A school of idealism: meditatio laici, by J. Cappon.--Beati possidentes, by R. M. Wenley.--Moral validity: a study in Platonism, by R. C. Lodge.--Plato and the poet's eidōla, by A. S. Ferguson.--Some reflections on Aristotle's theory of tragedy, by G. S. Brett.--The function of the phantasm in St. Thomas Aquinas, by H. Carr.--The development of the psychology of Maine de Biran, by N. J. Symons.--A plea for eclecticism, by H. W. Wright.--Some present-day tendencies in philosophy, by J. M. MacEachran.--Evolution and personality, (...) J. G. Hume.--Emergent realism, by J. Muirhead.--Bibliography of publications by Dr. John Watson (p. 343-346). (shrink)

Richard A. Watson - Augustinian-Cartesian Index: Texts and Commentary - Journal of the History of Philosophy 43:3 Journal of the History of Philosophy 43.3 359-361 Zbigniew Janowski. Augustinian-Cartesian Index: Texts and Commentary. South Bend, IN: St. Augustine's Press, 2004. Pp. xv + 275. Cloth, $35.00. This is an English translation and substantial expansion of the French edition . Besides augmenting Augustinian citations, Janowski has added indices and commentaries for Saint Thomas Aquinas, John Duns Scotus, Francis Bacon, and Montaigne. (...) The result is a crucial compilation and analysis of the major textual sources of Descartes's philosophy. Janowski demonstrates that Descartes's metaphysics is foundationally Augustinian, particularly in his dependence on the doctrine of God's creation of eternal truths: "the idea that God creates by an act of understanding" . This doctrine was, in fact, left out of the Meditations. Janowski argues that it logically belongs in the fourth Meditation but was deleted because it was almost universally denied by the.. (shrink)

Using historical documents and evidence gathered in the field, Rubie Watson provides a social history of the 600-year-old Chinese lineage village of Ha Tsuen in the New Territories of Hong Kong, and demonstrates the crucial role that the lineage played in the evolution of the community from a few scattered households in the fourteenth century into a regional power from the 1700s onwards. Despite a patrilineal ideology that extols the virtues of brotherhood and equality, Dr Watson shows that (...) the lineage has in fact played a central role in the formation, development and maintenance of an élite class of landlords and merchants, who, even though their economic importance has now declined, continue to exert political control. Dr Watson examines the dynamics of interclass relations within a single lineage and shows how these relations have been transformed as a consequence of the growth of wage labour. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE POLITICAL PHILOSOPHIES OF AQUINAS AND AWOLOW0 1 FRANCIS I. 0GUNMODEDE Semlnary of SS. Peter and Paul Ibadan, Nigeria Introduction W:HAT POSSIBLE connection is there between the hought of Aquinas and that of Awolowo? We must first observe a sharp difference in personality and approach to politics between the two men. Obafemi Awolowo ( 1909-87) was a recent Nigerian philosopher and politician whose works on politics include The (...) People's Republic (1968) and Thoughts on the Nigerian Constitution ( 1970), among others.2 St. Thomas, on the other hand, was a medieval Italian priest who, because of his intensive academic pursuits and religious calling, did not engage in practical politics. In fact, it has been said that St. Thomas was the greatest philosopher that ever lived after Plato and Aristotle, but one without a political theory. This opinion is drawn from the fact that he has left no complete work on politics to which we can turn as we do to the Politics of Aristotle or to the Social Contract of Rousseau. Thomas never completed his Commentary on the Politics of Aristotle or his treatise De Regimine Principum (De regno). There is another good reason to say that St. Thomas does not provide his readers with an adequate political doctrine. This is 1 This is an adaptation of an original lecture titled "Elements of St. Thomas's Politics in Awolowo's Social Philosophy" given to mark Aquinas Day at the Dominican Institute of Philosophy, Ibadan, Nigeria on January 28, 1989. 2 For other works and writings by Awolowo, see F. Ogunmodede, Obafemi Awolowo's Socio-Political Philosophy (Rome, 1986), pp. 269-272. 265 266 FRANCIS I. OGUNMODEDE his " essentially theoretical " 3 approach to the study of politics. Aquinas's political reflections did not arise from any practical issue. The impact of philosophy was the determining factor. His views on state and government were part of a philosophical system. The approach of Awolowo to politics is quite different. It is empirical and practical. For, as D'Entreves says, modern man, unlike his medieval counterpart, has " become so entangled in particulars, in the practical side of politics, that it is only with an effort that we can be brought to realize the existence of the more general issues which lie behind our immediate predicament." 4 Nevertheless, one can relate the political thought of both men. History is already filled with cases of scientific discoveries made at the same time by men in different places without any prior knowledge of one another's achievements. For instance, the controversy over the discovery of calculus was resolved by crediting both Newton and Leibniz with the discovery at the same time, each in his own country. Perhaps we can add that fundamental ideas about man and society can be shared, because of their universal nature, by people in different ages, places, and circumstances. This is the basis for the present comparison of Awolowo 's and St. Thomas's socio-political philosophies. This position is favored by the fact that, whichever way one looks at it, both have a political theory, a set of propositions systematically related to one another in such a way and manner that it is meaningful and realistic for us to talk of a "theory." Perhaps the contribution of this paper is to demonstrate that Awolowo and Aquinas do share many basic ideas and concepts about reality, about religion, and especially about polity. This view is supported by the fact that, even though Awolowo wrote no treatise on metaphysics,5 as Aquinas did, he nonetheless built on sound 3 A. P. D'Entreves, Aquinas: Selected Political Writings (Oxford: Basil Blackwell, 1959), p. viii. 4 Ibid. 5 Unfortunately, Awolowo died before he could write works setting out his metaphysics systematically. But he gave a very long interview to Dr. Makinde of the 0.A.U., Ile-Ife, just before he died. This gives some insight into his AQUINAS AND AWOLOWO 267 fundamental postulates and principles which are metaphysical in nature in his thinking about politics.6 Now, there are many approaches and methods in the study of any political theorist. According to B. J. Dudley, " we can concern ourselves with the sort of assumptions... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ch'an/Zen-Catholic Dialogue Spreads a "Welcome Table" at the 2009 Annual MeetingFrancis V. TisoA retreat program designed by the participants in the ongoing Ch'an/Zen-Catholic Dialogue explored the dialogue of religious experience and the dialogue of life, set amid the redwoods of Guerneville, California. The 28–31 January 2009 meeting was cochaired by the Rev. Heng Sure of the Berkeley Buddhist Monastery and the Institute for World Religions, Berkeley, California, and by (...) Most Rev. John C. Wester, Bishop of Salt Lake City, Utah.Sr. Mary Ann Donovan of the Jesuit School of Theology, Berkeley, led an experience of lectio divina based on John 15:1–17, Jesus's simile of the vine and the branches. Rev. Victoria Austin of the San Francisco Zen Center gave an "encouragement talk," which would typically be delivered to Zen retreatants. She referred to the Gospel passage, noting: "We don't prune the vine because it is dead, but because it has the capacity to be fruitful. We don't purify the mind to get rid of dirt, but to return to the mind's original purity, which is the source of our conscience and is the true life within us." Rev. Jan Chosen Bays of Great Vow Zen Monastery in Oregon observed that "Vows make our life energy more focused, keeping us from losing purpose and meaning. Vows prune away unnecessary things. When we ask for help with the challenge of being faithful to our vows, we call up and encounter unexpected sources of support and 'grace.' "The Ch'an Buddhist presentation focused on meditation experience, which was described as "recovering the natural state of the mind." Prof. Martin Verhoeven of the Pacific School of Religion pointed out that in meditation "we are returning to the origin, not moving forward to 'gain something.'" Linking ethical engagement with contemplation, he said, "When the mind of a meditator is motivated to act out of genuine compassion, its action is accurate and correct. Action is neither driven nor obstructed by ego or sentiment." These comments resonated with Rev. Heng Sure's presentation on the statement on the environment from the recent Gethsemane III conference "Simple and Sufficient," in which Buddhist and Christian monastics embraced an ecologically valid way of life. Urging the group to notice the connections between contemplation and ethical action, Bishop John C. Wester commented: "This [End Page 145] work embodies mercy by lifting people up; it embodies justice as it arises out of our common humanity."Because of the financial challenges that all three sponsoring institutions are facing, it was decided to conclude formal sponsorship of the Ch'an/Zen-Catholic Dialogue with this meeting. However, participants agreed to work together to reconstitute the dialogue regionally. A steering committee was designated to undertake new logistical arrangements and to draft a narrative of the previous seven years of dialogue for posting on our respective websites. Bishop Wester summarized the convictions of participants, both Buddhist and Catholic, by observing: "It is impossible not to be affected by this experience. Dialogue in this atmosphere has had an impact on my own way of ministering to others. I feel that my faith, sensitivity, compassion, and reverence have been enhanced by participating in these meetings."Participants in the 2009 dialogue meeting included Rev. Heng Sure, Berkeley Buddhist Monastery; Bishop John C. Wester, Salt Lake City; Dr. Snjezana Akpinar, Dharma Realm Buddhist University; Rev. Gigen Victoria Austin, San Francisco Zen Center; Rev. Jan Chozen Bays, Great Vow Zen Monastery; Sr. Phyllis D'Anna, SND, Zen Center, Palo Alto; Sr. Mary Ann Donovan, SC, Jesuit School of Theology at Berkeley; Dr. Ron Epstein, Dharma Realm Buddhist Association; Mrs. Lorraine Moriarty, Society of St. Vincent De Paul; Bhikshuni Heng Jiao, City of 10,000 Buddhas; Bhikshuni Heng Liang, City of 10,000 Buddhas; Rev. Canon Francis Tiso, United States Conference of Catholic Bishops; Rev. James Massa, United States Conference of Catholic Bishops; Rev. Thomas W. Devereaux, Diocese of Santa Rosa ecumenical and interreligious officer; Dr. Martin Verhoeven, Pacific School of Religion; and Ron Brown, observer (Cloverdale, California). [End Page 146]Francis V. TisoUnited States Conference of Catholic BishopsCopyright © 2009 University of Hawai'i Press... (shrink)

Excerpt from Vector Analysis and the Theory of Relativity One of the most striking effects of the publication of Einstein's papers on generalized relativity and of the discussions which arose in connection with the subsequent astronomical observations was to make students of physics renew their study of mathematics. At first they attempted to learn simply the technique, but soon there was a demand to understand more; real mathematical insight was sought. Unfortunately there were no books available, not even papers. Dr. (...) Murnaghan's little book is a most successful attempt to supply what is a definite need. Every physicist can read it with profit. He will learn the meaning of a vector for the first time. He will learn methods which are available for every field of mathematical physics. He will see which of the processes used by Einstein and others are strictly mathematical and which are physical. Every chapter is illuminating, and the treatment of the subject is that of a student of mathematics and is not developed ad hoc. The extension of surface and line integrals is most interesting for physicists and the discussion of the space relations in a four-dimensional geometry is one most needed. This is specially true concerning the case of point-symmetry which forms the basis of Einstein's formulae for gravitation as applied to the solar system. I feel personally that I owe to this book a great debt. I have read it with care and shall read it again. It has given me a definiteness of understanding which I never had before, and a vision of a field of knowledge which before was remote. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

Acting on what started as a hunch, Dr. Francis Martin has cataloged well over 20,000 distinct approaches to counseling and psychotherapy that are advertised on the webpages of licensed, practicing mental health providers. No doubt some portion of them are harmful, but the sheer volume of advertised practices and techniques, often with names deceptively similar to actual evidence-based practices, should be cause for concern among all stakeholders in the helping professions - from educators and researchers to policy makers and (...) insurance companies and, especially, consumers. Based on this significant original study, and drawing from other research and supports, Therapy Thieves describes a near-universal crisis in the field and recommends ways to rescue mental health care from itself. The crisis is caused by declining competence among counselors and psychotherapists who have failed to regulate themselves and who, therefore, deliver inadequate - if not harmful - services. In presenting a simple, yet powerful indictment of the field, Dr. Martin advocates for major reforms in several areas of mental health care, including how prospective licensees are trained, supervised and licensed, a major reworking of professional ethics, and the need to establish regulations for mental health care providers. In short, the book calls for major, specific, and urgently needed reforms. (shrink)

'I sincerely believe that Dr Kolnai is one of the most original and stimulating thinkers in the field of political philosophy alive today' (Karl Popper). Kolnai's moral and political thought was developed against the background of Liberal and then Bolshevist revolutions in Hungary, the gradual move towards fascism in twenties and thirties Vienna, and the progress of the second world war as seen from the USA. Born a Jew, he became a Roman Catholic, and lived successively in Hungary, Austria, France, (...) the USA, Canada and England. He remained, throughout his extraordinary life, a passionate believer in reason and common sense, and the sworn enemy of all philosophical and political systems. Study of Kolnai has been hampered by political developments, his own peripatetic life, and the fact that his writings appeared in five different languages, yet interest in Kolnai is now growing. This book offers the first comprehensive picture of Kolnai's complete works and life. Dunlop presents Kolnai the man in his social and political setting, and offers an accessible exploration of all his writings, whether published or not, including translated passages from papers and letters in Kolnai's various languages. Including a selective bibliography of Kolnai's works, this book presents an important study of this unique political and moral philosopher, showing his relevance in contemporary philosophical thought. (shrink)

Georgia State University College of Law Professor Emerita Charity Scott quoted these words from Albert Einstein in June of 2022 as she concluded a tribute to Professor Joseph (Jay) M. Healey, one of the founding lights of health law and health law teaching. She chose the quote because she thought the words and sentiment would resonate with Jay. I repeat it because Dr. Einstein’s words capture the essence and heart of Charity’s approach to teaching, pedagogy, and life. Charity modeled, urged, (...) nudged, and taught the community of health law professors to embrace imagination and creativity. Charity’s vision has helped us be more creative and reflective teachers.2. (shrink)

In so-called Christian countries an increasing number of people openly reject Christian morality. It is a commonplace that they do this for values that can be shown to be Christian. How did this state of affairs come about? An examination of the beginning of Christian ethical thought shows that, within great personal variety, certain patterns or concepts remain constant. Righteousness, discipleship, faith and love are traced in this book from the New Testament through to Augustine. There is a necessary tension (...) between high ideals and practical performance, or between perfection and contingency. When this tension is lost, Christian ethics can easily go wrong. The amoral perfectionism of second-century Gnostics is remarkably similar to the mysticism of communal movements; the opposite threat of legalism has always been present in conservative forms of Christianity. Dr Osborn is concerned to explain rather than to defend, to look at the way conclusions are reached, and to show the rich diversity of early Christian thought. Successive chapters deal with the New Testament, Clement of Alexandria, Basil the Great, John Chrysostom and Augustine. (shrink)

La Encíclica Laudato Si’ del Papa Francisco no solo realiza importantes afi rmaciones acerca de las cuestiones ambientales, sino que ofrece también indicaciones muy significativas para la adecuada comprensión de cuestiones antropológicas y éticas relevantes, en particular la ley natural. El presente trabajo intenta mostrar estos aportes y abrir horizontes de diálogo entre la tradición clásica y las posiciones actuales.

John Watson arrived at Queens University Kingston, Ontario, in 1872. In the Preface to the first volume of The Gifford Lectures, The Interpretation of Religious Experience, John Watson expresses his indebtedness to his former teacher, Dr. Edward Caird, and to Dr. F.H. Bradley: “…to those [works of Dr. Bradley and the late Dr. Edward Caird] I owe more than I can well estimate”. But he had previously qualified this debt as one of inspired doubt, not considered apprenticeship. “With (...) the Absolutism of Dr. Bradley, as I need hardly say, I have the greatest sympathy; but I do not think that it successfully avoids in all cases the vice of Spinozism — though, in insisting upon the idea of ‘degrees of reality’, it seems to me to come very clear to an abandonment of the abstract Absolutism elsewhere apparently contended for”. (shrink)

Francis W. Peabody, MDDepartment of MedicineBoston City Hospital and Harvard Medical SchoolBoston, MassachusettsMarch 19, 2017Dear Dr. Peabody,Thank you for giving us the opportunity to review your manuscript "The Care of the Patient." It has been carefully considered by the editors and two external reviewers. We regret to inform you that it cannot be considered further for publication in the Prestigious Journal of Medicine.Chief among our reasons is that it is overly long. Opinion pieces—especially non-data driven articles about topics like (...) ethics—should be no longer than 1,000 words. Compounding matters, the lack of graphics or tables makes the paper difficult to digest efficiently. We also agree with the... (shrink)

A definitive study of the great "philosopher of industrial science." Dr. Farrington pinpoints Bacon as the first man to grasp the revolutionary possibilities of man's increasing control over natural forces. The author sees Bacon's plan for the total reform of society by the application of science to production as the central theme of his life.

By modern standards Bacon's writings are striking in their range and diversity, and they are too often considered a separate specialist concerns in isolation from each other. Dr Jardine finds a unifying principle in Bacon's preoccupation with 'method', the evaluation and organisation of information as a procedure of investigation or of presentation. She shows how such an interpretation makes consistent sense of the whole corpus of Bacon's writings: how the familiar but misunderstood inductive method for natural science relations to the (...) more information strategies of argument in his historical, ethical, political and literary work. There is a substantial and valuable study of the intellectual Renaissance background from which Bacon emerged and against which he reacted. Through a series of details comparisons and contrasts we are led to appreciate the true originality and ingenuity of Bacon's own views and also to discount the more superficial resemblances between them and later developments in the philosophy of science. (shrink)

Článek představuje třetí a závěrečnou část série, která je věnována analýze chápání jazyka ve vybraných dílech Francise Bacona a Jana Amose Komenského. Pokouší se uplatnit srovnávací přístup, díky němuž nechá vystoupit specifické jednotě a diferenci přístupů a z nich vyplývajících závěrů zkoumaných myslitelů. V druhé části práce budeme sledovat přinejmenším implicitní vliv Baconova ideálu "učené společnosti" na Swiftovu vizi reformy a nápravy anglického jazyka cestou ustavení akademie. Závěrečná část práce přináší nová zjištění o překvapivé podobnosti Komenského přístupu jazyku s přístupem (...) Dr. Thomase Sheridana, ředitele reformované školy, filosofa a jazykovědce z Dublinu první třetiny 18. století, jehož Jonathan Swift nazývá "druhým Šalamounem" a považuje za největšího soudobého učitele. (shrink)

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical (...) requirements usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

Notes by Dr. Robert Gahringer, who was C.I. Lewis' assistant at Harvard, Dr. Francis H. Parker, and those of the editor were used to reconstruct Lewis' lectures in Phil. 130, Kant, as those lectures were presented at Harvard in the late 40's and early 50's. The test of the reconstruction includes a detailed discussion of European epistemology in the period before Kant in addition to Lewis' interpretation of Kant's epistemology, critique of metaphysics, theology, and a brief presentation of his (...) moral philosophy. (shrink)