The evidence-based practice and evidence-based medicine movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity and uncertainty (...) as integral parts of medical practice. We question the appropriateness of attempts to standardize professional practice through a discussion of the importance of uncertainty. Greenhalgh’s taxonomy of uncertainty is used to inform an analysis of the clinical reasoning occurring in a potentially life threatening emergency situation with a young patient. The case analysis is further developed by the use of the Canadian philosopher Bernard Lonergan’s theory about understanding and objective knowing. According to Lonergan it is not by getting rid of or even by reducing uncertainty, but by attending systematically to it and by relating to it in a self-conscious way, that objective knowledge can be obtained. The paper concludes that uncertainty is not a regrettable and unavoidable aspect of decision making but a productive component of clinical reasoning. (shrink)

While the theory of relative plausibility is presented by Allen and Pardo as a descriptive theory of the proof process, this commentary discusses their theory as a possible starting point for a prescriptive theory of evidence assessment. Generally, naturalness and simplicity are necessary for the success of such a theory. The theory of relative plausibility is very promising in this respect, as its key concept is the straightforward and intuitive notion of explanation, according to which an explanation is an answer (...) to a “why” question. Still, both the explanatory and the comparative dimensions of relative plausibility are in need of elaboration if one wants to give advice on evidence assessment in terms of Allen and Pardo’s framework. For one thing, it is necessary to examine the epistemological status of the various explanatory criteria regarding their potential as guides to truth or likelihood. Only epistemic criteria should be included in recommendations to fact-finders. Moreover, given the author’s interpretation of the ‘beyond any reasonable doubt’ standard, it is unclear what the comparative dimension amounts to in criminal trials. At least a comparison of the kind involved in the author's account of civil trials standards is absent in their interpretation of BARD. If the comparative dimension of relative plausibility is relevant at all in criminal trials, it must be clarified what is to be compared. (shrink)

An active ethically conscious consumer has been acclaimed as the new hero and hope for an ethically improved capitalism. Through consumers’ “voting” at the checkout, corporations are supposed to be held accountable for their conduct. In the literature on political consumerism, this has mainly been approached as political participation and governance. In this article, we do a critical review of this literature. We do so by questioning the existence of what we call a “generic active consumer model.” At the core (...) of this position, there is a belief that the active consumer is a universal entity, available across nations and time. Instead we call for an approach that takes accord of the ways consumers and consumer roles are framed in interactive processes in markets, governance structures, and everyday life. Consumers in different countries assess their responsibilities and their powers as consumers differently due to different institutionalizations within distinctive contexts. We also must take into account how the inertia of ordinary consumption and the moral complexities of everyday life restrict the adoption of an active consumerist role. Hence, the debate on political consumerism should make for a more realistic notion of ethical consumer-sovereignty and its role in improving the workings of capitalism. In our view, these findings have severe implications for understanding both theories of political consumption and the dynamics of political consumption per se. (shrink)

Three‐dimensional (3D) structures have been used to explore the evolution of proteins for decades, yet they have rarely been utilized to study the molecular evolution of peptides. Here, we highlight areas in which 3D structures can be particularly useful for studying the molecular evolution of peptide toxins. Although we focus our discussion on animal toxins, including one of the most widespread disulfide‐rich peptide folds known, the inhibitor cystine knot, our conclusions should be widely applicable to studies of the evolution of (...) disulfide‐constrained peptides. We show that conserved 3D folds can be used to identify evolutionary links and test hypotheses regarding the evolutionary origin of peptides with extremely low sequence identity; construct accurate multiple sequence alignments; and better understand the evolutionary forces that drive the molecular evolution of peptides.Also watch the video abstract. (shrink)

In this paper we compare causal models with reason models in the construction of Bayesian networks for legal evidence. In causal models, arrows in the network are drawn from causes to effects. In a reason model, the arrows are instead drawn towards the evidence, from factum probandum to factum probans. We explore the differences between causal models and reason models and observe several distinct advantages with reason models. Reason models are better aligned with the philosophy of Bayesian inference, as they (...) model reasons for up-dating beliefs. Reason models are better suited for measuring the combined support of the evidence, and a prior probability of guilt that reflects the number of possible perpetrators is accommodated more easily with reason models. (shrink)

After distinguishing two senses of 'analysis', the author claims that the purpose of Moore's analytical (meta-ethical) program in Principia Ethica was to serve as an indispensable tool for avoiding false judgments in substantial ethics and for establishing true ones. It is shown that Moore's analyses and assumptions are not normatively neutral in that, (1) he disagreed with other philosophers about the extension (as well as the intension) of moral terms, (2) he disagreed in extension with 'common-sense' morality. Finally, an attempt (...) is made to show that Moore's moral methodology, in which his analytical distinctions play the crucial part, is meant to be of practical value for everybody in their moral decisions. (shrink)

The Norwegian Arbeidernes leksikon, “Workers’ Encyclopedia,” was published in six volumes from 1931–1936. It was inspired by The Great Soviet Encyclopedia, explicitly aimed at working-class readers, and establishing an alternative to the hegemonic bourgeoise discourse. The editors and many of the contributors belonged to the Communist Party of Norway (NKP) and the independent communist intellectual organization Mot Dag (“Towards Dawn”). This article investigates the reception and representation of the ancient world in Arbeidernes leksikon based on selected articles through the lens (...) of narrative theory. Classical education was traditionally the domain of the upper classes. It is argued that the Workers’ Encyclopedia demonstrates that reorienting the reception of ancient history was considered essential both to rewrite history according to Marxist doctrine and to establish workers’ culture as a full-fledged alternative to its bourgeoise counterpart. In the Workers’ Encyclopedia, the classical past is celebrated not for its empires and rulers but for the effort of the masses and their struggle for freedom. (shrink)

According to Mohan Matthen and Edwin Levy, certain immunological processes require explanations in which the immune system is attributed intentional states. This, they think, strengthens the scientific credentials of intentional psychology and undermines the position of those who argue that the scientific treatment of human action should involve the elimination of intentional description. In this paper, I argue that immunology does not and need not employ intentional explanation or description and consequently has nothing to offer those who seek to defend (...) the scientific standing of intentional psychology by looking for other disciplines that "accommodate the intentional". (shrink)

Psychological experiments allegedly show that people have a tendency to confabulate explanations of their behavior, because their conscious selves do not know why they do what they do, and therefore create the explanations that make most sense. This article explains why confabulation is neither a threat to interpretivist social science nor a threat to the presumption of first-person authority in Davidson’s interpretation theory. The reason is that the interpretative endeavor, which is necessary in order to identify and provide evidence for (...) confabulation is governed by a presumption of first-person authority. Explanations of confabulation thus depend on prior interpretations. (shrink)

Comparing preferences for sport participation between alternative and conventional sports, this article exhibits some differences across sport contexts, as well as across gender and class. However, the main finding is the major similarities of preferences and dominating social groups across the contexts. This indicates that a similar habitus is in play in the alternative context as in the conventional one, and that "real alternatives" are merely to occur inside established frames of sport provision.

The concept ‘hereditary breast cancer’ is commonly used to delineate a group of people genetically at risk for breast cancer—all of whom also having risk for other cancers. People carrying pathogenic variants of the BRCA1 and BRCA2 genes are often referred to as those having predisposition for ‘hereditary breast cancer’. The two genes, however, are when altered, associated with different risks for and dying from breast cancer. The main risk for dying for carriers of both genes is from ovarian cancer. (...) These biological facts are of philosophical interest, because they are the facts underlying the public debate on BRCA1/2 genetic testing as a model for the discussion of how to implement genetic knowledge and technologies in personalized medicine. A contribution to this public debate describing inherited breast cancer as ‘biological citizenship’ recently printed in Med Health Care and Philos illustrated how fragmented and detached from the biological and socio-political facts this debate sometimes is. We here briefly summarize some of the biological facts and how they are implemented in today’s healthcare based on agreed philosophical, ethical and moral principles. The suggestion of a ‘biological citizenship’ defined by hereditary breast cancer is incorrect and ill-advised. ‘Identity politics’ focusing hereditary breast cancer patients as a group based on a bundle of ill-defined negative arguments is well known, but is supported neither by scientific nor philosophical arguments. To those born with the genetic variants described, the philosophical rule of not doing harm is violated by unbalanced negative arguments. (shrink)