The human masticatory system is a complex functional unit characterized by a multitude of skeletal components, muscles, soft tissues, and teeth. Muscle activation dynamics cannot be directly measured on live human subjects due to ethical, safety, and accessibility limitations. Therefore, estimation of muscle activations and their resultant forces is a longstanding and active area of research. Reinforcement learning (RL) is an adaptive learning strategy which is inspired by the behavioral psychology and enables an agent to learn the dynamics of an (...) unknown system via policy-driven explorations. The RL framework is a well-formulated closed-loop system where high capacity neural networks are trained with the feedback mechanism of rewards to learn relatively complex actuation patterns. In this work, we are building on a deep RL algorithm, known as the Soft Actor-Critic, to learn the inverse dynamics of a simulated masticatory system, i.e., learn the activation patterns that drive the jaw to its desired location. The outcome of the proposed training procedure is a parametric neural model which acts as the brain of the biomechanical system. We demonstrate the model’s ability to navigate the feasible three-dimensional (3D) envelope of motion with sub-millimeter accuracies. We also introduce a performance analysis platform consisting of a set of quantitative metrics to assess the functionalities of a given simulated masticatory system. This platform assesses the range of motion, metabolic efficiency, the agility of motion, the symmetry of activations, and the accuracy of reaching the desired target positions. We demonstrate how the model learns more metabolically efficient policies by integrating a force regularization term in the RL reward. We also demonstrate the inverse correlation between the metabolic efficiency of the models and their agility and range of motion. The presented masticatory model and the proposed RL training mechanism are valuable tools for the analysis of mastication and other biomechanical systems. We see this framework’s potential in facilitating the functional analyses aspects of surgical treatment planning and predicting the rehabilitation performance in post-operative subjects. (shrink)

Democracy and justice are often mutually antagonistic ideas, but in this innovative book Ian Shapiro shows how and why they should be pursued together. Justice must be sought democratically if it is to garner legitimacy in the modern world, he claims, and democracy must be justice-promoting if it is to sustain allegiance over time. _Democratic Justice_ meets these criteria, offering an attractive vision of a practical path to a better future. Wherever power is exercised in human affairs, Shapiro argues, the (...) lack of democracy will be experienced as injustice. The challenge is to democratize social relations so as to diminish injustice, but to do this in ways that are compatible with people’s values and goals. Shapiro shows how this can be done in different phases of the human life cycle, from childhood through the adult worlds of work and domestic life, retirement, old age, and approaching death. He spells out the implications for pressing debates about authority over children, the law of marriage and divorce, population control, governing the firm, basic income guarantees, health insurance, retirement policies, and decisions made by and for the infirm elderly. This refreshing encounter between political philosophy and practical politics will interest all those who aspire to bequeath a more just world to our children than the one we have inherited. (shrink)

This chapter charts various ways that religious persons and groups can be perpetrators and victims of epistemic injustice. The practices of testifying and interpreting experiences take a range of distinctive forms in religious life, for instance, if the testimonial practices require a special sort of religious accomplishment, such as enlightenment, or if proper understanding of religious experiences is only available to those with authentic faith. But it is also clear that religious communities and traditions have been sources of epistemic injustice, (...) for instance, by conjoining epistemic and spiritual credibility in ways disadvantageous to ‘deviant’ groups. I focus mainly on the major monotheistic religions, culturally dominant in the modern West. (shrink)

Review of J.E. Malpas, *Donald Davidson and the Mirror of Meaning* (CUP).

He concludes with an assessment of democracy's strengths and limitations as the font of political legitimacy. The book offers a lucid and accessible introduction to urgent ongoing conversations about the sources of political allegiance.

In this paper, I address the question of whether it is ever permissible to grant a request for physician-aid-in-dying (PAD) from an individual suffering from treatment-resistant depression. I assume for the sake of argument that PAD is sometimes permissible. There are three requirements for PAD: suffering, prognosis, and competence. First, an individual must be suffering from an illness or injury which is sufficient to cause serious, ongoing hardship. Second, one must have exhausted effective treatment options, and one’s prospects for recovery (...) must be poor. Third, the individual must be judged competent to request PAD. I argue that many cases of treatment-resistant depression meet the first two requirements. Thus, the key question concerns the third. I consider four features of depression that might compromise a person’s decision-making capacity. Ultimately, I conclude that PAD requests from depressed patients can be permissibly granted in some circumstances. (shrink)

This book gives a critical assessment of key developments in contemporary French philosophy, highlighting the diverse ways in which recent French thought has moved beyond the philosophical positions and arguments which have been widely associated with the terms 'post-structuralism' and 'postmodernism'. These developments are assessed through a close comparative reading of the work of seven contemporary thinkers: Jean-Luc Marion, Jean-Luc Nancy, Bernard Stiegler, Catherine Malabou, Jacques Rancière, Alain Badiou and François Laruelle. The book situates the writing of each philosopher in (...) relation to earlier traditions of French thought. In differing ways, these philosophers decisively distance themselves from the linguistic paradigm which dominated so much twentieth-century thought in order to rethink philosophical conceptions of materiality, worldliness, shared embodied existence and human agency or subjectivity. They thereby open the way for a radical renewal of the claims, possibilities and transformative power of philosophical thinking itself. This book will be an indispensable text for students of philosophy and for anyone interested in current developments in philosophy and social thought. (shrink)

This chapter offers a virtue epistemological framework for making sense of the common complaint that scientism is arrogant, dogmatic, or otherwise epistemically vicious. After characterising scientism in terms of stances, I argue that their components can include epistemically vicious dispositions, with the consequence that an agent who adopts such stances can be led to manifest epistemic vices. The main focus of the chapter is the vice of closed-mindedness, but I go on to consider the idea that arrogance and dogmatism are (...) ‘cooperative vices’, ones liable to be activated by closed-mindedness. I conclude that determining whether or not any given stance is vicious will require sensitivity to the ontology of that stance and the psychology of the agents who adopt them. This would be contribute to our understanding both of scientism and of epistemic virtuous and vicious characters or psychologies. (shrink)

Many epistemologists have recently defended views on which all evidence is true or perceptual reasons are facts. On such views a common account of basic perceptual reasons is that the fact that one sees that p is one’s reason for believing that p. I argue that that account is wrong; rather, in the basic case the fact that p itself is one’s reason for believing that p. I show that my proposal is better motivated, solves a fundamental objection that the (...) received view faces, and illuminates the nature of reasons for belief. (shrink)

b>—Several paradigms (e.g. change blindness, inattentional blindness, transsaccadic integra- tion) indicate that observers are often very poor at reporting changes to their visual environment. Such evidence has been used to suggest that the spatio-temporal coherence needed to represent change can only occur in the presence of focused attention. However, those studies almost always rely on explicit reports. It remains a possibility that the visual system can implicitly detect change, but that in the absence of focused attention, the change does not (...) reach awareness and consequently is not reported. To test this possibility, we used a simple change detection paradigm coupled with a speeded orien- tation discrimination task. Even when observers reported being unaware of a change in an item’s orientation, its nal orientation effectively biased their response in the orientation discrimination task. Both in aware and unaware trials, errors were most frequent when the changed item and the probe had incongruent orientations. These results demonstrate that the _nature _of the change can be represented in the absence of awareness. (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)

Ian Normile begins this study from the premise that critical thinking is often conceptualized and practiced in problematically narrow and instrumentalized ways. Following Ronald Barnett, he suggests that the idea of critical being can help expand the theory and practice of critical thinking to better meet the needs of education and society. Essential to this effort is greater consideration of how critical thinking articulates with other aspects of being. Normile uses two examples of “non-critical” experiences that he argues can help (...) critical thinking expand into critical being. First, he explores the emotive power of wonder as a source of inspiration and emotional education, and as an essential aspect of critical thinking. He then argues that curiosity, wonder, contemplation, and critical thinking are complementary aspects of critical being. The second example is the Chinese concept of wu-wei, a form of efficacious non-critical action. Normile argues that inevitable breakdowns in wu-wei provide opportunities for critical reflection while the unlearning common to both wonder and wu-wei facilitates receptivity to new perspectives and possibilities beyond the boundaries of the familiar; in this state, one is capable of facilitating the metacritique that is essential to truly transformative critical thinking. Normile concludes with some brief thoughts on implications for practice as a starting point for further inquiry. (shrink)

In her short story “Stable Strategies for Middle Management,” Eileen Gunn imagines a future in which Margaret, an office worker, seeks radical genetic enhancements intended to help her secure the middle-management job she wants. One source of the story’s tension and dark humor is dramatic irony: readers can see that the enhancements Margaret buys stand little chance of making her life go better for her; enhancing is, for Margaret, probably a prudential mistake. This paper argues that our positions in the (...) real world are sufficiently similar to Margaret’s position in Gunn’s fictional world that we should take this story seriously as grounding an argument from analogy for the conclusion that radical genetic enhancements are, for us, probably a prudential mistake. The paper then defends this method. When the question at hand is one of speculative ethics, there is no method better fit to the purpose than argument from analogy to speculative fiction. (shrink)

Deep brain stimulation interventions are novel devices being investigated for the management of severe treatment-resistant psychiatric illnesses. These interventions require the invasive implantation of high-frequency neurostimulatory probes intracranially aiming to provide symptom relief in treatment-resistant disorders including obsessive-compulsive disorder and anorexia nervosa. In the scientific literature, these neurostimulatory interventions are commonly described as reversible and to be used as a last resort option for psychiatric patients. However, the ‘last resort’ status of these interventions is rarely expanded upon. Contrastingly, usages of (...) DBS devices for neurological symptoms have paved the way for established safety and efficacy standards when used earlier in a disease’s timeline. As DBS treatments for these neurological diseases progress to have earlier indications, there is a parallel ethical concern that early implementation may one day become prescribed for psychiatric illnesses. The purpose of this article is to build off contemporary understandings of reversible neurostimulatory interventions to examine and provide clarifications on the ‘last resort’ status of DBS to better address its ethically charged use in psychiatric neurosurgery. To do this, evaluative differences between DBS treatments will be discussed to demonstrate how patient autonomy would be a paramount guiding principle when one day implementing these devices at various points along a psychiatric disease’s timeline. In presenting the clarification of ‘last resort’ status, the ethical tensions of early DBS interventions will be better understood to assist in providing psychiatric patients with more quality of life years in line with their values. (shrink)

Most contemporary approaches to meaning presume the limitation of semiotics (Didi-Huberman, Gumbrecht, Belting). The question of what kind of “semiotics” is required has not been asked. However, without some general science of meaning it is impossible to reform theory without committing past errors or ignoring progress. In the interest of reconnecting contemporary interests in “presence” to long-evolving needs, I review the ossification and decline of one theory of semiotics that serves as the tacit model rejected today. I return to problems (...) of the nature of the sign – whether it is “digital” or “analog” and conceived as “communication” or merely “meaning.” I then reconstitute a workable visual cognitive semiotics based on phenomenological premises. (shrink)

How to draw the line between depression-as-disorder and non-pathological depressive symptoms continues to be a contested issue in psychiatry. Relatively few philosophers have waded into this debate, but the tools of philosophical analysis are quite relevant to it. In this paper, I defend a particular answer to this question, the Contextual approach.On this view, depression is a disorder if and only if it is a disproportionate response to a justifying cause or else is unconnected to any justifying cause. I present (...) four objections to this approach and then defend it from them. Along the way, I explain why it matters whether we get this question right. (shrink)

An increasingly popular objection to anti-intellectualism about know-how is that there are clear cases where an agent having the dispositional ability to φ does not suffice for her knowing how to φ. Recently, Adam Carter has argued that anti-intellectualism can only rise to meet this sufficiency objection if it imposes additional constraints on know-how. He develops a revisionary anti-intellectualism, on which knowing how to φ not only entails that the agent possesses a reliable ability to φ, but also that she (...) is equipped with certain kind of intellectual grasp of the method by which she is able to reliably φ. This paper argues that Carter's revisionary know-how does not constitute an improvement over the more standard version of anti-intellectualism. Moreover, it is argued that Carter's additional demands concede too much to the intellectualist, and, as a result, commit his revised anti-intellectualism to familiar problems facing the intellectualist account of know-how. In other words, his attempts to respond to the sufficiency objection constitutes a dangerous compromise to the intellectualist. The paper finishes with a final analysis that suggests, in the end, there are still reasons to prefer standard anti-intellectualism over intellectualism. (shrink)

Edward Verrall Lucas and Francis Meynell were men of letters in the old-fashioned sense. They were indefatigable both in creating text and bringing like matter together in new and meaningful forms. Lucas was a journalist, anthologist and publisher. Meynell was a printer, anthologist and publisher, and also a poet of considerable sensitivity and charm. Lucas did not write much poetry but was passionate about its merits, and sought, through his collections, to bring children into contact with the best of verse. (...) Today, the significant contributions that these men made to publishing in Britain are in danger of becoming forgotten, relegated to the minor byways of publishing history. This article examines the origins and connections between two hugely successful anthologies that were inspired by a growing public interest in, and engagement with, the English countryside. (shrink)

This article analyses the aesthetics of digital compression as revealed in Thomas Ruff’s Jpegs series of photographs (2004–07). These images exhibit a poor standard of digital picture resolution fixed as large-scale, high-quality, lustrous C-type photographic prints. With reference to Vilém Flusser’s writing on photography, I argue that Ruff’s work discloses a ‘horror of digital photography’: a system of automated representation, which inverts our relationship to the photographic image.

Smith understood that as a professor he was required to publish his work and help administer his University. While his reputation for absent‐mindedness grew, his Glasgow colleagues benefited from his sound practical bent and entrusted him with a wide range of university management issues. As for publishing, he began by contributing to the two numbers of the first Edinburgh Review: commenting on Johnson's Dictionary in 1755; and in 1756, on d’Alembert's Encyclopédie, also on Rousseau's Discourse on Inequality, whose argument about (...) self‐love as an economic driving force he took up in TMS and WN. Following the publication of TMS in 1759, Smith concentrated more on political economy, also began work on the long process of the composition of WN, adding to his system lessons learned from a banking crisis in Scotland as his professorship came to an end in 1764. (shrink)

_A spirited defense of the Enlightenment against assaults from both the left and the right that explains its urgent implications for our contemporary politics_ Ours is an age when optimism about politics is hard to come by. Ian Shapiro explains why this is so and, without minimizing the daunting challenges, spells out an appropriate response. Written in the indomitable spirit exemplified by Tom Paine, _Uncommon Sense_ is a rich source of insight and inspiration in dark political times. The Enlightenment commitments (...) to reason and science are under assault from the Postmodern Left and the Authoritarian Right. Shapiro explains why the attacks are misguided and politically destructive. He agrees with the critics that there are no universal principles of justice that transcend political battles and no fair, impartial rules to govern the distribution of income, wealth, rights, or opportunities. But abandoning the search for them as futile does not mean junking the Enlightenment’s core political goal: to deploy the tools of reason and science to fight domination. Democracy is essential to vindicating that goal, yet citizens in many democracies are profoundly alienated and many democracies are in danger of failing. Shapiro explains what has gone wrong, debunks ill-considered remedies, and spells out better ones—deepening and extending his previous writing on political theory and democratic politics. (shrink)

Within cultural history there is a widespread eschewal of speculative reasoning. This article notes the complicity of the general postmodern avoidance of metanarratives with Anglo-Saxon empiricism and locates the major problem facing cultural history in postmodernism's conflation of trajectories and teleologies. Any discussion of the directionality of history is imputed to be a full-blown teleology. Using previous discussions from different fields, the difference between a teleology and trajectory is defended and, after clarifying certain confusions, it is argued that trajectories, as (...) following the working of generative mechanisms, are necessary to theorize in order to make interesting progress within the field of cultural history. (shrink)

A growing interest in affect holds much promise for anthropology by providing a new frame to examine and articulate subjective and intersubjective states, which are key parts of human consciousness and behavior. Affect has its roots in the social, an observation that did not go unnoticed by Durkheim and since then has been kept in view by those social scientists interested in the emotions, feelings, and subjectivity. However, the challenge for ethnographers has always been to articulate in words and conceptualize (...) theoretically what is only felt and sensed. What we are calling “evocative ethnography” is an ethnography that meets this challenge to make room for, and hold onto, feelings and affect in its description and explanation. The papers in this special issue accomplish that, as well as provide some anthropological insights into affect theory. (shrink)

Research has downplayed the complex discursive processes and practices through which decisions are constructed and blurs the relationship between macro- and micro-levels. The article argues for a critical and ecologically valid approach that articulates how discursive practices are influenced by, and in turn shape, the organizational settings in which they occur. It makes a methodological contribution using decision-making episodes of a senior management team meeting of a multinational company to demonstrate the insights that can be obtained from embedding the Discourse-Historical (...) Approach to Critical Discourse Analysis within a longitudinal ethnography. The approach illuminates the latent and intricate power dynamics and range of potentials of agents, triangulating micro-level discursive strategies with macro-level historical sources and background knowledge on the social and political fields. The article also makes a theoretical contribution by demonstrating the dependency of decision outcomes on often unpredictable and subtle changes in the power—context relationship. (shrink)

Examines one of the most exciting and dynamic periods in the development of medieval Islam, from the late 9th to the early 11th century, through the thought of five of its principal thinkers, prime among them al-Farabi. This great Islamic philosopher, called 'the Second Master' after Aristotle, produced a recognizable school of thought in which others pursued and developed some of his own intellectual preoccupations. Their thought is treated with particular reference to the most basic questions which can be asked (...) in the theory of knowledge or epistemology. The book thus fills a lacuna in the literature by using this approach to highlight the intellectual continuity which was maintained in an age of flux. Particular attention is paid to the ethical dimensions of knowledge. (shrink)

Jacques Lacan's impact upon the theory and practice of psychoanalysis worldwide cannot be underestimated. _Lacanian Psychoanalysis_ looks at the current debates surrounding Lacanian practice and explores its place within historical, social and political contexts. The book argues that Lacan’s elaboration of psychoanalytic theory is grounded in clinical practice and needs to be defined in relation to the four main traditions: psychiatry, psychology, psychotherapy and spirituality. As such topics of discussion include: the intersection between psychoanalysis and social transformation a new way (...) through deadlocks of current Lacanian debate a new approach to ‘clinical structures’ of neurosis, perversion and psychosis _Lacanian Psychoanalysis_ draws on Lacan's work to shed light on issues relevant to current therapeutic practice and as such it will be of great interest to students, trainees and practitioners of psychoanalysis, psychotherapy, counselling and other domains of personal and social change. (shrink)

In his testamentary letter to Auguste Chevalier, Évariste Galois states that, in modern terminology, the smallest simple group has order 60. No proof of this statement survives in his papers, and it has been suggested that a proof would have been impossible using the methods available at the time. We argue that this assertion is unduly pessimistic. Moreover, one fragmentary document, dismissed as a triviality and misunderstood, looks suspiciously like cryptic notes related to this result. We give an elementary proof (...) of Galois’s statement, explain why it is likely that he would have been aware of the methods involved, and discuss the potential relevance of the fragment. (shrink)

Ian Adams; Kant, Pestalozzi and the Role of Ideology in Educational Thought, Journal of Philosophy of Education, Volume 24, Issue 2, 30 May 2006, Pages 257–269.

Ian Ramsey; VII*—Facts and Disclosures, Proceedings of the Aristotelian Society, Volume 72, Issue 1, 1 June 1972, Pages 115–134, https://doi.org/10.1093/aristot.

Ian Ramsey; VII*—Facts and Disclosures, Proceedings of the Aristotelian Society, Volume 72, Issue 1, 1 June 1972, Pages 115–134, https://doi.org/10.1093/aristot.

This essay performs a comparative reading of the themes of language, otherness and subjectivity in the work of Emmanuel Levinas and Jacques Lacan. Their focuses on the place and role of an ethical subjectivity who is profoundly affected and displaced by the (non)presence of the absolute Other provide apt philosophical material for comparison and contrast. Through a close analysis of the important philosophical and psychoanalytic themes in Levinas’ early work Totality and Infinity and Lacan’s Seminar VII: The Ethics of Psychoanalysis, (...) I demonstrate how the different articulations of alterity in both influence their separate conceptions of the possibility of ethics in relation to decentered notions of subjectivity. In reading both, I argue that Lacan’s treatment of otherness and the eccentric nature of language provides a reimaging of certain gaps in Levinas. In return, I position Levinas as being able to provide a notion of ethical community that Lacan leaves out. (shrink)

An introduction for the general reader to David Hume's Dialogues Concerning Natural Religion.

Chris Thomas’ work explores species changes globally and in various ecosystems since the inception of the Anthropocene. In his work, Thomas acknowledges that we are in a period of rapid species ext...