appreciation refers to an individual’s understanding of the personal significance of both the medical facts and the experience of trial participation. Therefore, we recommend that: (1) in addition to the usual question, ‘Why do you want to participate in this trial?’, all potential participants should be asked the question: ‘What are you giving up by participating in this trial?’ and (2) researchers should consider the settings in which it may be possible and practical to obtain ‘two-point consent’. (shrink)

There are many examples in the literature that suggest that indistinguishability is intransitive, despite the fact that the indistinguishability relation is typically taken to be an equivalence relation (and thus transitive). It is shown that if the uncertainty perception and the question of when an agent reports that two things are indistinguishable are both carefully modeled, the problems disappear, and indistinguishability can indeed be taken to be an equivalence relation. Moreover, this model also suggests a logic of vagueness that seems (...) to solve many of the problems related to vagueness discussed in the philosophical literature. In particular, it is shown here how the logic can handle the sorites paradox. (shrink)

Galles & Pearl (l998) claimed that s [possible-worlds] framework.s framework. Recursive models are shown to correspond precisely to a subclass of (possible-world) counterfactual structures. On the other hand, a slight generalization of recursive models, models where all equations have unique solutions, is shown to be incomparable in expressive power to counterfactual structures, despite the fact that the Galles and Pearl arguments should apply to them as well. The problem with the Galles and Pearl argument is identified: an axiom that they (...) viewed as irrelevant, because it involved disjunction (which was not in their language), is not irrelevant at all. (shrink)

The question of whether knowledge is definable in terms of belief, which has played an important role in epistemology for the last 50 years, is studied here in the framework of epistemic and doxastic logics. Three notions of definability are considered: explicit definability, implicit definability, and reducibility, where explicit definability is equivalent to the combination of implicit definability and reducibility. It is shown that if knowledge satisfies any set of axioms contained in S5, then it cannot be explicitly defined in (...) terms of belief. S5 knowledge can be implicitly defined by belief, but not reduced to it. On the other hand, S4.4 knowledge and weaker notions of knowledge cannot be implicitly defined by belief, but can be reduced to it by defining knowledge as true belief. It is also shown that S5 knowledge cannot be reduced to belief and justification, provided that there are no axioms that involve both belief and justification. (shrink)

The field of science communication is plagued by challenges. Communicators face the difficulty of responding to unjustified public skepticism over issues like climate change and COVID-19 while also acknowledging the fallibility and limitations of scientific knowledge. Our goal in this paper is to suggest a new model for science communication that can help foster more productive, respectful relationships among all those involved in science communication. Inspired by the pragmatist philosophy of John Dewey, we develop an experience model, according to which (...) science communication consists in people’s experiences with science and the meanings they develop from those experiences. Three principles are central to the model: experience is cumulative, context matters, and audiences have agency. We argue that this model has significant implications both for communication research and practice, which we illustrate by applying it to the phenomenon of vaccine hesitancy. We show how science communicators can help to identify and alleviate structural factors that contribute to skepticism as well as fostering opportunities for meaning making around shared experiences. (shrink)

In 1960, E. P. Wigner, a joint winner of the 1963 Nobel Prize for Physics, published a paper titled On the Unreasonable Effectiveness of Mathematics in the Natural Sciences [61]. This paper can be construed as an examination and affirmation of Galileo's tenet that “The book of nature is written in the language of mathematics”. To this effect, Wigner presented a large number of examples that demonstrate the effectiveness of mathematics in accurately describing physical phenomena. Wigner viewed these examples as (...) illustrations of what he called the empirical law of epistemology, which asserts that the mathematical formulation of the laws of nature is both appropriate and accurate, and that mathematics is actually the correct language for formulating the laws of nature. At the same time, Wigner pointed out that the reasons for the success of mathematics in the natural sciences are not completely understood; in fact, he went as far as asserting that “… the enormous usefulness of mathematics in the natural sciences is something bordering on the mysterious and there is no rational explanation for it.”. (shrink)

This volume argues that feminist theory can provide distinctive and potent resources to confront and take on post-truth. By ‘post-truth’, we refer to a variety of discourses and practices that subvert the sense that we share a common world. Because post-truth undermines the norms and conditions that make possible shared political practices and institutions, post-truth politics is fundamentally anti-democratic. The most common response to post-truth has, however, come from those who call for reinstating truth and rationality, with special emphasis on (...) returning to the facts and fact-checking. From a feminist perspective, this approach is worrisome as it risks idealizing the connection between democracy and truth, disowning the tensions within and between them, and suppressing contestation tout court. Diagnosing the post-truth moment we face two challenges: on the one hand, there is too much contestation (of the post-truth variety); on the other hand, there is too much depoliticization (of the technocratic or rationalist variety). This binary effectively limits the space within which critiques of post-truth can meaningfully intervene. Feminist takes on post-truth must take seriously this dual challenge at the crossroads of depoliticization and hyper-politicization, acknowledging the anti-democratic dangers of post-truth while keeping open the possibility and necessity of contestation. Our gambit is that effective rejoinders to post-truth can be found in practices that affirm rather than repudiate a plural world. Rather than simply condemning or dismissing post-truth as mad or irrational, the feminist theorists in this volume move closer to what we’re up against in order to see how encounters with reality provide opportunities to radicalize and politicize our relation to it in ways that do not undermine the conditions for others to do the same. This volume is an attempt to open new, and emphasize existing, feminist modes of response that might break the deadlock in the post-truth discourse. (shrink)

There have been two major lines of research aimed at capturing resource-bounded players in game theory. The first, initiated by Rubinstein (), charges an agent for doing costly computation; the second, initiated by Neyman (), does not charge for computation, but limits the computation that agents can do, typically by modeling agents as finite automata. We review recent work on applying both approaches in the context of decision theory. For the first approach, we take the objects of choice in a (...) decision problem to be Turing machines, and charge players for the “complexity” of the Turing machine chosen (e.g., its running time). This approach can be used to explain well-known phenomena like first-impression-matters biases (i.e., people tend to put more weight on evidence they hear early on) and belief polarization (two people with different prior beliefs, hearing the same evidence, can end up with diametrically opposed conclusions) as the outcomes of quite rational decisions. For the second approach, we model people as finite automata, and provide a simple algorithm that, on a problem that captures a number of settings of interest, provably performs optimally as the number of states in the automaton increases. (shrink)

Natural conditions are provided that are sufficient to ensure that causality as defined by approaches that use counterfactual dependence and structural equations will be transitive.

Comment parvenons-nous à une connaissance du réel? Quels sont, sur ce point, les pouvoirs et les limites de la raison humaine? La raison, au fil des siècles, a été soit attaquée, soit placée sur un piédestal. Cet ouvrage se propose de répertorier les différentes positions adoptées par les philosophes, avant de trancher en faveur d'une conception modeste de la raison. Si celle-ci ne peut nous offrir des certitudes absolues quant à notre connaissance du réel, elle nous permet néanmoins d'élaborer un (...) savoir provisoire et révisable, à partir duquel nous parvenons à nous orienter et à agir dans le monde. (shrink)

We consider a setting where a decision maker’s uncertainty is represented by a set of probability measures, rather than a single measure. Measure-by-measure updating of such a set of measures upon acquiring new information is well known to suffer from problems. To deal with these problems, we propose using weighted sets of probabilities: a representation where each measure is associated with a weight, which denotes its significance. We describe a natural approach to updating in such a situation and a natural (...) approach to determining the weights. We then show how this representation can be used in decision making, by modifying a standard approach to decision making—minimizing expected regret—to obtain minimax weighted expected regret. We provide an axiomatization that characterizes preferences induced by MWER both in the static and dynamic case. (shrink)

In this paper I explore a famous part of Plato’s Theaetetus where Socrates develops various models of the mind (picturing it first as a wax tablet and then as an aviary full of specimen birds). These are to solve some puzzles about how it is possible to make a mistake. On my interpretation, defended here, the discussion of mistakes is no digression, but is part of the refutation of Theaetetus’s thesis that knowledge is “true doxa”. It reveals that false doxa (...) is possible only if there is a certain stock of abstract knowledge, conceptual knowledge, that is not awareness of the particular individual that is being described. The individual must be identified under some description, or seen as something of a certain kind. Error can only occur if the description applied misdescribes the situation, but then if it is to be applied falsely it must first have been known from somewhere else. So knowledge cannot be reduced to the application of descriptions to particulars, but is to be found in the prior possession of abstract descriptions that can be deployed in identifying particular individuals on the ground. (shrink)

The paper starts with reflections on Plato’s critique of the poets and the preference many express for Aristotle’s view of poetry. The second part of the paper takes a case study of analytic treatments of ancient philosophy, including the ancient philosopher poets, to examine the poetics of analytic philosophy, diagnosing a preference in Analytic philosophy for a clean non-poetic style of presentation, and then develops this in considering how well historians of philosophy in the Analytic tradition can accommodate the contributions (...) of philosophers who wrote in verse. The final part of the paper reviews the current enthusiasm for decoding Empedocles’ vague and poetic descriptions of the cosmic cycle into a precise scientific periodicity on the basis of the recently discovered Byzantine scholia on Aristotle. I argue that this enthusiasm speaks to a desire for definite and clear numerical values in place of poetic motifs of give and take, and that this mathematical and scientific poetic is comparable to the preferred poetic of analytic philosophy. (shrink)

Sociality of science has long been the topic of investigation in science studies and the social constructivist approaches advanced within critical race theory and feminist epistemology. Helen Longino’s career has provided a number of canonical and crucial advances in philosophical understanding of the sociality of science, and recently, she has argued that it is the sociality of interaction within scientific groups that makes them knowledge producing. In this article, forthcoming in a volume dedicated to the work of Longino's career, we (...) use case studies in potato science research to offer a friendly but important amendment to Longino's recent analysis of the sociality of interaction. (shrink)

This collection of essays is a Festschrift for Ernest W. Adams, and is based on a symposium that was held in his honor in 1993. As the title suggests, most of the essays focus on probability and the logic of conditionals, and the relationship between them; they draw their inspiration from Adams’s seminal work on the subject. As a computer scientist, I was struck by just how much the topics discussed play a major role in much recent work in computer (...) science, and how relevant much recent work in computer science is to some of the issues discussed here. (shrink)

Professor Christopher Stead was Ely Professor of Divinity from 1971 until his retirement in 1980 and one of the great contributors to the Oxford Patristic Conferences for many years. In this paper I reflect on his work in Patristics, and I attempt to understand how his interests diverged from the other major contributors in the same period, and how they were formed by his philosophical milieu and the spirit of the age. As a case study to illustrate and diagnose his (...) approach, I shall focus on a debate between Stead and Rowan Williams about the significance of the word idios in Arius's theology (in the course of which I also make some suggestions of my own about the issue). (shrink)