Sometimes it's better to be lucky than good. As new blood filled our young patient's veins, her breathing became regular and her pulse full. She was so far gone I would not have expected her to recover consciousness for a day, if at all, but within an hour, she began to wake up. We removed the breathing tube a couple of hours later— no ventilator ever needed.As life-sustaining technology becomes more widely available in fortunate parts of the developing world, benefits (...) come with complications. The temptation is to focus on the thing—the ventilator itself—as the crucial element and press to buy more, mistaking the problem for one of resource scarcity only. But we need a culturally relevant ethical framework to guide the use and withdrawal of ventilators and similar life-sustaining tools. Resource scarcity is only part of the problem. Buying additional ventilators only defers allocation decisions and entirely fails to address end-of-life suffering. It is unsustainable in Rwanda; it is a dubious solution anywhere. The intangible need for an ethical framework hides beneath apparent scarcity and, when this need is not addressed and luck runs out, one salvageable patient can die for want of a ventilator that serves only to prolong the suffering of another. (shrink)

The man had fallen in the hospital recovery room while attempting to put on his pants, readying himself to return home after an outpatient procedure. The case seemed so pedestrian at first. The emergency department charge nurse was annoyed; she called it a dump. “They’re sending a patient from the PACU to the ER!” she fumed. “Why can’t they take care of their own problems up there? Isn’t this a hospital?”I could relate to the gut aversion to having yet another (...) patient in an already busy emergency department. The case did not fit our usual model. Most patients arrive at the emergency department from outside the hospital, by private car or ambulance. It was tempting say that this was outside our scope of... (shrink)

An earthy smell seeps from the cinderblock room, and a fan in the corner rattles as it circulates the heat. My eyes cross trying to read the square black numbers on the thermometer. I feel achy and tired. I would not be so nervous about the result except that I have been caring for Ebola patients in West Africa.

Noah Rosenberg et al.'s 2002 article “Genetic Structure of Human Populations” reported that multivariate genomic analysis of a large cell line panel yielded reproducible groupings (clusters) suggestive of individuals' geographical origins. The paper has been repeatedly cited as evidence that traditional notions of race have a biological basis, a claim its authors do not make. Critics of this misinterpretation have often suggested that it follows from interpreters' personal biases skewing the reception of an objective piece of scientific writing. (...) I contend, however, that the article itself to some degree facilitates this misrepresentation. I analyze in detail several verbal and visual features of the original article that may predispose aspects of its racial interpretation; and, tracing the arguments of one philosopher and one popular science writer, I show how these features are absorbed, transformed into arguments for a biological basis of race, and re-attributed to the original. The essay demonstrates how even slight ambiguities can enable the misappropriation of scientific writing, unintentionally undermining the authors' stated circumspection on the relationship between cluster and race. (shrink)

The purpose of this study was to assess the presence of ethics committees in rural critical access hospitals across the United States. Several studies have investigated the presence of ethics committees in rural health care facilities. The limitation of these studies is in the definition of ‘rural hospital’ and a regional or state focus. These limitations have created large variations in the study findings. In this nation-wide study we used the criteria of a critical access hospital (CAH), as defined by (...) the Medicare Rural Hospital Flexibility Program (Flex Program, 2007), to bring consistency and clarity to the assessment of the presence of ethics committees in rural hospitals. The Flex Monitoring Team conducted a national telephone survey of 381 CAH administrators throughout the United States. The survey covered a wide variety of questions concerning hospitals’ community benefit, impact activities, and whether the hospital had a formally established an ethics committee. About 230 (60%) of the respondents indicated they had a formally established ethics committee or ethics consultation program at their CAH. The prevalence of ethics committees declined as the CAH location became increasingly rural along a rural–urban continuum. Unlike CAHs, all rural Department of Veterans Affairs Medical Centers have ethics committees. The results of this study provide an understanding of the limited presence of ethics committee in rural America and the need to consider new approaches for providing ethics assistance. A virtual ethics committee network may be the most efficient and effective way of providing rural hospitals access to a knowledgeable ethics committee or consultant. (shrink)

We analyze the logical strength of theorems on marriage problems with unique solutions using the techniques of reverse mathematics, restricting our attention to problems in which each boy knows only finitely many girls. In general, these marriage theorems assert that if a marriage problem has a unique solution then there is a way to enumerate the boys so that for every m, the first m boys know exactly m girls. The strength of each theorem depends on whether the underlying marriage (...) problem is finite, infinite, or bounded. (shrink)

Being the parents of a premature infant can be extremely stressful. Even when parents know that there is a high chance of premature birth, they are often in shock when their infant arrives too earl...

Book Symposium on Don Ihde’s Expanding Hermeneutics: Visualism in Science Content Type Journal Article Category Book Symposium Pages 1-22 DOI 10.1007/s13347-011-0060-5 Authors Jan Kyrre Berg Olsen Friis, University of Copenhagen, Nørre Farimagsgade 5 A, Room 10.0.27, 1014 Copenhagen, Denmark Larry A. Hickman, The Center for Dewey Studies, Southern Illinois University Carbondale, Carbondale, IL 62901, USA Robert Rosenberger, School of Public Policy, Georgia Institute of Technology, DM Smith Building, 685 Cherry Street, Atlanta, GA 30332-0345, USA Robert C. Scharff, University of New (...) Hampshire, Durham, NH 03824-3574, USA Don Ihde, Stony Brook University, Harriman Hall 221, Stony Brook, NY 11794-3750, USA Journal Philosophy & Technology Online ISSN 2210-5441 Print ISSN 2210-5433. (shrink)

Children deserve optimal medical care. Although prescription drugs play a prominent and essential role in pediatric health care delivery, health care providers often must make prescribing decisions for their young patients based on imperfect or absent safety and efficacy data for pediatric populations. Until relatively recently, the Food and Drug Administration made surprisingly little effort to improve the quality or quantity of clinical research data for this patient group. Despite recent agency efforts to improve the situation, only one-third of drugs (...) prescribed to children currently have been studied for safety and efficacy in pediatric populations. Moreover, recent agency initiatives to encourage pediatric drug research have generated mixed results and unintended consequences. The complex of issues surrounding the testing and prescribing of prescription drugs used for children will require that pharmaceutical companies, the FDA, and health care providers examine current practices, acknowledge their shortcomings, and consider cooperative, creative solutions. (shrink)

For Sober and Wilson, the key to group selection is the persistence of within-group behaviours that are individually altruistic -- the so-called ‘primary behaviours'. In the absence of kin-relatedness, such primary behaviours will render the group liable to invasion by non-cooperative strategies unless ‘secondary behaviours’ are in place. Secondary behaviour must in effect make the costs of deviation from the primary altruistic behaviour greater than the benefits of deviation. The secondary behaviour in effect enforces the primary behaviour. Secondary behaviour is (...) also behaviour which is altruistic from the point of view of the individual, whenever enforcement has some costs and lower benefits to the enforcer. Enforcement always has some cost, when imposed. However, it increases the rate of cooperative primary behaviour and so has benefits for the group as a whole, whence its status as altruistic. When altruism and enforcement both emerge, altruism is amplified. (shrink)

The word “epidemic” seems inadequate to describe the spread of the HIV virus in sub-Saharan Africa. The latest estimates suggest that 28.5 million people in this region are infected, including 5 million in South Africa alone. The HIV and AIDS pandemic, with infection rates of over 20 percent in seven African countries, rivals the worst of history's disease outbreaks, including the bubonic plague of medieval times. The devastating effects of the disease on the continent are compounded by extreme poverty in (...) the region and the lack of medical infrastructure essential for delivering the full range of available treatments for HIV infection, AIDS, and the opportunistic infections associated with the disease. Of the 40 million people infected with HIV worldwide, only 730,000 receive combination antiretroviral therapies. In the entire African continent, only 30,000 infected people currently receive such forms of treatment. (shrink)

Imaging technologies “transform” an object of study into something we can visually perceive in the form of an image. In science and medicine, imaging technologies enact a large variety of transformations, sometimes changing the spatiality of an object of study, or changing its temporality. I make use of the postphenomenological philosophical perspective, and in particular the work of its founder, Don Ihde, for guidance in exploring the different ways that imaging technologies transform our world in the process of rendering it (...) available to visual perception. The main project of this paper is to develop a provisional categorization of a large variety of image transformations common to science and medicine. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and (...) made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This user-friendly text covers key issues in the philosophy of science in an accessible and philosophically serious way. It will prove valuable to students studying philosophy of science as well as science students. Prize-winning author Alex Rosenberg explores the philosophical problems that science raises by its very nature and method. He skilfully demonstrates that scientific explanation, laws, causation, theory, models, evidence, reductionism, probability, teleology, realism and instrumentalism actually pose the same questions that Plato, Aristotle, Descartes, Hume, Kant and their (...) successors have grappled with for centuries. (shrink)

What place does consciousness have in the natural world? If we reject materialism, could there be a credible alternative? In one classic example, philosophers ask whether we can ever know what is it is like for bats to sense the world using sonar. It seems obvious to many that any amount of information about a bat's physical structure and information processing leaves us guessing about the central questions concerning the character of its experience. A Place for Consciousness begins with reflections (...) on the existence of this gap. Is it just a psychological shortcoming in our merely human understanding of the physical world? Is it a trivial consequence of the simple fact that we just cannot be bats? Or does it mean there really are facts about consciousness over and above the physical facts? If so, what does consciousness do? Why does it exist? Rosenberg sorts out these problems, especially those centering on the causal role of consciousness. He introduces a new paradigm called Liberal Naturalism for thinking about what causation is, about the natural world, and about how to create a detailed model to go along with the new paradigm. Arguing that experience is part of the categorical foundations of causality, he shows that within this new paradigm there is a place for something essentially like consciousness in all its traditional mysterious respects. A striking feature of Liberal Naturalism is that its central tenets are motivated independently of the mind-body problem, by analyzing causation itself. Because of this approach, when consciousness shows up in the picture it is not introduced in an ad hoc way, and its most puzzling features can be explained from first principles. Ultimately, Rosenberg's final solution gives consciousness a causally important role without supposing either that it is physical or that it interacts with the physical. (shrink)

This article proposes a new model of human concept learning that provides a rational analysis of learning feature‐based concepts. This model is built upon Bayesian inference for a grammatically structured hypothesis space—a concept language of logical rules. This article compares the model predictions to human generalization judgments in several well‐known category learning experiments, and finds good agreement for both average and individual participant generalizations. This article further investigates judgments for a broad set of 7‐feature concepts—a more natural setting in several (...) ways—and again finds that the model explains human performance. (shrink)

The sages of Israel and natural wisdom -- Jews and natural philosophy -- Jews and science.

Collected and edited by Noah Levin -/- Table of Contents: -/- UNIT ONE: INTRODUCTION TO CONTEMPORARY ETHICS: TECHNOLOGY, AFFIRMATIVE ACTION, AND IMMIGRATION 1 The “Trolley Problem” and Self-Driving Cars: Your Car’s Moral Settings (Noah Levin) 2 What is Ethics and What Makes Something a Problem for Morality? (David Svolba) 3 Letter from the Birmingham City Jail (Martin Luther King, Jr) 4 A Defense of Affirmative Action (Noah Levin) 5 The Moral Issues of Immigration (B.M. Wooldridge) 6 The (...) Ethics of our Digital Selves (Noah Levin) -/- UNIT TWO: TORTURE, DEATH, AND THE “GREATER GOOD” 7 The Ethics of Torture (Martine Berenpas) 8 What Moral Obligations do we have (or not have) to Impoverished Peoples? (B.M. Wooldridge) 9 Euthanasia, or Mercy Killing (Nathan Nobis) 10 An Argument Against Capital Punishment (Noah Levin) 11 Common Arguments about Abortion (Nathan Nobis & Kristina Grob) 12 Better (Philosophical) Arguments about Abortion (Nathan Nobis & Kristina Grob) -/- UNIT THREE: PERSONS, AUTONOMY, THE ENVIRONMENT, AND RIGHTS 13 Animal Rights (Eduardo Salazar) 14 John Rawls and the “Veil of Ignorance” (Ben Davies) 15 Environmental Ethics: Climate Change (Jonathan Spelman) 16 Rape, Date Rape, and the “Affirmative Consent” Law in California (Noah Levin) 17 The Ethics of Pornography: Deliberating on a Modern Harm (Eduardo Salazar) 18 The Social Contract (Thomas Hobbes) -/- UNIT FOUR: HAPPINESS 19 Is Pleasure all that Matters? Thoughts on the “Experience Machine” (Prabhpal Singh) 20 Utilitarianism (J.S. Mill) 21 Utilitarianism: Pros and Cons (B.M. Wooldridge) 22 Existentialism, Genetic Engineering, and the Meaning of Life: The Fifths (Noah Levin) 23 The Solitude of the Self (Elizabeth Cady Stanton) 24 Game Theory, the Nash Equilibrium, and the Prisoner’s Dilemma (Douglas E. Hill) -/- UNIT FIVE: RELIGION, LAW, AND ABSOLUTE MORALITY 25 The Myth of Gyges and The Crito (Plato) 26 God, Morality, and Religion (Kristin Seemuth Whaley) 27 The Categorical Imperative (Immanuel Kant) 28 The Virtues (Aristotle) 29 Beyond Good and Evil (Friedrich Nietzsche) 30 Other Moral Theories: Subjectivism, Relativism, Emotivism, Intuitionism, etc. (Jan F. Jacko). (shrink)

In this essay, I defend the Moorean position on organic unities. I will present some plausible examples of organic unites and consider some objections to them. In particular, I will consider an objection from evaluative inadequacy and an objection from Holism or Conditionalism. I will also examine one line of criticism that claims the Moorean position is incoherent.

In this 2004 book, Noah Lemos presents a strong defense of the common sense tradition, the view that we may take as data for philosophical inquiry many of the things we ordinarily think we know. He discusses the main features of that tradition as expounded by Thomas Reid, G. E. Moore and Roderick Chisholm. For a long time common sense philosophers have been subject to two main objections: that they fail to give any non-circular argument for the reliability of (...) memory and perception; and that they pick out instances of knowledge without knowing a criterion for knowledge. Lemos defends the appeal to what we ordinarily think we know in both epistemology and ethics and thus rejects the charge that common sense is dogmatic, unphilosophical or question-begging. Written in a clear and engaging style, this book will appeal to students and philosophers in epistemology and ethics. (shrink)

The United States’ Genetic Information Nondiscrimination Act of 2008 was sweeping legislation intended to protect the privacy of genetic information and prevent discrimination based on genetic factors in health insurance and employment. It protects the genetic privacy of individuals in these contexts and limits the likelihood that genetic discrimination will occur. However, in the case of employment, it does so at the cost of safety, both to the individuals it is meant to protect and to others. On occasion, adherence to (...) the dictates of GINA could lead to serious and avoidable harm to many people. Odd as it may seem, then, there can be such a thing as justified genetic discrimination. There are times when knowledge of genetic factors and subsequent action overrides reasons against obtaining or using such information. Moreover, this knowledge can be obtained without violating one's genetic privacyx. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy can (...) be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (shrink)

This book provides a comprehensive guide to the conceptual methodological, and epistemological problems of biology, and treats in depth the major developments in molecular biology and evolutionary theory that have transformed both biology and its philosophy in recent decades. At the same time the work is a sustained argument for a particular philosophy of biology that unifies disparate issues and offers a framework for expectations about the future directions of the life sciences. The argument explores differences between autonomist and anti-autonomist (...) views of biology. The result is a vindication of reductionism, but one that is unexpectedly hollow. For it leaves the exponents of the autonomy of biology from physical science with as much as their view of biology really requires - and rather more than the reductionist might comfortably concede. Professor Rosenberg shows how the problems of the philosophy of biology are interconnected and how their solutions are interdependent, However, this book focuses more on the direct concerns of biologists, rather than the traditional agenda of philosophers' problems about biology. This departure from earlier books on the subject results both in greater understanding and relevance of the philosophy of science to biology as a whole. (shrink)