Trust is a core feature of the physician-patient relationship, and risk is central to trust. Patients take risks when they trust their providers to care for them effectively and appropriately. Not all patients take these risks: some medical relationships are marked by mistrust and suspicion. Empirical evidence suggests that some patients and families of color in the United States may be more likely to mistrust their providers and to be suspicious of specific medical practices and institutions. Given both historical and (...) ongoing oppression and injustice in American medical institutions, such mistrust can be apt. Yet it can also frustrate patient care, leading to family and provider distress. In this paper, I propose one way that providers might work to reestablish trust by taking risks in signaling their own trustworthiness. This interpersonal step is not meant to replace efforts to remedy systemic injustice, but is an immediate measure for addressing mistrust in occurrent cases. (shrink)

In evolutionary psychology predictions, women’s mate preferences shift between fertile and nonfertile times of the month to reflect ancestral fitness benefits. Our meta-analytic test involving 58 independent reports (13 unpublished, 45 published) was largely nonsupportive. Specifically, fertile women did not especially desire sex in short-term relationships with men purported to be of high genetic quality (i.e., high testosterone, masculinity, dominance, symmetry). The few significant preference shifts appeared to be research artifacts. The effects declined over time in published work, were limited (...) to studies that used broader, less precise definitions of the fertile phase, and were found only in published research. (shrink)

To examine whether anticipatory attention or expectancy is a cognitive process that is automatic or requires conscious control, we employed a paired-stimulus event-related potential paradigm during the transition to sleep. The slow negative ERP wave observed between two successive stimuli, the Contingent Negative Variation , reflects attention and expectancy to the second stimulus. Thirteen good sleepers were instructed to respond to the second stimulus in a pair during waking sessions. In a non-response paradigm modified for sleep, participants then fell asleep (...) while tones played. As expected, N1 decreased and P2 increased in amplitude systematically with the loss of consciousness at sleep onset; the CNV was increasingly more positive. Sleep onset latency was correlated with the amplitude of the CNV. The systematic attenuation of the CNV waveform at sleep onset and its absence in sleep indicates that anticipatory attention requires endogenous conscious control. (shrink)

The Victorian period in Britain was an “age of reform.” It is therefore not surprising that two of the era’s most eminent intellects described themselves as reformers. Both William Whewell and John Stuart Mill believed that by reforming philosophy—including the philosophy of science—they could effect social and political change. But their divergent visions of this societal transformation led to a sustained and spirited controversy that covered morality, politics, science, and economics. Situating their debate within the larger context of Victorian society (...) and its concerns, _Reforming Philosophy_ shows how two very different men captured the intellectual spirit of the day and engaged the attention of other scientists and philosophers, including the young Charles Darwin. Mill—philosopher, political economist, and Parliamentarian—remains a canonical author of Anglo-American philosophy, while Whewell—Anglican cleric, scientist, and educator—is now often overlooked, though in his day he was renowned as an authority on science. Placing their teachings in their proper intellectual, cultural, and argumentative spheres, Laura Snyder revises the standard views of these two important Victorian figures, showing that both men’s concerns remain relevant today. A philosophically and historically sensitive account of the engagement of the major protagonists of Victorian British philosophy, _Reforming Philosophy_ is the first book-length examination of the dispute between Mill and Whewell in its entirety. A rich and nuanced understanding of the intellectual spirit of Victorian Britain, it will be welcomed by philosophers and historians of science, scholars of Victorian studies, and students of the history of philosophy and political economy. (shrink)

Trust in medicine is often conceived of on an individual level, with respect to how people rely on particular clinicians or institutions. Yet as discussions of trust during the Covid‐19 pandemic highlighted, trust decisions are not always as individual or interpersonal as this conception suggests. Rather, individual instances of trusting behavior are related to social trust, which is conceived as a willingness to be vulnerable to people in general, based on a sense of shared norms. In this essay, I propose (...) that individual and social trust are connected to each other in what can be termed a “climate of trust.” I explain how masking trends during the pandemic facilitated a “climate of distrust,” and I consider the role that clinicians might play in transforming climates of distrust into climates of trust. (shrink)

The concept of paternalism is intricately tied to the concept of autonomy. It is commonly assumed that when paternalistic interventions are wrong, they are wrong because they impede individuals’ autonomy. Our aim in this paper is to show that the recent shift towards conceiving of autonomy relationally highlights a separate conceptual space for a nonpaternalistic kind of interpersonal intervention termed maternalism. We argue that maternalism makes a twofold contribution to the debate over the ethics of interpersonal action and decision-making. Descriptively, (...) it captures common experiences that, while not unusual in everyday life, are largely absent from the present discussion. Normatively, it describes a type of intervention with justification conditions distinct from the standard framework of paternalism. We explicate these contributions by describing six key differences between maternalism and paternalism, and conclude by anticipating and responding to potential objections. (shrink)

Sexual self-determination is considered a fundamental human right by most of us living in Western societies. While we must abide by laws regarding consent and coercion, in general we expect to be able to engage in sexual behaviour whenever, and with whomever, we choose. For older people with dementia living in residential aged care facilities (RACFs), however, the issue becomes more complex. Staff often struggle to balance residents' rights with their duty of care, and negative attitudes towards older people's sexuality (...) can lead to residents' sexual expression being overlooked, ignored, or even discouraged. In particular, questions as to whether residents with dementia are able to consent to sexual activity or physically intimate relationships pose a challenge to RACF staff, and current legislation does little to assist them. This paper will address these issues, and will argue that, while every effort should be made to ensure that no resident comes to harm, RACFs must respect the rights of residents with dementia to make decisions about their sexuality, intimacy and physical relationships. (shrink)

This paper presents a conception of the self partially in terms of a particular notion of preference. It develops a coherentist account of when one's preferences are "authorized", or sanctioned as one's own, and presents a coherence theory of autonomous action. The view presented solves certain problems with hierarchical accounts of freedom, such as Harry Frankfurt's.

Ethical analyses of the effects of neural interventions commonly focus on changes to personality and behavior, interpreting these changes in terms of authenticity and identity. These phenomena have led to debate among ethicists about the meaning of these terms for ethical analysis of such interventions. While these theoretical approaches have different criteria for ethical significance, they agree that patients’ reports are concerning because a sense of self is valuable. In this paper, I question this assumption. I propose that the Buddhist (...) theory of no‐self offers a novel approach to making ethical sense of patients’ claims following deep brain stimulation. This alternative approach is based on the value of insight into patterns of cause and effect among mental states and actions. (shrink)

Brain–Computer Interface research is an interdisciplinary area of study within Neural Engineering. Recent interest in end-user perspectives has led to an intersection with user-centered design. The goal of user-centered design is to reduce the translational gap between researchers and potential end users. However, while qualitative studies have been conducted with end users of BCI technology, little is known about individual BCI researchers’ experience with and attitudes towards UCD. Given the scientific, financial, and ethical imperatives of UCD, we sought to gain (...) a better understanding of practical and principled considerations for researchers who engage with end users. We conducted a qualitative interview case study with neural engineering researchers at a center dedicated to the creation of BCIs. Our analysis generated five themes common across interviews. The thematic analysis shows that participants identify multiple beneficiaries of their work, including other researchers, clinicians working with devices, device end users, and families and caregivers of device users. Participants value experience with device end users, and personal experience is the most meaningful type of interaction. They welcome end-user input, but are skeptical of limited focus groups and case studies. They also recognize a tension between creating sophisticated devices and developing technology that will meet user needs. Finally, interviewees espouse functional, assistive goals for their technology, but describe uncertainty in what degree of function is “good enough” for individual end users. Based on these results, we offer preliminary recommendations for conducting future UCD studies in BCI and neural engineering. (shrink)

BackgroundEthics consult services are well established, but often remain underutilized. Our aim was to identify the barriers and perceptions of the Ethics consult service for physicians, advance practice providers (APPs), and nurses at our urban academic medical center which might contribute to underutilization.MethodsThis was a cross-sectional single-health system, anonymous written online survey, which was developed by the UCSD Health Clinical Ethics Committee and distributed by Survey Monkey. We compare responses between physicians, APPs, and nurses using standard parametric and non-parametric statistical (...) methods. Satisfaction with ethics consult and likelihood of calling Ethics service again were assessed using a 0–100 scale using a 5-likert response structured (0 being “not helpful at all” to 100 being “extremely helpful”) and results presented using box plots and interquartile ranges (IQR).ResultsFrom January to July 2019, approximately 3800 surveys were sent to all physicians, APPs and nurses with a return rate of 5.5—10%. Although the majority of respondents had encountered an ethical dilemma (85–92.1%) only approximately half had ever requested an Ethics consult. The primary reason for physicians never having requested a consult was that they never felt the need for help (41%). For APPs the primary reasons were not knowing an Ethics consult service was available (33.3%) or not knowing how to contact Ethics (27.8%). For nurses, it was not knowing how to contact the Ethics consult service (30.8%) or not feeling the need for help (26.2%). The median satisfaction score (IQR) for Ethics consult services rated on a 0–100 scale, from physicians was 76 (29), for AAPs 89 (49), and nurses 70 (40) (p = 0.62). The median (IQR) of likelihood of consulting Ethics in the future also on a 0–100 scale was 71 (47) for physicians, 69 (45) for APPs, and 61 (45) for nurses (p = 0.79). APP’s and nurses were significantly more likely than physicians to believe that the team did not act on the Ethics consult’s recommendations.ConclusionsBased on the results presented, we were able to identify actionable steps to better engage healthcare providers—and in particular APPs and nurses—and scale up institutional educational efforts to increase awareness of the role of the Ethics consult service at our institution. Actionable steps included implementing a system of ongoing feedback that is critical for the sustainability of the Ethics service role. We hope this project can serve as a blueprint for other hospital-based Ethics consult services to improve the quality of their programs. (shrink)

Se trata de la reseña bibliográfica del libro de Emmanuel Biset et. al., Sujeto, una categoría en disputa.

As neurotechnologies continue to develop and diffuse, this fast-paced field must be guided by robust governance frameworks in order to promote responsible innovation. The article by Bublitz (2024)...

The concepts currently operating in much medical microbiome research bear a curious resemblance to an ancient tradition of Western medicine. This tradition, humoral medicine, is concerned with the four humors: yellow and black bile, phlegm, blood. Both humoral medicine and medical microbiome research use notions of imbalance and balance for broad explanations of disease and health. Both traditions also hold that the composition of humors or microbiomes determines bodily as well as mental states. Causality in each system is often conceived (...) teleologically, meaning that humors or microbiomes "function for" the maintenance of the whole. And ultimately, each framework situates the humors or microbiomes in a multilevel interactionist theory that conceptualizes individual health within a broader environmental context. As well as critically assessing the parallels between these systems, this article sketches some explanations of how they may have arisen. The authors also evaluate the implications of these similarities for the future of medical microbiome research and suggest ways in which the field might move forward. (shrink)

This paper investigates the relationship between structural explanation and the New Mechanistic account of explanation. The aim of this paper is twofold: firstly, to argue that some phenomena in the domain of fundamental physics, although mechanically brute, are structurally explained; and secondly, by elaborating on the contrast between SE and mechanistic explanation to better clarify some features of SE. Finally, this paper will argue that, notwithstanding their apparently antithetical character, SE and ME can be reconciled within a unified account of (...) general scientific explanation. (shrink)

The graphical presentation of experimental data in the physical sciences has several advantages which today are too familiar to require very detailed enumeration. Its greatest strength lies in the clarity and succinctness with which it displays the information contained in tabulated results: for the experimenter a graph provides a rough and immediate check on the accuracy and suitability of the methods he is using, and for the reader of a scientific report it may convey in a few seconds information that (...) could only be gleaned from a table of measurements by hours of close study. There are occasions whereonlythe analysis of experimental graphs will provide the information we require, but usually the actual analysis of results is carried out nowadays by computational methods. The use of graphs is therefore not so much a necessary part of scientific procedure as an extremely useful one, and one that is often taken very much for granted. (shrink)

Research with human–animal chimera raises a number of ethical concerns, especially when neural stem cells are transplanted into the brains of non-human primates . Besides animal welfare concerns and ethical issues associated with the use of embryonic stem cells, the research is also regarded as controversial from the standpoint of NHPs developing cognitive or behavioural capabilities that are regarded as “unique” to humans. However, scientists are urging to test new therapeutic approaches for neurological diseases in primate models as they better (...) mimic human physiology than all current animal models. As a response, various countries have issued reports on the topic. Our paper summarizes the ethical issues raised by research with human–animal brain chimeras and compares the relevant regulatory instruments and different recommendations issued in national reports from three important European research nations: Germany, Switzerland and the United Kingdom. We assess and discuss the focus and priorities set by the different reports, review various reasons for and perspectives on the importance of the brain in chimera research, and identify critical points in the reports that warrant further specification and debate. (shrink)

This paper explores the rise of agential materialism in humanities and science and its influence on technological progress, proposing ‘softness’ as a paradigm for designing increasingly ‘agentised’ technologies. Soft technologies – defined by plastic embodiments, self-organisation, and multi-scalar material design – challenge hegemonic visions of machines as rigid, unfeeling, and subordinate to human control. Case studies in soft and biohybrid robotics, wetware computing, and nanotechnology demonstrate how emerging soft technologies embody unprecedented forms of artificial agency and outline future possibilities for (...) embodied intelligence. A paradigm shift towards softness fosters ‘micro-sustainability’, embedding self-contained, regenerative energy and resource management at the material scale. By complicating the separation of nature and artifact and the hierarchical relationship of humans and technologies, the paradigm of softness contributes to a broader ‘ecology of technology’, offering pathways for sustainable innovation in the face of global ecological challenges. (shrink)

According to some technology enthusiasts our technological developments appear to be accelerating at an exponential rate. A common vision of such enthusiasts is that the accelerating pace of science and technology development will enable us to transform the world in more profound and significant ways than at any other time in our history. More importantly, some of these technology enthusiasts have gone beyond having technological-driven visions about the future to be actively engaged in a diverse set of activities aimed at (...) shaping the future they envision. These are not just people with visions about the future, they are visioneers. (shrink)

Philosophy and Phenomenological Research, EarlyView.

Ethics training has become a common phenomenon in the training of military professionals at all levels. However, the perceived outcomes of this training remain open. In this article, we analyze the experiences of course participants who were interviewed 6–12 months after they had participated in a train-the-trainer course in military ethics developed by the Faculty of Military Sciences of the Netherlands Defence Academy. Through qualitative inductive analysis, it is shown how participants evaluate the training, how they perceive the development of (...) their moral competence, and how they see the impact of the training on their own training practice. (shrink)

Frank Jackson often writes as if his descriptivist account of public language meanings were just plain common sense. How else are we to explain how different speakers manage to communicate using a public language? And how else can we explain how individuals arrive at confident judgments about the reference of their words in hypothetical scenarios? Our aim in this paper is to show just how controversial the psychological assumptions behind in Jackson’s semantic theory really are. First, we explain how Jackson’s (...) theory goes well beyond the commonsense platitudes he cites in its defence. Second, we sketch an alternative explanation of those platitudes, the jazz model of meaning, which we argue is more psychologically realistic. We conclude that the psychological picture presupposed by Jackson’s semantic theory stands in need of a much more substantial defence than he has so far offered. (shrink)

This paper approaches the much-debated issue of corporate citizenship (CC). Many models depict the development process of CC, and yet attempts to find one extensive definition remain in progress. We argue that more than one type of citizenship may be needed to fully describe the concept. So far, social factors have dominated the definitions of CC, but citizenship functions can also be found in other areas. In fact, for maximum benefit, the type of citizenship should be tied to the sector (...) and business field of the corporation in question. Using data drawn from three internationally operating corporations headquartered in Finland, we introduce three different types of CC that are in line with their core business ideas: cultural citizenship, environmental citizenship and technological citizenship. These new types of citizenships can help in grasping the complexity of business responsibility and ethics, and offer tools for gaining competitive advantage by differentiation. (shrink)

The label ‘Translational Research’ (TR) has become ever more popular in the biomedical domain in recent years. It is usually presented as an attempt to bridge a supposed gap between knowledge produced at the lab bench and its use at the clinical bedside. This is claimed to help society harvest the benefits of its investments in scientific research. The rhetorical as well as moral force of the label TR obscure, however, that it is actually used in very different ways. In (...) this paper, we analyse the scientific discourse on TR, with the aim to disentangle and critically evaluate the different meanings of the label. We start with a brief reconstruction of the history of the concept. Subsequently, we unravel how the label is actually used in a sample of scientific publications on TR and examine the presuppositions implied by different views of TR. We argue that it is useful to distinguish different views of TR on the basis of three dimensions, related to (1) the construction of the ‘translational gap’; (2) the model of the translational process; and (3) the cause of the perceived translational gap. We conclude that the motive to make society benefit from its investments in biomedical science may be laudable, but that it is doubtful whether the dominant views of TR will contribute to this end. (shrink)

This paper explores the question of what makes an action morally worthy. I start with a popular theory of moral worth which roughly states that a right action is morally praiseworthy if and only if it is performed in response to the reasons which make the action right. While I think the account provides promising foundations for determining praiseworthiness, I argue that the view lacks the resources to adequately satisfy important desiderata associated with theories of moral worth. Firstly, the view (...) does not adequately capture the degree to which an action has moral worth, and secondly, the view does not identify if right actions produced from overdetermined motives have moral worth. However, all is not lost; I also argue that the account can satisfy the desiderata when it attends to the agent’s counterfactual motives in addition to their actual motives. By considering counterfactual motives, we can measure the robustness of the actual praiseworthy motive, and attending to motivational robustness allows the new proposal to fully satisfy the two desiderata. At the end of this paper, I respond to some criticisms typically brought against a counterfactual view of moral worth. (shrink)

Prominent accounts of collective intentional activity explain the nature of social groups by virtue of a specific criterion: goal-directedness. In doing so, these accounts offer little in the way of determining whether there are any differences among social groups. In this paper, I propose a refined framework of collective intentional activity that can distinguish among social groups better than alternative accounts, and which has revisionary but nevertheless plausible implications for the nature of the family: specifically, that certain friendship relationships may (...) count as genuinely familial, and that we ought to count them as such. I argue that social groups are distinguished by what we can expect from one another within different kinds of social groups; specifically, that there is an important difference between reciprocity that is equivalent in performance and reciprocity that is equivalent in intention; familial groups are specifically guided by this latter kind of reciprocity. This more inclusive definition of familial groups may have important implications for how such groups are supported within a given society – for instance, by recognizing certain caring relations as essential for well-being and supporting them accordingly. (shrink)

Fortunato and colleagues' target article extends both the ethical analysis and the clinical practice of nondisclosure by focusing on nocebo effects (Fortunato, Wasserman, and Menkes 2017). Instance...

In his recent book Bananaworld. Quantum mechanics for primates, Jeff Bub revives and provides a mature version of his influential information-theoretic interpretation of Quantum Theory (QT). In this paper, I test Bub’s conjecture that QT should be interpreted as a theory about information, by examining whether his information-theoretic interpretation has the resources to explain (or explain away) quantum conundrums. The discussion of Bub’s theses will also serve to investigate, more in general, whether other approaches succeed in defending the claim that (...) QT is about quantum information. First of all, I argue that Bub’s interpretation of QT as a principle theory fails to fully explain quantum non-locality. Secondly, I argue that a constructive interpretation, where the quantum state is interpreted ontically as information, also fails at providing a full explanation of quantum correlations. Finally, while epistemic interpretations might succeed in this respect, I argue that such a success comes at the price of rejecting some in between the most basic scientific standards of physical theories. (shrink)

Bioethics seeks to answer questions and resolve problems that change along with developments in medicine and biology. Ethical justification plays a crucial role in bioethical analysis by clarifying the reasons that support complex judgments about particular actions and general policies.1 It helps bioethicists to determine what to allow, forbid, support, and minimize. When there is disagreement, it can also aid understanding of competing positions. However, at times, disagreement on particular issues becomes so entrenched that understanding seems impossible. In such circumstances, (...) how might bioethicists proceed? In answering this question, this paper considers a particularly significant area of.. (shrink)

The aim of this paper is to explore the ways in which Axiomatic Reconstructions of Quantum Theory in terms of Information-Theoretic principles can contribute to explaining and understanding quantum phenomena, as well as to study their explanatory limitations. This is achieved in part by offering an account of the kind of explanation that axiomatic reconstructions of Quantum Theory provide, and re-evaluating the epistemic status of the program in light of this explanation. As illustrative case studies, I take Clifton's, Bub's and (...) Halvorson's characterization theorem and Popescu's and Rohrlich's toy models, and their explanatory contribution with respect to quantum nonlocality. On the one hand, I argue that ARQITs can aspire to provide genuine explanations of quantum nonlocality. On the other hand, I argue that such explanations cannot rule out a mechanical quantum theory. (shrink)

Comparative philosophy is gaining traction in professional academic philosophy, with specialist journals, organizations, books, and public campaigns. These inroads have been made in canonical areas of philosophy, including epistemology, metaphysics, logic, and value theory. Yet comparative philosophy still plays little role in practical applied ethics, an interdisciplinary research area in which work with practice and policy implications are dominated by the anglophone world. In this article, I explain why comparative work might be especially difficult in this type of applied ethics, (...) and I suggest how comparative philosophers might overcome these challenges to connect their theoretical work with contemporary practical issues. (shrink)

The emerging discipline of educational neuroscience stands at a crossroads between those who see great promise in integrating neuroscience and education and those who see the disciplinary divide as insurmountable. However, such tension is at least partly due to the hitherto predominance of philosophy and theory over the establishment of concrete mechanisms and agents of change. If educational neuroscience is to move forward and emerge as a distinct discipline in its own right, the traditional boundaries and methods must be bridged, (...) and an infrastructure must be in place that allows for collaborative and productive exchange. In the present paper, we argue that school psychologists have the potential to fulfill this need and represent important agents of change in establishing better connections between research and practice. More specifically, we use theNational Association of School Psychologists (NASP) (2020)Domains of Practice to highlight several areas where school psychology can actively support forging connections between neuroscience and educational practice. School psychologists represent untapped potential in their knowledge, skillset, and placement to serve a vital role in building the bridge between neuroscience and education. (shrink)

The creation of guidelines has long been a popular means of conveying normative requirements in scientific and medical research. The recent case of He Jiankui, whose research flouted both widely accepted ethical standards and a set of field-specific guidelines he co-authored, raises the question of whether guidelines are an effective means of preventing misconduct. This paper advances the theory that guidelines can facilitate moral rationalization, a form of motivated reasoning. Moral rationalization in research occurs when individuals justify their actions with (...) plausible reasons that cohere with their moral standards. This allows them to act as they want while believing in their own goodness. If guidelines facilitate moral rationalization, this has implications for research ethics training and for the work of applied ethicists. Research ethics training ought to incorporate reflection on conative features of reasoning, including incentives to commit misconduct, and applied ethicists ought to be circumspect about their use of ethics guidelines. Otherwise, they are feeding the fire of rationalization with the cognitive material practitioners need to accomplish their desired ends. (shrink)

In his article, “Defining Death: Beyond Biology,” John Lizza argues in favor of a civil definition of death, according to which the potential for consciousness and social interaction marks us as the “kind of being that we are.” In this commentary, I critically discuss this approach to the bioethical debate on the definition of death. I question whether Lizza’s account is based on a full recognition of the “practical, moral, religious, philosophical, and cultural considerations” at play in this debate. I (...) further propose that a truly ethical debate on definitions of death ought to concentrate on how different definitions of death are used in diverse contexts – what definitions of death do – and focus less on who has the right definition of death for all situations. (shrink)

The thesis of this article is that implicit memory does not exist. Implicit memory.

El presente trabajo tiene dos objetivos centrales. Primero caracterizaré una variante de pragmatismo conceptual según la cual algunos conceptos deben entenderse como habilidades para identificar sustancias e identificar propiedades del entorno, y mostraré que quien cuenta con esas dos habilidades satisface, en grados diversos en cada caso, distintos requisitos centrales para la posesión de conceptos. Posteriormente defenderé la viabilidad de extender este enfoque a los animales no humanos, apelando a evidencia empírica que indica que distintas especies son capaces de identificar (...) sustancias de su entorno y que sugiere la presencia de habilidades para identificar propiedades en algunos primates y pájaros. (shrink)