A collective choice mechanism can be viewed as a game in normal form; in this article it is shown, for very attractive rules and for sets with any number of alternatives, how individuals involved in a collective decision problem can construct the preferences they choose to express. An example is given with a version of plurality rule. Manipulability results are deduced from such a characterization.

Which objects and properties are represented in perceptual experience, and how are we able to determine this? The papers in this collection address these questions together with other fundamental questions about the nature of perceptual content. The book draws together papers by leading international philosophers of mind, including Alex Byrne (MIT), Alva Noë (University of California, Berkeley), Tim Bayne (St Catherine’s College, Oxford), Michael Tye (University of Texas, Austin), Richard Price (All Souls College, Oxford) and Susanna Siegel (Harvard University) Essays (...) address the central questions surrounding the content of perceptual experience Investigates how are we able to determine the admissible contents of experience Published in association with the journal Philosophical Quarterly . (shrink)

The concept of strong admissibility plays an important role in dialectical proof procedures for grounded semantics allowing, as it does, concise proofs that an argument belongs to the grounded extension without having necessarily to construct this extension in full. One consequence of this property is that strong admissibility ceases to be a unique status semantics. In fact it is straightforward to construct examples for which the number of distinct strongly admissible sets is exponential in the number of arguments. (...) We are interested in characterizing properties of collections of strongly admissible sets in the sense that any system describing the strongly admissible sets of an argument framework must satisfy particular criteria. In terms of previous studies, our concern is the signature and with conditions ensuring realizability. The principal result is to demonstrate that a system of sets describes the strongly admissible sets of some framework if and only if that system has the property of being decomposable. (shrink)

We use a deontic logic of collective agency to study reducibility questions about collective agency and collective obligations. The logic that is at the basis of our study is a multi-modal logic in the tradition of *stit* logics of agency. Our full formal language has constants for collective and individual deontic admissibility, modalities for collective and individual agency, and modalities for collective and individual obligations. We classify its twenty-seven sublanguages in terms of their (...) expressive power. This classification enables us to investigate reducibility relations between collective deontic admissibility, collective agency, and collective obligations, on the one hand, and individual deontic admissibility, individual agency, and individual obligations, on the other. (shrink)

Background and PurposeMany critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients’ preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission (...) and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making. Before introducing the tool into the admissions routine, the staff were educated about its use and value to the decision-making process.Project and MethodsThe study was to determine if early use of a simple method of identifying a patient’s surrogate and treatment preferences might impact length of stay (LOS) and total hospital charges. A pre- and post-intervention study design was used. Nurses completed the surrogacy information tool for all patients upon admission to the neuroscience ICU. Subjects (total N=203) were critically ill patients who had been on a mechanical ventilator for 96 hours or longer, or in the ICU for seven days or longer. The project included staff education on biomedical ethics, critical communication skills, early identification of families and staff in crisis, and use of a simple tool to document patients’ surrogates and previously expressed care wishes. Data on hospital LOS and hospital charges were collected through a retrospective review of medical records for similar four-month time frames pre- and post-implementation of the assessment tool.ResultsSignificant differences were found between pre- and post-groups in terms of hospital LOS (F=6.39, p=.01) and total hospital charges (F=7.03, p=.009).ConclusionsProject findings indicate that the use of a simple admission assessment tool, supported by staff education about its completion, use, and available resources, can decrease LOS and lower total hospital charges. The reasons for the difference between the pre- and post-intervention groups remain unclear. Further research is needed to evaluate if the quality of communications between patients, their legally authorized representatives, and clinicians—as suggested in the literature—may have played a role in decreasing LOS and total hospital charges. (shrink)

In a couple of recent papers Deborah Tollefsen has argued that groups should be viewed as having some of the intentional and epistemic properties as do individuals. In “Organizations as True Believers” she argues that corporations really do have intentional states.1 In “Collective Epistemic Agency”2 she continues her development of group agency and she now argues that collectives can be genuine knowers. The target of her arguments is, naturally, the wide spread view that “knowers are individuals, and knowledge is (...) generated by mental processes and lodged in the mind-brain.”3 According to Tollefsen, “An epistemic agent is a deliberator that is subject to epistemic assessment; she can be charged with incoherency, inconsistency, ambiguity, and so on.”4 Further, “To be a deliberator in the rich sense in which you or I deliberate is to be subject to the immediacy that is characteristic of reason. When we engage in reasoning (and assuming we have the appropriate desires) we are moved to act immediately or think in accordance with the reasons that we arrive at through deliberation.”5 When we identify which attitudes and acts should be shaped or informed, then such identification takes place from a point of view. Typically, the point of view is the first person singular I, but Tollefsen argues that reflections on group deliberation show that the we-concept often marks the point of view in question. So, Tollefsen argues in effect that 1. A group can be a deliberator 2. A deliberator, in the sense being discussed, is an epistemic agent 3. An epistemic agent can have knowledge 4. So a group can have knowledge. The bulk of Tollefsen’s paper, “Collective Epistemic Agency,” is focused on arguing that (1) is true, i.e., that a group can be a deliberator. One of the examples she uses to make her case involves the decision made by a college admissions committee. The three committee members consider each candidate and vote ‘yes’ or ‘no’ depending on whether or not the candidate should be accepted into the program.. (shrink)

Systematic cross-national analyses of political debates on the admission of refugees and asylum seekers require a theoretically coherent and empirically comprehensive typology of frames and arguments used. The paper proposes such a typology of frames and arguments used by governments, opposition parties and social movements in public debates on the admission of refugees. We argue that the collective identity and characteristics of the receiving country on the one hand and refugees’ characteristics on the other constitute the key dimensions to (...) which frames in political discourse about the admission of refugees refer. We distinguish between six different frames – economic, cultural, moral, legal, security-related and international – of how the “we” and the “others” can be interpreted. Furthermore, we specify typical arguments associated with the respective frames for or against the admission of refugees. Given that the typology was developed based on a discourse analysis of a very diverse set of countries, including some of the so-called “Global South”, we claim that it can be used to analyze political debates on the admission of refugees in other countries as well and can thus contribute to an accumulation of knowledge. (shrink)

In this paper, we consider argumentation frameworks with sets of attacking arguments (SETAFs) due to Nielsen and Parsons, an extension of Dung’s abstract argumentation frameworks that allow for collective attacks. We first provide a comprehensive analysis of the expressiveness of SETAFs under conflict-free, naive, stable, complete, admissible, preferred, semi-stable, and stage semantics. Our analysis shows that SETAFs are strictly more expressive than Dung AFs. Towards a uniform characterization of SETAFs and Dung AFs we provide general results on expressiveness which (...) take the maximum degree of the collective attacks into account. Our results show that, for each [Formula: see text], SETAFs that allow for collective attacks of [Formula: see text] arguments are more expressive than SETAFs that only allow for collective attacks of at most k arguments. (shrink)

The issue of what constitutes a valid logical inference is a difficult question. At a minimum, we believe a permissible step in a proof must provide the reader with rational grounds to believe that the new step is a logically necessary consequence of previous assertions. However, this begs the question of what constitutes these rational grounds. Formalist accounts typically describe valid rules of inferences as those that can be found by applying one of the explicit rules of inference in the (...) formal system in which the proof is couched. However, philosophers of mathematics find such a description unhelpful because many inferences in the proofs that mathematicians actually produce cannot be expressed in a formal language, at least not without seriously distorting the semantic content of the inference (e.g., Larvor, 2012). In this chapter, we investigate mathematicians’ perceptions of a particular kind of inference in a particular setting. Specifically, we shed light on what types of graphical inferences mathematicians find permissible in a real analysis proof. Following Larvor (in press), we examine mathematicians’ reactions to metrical graphical inferences (i.e., inferences whose validity depends on the accuracy of the graph that was drawn and whose validity can be changed by minor deformations) and nonmetrical graphical inferences (i.e., inferences whose validity does not depend on a the accuracy of the graph and whose validity is not vulnerable to local deformations). The goal of this chapter is threefold. First, we demonstrate that most mathematicians reject metrical graphical inferences as impermissible in a real analysis proof. Second, we show that many mathematicians regard nonmetrical graphical inferences as permissible in a real analysis proofs. Third, we illustrate how mathematicians collectively disagree on the permissibility of nonmetrical inferences. (shrink)

The Vestal Virgins are one of the most famous elements of Roman religion, yet despite their perennial appeal and the importance of some smaller scale studies of the priesthood, the priestesses have not received a monograph-length study since F. Giuzzi, Aspetti giuridici del sacerdozio romano. II sacerdozio di Vesta (Naples, 1968). Now we have books by R.L. Wildfang and M.C. Martini that could not be more different. The former offers a thorough survey of what the sources can tell us about (...) the priesthood in the period from the end of the Second Carthaginian War to the first century C.E. The latter is an analysis of early Roman historiography and the role the Vestals, in particular their periodic unchastity, played in the creation of the traditional account of the development of Rome. W's book puts forward two main arguments: (1) the Vestals were charged with the ritual purification of the city and with the storage and preparation of ritual materials, and (2) many aspects of the priesthood that have long puzzled scholars are tied to the Vestals' status as Roman citizens, but citizens who existed outside the traditional family structure. The book will be accessible to those new to the topic, but the notes will repay specialists. Ancient sources are quoted in translation, with original texts provided in an appendix. A second appendix provides a list of known Vestals. This slender volume could have been even thinner if the frequent repetitions were cut down. W's work might have been better as a hefty article, so little is there to know about the Vestals. The Classical Review vol. 58 no. 1 C The Classical Association 2008; all rights reserved This content downloaded from 204.235.148.90 on Sat, 26 Jul 2014 11:47:09 AM All use subject to JSTOR Terms and Conditions THE CLASSICAL REVIEW 213 In the Introduction, W makes a welcome distinction among types of rituals often lumped together in discussions of 'fertility' rituals, with which the Vestals are often associated (p. 4). W reserves 'fertility' to describe only those rites that deal with the reproduction of people, livestock and the growth of crops. Harvest rituals are linked to the harvesting of crops, while another set of rites, 'storage rites', are tied to the preservation of the harvest. The final group, purification rituals, aim at the cleansing of an individual, place or object of 'all forms of pollution that would render it or them unfit to come into contact with the religious sphere'. The book is arranged thematically. The first two chapters lay out all we can know about the priestesses' ritual obligations performed in the seclusion of the temple and out amongst the people. While a reader may not find W's interpretation of each of the Vestals' actions equally persuasive, the overall argument that the priestesses' activities were, by and large, purificatory is convincing. Two of the more interesting aspects of W.'s discussion are her considerations of Vesta's fire and of the water required for some of her rituals (pp. 8-11). Fire was seen by the Romans as both a fertile and a sterile force, and scholars have emphasised one or the other, or the contrast between them, in their interpretation of the Vestals. W points out that fertile fire is always described in masculine terms and is associated with Vulcan. Vesta's fire, however, is always associated with sterility and purity, and so should be understood as having a purificatory significance. W points out that Vesta's fire was used only in the manufacture of ritually necessary items: roasting spelt for mola salsa, baking brine for muries and burning ashes from the fetal cow from the Fordicidia and the tail of the October horse, both of which were used at the Parilia. For other rituals, the Vestals were required to use water, the purificatory substance par excellence, drawn only from the spring of Juturna and carried only in vessels that could not be set down. These restrictions ensured that the water was always fresh, running water that never touched profane earth. Chapters 3-5 trace out the unique position the Vestals occupied in Roman society, arguing that they existed outside the standard Roman familial and other social structures, yet remained fully part of the Roman state. W suggests that the initiation rite of captio removed the new priestess not only from her family but, more importantly, from her family cult, thus avoiding any potential contamination of familial and public cult. Virginity was required for multiple reasons, the most significant being that such a status allowed the priestess to remain a full member of the Roman state, but prevented her from being a member of a traditional family structure. Throughout the book, W makes much of the idea of Vestals as represen tatives of Roman citizen women without ever really dealing with the question to what extent any Roman woman, priestess or not, was a ciuis. Though W is probably correct, it is not entirely certain to what extent women were citizens in the Republic, and at least a reference to some key ancient sources and to recent scholarship on this question should be made (e.g. L. Peppe, Posizione giuridica e ruolo sociale della donna romana in eta repubblicana [Milan, 1984]). The sixth chapter, 'The Vestals in the Romans' History', looks at the appearance of Vestals in the early history of Rome, refining the common assumption that accusations of, and convictions for, incestum arose only in periods of great stress and danger. W adds that a priestess's involvement, or her family's involvement, in one of the groups taking part in the conflict or struggle of the moment also played a role. This chapter traces changes over the course of 300 years in the attitudes of the priestesses and the Romans more generally toward the priesthood, its role in society This content downloaded from 204.235.148.90 on Sat, 26 Jul 2014 11:47:09 AM All use subject to JSTOR Terms and Conditions 214 THE CLASSICAL REVIEW and its requirement of 30 years of chastity. The argument hangs on even less evidence than other sections of the work. In contrast to their central place in W's book, the Vestals play only a small (though crucial, in her interpretation) role in M.'s work. The basic argument of the book is that episodes of Vestal incestum are linked in the historiographic tradition to key moments in the development of the Roman state: the separation of augurium from regnum, the development of a mixed patrician-plebeian aristocracy, the creation of a monetary system and the expansion of the colonial system outside Italy. The history of Rome can be seen as alternating phases of stasis and transformation; instances of Vestal incestum mark the transitions (p. 95). The work falls into two parts that are not well integrated. The first is a useful discussion of the historiography of the Roman Republic, taking in turn each element of the story of the founding of Rome from the arrival of Aeneas to the death of Remus. M. traces how early Roman writers, especially Fabius Pictor, reshaped the tradition already present in some Greek authors, distancing Rome from the Greek world and adding an Italic element to the tale. This detailed analysis is well worth consulting and will be of interest to those working on many aspects of cultural life in the Republic. The second, larger, section of the book comprises a series of studies of the Vestals known to have been convicted of incestum during the Republic. After dealing with issues of dating and sources, M. links each case of incestum to a major event in Roman history. Not all the events are equally important for the creation of the Rome of the middle and late Republic. One wonders why M. chose to tie the conviction of Minucia, somewhere between 339 and 332, to the admission of plebeians to the praetorship in 337 rather than to the conclusion of the Latin War in 338. Some explanation is warranted. The connection M. draws is often very vague, as in the case of Sextilia (pp. 144-54), convicted and interred alive in either 275 or 274. M. sees this as marking the end of any meaningful distinction between patricians and plebeians, following as it does the first time a plebeian censor completed a lustrum. The gap of five or six years between Sextilia's conviction and Cn. Domitius Calvinus Maximus' censorship in 280 passes unremarked. Similarly, in discussing the three Vestals accused of incestum in 114-113 (pp. 188-210), M. steps away from the commonly accepted interpretation of the event as part of the continuing struggle between Gracchan and senatorial forces, arguing instead that it is tied to the establishment in 118 of the colony of Narbo Martius, Rome's first colony in Gaul. Here, as elsewhere, there is no evidence that any ancient author linked the founding of the colony and Vestal unchastity; the temporal gap makes an association even more unlikely. Ultimately, it is not possible to accept M.'s argument that Vestal incestum punctuated key stages in the development of the 'cosmo Romano' in the way she imagines. Even so, M.'s effort to reintegrate the Vestals into the larger narrative of Rome's history is thought-provoking, and it is to be hoped that it will spark further work in the same vein. The field is perhaps in a better position to undertake work on this scale now that we have W's careful and comprehensive collection and interpre tation of what there is to know about the Vestals. Yale University CELIA E. SCHULTZ celia.schultz(yale.edu This content downloaded from 204.235.148.90 on Sat, 26 Jul 2014 11:47:09 AM All use subject to JSTOR Terms and Conditions. (shrink)

This paper aims to find the bright spots for implementing the new zoning system applicable to Indonesian education by comparing other countries that have already applied. Some other writers still have pros and cons with the zoning system, starting from the implementation, benefits, and even different things that affect the quality of education in Indonesia, namely the needs of teaching staff. To find a problem approach, the authors use theoretical references from Viennet and Pont. Data collection was collected from various (...) education policy books, journals related to the zoning system, publications from the Ministry of Education and the Central Statistics Agency and then concluded as a result of the journal that was analyzed qualitatively. Developed countries have implemented a zoning system for schools to overcome conducive classrooms, but there are new problems facing developed countries today with zoning conditions. The implications of the developed countries' zoning system can be used as material for the evaluation of the Indonesian government to avoid the same thing. This paper concludes that equitable distribution of facilities and infrastructures, as well as the quality of teachers and the needs of the number of teachers, are important keys in implementing the zoning system to run as expected. (shrink)

While work in modern corporations tends to take place in groups or teams it is not quite clear which status these groups have. Are they genuine agents or are they simply collections of individuals? The question is important because the answer is often held to determine whether collectives can be viewed as subjects of responsibility. This paper raises the question of collective responsibility and focuses on the impact the use of information systems (IS) has on it. Starting with an (...) analysis of the concept of responsibility it argues that the ascription of responsibility is admissible if it achieves certain social goals and it reviews the arguments concerning responsibility and collective subjects. Turning to information systems, it argues that their use can affect the process of ascribing responsibility both negatively and positively. It proposes the idea of ‘reflective responsibility’ and employs the reflective approach as a basis for using IS to support and enable the ascription of collective responsibility. (shrink)

Methodological individualists often claim that any social phenomenon can ultimately be explained in terms of the actions and interactions of individuals. Any Nagelian version of methodological individualism requires that there be bridge laws that translate social statements into individualistic ones. We show that Nagelian individualism can be put to logical scrutiny by making the relevant social and individualistic languages fully explicit and mathematically precise. In particular, we prove that the social statement that a group of (at least two) agents performs (...) a deontically admissible group action cannot be expressed in a well-established deontic logic of agency that models every combination of actions, omissions, abilities, and obligations of finitely many individual agents. (shrink)

The trial of Jean-Paul Akayesu is by far the most well known and widely discussed case at the International Criminal Tribunal for Rwanda, a distinction that can be attributed to the fact that it was groundbreaking for several reasons. However, with regard to the importance of this trial both as a precedent for subsequent ICTR cases and within the broader context of international jurisprudence, its most significant contribution has undoubtedly been the recognition and prosecution of rape as a means of (...) perpetrating genocide. The task of collecting admissible evidence to that end was heavily impacted by the necessity of interpreting and translating witness testimonies from their original language of expression, Kinyarwanda, into the working languages of the Tribunal, French and English. The multiple challenges associated with this translation process concerned not only questions of semantic equivalence of specific lexical terms. They also highlighted the considerable ‘cultural collision’ that occurred in the courtroom between the Rwandan witnesses and the international judiciary. This article elucidates the complex task faced by the courtroom interpreters in navigating these linguistic and sociocultural considerations underpinning the evocations of rape within the evidentiary framework of the Akayesu trial. (shrink)

This collection reflects the extraordinary career of the man it honors in its variety of subjects and range of scholarship. Mortimer Adler proposes six amendments to the Constitution. Paul Eidelberg surveys the rise of secularism from Socrates to Machiavelli. Hellmut Fritzsche, a physicist, catalogs some famous scientific mistakes. David Grene (Anastaplo's dissertation advisor) looks at Shakespeare's Measure for Measure as "mythological history." Harry V. Jaffa continues a running debate with Anastaplo on how to read the Constitution, James Lehrberger examines Aquinas's (...) views on natural law, Harry Newman argues "The Case Against Politics." Studs Terkel interviews Anastaplo on his encounter with the Illinois bar, and John Van Doren and others contribute a selection of poems. George Anastaplo turned to an academic career when he was denied admission to the bar in 1950 because, on principle, he affirmed the right of revolution and refused to say whether he was a Communist. In this age of academic specialization, Anastaplo's career has been distinguished by a remarkable versatility of thought. Author of five books, including The Artist as Thinker: From Shakespeare to Joyce (Swallow Press, 1983), Human Being and Citizen: Essays on Virtue, Freedom and the Common Good (Swallow Press, 1986), The Constitution of 1787: A Commentary (1989), and The American Moralist: On Law, Ethics, and Government (Ohio University Press, 1992), Anastaplo has also, for the past three decades, produced a steady stream of essays, articles, and papers on subjects from baseball to the Koran, from Socrates to Freud. Volume 2 of Law and Philosophy includes a complete bibliography of his works. (shrink)

Background: Admission to a nursing home does not necessarily diminish an older person’s desire for sexual expression and fulfillment. Given that nursing staff directly and indirectly influence the range of acceptable sexual expressions of nursing home residents, their knowledge and attitudes toward aged sexuality can have far-reaching effects on both the quality of care they provide to residents and the self-image and well-being of these residents. Research objectives: To investigate nursing staff’s knowledge and attitudes toward aged sexuality, to determine whether (...) certain sociodemographic factors of the nursing staff relate to their knowledge and attitudes toward later-life sexuality, and to examine the relationship between knowledge and attitudes. Research design: Descriptive cross-sectional survey study. Research participants and research context: The administered questionnaire collected sociodemographic data and data from an adapted, Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Data were collected from November 2011 through April 2012. A total of 43 geographically dispersed nursing homes in Flanders, Belgium, participated. Out of a potential research sample of 2228 nursing staff respondents, 1166 participated. Ethical considerations: The study protocol was approved by the Ethics Committee of the Faculty of Medicine of the KU Leuven. Findings: Nursing staff appeared to be moderately knowledgeable about aged sexuality and displayed a rather positive attitude toward sexuality in older people. Significant relationships between various variables were found both at univariable and multivariable levels. Knowledge and attitudes proved to be positively related, indicating that a higher level of knowledge of aged sexuality is associated with a more positive attitude toward sexuality in later life. Discussion: Research findings are discussed within a broader international context. Conclusion: There is room for improvement for both nursing staff’s knowledge and attitudes toward aged sexuality. This might be aided by appropriate educational interventions. Our results identified different target groups of nursing home staff for these interventions. (shrink)

Background:Admission to a nursing home does not necessarily diminish an older person’s desire for sexual expression and fulfillment. Given that nursing staff directly and indirectly influence the range of acceptable sexual expressions of nursing home residents, their knowledge and attitudes toward aged sexuality can have far-reaching effects on both the quality of care they provide to residents and the self-image and well-being of these residents.Research objectives:To investigate nursing staff’s knowledge and attitudes toward aged sexuality, to determine whether certain sociodemographic factors (...) of the nursing staff relate to their knowledge and attitudes toward later-life sexuality, and to examine the relationship between knowledge and attitudes.Research design:Descriptive cross-sectional survey study.Research participants and research context:The administered questionnaire collected sociodemographic data and data from an adapted, Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Data were collected from November 2011 through April 2012. A total of 43 geographically dispersed nursing homes in Flanders, Belgium, participated. Out of a potential research sample of 2228 nursing staff respondents, 1166 participated.Ethical considerations:The study protocol was approved by the Ethics Committee of the Faculty of Medicine of the KU Leuven.Findings:Nursing staff appeared to be moderately knowledgeable about aged sexuality and displayed a rather positive attitude toward sexuality in older people. Significant relationships between various variables were found both at univariable and multivariable levels. Knowledge and attitudes proved to be positively related, indicating that a higher level of knowledge of aged sexuality is associated with a more positive attitude toward sexuality in later life.Discussion:Research findings are discussed within a broader international context.Conclusion:There is room for improvement for both nursing staff’s knowledge and attitudes toward aged sexuality. This might be aided by appropriate educational interventions. Our results identified different target groups of nursing home staff for these interventions. (shrink)

Raimo Tuomela’s most important contribution to the philosophy of collective intentionality was his development of the notion of the we-mode. In my chapter I extend the notion of we-mode to that of role-mode, the mode in which individual and collective subjects feel, think and act as occupants of roles within groups and institutional structures. I focus on how being in role-mode is manifest in the minds of subjects and on the following points. First, I argue that both we-mode (...) and role-mode are best thought of as further modifications of I-consciousness, respectively we-consciousness. Second, role-mode is further characterized by the fact that subjects will take positions as role occupants that they won’t take as mere individuals, or we-mode group members, or in other roles. Third, such divergences are only possible against a background of agreements between positions taken in different modes. Fourth, such divergences are also grounded in decision making procedures and the accessibility and admissibility of sources of evidence. Fifth, role-mode goes all the way down, that is, it is also manifest in how subjects feel, move and comport themselves when they occupy their roles. To put it into fashionable jargon, it is embodied and enacted. (shrink)

A down-to-earth admission of abstract objects can be based on detailed explanation of where the objectivity of mathematics comes from, and how a ‘thin’ notion of object emerges from objective mathematical discourse or practices. We offer a sketch of arguments concerning both points, as a basis for critical scrutiny of the idea that mathematical and social objects are essentially of the same kind—which is criticized. Some authors have proposed that mathematical entities are indeed institutional objects, a product of our (...) class='Hi'>collective imposition of function onto reality (the phrase comes from Searle) and of surrogation or hypostasis. Yet there are significant disanalogies between the typical social objects and mathemata, on which basis I argue that one should make a clear distinction between both. The comparison of mathematical with social objects helps understanding how non-physical objects can figure prominently in our explanations of reality. Yet mathematical objects have a different kind of cognitive grounding, and the more elementary of them emerge under relatively very simple sociocultural conditions. The differences are also reflected in the wide scope of use of mathematical concepts, and the much higher degree of variation found among social objects. On the basis of all of these features, I defend the thesis that one can significantly distinguish degrees of objectivity, and I use the distinction to articulate a graded ontology where one can locate the different kinds of mathematical and social objects. (shrink)

This volume collects twenty-one original essays that discuss Michael Krausz’s distinctive and provocative contribution to the theory of interpretation. At the beginning of the book Krausz offers a synoptic review of his central claims, and he concludes with a substantive essay that replies to scholars from the United States, England, Germany, India, Japan, and Australia. Krausz’s philosophical work centers around a distinction that divides interpreters of cultural achievements into two groups. Singularists assume that for any object of interpretation only one (...) single admissible interpretation can exist. Multiplists assume that for some objects of interpretation more than one interpretation is admissible. A central question concerns the ontological entanglements involved in interpretive activity. Domains of application include works of art and music, as well as literary, historical, legal and religious texts. Further topics include truth commissions, ethnocentrism and interpretations across cultures. (shrink)

Objectives: The objective of this study is to investigate the relationship between a physician’s subjective mortality prediction and the level of confidence with which that mortality prediction is made.Design and participants: The study is a prospective cohort of patients less than 18 years of age admitted to a tertiary Paediatric Intensive Care Unit at a University Children’s Hospital with a minimum length of ICU stay of 10 h. Paediatric ICU attending physicians and fellows provided mortality risk predictions and the level (...) of confidence associated with these predictions on consecutive patients at the time of multidisciplinary rounds within 24 hours of admission to the paediatric ICU. Median confidence levels were compared across different ranges of mortality risk predictions.Results: Data were collected on 642 of 713 eligible patients . Mortality predictions greater than 5% and less than 95% were made with significantly less confidence than those predictions 95%. Experience was associated with greater confidence in prognostication.Conclusions: We conclude that a physician’s subjective mortality prediction may be dependent on the level of confidence in the prognosis; that is, a physician less confident in his or her prognosis is more likely to state an intermediate survival prediction. Measuring the level of confidence associated with mortality risk predictions may therefore be important because different levels of confidence may translate into differences in a physician’s therapeutic plans and their assessment of the patient’s future. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Scaena Feralium Nuptiarum: Wedding Imagery In Apuleius’ Tale Of Charite ( Met. 8.1–14)Stavros FrangoulidisThe implicit presence of wedding imagery in the servant’s narrative regarding the tragic end of Charite in Apuleius’ Metamorphoses (8.1–14) 1 has received little scholarly attention. 2 In the tale of Charite, her unsuccessful suitor, Thrasyllus, devises a scheme to kill her husband, Tlepolemus, during a hunt and to marry the widowed Charite. After the ghost (...) of Tlepolemus has exposed to his wife the actual circumstances of his death, the heroine devises a scheme for exacting vengeance on Thrasyllus, both for his cunning in killing her husband in the boar hunt and for his sexual ambitions toward her. The former is revealed in the similarities between Charite’s revenge scheme and Thrasyllus’ plot to bring about Tlepolemus’ death; the latter emerges from Charite’s clever exploitation of aspects of the wedding ritual in her revenge scheme. To be persuasive, the (fictional) marriage ritual, like the hunting scheme before it, requires role playing 3 and a reversal in gender roles such that [End Page 601] the heroine punishes her opponent most appropriately for his actions within the tale’s narrative. This wedding imagery is further sustained in the conclusion of the tale: Charite’s suicide on her husband’s tomb is represented as (re)marriage to her husband in death, since it reenacts several aspects of the wedding ritual from the earlier narrative of Tlepolemus’ liberation of his bride from her captivity in a robbers’ cave, and their subsequent marriage. 4 In the end, Thrasyllus’ suicide by starvation is also represented as a marriage in death, as Charite herself foreshadows in her angry speech as she prepares to attack him in his sleep.Our object here is to explore the ways in which Apuleius artfully designs the narrative of the latter portion of Charite’s story: the wedding imagery enhances her scheme for revenge, which is based both on Thrasyllus’ murderous plot against her husband and on Thrasyllus’ amatory designs upon her, and also intensifies the tragedy of the narrative, as all three marriages, Tlepolemus’, Charite’s, and Thrasyllus’, are fulfilled only in death. 5There are a number of intriguing resonances between the story of Charite and the tale of Cupid and Psyche that features so centrally in the novel as a whole. Space here does not permit much development of comparisons between the two narratives, but particularly striking points of similarity or contrast are indicated in the notes as we proceed.In the servant’s tale, Thrasyllus, the unsuccessful suitor, assumes the persona of a trusted friend in order to gain admission to the house of the married couple. After being forbidden access to Charite, he tricks his rival, Tlepolemus, into going hunting. Their departure on the hunt marks a spatial shift, from the interior of Tlepolemus’ home to the open space of wild nature, where Thrasyllus works his scheme.Charite has forbidden Tlepolemus to hunt horned and tusked animals (except mountain goats), a request that reveals her concern for her husband’s safety. Her apprehensions about his vulnerability also suggest a female aspect to Tlepolemus’ identity, an ambivalence of gender role that adumbrates her later worship of him as Liber/Dionysus, with both male and female characteristics. [End Page 602]For the tale’s authorial audience, Thrasyllus’ invitation to go hunting also recalls his own earlier advice to some robbers, to go on a hunt to collect animals for a sacrifice to their patron deity, Mars the Companion (7.10). In contrast to Tlepolemus’ earlier success in a hunt (which led to Charite’s liberation from captivity in the robbers’ den, and his marriage to her), Thrasyllus’ hunting scheme brings about Tlepolemus’ death, putting a violent end to Charite’s marriage. 6In a wedding context, Tlepolemus’ death may be interpreted as a prenuptial sacrifice for Thrasyllus’ planned marriage to Charite. Thrasyllus’ “sacrifice” here mirrors Tlepolemus’ earlier sacrifices of various animals at temples and public places in connection with the symbolic abduction of his bride from her parental home, at the opening of the Charite complex (4.26, ad nuptias... templis et aedibus publicis victimas [End Page 603] immolabat... (shrink)

Since the start of the new millennium, many contemporary jurisdictions have been revisiting the fundamental principles of their civil procedures. Even the core areas of the civil process are not left untouched, including the way in which evidence is introduced, collected and presented in court. One generator of the reforms in the field of evidence-taking in recent decades has been slow and inefficient litigation. Both in Europe and globally, reaching a balance between the demands of factual accuracy and the need (...) to adjudicate disputes in a swift, cost-effective and efficient way is still one of the key challenges. The second reason that many countries are reforming their law of evidence is related to cultural and technological changes in modern societies. As the balance between, on the one side, traditional human rights such as the right to privacy and due process is shifting towards, on the other side, the modern need for security, efficiency and quick access to justice, the perception of what is admissible or not in the context of evidence-taking is changing as well."--Back cover. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reply to My CommentatorsDavid CarrierI am immensely thankful to Rika Burnham and Elliott Kai-Kee, Enrique Martínez Celaya, Klaus Ottmann, and Sean Ulmer for their comments on my book. And to Daniel A. Siedell for organizing this mini-symposium, which really is an author's dream. By gently pressing me to think about important issues, these sympathetic commentators have advanced dialogue.When writing Museum Skepticism I became very aware that there are two (...) kinds of literature that discuss museums. There are memoirs of curators or other museum employees, and there are the commentaries by academics, which usually look at museums from the outside. My ambition was to look at this institution in a way that would both be sympathetic to the practical concerns and embody a theoretical point of view. One otherwise sympathetic reviewer complained that I was only looking at the museum from the outside.1 That certainly is correct, but for obvious reasons people who work in museums are unusually unwilling to describe their inner workings. To have a good theory of the museum, you need to be practical. Often, for example, critics complain about the proliferation of shops and restaurants, urge that admission be free, or say that blockbuster shows are destructive and overcrowded. However one judges such moralizing, the museum director who needs to balance the budget can hardly be guided by such reasoning. One can be critical, as I am, about the power of the super-rich in museum life. But in what other way could funding be found? The history of debates about the National Endowment for the Arts (NEA) points to obvious ways in which, in America at least, reliance on public funding poses problems. My goal, then, was to develop a realistic analysis.Sean Ulmer correctly notes that to understand the art in museums, we must consider its prior history. Chinese paintings, Islamic decorations, Maori sculpture, and premodern European art were not made to be displayed in public galleries. And so there are legitimate questions about how to set it alongside modernist art, whose natural home is the art museum. Allowing this much, I am not sure why he thinks it impossible to describe museums in a single book. We need to understand how artifacts with such varied origins can be coherently displayed in one building. Here, then, we get to Ulmer's second concern—museum displays. Recently museums have experimented with thematic displays. The Museum of Modern Art in New York did that before its recent reconstruction; the Tate Modern has such a system; and during summer 2006 the Whitney tried such a plan. I understand the need of museums to experiment, to find new ways to attract visitors to the permanent collection. Still, a straight chronological display has the obvious advantage of presenting that history of art in which, for example, Impressionism leads to Cubism, and then on to Abstract Expressionism. The obvious danger of thematic displays is that they bewilder the larger public. [End Page 22]When I said that museums are top-down institutions, I was thinking of the grander public museums where the function of the trustees is to raise money, either by giving themselves or by networking. These people who provide funding no doubt have their own agendas, but they, in turn, respond to larger economic and political concerns. I would be astonished if the Metropolitan Museum of Art asked Arthur Danto or Leo Steinberg to be a trustee; or, to look closer at hand, if the Carnegie Museum of Art or the Cleveland Museum of Art asked me to play that role. Since we are mere professors, what practical help could we provide? I expect that at smaller museums the situation is different. But here, again, it is important to be realistic. Cleveland's art historians have not had any influence on the rebuilding plan for the Cleveland Museum of Art. Of course I would be flattered if the new director asked for my opinion, but to be honest, I am not sure that I could tell him anything useful. When Ulmer discusses the comparative role of permanent collections and temporary exhibitions, he touches on a very important point. Like him, I... (shrink)

Genericity is the idea that the same program can work at many different data types. Longo, Milstead and Soloviev proposed to capture the inability of generic programs to probe the structure of their instances by the following equational principle: if two generic programs, viewed as terms of type , are equal at any given instance A[T], then they are equal at all instances. They proved that this rule is admissible in a certain extension of System F, but finding a semantically (...) motivated model satisfying this principle remained an open problem.In the present paper, we construct a categorical model of polymorphism, based on game semantics, which contains a large collection of generic types. This model builds on two novel constructions:•A direct interpretation of variable types as games, with a natural notion of substitution of games. This allows moves in games A[T] to be decomposed into the generic part from A, and the part pertaining to the instance T. This leads to a simple and natural notion of generic strategy.•A “relative polymorphic product” which expresses quantification over the type variable Xi in the variable type A with respect to a “universe” which is explicitly given as an additional parameter B. We then solve a recursive equation involving this relative product to obtain a universe in a suitably “absolute” sense.Full Completeness for ML types is proved for this model. (shrink)

We generalize the concept of a cooperative non-transferable utility game by introducing a socially structured game. In a socially structured game every coalition of players can organize themselves according to one or more internal organizations to generate payoffs. Each admissible internal organization on a coalition yields a set of payoffs attainable by the members of this coalition. The strengths of the players within an internal organization depend on the structure of the internal organization and are represented by an exogenously given (...) power vector. More powerful players have the power to take away payoffs of the less powerful players as long as those latter players are not able to guarantee their payoffs by forming a different internal organization within some coalition in which they have more power.We introduce the socially stable core as a solution concept that contains those payoffs that are both stable in an economic sense, i.e., belong to the core of the underlying cooperative game, and stable in a social sense, i.e., payoffs are sustained by a collection of internal organizations of coalitions for which power is distributed over all players in a balanced way. The socially stable core is a subset and therefore a refinement of the core. We show by means of examples that in many cases the socially stable core is a very small subset of the core.We will state conditions for which the socially stable core is non-empty. In order to derive this result, we formulate a new intersection theorem that generalizes the KKMS intersection theorem. We also discuss the relationship between social stability and the wellknown concept of balancedness for NTU-games, a sufficient condition for non-emptiness of the core. In particular we give an example of a socially structured game that satisfies social stability and therefore has a non-empty core, but whose induced NTU-game does not satisfy balancedness in the general sense of Billera. (shrink)

Whilst the nature of human illness is not determined by time of day or day of week, we currently structure health service delivery around a five-day delivery model. At least one country is endeavouring to develop a systems-based approach to planning a transition from five- to seven-day healthcare delivery models, and some services are independently instituting program reorganization to achieve these ends as research, amongst other things, highlights increased mortality and morbidity for weekend and after-hours admissions to hospitals. In this (...) article, we argue that this issue does not merely raise instrumental concerns but also opens up a normative ethical dimension, recognizing that clinical ethical dilemmas are impacted on and created by systems of care. Using health policy ethics, we critically examine whether our health services, as currently structured, are at odds with ethical obligations for patient care and broader collective goals associated with the provision of publicly funded health services. We conclude by arguing that a critical health policy ethics perspective applying relevant ethical values and principles needs to be included when considering whether and how to transition from five-day to seven-day models for health delivery. (shrink)

This study in the context of short-stay surgery is based on a definition according to which informed consent consists of five elements: consent, voluntariness, disclosure of information, understanding and competence. The data were collected in four district hospitals in southern Finland by using a structured questionnaire. The population consisted of short-stay and one-day surgery patients (n = 107). Data analysis was based on statistical methods. The results indicated some problems in the realization of informed consent. Most commonly, consent was expressed (...) by voluntary admission. Most patients had indicated their voluntary consent by making their decision independently. There were also certain problems with information. The respondents were least well informed about the drawbacks of anaesthesia and about alternative forms of treatment. The patients had not understood all the information they had received; problems of understanding were greatest with information about the advantages and disadvantages of anaesthesia. Problems were also reported with competence. These patients had the most difficulty in assessing the advantages and drawbacks of different treatments and anaesthesia. (shrink)

ObjectiveTo confirm the effects of a transtheoretical model based on multidimensional life management on healthy behavior in patients with polycystic ovary syndrome.MethodsIn total, eighty eligible patients were recruited from March 2021 to June 2021 and randomly assigned to either the intervention or control groups. Outcome measures include health-promoting behavior, self-efficacy, anthropometrics, and the number of unplanned outpatient admissions. Data were collected at baseline, 3, and 6 months after the intervention. The chi-square test, rank-sum test, t-test, and repeated measurement analysis of (...) variance were used to analyze the data.ResultsIn total, sixty-six participants completed the study: 35 participants in the intervention group and 31 participants in the control group. After 6 months of intervention, the healthy behavior level of patients with PCOS increased from moderate [health-promoting lifestyle profile -II score of 105.37 ± 12.57] to good in the intervention group; and there was no change observed in the control group. In addition, the total self-efficacy score, PCOS-related unplanned outpatient admissions, waist circumference, and body mass index were found to have a significant difference in the intervention group at 6 months. Meanwhile, repeated measures analysis of variance showed a significantly greater improvement in health-promoting behavior and self-efficacy over time in the intervention group than in the control group.ConclusionThe transtheoretical model based on multidimensional life management positively affected healthy behavior, self-efficacy, the number of unplanned outpatient admissions, and anthropometrics in patients with PCOS.Clinical Trial Registrationwww.chictr.org.cn, ChiCTR2000034572. (shrink)

À ses frontières, la démocratie se heurte à un paradoxe. La liberté individuelle de mouvement s'y confronte à la volonté collective qui se juge souveraine dans ses politiques d'admission. La réconciliation entre le principe d'autodétermination et les normes universelles, opérée tant bien que mal à l'intérieur des États démocratiques, vole alors en éclats. Ce qui ne soulève pas seulement des interrogations quant à la porosité de la démocratie mais la met également face à la question de son horizon. Doit-elle (...) se satisfaire d'un repli sur une autodétermination rassurante entre semblables? Ou faudrait-il réinventer les principes démocratiques en dehors d'un cadre devenu trop étroit?"--Page 4 of cover. (shrink)

Similarity is a philosophically much-maligned concept. Bertrand Russell claimed that its ineliminability forces on us the admission of at least one universal, thereby undermining nominalism. But even if things must be supposed to be similar if our language functions publicly by way of using finitely many terms repeatedly for purposes of designation, reference, and predication, Russell’s insistence has as such no bearing at all on the epistemological questions of sorting the actual similarities among things and of fixing the grounds on (...) which we may be sure that they are what they are alleged to be. It need not even affect nominalism. Speculation about universals oscillates between the metaphysical and the epistemological. No one doubts that things must be similar in some respect if natural languages behave as they do. But the concession is thought to be a vacuous one precisely because the respect required need never be specified in that admission. On the other hand, it is characteristically said to be epistemologically superfluous because to say that a set of things are similar in respect R is just to say that they are R’s, and to know that—so the argument goes—is to out-flank the original need to inquire whether they are merely similar, thereby restoring the viability of nominalism. This, briefly, is Nelson Goodman’s strategy laid out compellingly in The Structure of Appearance and collected, with explicitly greater scope as far as his own work is concerned but not essentially altered, in a comparatively recent paper. Of course, the legitimacy of terming a set of things R’s, predicatively, invites us to consider whether, on some theory, things really are such. This, the problem of realism, signifies that however vacuous the admission of similarity may be, the putative finding that a set of things are R’s threatens to be epistemically arbitrary unless we have a reasonable theory regarding the validity of so construing them. On Goodman’s account, realism concerns a system’s admitting or not admitting “non-particulars as individuals”—which is to say, Goodman views the issue neutrally as between platonism and nominalism. On that view, “an individual is particular if and only if it is exhaustively divisible into unrepeatable complexes; while an individual is universal if and only if it contains no unrepeatable complex.” The denial of platonism is the denial that there are nonindividuals, not nonparticulars. Alternatively put, “universality is … a matter of multiplicity of instances.” And “repeatability” occurs if a complex “occurs with some two individuals of one category. A color, for example, is repeated if it occurs at two places, even at the same time; and a time is repeated if two qualia of some one kind occur at that time.” Qualia, then, colors for instance, are complexes. (shrink)

This guide accompanies the following article(s): ‘Full Disclosure of the “Raw Data” of Research on Humans: Citizens’ Rights, Product Manufacturer’s Obligations and the Quality of the Scientific Database.’Philosophy Compass 6/2 (2011): 90–99. doi: 10.1111/j.1747‐9991.2010.00376.x Author’s Introduction Securing consent (and informed consent) from patients and research study participants is a key concern in patient care and research on humans. Yet, the legal doctrines of consent and informed consent differ in their applications. In patient care, the judicial doctrines of consent and informed (...) consent are disclosure doctrines based on the obligation of physicians to inform their patients of the following types of information: the nature of the procedure the physician is recommending in the patent’s care (P), the alternatives to the physician‐recommendation (A), and the risks of procedure and its alternatives (R). In addition, the physician must provide truthful answers to the patient’s questions (Q) to the best of the physician’s abilities. In research on humans, the onus of disclosure by study sponsors and principal investigators is much greater than in patient care precisely because the purpose of research is not patient care. The purpose of research is the identification and development of new generalizable knowledge. Thus, participation in a research study or trial may not benefit the study volunteer at all. In addition, the participant may carry a heavy risk burden in relationship to any testing of a newly designed drug or device as part of their experiences in the research study. Presently, despite the risks borne by the research study participant, the raw data collected from volunteers in research trials are treated by courts as if they were the private property of the study sponsor rather than generally owed to the public as would be expected by an effort like research participation aimed at contributing to the development of generalizable knowledge. This paper reviews the obligations that study sponsors owe to their study participants based on the very definition of research as a systematic activity whose purpose is to develop generalizable knowledge to help all humans. Author Recommends Court cases Canterbury v. Spence, United States Court of Appeals, District of Columbia Circuit 464 F.2d 772 (1972). (Federal appellate decision heard in the District of Columbia, USA) Reibl v. Hughes, 2 S.C.R. 880 (1980). (Supreme Court of Canada) Rogers v. Whitaker, 175 C.L. R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Canterbury v. Spence is the landmark Federal informed consent case in the United States heard in the District of Columbia. In this case, Judge Spottswood Robinson articulated the reasonable person standard of informed consent. This standard was subsequently adopted by the Supreme Court of Canada (Reibl v. Hughes, 2 S.C.R. 880 (1980)) and the High Court of Australia (Rogers v. Whitaker, 175 C.L. R. 479 (1992)). The House of Lords rejected the reasonable person standard in England in Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985). Book Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. This book is a detailed guide for the review of scientific and ethical aspects of research on humans contained in the research study protocols and research informed consent forms which need to be submitted by study sponsors and principal investigators to institutional review boards (IRBs) for IRB review before a research study can receive approval to be conducted within a human study population in those institutions over which the IRB has authority. It also presents basic definitions in the area of research on humans and basic approaches to help conduct a deep review of the underlying scientific and ethical issues that are present within a research study protocol and its accompanying research informed consent form. Report National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). This U.S. National Commission in the Belmont Report argued for the necessity of a reasonable volunteer standard in research on humans in the United States. Arguing that the professional standard and the reasonable person standard of consent and informed consent were insufficient to base a disclosure standard in research on humans, this National Commission developed the reasonable volunteer standard where a study participant is to be approached in research informed consent with that information that a reasonable volunteer would want to know. Online Materials Belmont Report: Syllabus Topics for Lecture and Discussion Week I: Introduction and Overview Readings: Rogers v. Whitaker, 175 C.L.R. 479 (1992). (High Court of Australia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week II: The Different Standards of Consent and Informed Consent Readings: Canterbury v. Spence, 464 F.2d 772 (1972). (Federal appellate opinion heard in the District of Columbia) Sidaway v. Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital and Others. 1 A.C. 871 (1985) (House of Lords) Week III: Definition of Research Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 2 and 3) Week IV: How to Review a Research Study Protocol and Research Informed Consent Form Reading: Mazur, Dennis J. The Science and Ethics of Research on Humans. Baltimore, MD: Johns Hopkins University Press, 2007. (Especially Chapters 4–6, 10, and 12–14) Week V: Obligations in Research of Humans Versus Patient Care Reading: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: DHEW Publications, 1978 (78‐0012). Focus Questions • How do the judicial doctrines of consent in England and Australia compare to the judicial doctrines of informed consent in the United States and Canada? • How does a professional standard of disclosure differ from a reasonable person standard of disclosure? • What is the definition of research? • How is a research study (study proposal and research informed consent form) reviewed from scientific and ethical bases for considerations of approval by an IRB? • How do the obligations of a study sponsor, a principal investigator, and a research team conducting a research trial on human study participants differ from the obligations of a physician caring for a patient? • Should all raw data of research derived from humans be made available to the public for use in developing generalizable knowledge to help others, or should raw data be considered the private property of the study sponsors (for example, prescription drug manufacturers), who fund the research trials? Seminar/project Idea Draw a timeline of the development of the basic concepts of consent and informed consent in patient care and in patient research. On this timeline, first place the dates of the key court cases in England, the United States, Canada, and Australia on consent and informed consent. Then place the date of the development of the Belmont Report. Why do differences exist between these four countries in terms of the legal requirements of informedness of a patient (in medical care) and a study participant (in medical research)? What roles if any do the concepts of self‐determination and self‐decision have in consent and informed consent in patient care and in informed consent in research on humans among the four countries of interest? What are the realities of research on human participants that require a new standard of informed consent, the reasonable volunteer standard, to be developed beyond the two standards in patient care, the professional standard, and the reasonable person standard? Counterpoint Arguments The following are counterpoint arguments that need to be appreciated to more fully understand the concepts that impact the thesis that ‘raw data’ should be open to the public to allow the opportunity of checking of the results of its associated scientific paper and for further analysis. De‐Identified (Anonymized) Raw Data A current approach to identifying (anonymizinig) raw data is based on the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104‐191). HIPAA was enacted by the U.S. Congress in 1996 to keep a person’s medical information private. In a research study, a person’s private medical information can become research data. HIPAA’s Privacy Rule allows a covered entity to de‐identify data by removing all 18 elements that could be used to identify the individual or the individual’s relatives, employers, or household members; these elements are enumerated in the Privacy Rule. The covered entity must also have no actual knowledge that the remaining information could be used alone or in combination with other information to identify the individual who is the subject of the information. Under this method, the identifiers that must be removed are the following: 1 Names. 2 All geographic subdivisions smaller than a state, including street address, city, county, precinct, ZIP Code, and their equivalent geographical codes, except for the initial three digits of a ZIP Code if, according to the current publicly available data from the Bureau of the Census: 2a. The geographic unit formed by combining all ZIP Codes with the same three initial digits contains more than 20,000 people. 2b. The initial three digits of a ZIP Code for all such geographic units containing 20,000 or fewer people are changed to 000. 3 All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, and date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older. 4 Telephone numbers. 5 Facsimile numbers. 6 Electronic mail addresses. 7 Social security numbers. 8 Medical record numbers. 9 Health plan beneficiary numbers. 10 Account numbers. 11 Certificate/license numbers. 12 Vehicle identifiers and serial numbers, including license plate numbers. 13 Device identifiers and serial numbers. 14 Web universal resource locators (URLs). 15 Internet protocol (IP) address numbers. 16 Biometric identifiers, including fingerprints and voiceprints. 17 Full‐face photographic images and any comparable images. 18 Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re‐identification. Even though ‘raw data’ can be de‐identified (anonymized) so that there is no way to trace back the data to the study participant from which it was drawn, there are still questions whether the ‘de‐identified raw data’ can be given to other researchers or made public without the original study participant’s approval. It may be the case that this approval could be done at the start of any research study where the individual considering study participation would be counseled on what the process of de‐identification consists of and would be asked whether the participant would allow use of the data by other researchers or made available to the public in a de‐identified state. However, there may be questions of the study participants as to whether the data are truly de‐identified and untraceable back to the study participant since the participant would not be able to see the process actually being carried out in detail in all relevant circumstances. Using Raw Data in Context Simply being in possession of raw data is never enough to build on that data from a research perspective. Researchers need to understand the context of the scientific research study in which the data were collected. This research context includes (but is not limited to): (i) the scientific hypothesis of the research study, (ii) the inclusion and exclusion criteria selected by the research designers of the study to determine which study participants were included and which were excluded from the study, (iii) the methods used to collect the data and possibilities of errors in the data collection processes, and (iv) answers to questions regarding whether any data were excluded from the study data and why these data were excluded. Ownership Rights Over Data There are ownership rights over data. Ownership rights include court decision making related to the question which parties are to be considered as the owners of the data. Possible owners here include (but are not limited to) (i) the study sponsor whose only role was to fund that study, (ii) the principal investigator(s) who developed the scientific hypothesis, and (iii) individual study participants through special contracts made by individual participants who negotiate such contracts with study sponsors and principal investigators to share in the ownership of data. Examples of such data are participant sources of unique gene lines or unique cell lines to be used in future research. Objections to Data Sharing Finally, individual researchers may simply object to sharing data. A researcher’s arguments here may be simply stating that he or she has a right to fully analyze the data since the collection of the data was the researchers’ idea in the first place. These researchers may argue that they have the right to mine the data as fully as they can before deciding to make the data open to the public for others to analyze. Works Cited 1 Kaiser, J. ‘Making Clinical Data Widely Available.’Science 322.5899 (10 Oct. 2008): 217–8. 2 de Lusignan, S., J.F. Metsemakers, P. Houwink, V. Gunnarsdottir, and J. van der Lei. ‘Routinely Collected General Practice Data: Goldmines for Research? A Report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands.’Informatics in Primary Care 14.3 (2006): 203–9. 3 Sim, I. ‘Human Studies Database Project’, CTSA Data Repositories Symposium (17 Oct. 2008). 23 Nov. 2010. 4 Sim, I., C.G. Chute, H. Lehmann, R. Nagarajan, M. Nahm, and R.H. Scheuermann. ‘Keeping Raw Data in Context.’Science 323.5915 (6 Feb. 2009): 713. 5 U.S. Department of Health and Human Services, National Institutes of Health, HIPAA Privacy Rule, Information for Researchers. 13 Nov. 2010. 6 Wilczynski, N.L., R.B. Haynes, and Hedges Team. ‘EMBASE Search Strategies for Identifying Methodologically Sound Diagnostic Studies for Use by Clinicians and Researchers.’BMC Medicine 29.3 (March 2005): 7. (shrink)

In [7] Wojtylak showed that the supremum of a finite collection of strongly finite logics is not necessarily strongly finite, putting to an end the dispute concerning the underlying algebraic structure of the set of all strongly finite logics defined on a propositional language. In this paper we prove that Wojtylak’s result extends to a wider class of propositional logics defined by finite sets of finite matrices with admissible valuations.

Inequitable access to health care, social inequities, and racist and discriminatory care has resulted in the trend toward poorer health outcomes for Indigenous infants and their families when compared to non‐Indigenous families in Canada. How Indigenous mothers experience care during an admission of their infant to the Neonatal Intensive Care Unit has implications for future health‐seeking behaviors which may influence infant health outcomes. Nurses are well positioned to promote positive health care interactions and improve health outcomes by effectively meeting the (...) needs of Indigenous families. This qualitative study was guided by interpretive description and the Two‐Eyed Seeing framework and aimed to understand how Indigenous mothers experience accessing and using the health care system for their infants. Data were collected by way of interviews and a discussion group with self‐identifying Indigenous mothers of infants less than two years of age living in Hamilton, Ontario, Canada. Data underwent thematic analysis, identifying nursing strategies to support positive health care interactions and promote the health and wellness of Indigenous infants and their families. Building relationships, providing holistic care, and taking a trauma‐informed approach to the involvement of child protection services are three key strategies that nurses can use to positively impact health care experiences for Indigenous families. (shrink)

Background: Despite the growing importance of spiritual care, the delivery of spiritual care is still an area of disagreement among healthcare providers. Objective: To develop a grounded theory about spiritual care delivery based on Iranian nurses’ perceptions and experiences. A grounded theory approach: A qualitative study using the grounded theory approach. Participants and research context: Data were collected through holding 27 interviews with 25 participants (17 staff nurses, 3 physicians, 3 patients, 1 family member, and 1 nurse assistant). The study (...) setting was the Imam Khomeini Hospital Complex. Sampling was started purposively and continued theoretically. Data analysis was performed by the method proposed by Strauss and Corbin. Ethical consideration: The study was approved by the Ethics Committee of Tarbiat Modares University and the agreement of the administrators of the study setting was got before starting the study. Results: The core category of the study was “Trust building” which reflected the nature of spiritual care delivery by nurses. Trust building was the result of eight main categories or strategies including creating a positive mentality at hospital admission, understanding patients in care circumstances, having a caring presence, adhering to care ethics, developing meaningful relationships, promoting positive thinking and energy, establishing effective communication with patients, and attempting to create a safe therapeutic environment. Poor interprofessional coordination negatively affected this process while living toward developing greater cognizance of divinity and adhering to the principles of professional ethics facilitated it. The outcome of the process was to gain a sense of partial psychological security. Conclusion: The “Trust building” theory can be used as a guide for describing and expanding nurses’ roles in spiritual care delivery, developing care documentation systems and clinical guidelines, and planning educational programs for nursing students and staff nurses. (shrink)

DNA evidence has rapidly become a significant and routine feature of modern criminal prosecutions. The first introduction of DNA evidence in a U.S. Court occurred in 1987. By 1994, 42 percent of local prosecutors reported that they had used DNA evidence in a felony case at least once. By 2001 that number had increased to 68 percent. Moreover, from a technical point of view, the potential benefits of DNA testing are substantial. Early hurdles to admissibility during trial have been (...) overcome by the adoption of rigorous standards for DNA analysis. Rapid development of identification technology, fueled in significant part by the Human Genome Project, and the resultant development and expansion of national forensic DNA databases, has increased the potential of DNA to play a major role in crime solving. Indeed, over three million offender profiles, collected by state and federal authorities, now reside in the National DNA Index System. This number is likely to increase as more states and the federal government are expanding compelled DNA collections to individuals arrested for certain crimes. (shrink)

The article explores theoretical and practical aspects of evidence collection, examination and assessment in cases of administrative offences, which have been little analyzed as yet. In the article, evidence collection refers to the search for evidence, its discovery and consolidation in a material object. Evidence examination is defined as the establishment of actual data on the circumstances relevant to the case, which are recorded in the evidence, and an additional examination of certain circumstances. Evidence assessment means thinking activities to analyze (...) evidence collected and examined in the case and to establish the truth in the case, according to appropriate criteria. Referring to the opinions of various scientists and the case law of the Supreme Administrative Court of Lithuania, the article reveals elements of evidence in cases of administrative offences, thoroughly explores each stage of the averment process and provides practical examples and makes suggestions for solving problems. The article substantiates a conclusion that early examination and assessment of evidence should also be carried out during the process of drawing up a record of administrative offence. (shrink)

The purpose of this study is to identify the needs of vocational and technical Anatolian high school students for guidance. A mixed research methodology is employed in this descriptive study. With the guidance needs analysis survey, quantitative data was collected about the needs of students for guidance from a total of 2228 participants including 1437 students, 304 teachers and 487 parents. The qualitative data in the research were collected from school counsellors employed in vocational and technical high schools, from the (...) heads of guidance services employed in guidance research centres, from psychological guidance and counselling specialists working in the Ministry of National Education, from psychological counsellors representing Turkish Psychological Counselling and Guidance Association and those engaged by educational unions. The research revealed findings that the students need intensive guidance on topics such as identification of future career goals, learning effective studying methods, self-knowledge of interests and abilities, knowledge of professions and their basic requirements, focusing attention during lessons, protection from addiction, knowledge of developmental features of adolescence, university admission exams and opportunities for higher education. Furthermore, it was revealed that the guidance needs of the students were not met sufficiently, they needed services in all areas of personal-social, educational and career guidance, female students needed guidance services more than male students, and students felt more need of guidance services at higher grades. In line with the results of the study, further recommendations are presented to provide for the guidance needs of students. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 533 Mind in Action: Essays in the Philosophy of Mind. By AMELIE OKSEN· BERG RORTY. Boston: Beacon Press, 1988. Pp. x & 378. This volume assembles essays written over a period of fifteen years (1973-1988), dealing with topics grouped into the following four areas: (1) persons and identity, (2) the nature of psychological activities, (3) problems in philosophy of mind such as fear, self-deception and akrasia, and (...) (4) issues of virtue and character in social context. Rorty's approach to these topics is governed by a " commitment to the primacy of the particular" (ix). Her style, consequently, is rich in detail, in the exhibition of differences between related issues (e.g., between personal identity and identity of human being), and in the dis· play of the importance of context for setting the philosophical problems concerning mind. Indeed, she writes: " If there were a great ontological table of contents, neither mind nor individ"Ual minds would be likely to appear on the list of independent substances " (5). Thus the collec· tion does not set out a substantial theory of mind; rather, it exhibits a set of commitments and preoccupations-in the author's words, " a point of view." The value of the collection lies in its wealth of discriminating exposition of intricately related issues, and in the display of a philosophical intellect whose consistency survives the strategic pre· disposition to analyze by distinguishing contexts. The first grouping of essays is "Persons and Personae." The title essay "Persons and Personae" (1987) argues that there is no over· arching synthesis that will reconcile the several concepts of a person. Rorty argues from the premise that any concept of person is rooted in and reflects the characteristic central activities of a society: "primary, privileged activities, the activities that are thought to express human excellence and tasks " (25). This unpacks into three parts: (1) that there is no such thing as the concept of a person; (2) that concepts of persons are always reflective of some particular society; and (3) that the element of a society that defines its concept of self will be its list of central human activities, be they religious, political, economic, or moral in nature. Rorty analyzes seven such concepts, and concludes by eschewing what she calls a "vulgar Wittgensteinian" approach; namely, simply advising philosophers to be cured of the yearning for one metaphysical concept of person. Instead, briefly, she acknowledges that yearning and recommends inquiry into its roots and recommends scrutiny of the various overlapping but uncoordinatable concepts of person in the various areas of life that give rise to them. In "The Transformation of Persons" (1973) she argues that the question " Is this the same person? " may have multiple admissible 534 BOOK REVIEWS answers. The question of personal identity through change has, she argues, typically given rise to either psychological, memory-based criteria, or to criteria based on reidentification of the same physical agent. Her claim is that either of these, pressed hard enough, presupposes the other. She dismisses the potentially dismal construal of this conclusion, holding that a recognition of the interdependence of psychological and physical criteria of identity is in fact beneficial, as both kinds of criteria tend to emphasize our notion of persons as (at least) the "irreducible units of responsible agency " (57). The argumentation supporting this contention of criterial interdependence is, however, thin. In "Persons, Policies, and Bodies" (1973) Rorty moves her concerns further toward the issues of responsibility. She examines the theory that a person is a locus of rational agency, that is, one who operates according to deliberately adopted policies that guide particular choices. She notes that if this theory holds, the concept of a person is conceptually distinct from the concept of an individual human being and from an individuated self as a subject of experience. But it does not hold, according to her, at least in any robust sense. She discloses difficulties in fleshing out the notions of choice and rational agency required by the theory, arguing that attempts to salvage it by resorting to rationality as a matter of degree or as a potential tend to vitiate the theory instead of saving it. Rather, her view is that... (shrink)

The purpose of this study was to determine the opinions and expectations of patients and nurses about privacy during a hospital admission for surgery. The study explored what enables and maintains privacy from the perspective of Turkish surgical patients and nurses. The study included 102 adult patients having surgery and 47 nurses caring for them. Data were collected via semistructured questionnaire by face-to-face interviews. The results showed that patients were mostly satisfied by the respect shown to their privacy by the (...) nurses but were less confident of the confidentiality of their personal data. It was found that patients have expectations regarding nursing approaches and attitudes about acknowledging and respecting patient autonomy and confidentiality. It is remarkable that while nurses focused on the physical dimension of privacy, patients focused on informational and psychosocial dimensions of privacy, as well as its physical dimension. (shrink)

In this article the author offers, on the one hand, a general view of the forms of collective action that have taken place in Spanish agriculture during the democratic transition and that have facilitated the development of the farmers' unions and workers' unions. On the other hand, he analyses the problems that these organizations have had in trying to consolidate themselves in a context characterized by the presence of institutional remains of the old Franco-ist agrarian corporatism. Finally he analyses (...) the role played by these organizations in the creation and implementation of Spanish agricultural policy as well as the changes that are taking place after the admission of Spain to the EEC. (shrink)

Thomas Hill Green was one of the most influential English thinkers of his time, and he made significant contributions to the development of political liberalism. Much of his career was spent at Balliol College, Oxford: having begun as a student of Benjamin Jowett, he later acted effectively as his second-in-command at the college. Interested for his whole career in social questions, Green worked on the commission which led to the Endowed Schools Act of 1869, and supported the temperance movement, the (...) extension of the franchise, and the admission of women to university education. He became Whyte's professor of moral philosophy at Oxford in 1878, and his lectures had a lasting influence on a generation of students of philosophy and political thought. This collection of Green's writings, published in three volumes from 1885 to 1888, was edited by R. L. Nettleship, one of his Balliol students. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Artificial Virtues and the Equally Sensible Non-Knaves: A Response to Gauthier Annette C. Baier Gauthier's splendidly dialectical paper1 first sets out Hume's official Treatise account ofhow each personhas a self-interested motive to curb her natural but socially troublesome self-interest, by agreeing to the adoption ofthe artifices ofprivate property rights, transfer by consent, and promise (provided others are also agreeing to adopt them), andhow the sympathy-dependent moral sentiment approves of (...) such a redirection of"the interested passion." Enlightened self-interest gives us the natural obligation tojustice; the fact that it is morally approved turns it into a moral obligation. Self-hatred for any breaches of the moral obligation may come in to bolster the self-interested motivation, and this will be helped along by the extra artifices employed by educators and politicians. So far so good. But now enters the sensible knave, who queries the initial assumption that each will in fact gain more by strict conformity to the rules of the Humean social artifices than by occasional carefully calculated and undetected breaches of them. If the knave is right, then the Treatise story ofhow reasonable self-interested people can get themselves to conscientiously respect property rights (including rights ofbarter), and to keep promises, is in trouble. Only by an erroneous calculation of their interest could they end with the motivation which Hume attributes to them, and finds to be morally approvable.Gauthier argues that there are indications even in the Treatise that Hume is aware ofthe flawed nature ofhis official account, since he attributes "sophistry" to some attempted justifications of honest behaviour, and attributes "feigned acts" of impossible willing to some conscientious promise-keepers. Gauthier finds Hume to have, in the Treatise, a second, less official story ofwhat it takes to be motivated to be just—that it takes error, and letting oneself be taken in by feignings and sophistry. In the Enquiry Concerning the Principles ofMorals this submerged account surfaces in the sensible knave's challenge and Hume's admission that his own answer will not be satisfactory to the knave. The charms of official Humeanjustice, Gauthierconcludes, are spurious, sincethe "anatomy" of the account of the rational motivation to be just is known to be unsound. "The sensible knave's message is thathuman society... lacks any moral foundation." Volume XVIII Number 2 429 ANNETTE C. BAIER This is a sombre tale. One of its unwelcome implications is that Hume himself, really believing that the knave is right, but unwilling tobe seen tohave the bad grace to "dehver a theory, however true which... leads to a practice dangerous and pernicious," is simply trying to "sink" the knave's truth in oblivion by creating a smoke-screen of insincere rhetoric about the greater delights of consciousness of integrity over the knave's satisfaction in his ill-gotten gains. So there really are two sombre tales—one, attributed to Hume, about justice, and one about Hume's dupUcity (or is it mere cynical frivolity?): Gauthier crafts both stories beautifully, directing our attention to bits ofHume's text injust the right order for his dramatic purposes. But is he giving us truth or fiction? I completely agree with Gauthier's version of Hume's official Treatise story, that the moral obligation to justice supervenes on the "natural obligation" for which Hume believes the natural motivation to be collectively redirected self- (or family) interest.2 1 agree that there are one or two passages, especially in the Treatise section, "Of the obUgation of promises," that seem to jar with this account, and which much somehow be explained. I agree that Hume believes that his reply to the knave is, from the knave's point ofview, unsatisfactory. Now for some disagreements. First, about Hume's reply to the knave.3From the viewpointofthevirtuous dues-payingmemberof"the party of humankind," Hume's is a perfectly satisfactory reply. It will be plain truth, for a person with the other Humean virtues (including equity, which is listed as a natural virtue),4 that justice will bring as great or greater good than would judicious injustice. Even if it would be "simply preposterous" to believe that the social order is dangerously threatened by any... (shrink)

In many real-life applications of logic it is useful to interpret a particular sentence as true together with its negation. If we are talking about classical logic, this situation would force all other sentences to be equally interpreted as true. Paraconsistent logics are exactly those logics that escape this explosive effect of the presence of inconsistencies and allow for sensible reasoning still to take effect. To provide reasonably intuitive semantics for paraconsistent logics has traditionally proven to be a challenge. Possible-translations (...) semantics can meet that challenge by allowing for each interpretation to be composed of multiple scenarios. Using that idea, a logic with a complex semantic behavior can be understood as an appropriate combination of ingredient logics with simpler semantic behaviors into which the original logic is given a collection of translations preserving its soundness. Completeness is then achieved through the judicious choice of the admissible translating mappings. The present note provides interpretation by way of possible-translations semantics for a group of fundamental paraconsistent logics extending the positive fragment of classical propositional logic. The logics PI, Cmin, mbC, bC, mCi and Ci, among others, are all initially presented through their non-truth-functional bivaluation semantics and sequent versions and then split by way of possible-translations semantics based on 3-valued ingredients. (shrink)

The use of patient restrictions (e.g. involuntary admission, seclusion, restraint) is a complex ethical dilemma in psychiatric care. The present study explored nurses’ (n = 22) and physicians’ (n = 5) perceptions of what actually happens when an aggressive behaviour episode occurs on the ward and what alternatives to seclusion and restraint are actually in use as normal standard practice in acute psychiatric care. The data were collected by focus group interviews and analysed by inductive content analysis. The participants believed (...) that the decision-making process for managing patients’ aggressive behaviour contains some in-built ethical dilemmas. They thought that patients’ subjective perspective received little attention. Nevertheless, the staff proposed and appeared to use a number of alternatives to minimize or replace the use of seclusion and restraint. Medical and nursing staff need to be encouraged and taught to: (1) tune in more deeply to reasons for patients’ aggressive behaviour; and (2) use alternatives to seclusion and restraint in order to humanize patient care to a greater extent. (shrink)

Nursing professionals in a variety of practice settings routinely use implied consent. This form of consent is used in place of or in conjunction with informed or explicit consent. This article looks at one aspect of a qualitative exploratory study conducted in a Day of Surgery Admission unit. This article focuses on the examination of nurses’ understandings of implied consent and its use in patient care in nursing practice. Data were collected through one-on-one interviews and analysed using a thematic analysis. (...) Nurses participating in this study revealed that they routinely used implied consent in their nursing practice. This article will look at whether implied consent supports or impedes a patient’s autonomy. (shrink)

Loren Lomasky is a leading advocate of a rights-based libertarian approach to political and social issues. This volume collects fifteen of his articles that have appeared since his influential volume Persons, Rights, and the Moral Community alongside one new essay. The volume represents Lomasky's more recent efforts at constructing the underpinnings of liberal rights theory, in which he formulates a series of questions about the nature and scope of rights and rights holders.Among the questions Lomasky addresses: In what way is (...) classical utilitarianism fundamentally illiberal? To what extent might utilitarian cost-benefit analyses be admissible within rights-upholding political theory? Does it even make sense to speak of maximizing liberty? How can this be understood in Hobbesian, Kantian, and Rawlsian theoretical settings? In a world in which rights-talk is ubiquitous, what is the role of traditional virtues such as loyalty and charity? Is it inconsistent to espouse both an austere classical liberalism and a social safety net? Liberalism is most often presented as a theory about the internal contours of the state, but how does it speak to the relationships between one state and another? Between the state and would-be immigrants? In a world displaying massive cross-border inequalities, does justice require the extension of aid from the rich to the poor? The book opens with an unpublished essay, "Everything Old is New Again: The Death and Rebirth of Classical Liberalism," which features a history of the century-long decline of traditional liberalism and its remarkable, unanticipated return to vitality in the second half of the 20th century. It then offers the prospectus for a libertarian research program for the next half century. (shrink)

Let M be a structure for a language L on a set M of urelements. HYP(M) is the least admissible set above M. In § 1 we show that pp(HYP(M)) [ = the collection of pure sets in HYP(M] is determined in a simple way by the ordinal α = ⚬(HYP(M)) and the $\mathscr{L}_{\propto\omega}$ theory of M up to quantifier rank α. In § 2 we consider the question of which pure countable admissible sets are of the form pp(HYP(M)) for (...) some M and show that all sets L α (α admissible) are of this form. Other positive and negative results on this question are obtained. (shrink)

The main thesis of this paper is that when we trust the results of scientific research, that trust is inevitably directed at least in part at collective bodies rather than at single researchers, and that accordingly, reasonable assessments of epistemic trustworthiness in science must attend to these collective bodies. In order to support this claim, I start by invoking the collaborative nature of most of today’s scientific research. I argue that the trustworthiness of a collaborative research group does (...) not supervene on the trustworthiness of its individual members and point out some specific problems for the assessment of epistemic trustworthiness that arise from the specific nature of today’s collaborative research. Next, I argue that the social diffusion of trustworthiness goes even further; we always also need an assessment of the trustworthiness of the respective research community as a whole. Communities, I claim, play an essential role in the epistemic quality management of science. To see why this role is indispensible, we have to appreciate the full complexity of determining what is desirable in a method of inquiry. The relevant features of a method include three different dimensions: the reliability of positive results, the reliability of negative results, and the method’s power. Every methodological choice involves a trade-off between these three dimensions. The right balance between them (the “distribution of inductive risks”, or DIR) depends on value judgments about the costs of false results and the benefits of correct ones. Conventional methodological standards of research communities impose constraints on admissible DIR and thereby harmonize the implicit value judgments. Trusting that the research community has set the limitations on DIR in a suitable way is thus always part of placing our trust in a scientific result. (shrink)

SummaryIn 1968, a prospective study was started in collaboration with the Family Planning Association to try to provide a balanced view of the beneficial and harmful effects of different methods of contraception. This investigation is now in progress at seventeen clinics and over 17,000 women are under observation. At the time of recruitment, all these women were married white British subjects, aged 25–39 years, who voluntarily agreed to participate. Fifty-six per cent were using oral contraceptives, 25% were using a diaphragm (...) and 19% were using an intrauterine device. During follow-up each woman is questioned at return visits to the clinic and a record of pregnancies and their outcome, hospital referrals, changes in contraceptive methods and the results of cervical smears, is accumulated. Women who default are sent a postal questionnaire and, if this is not returned, are telephoned or visited in their homes to collect the necessary information.So far, data obtained during 56,000 woman-years of observation are available for analysis. Follow-up has been maintained with an annual lapse rate of about 0.3%due to withdrawal of co-operation or loss of contact; adherence to the method of contraception in use at recruitment has been reasonably good, and the reporting of pregnancies and hospital admissions appears to have been both reliable and unbiased.The present data include only 24 deaths, so the mortality associated with different contraceptive methods cannot yet be estimated. With regard to morbidity, however, our preliminary results closely resemble those obtained in the prospective study carried out by the Royal College of General Practitioners and in the principal retrospective studies carried out in Britain and the United States. Women who used oral contraceptives at the start of the study experienced adeficiencyof hospital referrals for cancer, benign lesions of the breast, menstrual disorders other than amenorrhoea, duodenal ulcer, and retention cysts of the ovary; they showed anexcessof referrals for cerebrovascular disease, cervical erosion, skin disorders, self-poisoning, migraine, venous thrombosis and embolism, hayfever, gallbladder disease, amenorrhoea, and sterility. Women who used a diaphragm showed adeficiencyof hospital referrals for carcinoma-in-situ and dysplastic lesions of the cervix uteri and accidental injury; and anexcessof referrals for haemorrhoids and cystitis. Women who used an IUD experienced anexcessof hospital referrals for anaemia, varicose veins and salpingitis. About half of these differences were predicted from other studies while some suggestive evidence already existed for a further five. Of the remaining six, some probably reflect the influence of selective factors or chance.Multiple pregnancies, stillbirths, malformations, the sex ratio and birthweight showed no consistent relationship to method of contraception. The outcome of unplanned pregnancies occurring in women using an IUD, however, was remarkably unfavourable both in terms of ectopic gestation and miscarriage.Clear evidence was found of impairment of fertility after discontinuation of oral contraceptives. Whether this is likely to lead to permanent sterility in some women is uncertain.The study has provided data on the efficacy of a wide variety of contraceptive methods. In general the failure rates are in keeping with those obtained in other large-scale studies, save that those for the diaphragm and the sheath are much lower than those usually quoted.The available evidence does not yet allow a final balance to be struck between the benefits and risks associated with the new methods of contraception that have become widely used during the last two decades. It seems clear, however, that there are no material risks associated with the use of the diaphragm apart from the risk of pregnancy and that there may be some unintended benefits. (shrink)