Pandemics first and foremost hit those who are most vulnerable, and the COVID-19 pandemic is not different. Although the infection rate in the nation’s poorest neighborhoods is twice as it is in th...

Meier et al. describe a pilot study that developed METHAD, an AI-based Medical Ethics Advisor tool that draws on the principlism approach and was tested using text-book cases and clinical et...

The usefulness of machine learning algorithms has led to their widespread adoption prior to the development of a conceptual framework for making sense of them. One common response to this situation is to say that machine learning suffers from a “black box problem.” That is, machine learning algorithms are “opaque” to human users, failing to be “interpretable” or “explicable” in terms that would render categorization procedures “understandable.” The purpose of this paper is to challenge the widespread agreement about the existence (...) and importance of a black box problem. The first section argues that “interpretability” and cognates lack precise meanings when applied to algorithms. This makes the concepts difficult to use when trying to solve the problems that have motivated the call for interpretability. Furthermore, since there is no adequate account of the concepts themselves, it is not possible to assess whether particular technical features supply formal definitions of those concepts. The second section argues that there are ways of being a responsible user of these algorithms that do not require interpretability. In many cases in which a black box problem is cited, interpretability is a means to a further end such as justification or non-discrimination. Since addressing these problems need not involve something that looks like an “interpretation” of an algorithm, the focus on interpretability artificially constrains the solution space by characterizing one possible solution as the problem itself. Where possible, discussion should be reformulated in terms of the ends of interpretability. (shrink)

In recent years, new forms of high-tech controlled environment agriculture (CEA) have received increased attention and investment. These systems integrate a suite of technologies – including automation, LED lighting, vertical plant stacking, and hydroponic fertilization – to allow for greater control of temperature, humidity, carbon dioxide, oxygen, and light in an enclosed growing environment. Proponents insist that CEA can produce sustainable, nutritious, and tasty local food, particularly for the cities of the future. At the same time, a variety of critics (...) raise concerns about its environmental impacts and energy use, high startup costs, and consumer accessibility challenges, among other issues. At this stage, however, relatively little research has explored actual consumer knowledge and attitudes related to CEA processes and products. Guided by theories of sense-making, this article draws from structured interviews with local food consumers in New York City to examine what people know and think about high-tech CEA. From there, it explores the extent to which CEA fits into consumer conceptualizations of what makes for “good food.” Key findings emphasize that significant gaps in public understanding of CEA remain, that CEA products’ success will depend on the ability of the industry to deliver on its environmental promises, and that concerns about “unnatural” aspects of CEA will need to be allayed. Given the price premium at which high-tech CEA products are currently sold, the industry’s expansion will depend in large part on its ability to convince value-oriented food consumers that the products meet the triple-bottom-line of economic, social, and environmental sustainability goals. (shrink)

Whole genome and exome sequencing techniques raise hope for a new scale of diagnosis, prevention, and prediction of genetic conditions, and improved care for children. For these hopes to materialize, extensive genomic research with children will be needed. However, the use of WGS/WES in pediatric research settings raises considerable challenges for families, researchers, and policy development. In particular, the possibility that these techniques will generate genetic findings unrelated to the primary goal of sequencing has stirred intense debate about whether, which, (...) how, and when these secondary or incidental findings should be returned to parents and minors. The debate is even more pronounced when the subjects are adolescents, for whom decisions about return of SFs may have particular implications. In this paper, we consider the rise of “genomic citizenship” and the main challenges that arise for these stakeholders: adolescents' involvement in decisions relating to return of genomic SFs, the types of SFs that should be offered, privacy protections, and communication between researchers and adolescents about SFs. We argue that adolescents' involvement in genomic SF-related decisions acknowledges their status as valuable stakeholders without detracting from broader familial interests, and promotes more informed genomic citizens. (shrink)

Through the use of culturally appropriate videos on precision medicine research (PMR) that were developed and tailored to five racial and ethnic groups of patients, and subsequent focus-group discu...

In recent years, Cesar Chavez’s life and legacy have been subjected to increased scrutiny. The ensuing reevaluations of Chavez, wittingly or not, are matters of ethical, as well as historical and biographical, concern. This article has two aims. First, it reconstructs Chavez’s account of exemplarity and uses it to assess his legacy. Second, it provides an account of exemplarity situated within social practices. As I argue, exemplarity operates through social practices, rather than mystically as posited by a contagion model. The (...) end result is an ethically nuanced reassessment of Chavez and an account of exemplarity that includes its social dimension. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should (...) be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

This book offers an interdisciplinary approach to religion and psychology, including a compelling denouement that reveals new narratives about longstanding rumours in the early history of the psychoanalytic movement. This volume demonstrates that the first generation of psychoanalysts succeeded in writing themselves into the history of religious thought and sacralizing the origins of psychoanalysis.

This article considers the issue of racial difference in the Goddess movement, using the mythological figure of Arachne, a skilful weaver whom the goddess Athena transformed into a spider, to explore the unequal relational dynamics between white Goddess feminists and women of colour. Bringing Goddess spirituality and thealogical metaphors of webs and weaving into dialogue with postcolonial and black feminist perspectives on the politics of voice, marginality and representation, the article points to some of the ways in which colonial narratives (...) weave through Goddess feminism, including practices of silencing and the romanticization of racial difference. Ultimately, I argue that feminist spirituality must recognize and address structural inequality between white women and women of colour, or in other words, listen to Arachne’s voice. (shrink)

While most of healthcare research and practice fully endorses evidence-based healthcare, a minority view borrows popular themes from philosophy of science like underdetermination and value-ladenness to question the legitimacy of the evidence-based movement’s philosophical underpinnings. While the feminist origins go unacknowledged, those critics adopt a feminist reading of the “gap argument” to challenge the perceived objectivism of evidence-based practice. From there, the critics seem to despair over the “subjective elements” that values introduce to clinical reasoning, demonstrating that they do not (...) subscribe to feminist science studies’ normative program——where contextual values can enable good science and justified decisions. In this paper, I investigate why it is that the critics of evidence-based medicine adopt feminist science’s characterization of the problem but resist the productive solutions offered by those same theorists. I suggest that the common feminist empiricist appeal to idealized epistemic communities is impractical for those working within the current biomedical context and instead offer an alternate stream of feminist research into the empirical content of values (found in the work of Elizabeth Anderson and Sharyn Clough) as a more helpful recourse for facilitating the important task of legitimate and justified clinical decision-making. I use a case study on clinical decision-making to illustrate the fruitfulness of the latter feminist empiricist framework. -/- See response by Sharyn Clough: http://wp.me/p1Bfg0-1aN See reply by Maya Goldenberg: http://wp.me/p1Bfg0-1oY. (shrink)

The standard counterexamples to David Lewis’s account of intrinsicality involve two sorts of properties: identity properties and necessary properties. Proponents of the account have attempted to deflect these counterexamples in a number of ways. This paper argues that none of these moves are legitimate. Furthermore, this paper argues that no account along the lines of Lewis’s can succeed, for an adequate account of intrinsicality must be sensitive to hyperintensional distinctions among properties.

Wiggins and Wilbanks (2019) raise a number of interesting concerns vis-à-vis citizen science and research. However, one area of innovation in citizen science that has seen significant advancements...

This paper offers a theoretical discussion on why the nursing profession has had a delayed response to the issue of climate change. We suggest this delay may have been influenced by the early days of nursing's professionalization. Specifically, we examine nursing's professional mandate, the generally accepted metaparadigm, and the grand theorists’ conceptualizations of both the environment and the nurse–environment relationship. We conclude that these works may have encouraged nurses to conceptualize the environment, as well as their relationship with it, mainly (...) in terms of the individual patient, and as such, nurses have not been encouraged to understand these concepts from a broader perspective. By not having the philosophical and theoretical foundations to understand the environment in relation to society, it is not surprising that nurses have had a delayed response to climate change and may not have viewed it as a professional concern. A planetary health perspective is suggested as a theoretical basis for nursing education, research and practice. Taking on a planetary health perspective could help nurses progress the profession and move healthcare systems towards supporting a climate‐resilient future. (shrink)

Is it enough? Reflecting on a prepandemic monograph on vaccine hesitancy two years into the COVID-19 pandemic demands answer to the questions whether the analysis still holds and whether it offers sufficient resources to address the current situation. Maya J. Goldenberg's Vaccine Hesitancy: Public Trust, Expertise, and the War on Science argues that vaccines are about much more than vaccines, and vaccine hesitancy reflects the cultural anxieties of the moment. The global attention and geopolitical reach of COVID-19 vaccination has (...) further elevated vaccines as an outsized symbol of this political moment of sharp polarization, conflict... (shrink)

Because few would object to evidence-based medicine’s (EBM) principal task of basing medical decisionmaking on the most judicious and up-to-date evidence, the debate over this prolific movement may seem puzzling. Who, one may ask, could be against evidence (Carr-Hill, 2006)? Yet this question belies the sophistication of the evidence-based movement. This chapter presents the evidence-based approach as a socio-medical phenomenon and seeks to explain and negotiate the points of disagreement between supporters and detractors. This is done by casting EBM as (...) more than the simple application of research findings to clinical care and improved health outcomes, but rather an umbrella term that harnesses a specific set of pedagogical objectives (some rather radical) under a name that makes it difficult to argue against. (shrink)

Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of (...) its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- . (shrink)

The public rejection of scientific claims is widely recognized by scientific and governmental institutions to be threatening to modern democratic societies. Intense conflict between science and the public over diverse health and environmental issues have invited speculation by concerned officials regarding both the source of and the solution to the problem of public resistance towards scientific and policy positions on such hot-button issues as global warming, genetically modified crops, environmental toxins, and nuclear waste disposal. The London Royal Society’s influential report (...) “Public Understanding of Science”, which spearheaded the now-thriving area of science... (shrink)

Intelligible speakers achieve specific vocal tract constrictions in rapid sequence. These constrictions are associated in theory with speech motor goals. Adult-focused models of speech production assume that discrete phonological representations, sequenced into word-length plans for output, define these goals. This assumption introduces a serial order problem for speech. It is also at odds with children's speech. In particular, child phonology and timing control suggest holistic speech plans, and so the hypothesis of whole word production. This hypothesis solves the serial order (...) problem by avoiding it. When the same solution is applied to adult speech the problem becomes how to explain the development of highly intelligible speech. This is the problem addressed here. A modeling approach is used to demonstrate how perceptual-motor units of production emerge over developmental time with the perceptual-motor integration of holistic speech plans that are also phonological representations; the specific argument is that perceptual-motor units are a product of trajectories (nearly) crossing in motor space. The model, which focuses on the integration process, defines the perceptual-motor map as a set of linked pairs of experienced perceptual and motor trajectories. The trajectories are time-based excursions through speaker-defined perceptual and motor spaces. By hypothesis, junctures appear where motor trajectories near or overlap one another in motor space when the shared (or extremely similar) articulatory configurations in these regions are exploited to combine perceptually-linked motor paths along different trajectories. Junctures form in clusters in motor space. These clusters, along with their corresponding (linked) perceptual points, represent perceptual-motor units of production, albeit at the level of speech motor control only. The units serve as pivots in motor space during speaking; they are points of transition from one motor trajectory to another along perceptually-linked paths that are selected to produce best approximations of whole word targets. (shrink)

Autism spectrum disorder (ASD) is a neuro-developmental condition, which requires a multi-disciplinary matrix of treatments, including functional, educational, and emotional interventions. The latter mode of treatment entails particular difficulties, inasmuch as the core deficits of this condition seem to challenge the very premises of traditional psychotherapy. Reciprocity, verbal, and symbolic expression and inter-subjective dynamics are often difficult to attain with clients diagnosed with ASD, and emotional treatment thus often turns out to be a frustrating process, which may well elicit questions (...) as to the efficacy of psychotherapeutic emotional interventions. These core challenges, described in the literature, become particularly acute in view of the increasing number of clients diagnosed on the autistic spectrum in recent years, and the growing need for qualified therapists who have trained for working specifically with this condition. It seems, therefore, that it is high time for systematic research into the lived experience of therapists working with these clients in order to attain a better clinical and theoretical understanding of the condition itself and broaden the range of effective interventions. This study, informed by a phenomenological-hermeneutic approach which guided both the collection of data and its subsequent analysis, aims to address these issues by exploring the particular challenges faced by therapists in this field, the questions that come up in the process, modes of personal and professional coping, and the insights elicited by the therapeutic encounter. The research consisted of in-depth interviews with 28 practicing therapists from a broad range of clinical orientations, including dance/movement, arts, music, and drama therapists, clinical psychologists, and clinical social workers. The essential themes that emerged from the participants’ responses and the analysis of the findings lend support to theoretical and developmental approaches, which focus on the primacy and the foundational role of the concrete body in inter-subjective relationships and in the therapeutic process, and indicate the potential efficacy of somatic and kinetic interventions. The clinical implications of this study are thus highly relevant to the training and support of therapists working with ASD, who should be encouraged to develop greater receptivity to non-verbal modes of interaction in the therapeutic process. (shrink)

Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current (...) ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for reconsideration of the methods used for moral evaluation and resolution, however the options should not include obscuring normative content by seemingly neutral technical measure. (shrink)

Color conveys critical information about the flavor of food and drink by providing clues as to edibility, flavor identity, and flavor intensity. Despite the fact that more than 100 published papers have investigated the influence of color on flavor perception in humans, surprisingly little research has considered how cognitive and contextual constraints may mediate color–flavor interactions. In this review, we argue that the discrepancies demonstrated in previously-published color–flavor studies may, at least in part, reflect differences in the sensory expectations that (...) different people generate as a result of their prior associative experiences. We propose that color–flavor interactions in flavor perception cannot be understood solely in terms of the principles of multisensory integration but that the role of higher-level cognitive factors, such as expectations, must also be considered. (shrink)

One of the most fundamental and recurring issues in the social sciences--the relation between language and thought--is examined in this work from a broad and coherent interdisciplinary perspective. Many of the great historical issues are also addressed and newly examined such as: the multifunctionality of language, the role of natural logic in the structuring of linguistic rules, and the place of linguistic disambiguation and repair in particular cultures.

The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients’ empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical dimensions is needed. (...) Drawing on scholarship of nationalism and democracy, we discuss the PMI's construction of what we term “genomic citizenship”; the possible normative obligations arising therefrom; and the ethical, legal, and social challenges that will ensue. Although the PMI is a work in progress, discussion of the existing and emerging issues can facilitate the development of policies, structures, and procedures that can maximize the initiative's ability to produce equitable and socially sensitive outcomes. Our analysis can also be applied to other population-based, precision medicine research programs. (shrink)

In response to the ravages perpetrated on planet earth by the single-minded pursuit of short-term business bottomline, the author outlines the keynotes of shifting consciousness about economics in the West. She points out the new upsurge of active interest in finer values, including spirituality in business circles. With out a spiritual compass to guide, industrialization has been fostering disvalues. The impact of Eastern reli gions, and their emphasis on the inner self, on American thinking has of late become very strong. (...) The paper also draws atiention to Gandhi's trusteeship concept, and to the successful spiritual experiments done at Nagarjuna Fertilizers Ltd. She, however, has doubts whether business will changes its ways by itself unless something more powerful forces it to do so. (shrink)

This article seeks to explore the relationship between populism, 21st-century socialism, and the emergence of what has been referred to as an ‘ estado delincuente’ (criminal state), in the case of Venezuela. That is, a state structure permeated with transnational organized crime mafias in the executive and the judiciary, in the financial system, the prosecutor’s office, the police, the armed forces, the prison system, state-owned companies, governorships, and city councils, among other state institutions. First, I review conceptual aspects of populism (...) to understand how this served as the basis for creating the postulates of 21st-century socialism, which promoted the institutional destruction of Venezuelan democracy and created the conditions for the unbridled dissemination of state corruption. Second, emblematic cases of white-collar and blood crimes, nepotism and other corrupt activities are discussed to provide an idea of the magnitude of the issues that permeate the state apparatus. To conclude, I provide a critical summary of the consequences of this way of doing politics in contemporary Venezuela. (shrink)

Nursing as a profession seems to avoid considering the problem of racism. There is, however, a need to address this topic and to evaluate its implications for nursing practice. This article attempts to establish a rationale for nursing to address racism and introduce it into academic discourse. The results of a small-scale study by the author are analysed and the implications for ethical-moral reasoning in nursing practice are discussed in relation to professional codes of conduct developed by nurses’ professional organizations (...) in the UK and elsewhere. (shrink)

With unexpectedly good timing, I published a monograph on vaccine hesitancy in March 2021, just as COVID vaccine rollouts were reaching full steam in high income countries, including my own. My years of research and writing were near completion when the SARS-CoV-2 virus was first identified; my focus was on parents' hesitancy over routine childhood vaccinations. Vaccine hesitancy in industrialized nations has been intensely studied by social and behavioral scientists and was the subject of considerable media commentary and popular science (...) writing up until COVID vaccine hesitancy redirected that energy. Past knowledge informs current understanding, and I proposed a shift in characterizing... (shrink)

Resemblances obtain not only between objects but between properties. Resemblances of the latter sort - in particular resemblances between quantitative properties - prove to be the downfall of a well-known theory of universals, namely the one presented by David Armstrong. This paper examines Armstrong's efforts to account for such resemblances within the framework of his theory and also explores several extensions of that theory. All of them fail.

A framework to support ?Arguing from Experience? using groups of collaborating agents (termed participant agents/players) is described. The framework is an extension of the PISA multi-party arguing from experience framework. The original version of PISA allowed n participants to promote n goals (one each) for a given example. The described extension of PISA allows individuals with the same goals to pool their resources by forming ?groups?. The framework is fully described and its effectiveness illustrated using a number of classification scenarios. (...) The main finding is that by using groups more accurate results can be obtained than when agents operate in isolation. (shrink)

Volume 20, Issue 7, July 2020, Page 187-190.