In their daily practices, can doctors be both patient advocates and society's agents in rationing costly care? Doctors disagree among themselves. Some argue that patients stand to benefit if doctors lead the movement for cost‐effective care in hospitals, nursing homes, and patients' homes. For others cost‐cutting at the bedside erodes the foundations of the doctor‐patient relationship and compromises the quality of care.

We aimed to conduct a scoping review to assess the profile of retracted health sciences articles authored by individuals affiliated with academic institutions in Latin America and the Caribbean (LAC). We systematically searched seven databases (PubMed, Scopus, Web of Science, Embase, Medline/Ovid, Scielo, and LILACS). We included articles published in peer‐reviewed journals between 2003 and 2022 that had at least one author with an institutional affiliation in LAC. Data were collected on the year of publication, study design, authors' countries of (...) origin, number of authors, subject matter of the manuscript, scientific journals of publication, retraction characteristics, and reasons for retraction. We included 147 articles, the majority being observational studies (41.5%). The LAC countries with the highest number of retractions were Brazil (n = 69), Colombia (n = 16), and Mexico (n = 15). The areas of study with the highest number of retractions were infectology (n = 21) and basic sciences (n = 15). A retraction label was applied to 89.1% of the articles, 70.7% were retracted by journal editors, and 89.1% followed international retraction guidelines. The primary reasons for retraction included errors in procedures or data collection (n = 39), inconsistency in results or conclusions (n = 37), plagiarism (n = 21), and suspected scientific fraud (n = 19). In conclusion, most retractions of scientific publications in health sciences in LAC adhered to international guidelines and were linked to methodological issues in execution and scientific misconduct. Efforts should be directed toward ensuring the integrity of scientific research in the field of health. (shrink)

What is the real significance of covariance anyway, and why should it be regarded as so fundamental ? What we mean by a covariant expression is one whose ...

Throughout his literary career Walker Percy read and studied the philosophical thought of Charles Sanders Peirce in an attempt to re-present in language the world as Percy knew it. Beginning in 1984 and ending in 1990, the year of his death, Percy corresponded with Kenneth Laine Ketner about the "semiotic" of Peirce. Their letters - honest, instructive, and often filled with down-home humor - record an epistolary friendship of two men both passionately interested in Peirce's theory of (...) signs. This volume of letters provides a rich philosophical perspective for better understanding the fiction and nonfiction of Walker Percy. (shrink)

The stream of human consciousness appears to be interruptible, in that we can experience a sensation of ‘returning to ourselves after an absence of content’ (e.g. sleep, anaesthesia, full-absorption meditation). Prima facie, such evidence poses a challenge to simple applications of theories of consciousness based on electromagnetic or neural activity in the brain, because some of this activity persists during periods of interruption. This paper elaborates one of several possible responses to the challenge. We build on a previous theory in (...) which EM field topology delineates complex macrophenomenal experience. We first apply an analytic lens to identify different ways in which field topologies might generate sensations of ‘absence of content’. We then test the feasibility of a particular phenomenological approach for assessing those field topologies, powered by the unusual lucidity about cessation pathways induced via certain meditation practices and psychedelic dosages. We build computational simulations of these cessation pathways and test them on eight interviewees with various levels of experience in cessation states. We conclude that this approach can generate usable insight, but requires further formalisation to fulfil its potential. The findings tentatively support our claims but the theory remains speculative at this stage. We set out empirical tests with 11 specific predictions, both for further phenomenological research and for brain manipulation research. Although they align neatly, our ontological and cessation theories can also be separated. The paper describes how our theories can be consistent with other perspectives on consciousness, such as variants of predictive processing or global network theory. (shrink)

The “Slicing Problem” is a thought experiment that raises questions for substrate-neutral computational theories of consciousness, including those that specify a certain causal structure for the computation like Integrated Information Theory. The thought experiment uses water-based logic gates to construct a computer in a way that permits cleanly slicing each gate and connection in half, creating two identical computers each instantiating the same computation. The slicing can be reversed and repeated via an on/off switch, without changing the amount of matter (...) in the system. The question is what do different computational theories of consciousness believe is happening to the number and nature of individual conscious units as this switch is toggled. Under a token interpretation, there are now two discrete conscious entities; under a type interpretation, there may remain only one. Both interpretations lead to different implications depending on the adopted theoretical stance. Any route taken either allows mechanisms for “consciousness-multiplying exploits” or requires ambiguous boundaries between conscious entities, raising philosophical and ethical questions for theorists to consider. We discuss resolutions under different theories of consciousness for those unwilling to accept consciousness-multiplying exploits. In particular, we specify three features that may help promising physicalist theories to navigate such thought experiments. (shrink)

Implementing an algorithm on part of our causally-interconnected physical environment requires three choices that are typically considered arbitrary, i.e. no single option is innately privileged without invoking an external observer perspective. First, how to delineate one set of local causal relationships from the environment. Second, within this delineation, which inputs and outputs to designate for attention. Third, what meaning to assign to particular states of the designated inputs and outputs. Having explained these types of arbitrariness, we assess their relevance for (...) algorithms from various computational theories of mind (CTM) seeking to account for phenomenal consciousness. Some CTM accounts can survive some of these arbitrariness challenges, but eventually each one examined faces a trilemma. Each is under pressure to dilute at least one of three important CTM desiderata: its causal relevance, its substrate neutrality, or its assignment discrimination (e.g. ability to avoid near-panpsychism). However, unlike previous research, we suggest the debate cannot be fully settled at the level of principle. Certain complex CTM algorithms may be salvageable, albeit not the algorithms specified to date. The paper specifies three areas of investigative work, as well as further theoretical avenues of research, which computationalists may wish to explore to escape the trilemma. (shrink)

In 1971, John Rawls published A Theory of Justice, the burden of which was strongly egalitarian. But Rawls eventually came to the conclusion that the project of working out a stable, well‐ordered society as argued in A Theory of Justice had failed. In 1993, in Political Liberalism, Rawls sought to establish a sounder theoretical foundation for a stable, well‐ordered society. Rawls was widely viewed, however, as having given up egalitarianism in Political Liberalism ‐ the commitment to a fair distribution, or (...) ‘justice as fairness’, along lines originally developed in A Theory of Justice. I argue, by contrast, that Political Liberalism does not in fact repudiate the egalitarianism of A Theory of Justice. Political liberalism has many variants, including variant conceptions of justice. In the first part of what follows, the question is raised whether political liberalism can defend a conception of justice that is as egalitarian as ‘justice as fairness’. Such a conception would guarantee the fair value of political liberties and would also contain the so‐called ‘difference principal’, which states that social and economic inequalities are to be adjusted so that they are to the greatest benefit of the least advantaged. Although it seems possible to defend such an egalitarian conception of justice, it does not seem necessary, all the same, that all variants of political liberalism should be as egalitarian as justice as fairness. Thus, in the second part of my argument, I seek to overturn, or at least substantially to qualify, the idea that there is no need for political liberalism to be strongly egalitarian. I conclude that the egalitarian credentials of political liberalism have to be bolstered, even more so than Rawls himself seems to think. (shrink)

What is a just political order? What does justice require of us? These are perennial questions of political philosophy. John Rawls, generally acknowledged to be one of the most influential political philosophers of the twentieth century, answered them in a way that has drawn widespread attention, not only from political philosophers, but from political scientists, economists, those in the field of public policy, and experts in jurisprudence. It is not only academics who have been inspired by Rawls' ideas; they have (...) also influenced the theory of government and continue to play a role in actual public political debates. This introduction outlines Rawls' work on the theory of justice. Focusing on Rawls' own writings, from his first publication in 1951 to his final ones some fifty years later, Percy B. Lehning demonstrates how and why they can be considered as one consistent and coherent body of work. (shrink)

The ordination of women in the Church of England has had a long hard road. Other denominations, and other parts of the Anglican Communion took the step, but it was not until the 1990s that the first women priests were ordained in the Church of England itself. Even then, Emma Percy describes the situation as an ‘ambiguous welcome’. Careful provision has been made at every stage for those who not only will not accept women as priests, but require the (...) service of bishops who have not participated in the ordination of women. The path to acceptance for women bishops has also been lengthy and subject to the same caveats and provisions. Percy argues that this reveals an underlying failure to think theologically about gender. She recognizes that there are still profound inequalities in the Church’s treatment of women in leadership. (shrink)

Cyril Scott once described Percy Grainger as a `lovable eccentric'. The Australian-American pianist, composer, ethnologist, and aspiring `all-round man' was, however, more eccentric to his own age than to ours. His views on the environment, food, the body, participatory democracy, and sex all anticipated by several decades views more typical of the mid-late twentieth century. Prolific as a composer, performer, and recording artist, Grainger was an indefatigable writer. This selection of forty-six essays about the production, promotion, and propagation of (...) music is drawn from his over 150 public writings. Written between the turn of the century and the early 1950s, these essays reveal Grainger's youthful compositional plans, his ideas about piano technique, and his enduring high regard for the music of Edvard Grieg, Frederick Delius, and `Frankfurt Group' colleagues Cyril Scott, Roger Quilter, and Henry Balfour Gardiner. Grainger on Music also pursues his evolving thoughts about Nordic music, `Free Music', instrumental usage, and his occasional suggestions for musical development in Australia and the United States. (shrink)

Although Polanyi regards technological knowledge as inferior to scientific knowledge, he uses the idea of machine-like operational principles as an analogy for both his epistemology and his ontology. Since his epistemology is based on personal knowledge, this suggest the need for a personal ontology. Polanyi tries to avoid such a conclusion by invoking impersonal evolutionary factors.

In a comprehensive assessment of the penetration of Rawls's ideas in the Netherlands since 1971 five debates are discerned in which different aspects are highlighted or play a role. Some of these debates are more or less ongoing ones, some overlap with each other, and some can be pinpointed more precisely in time. In the first 15 years following the publication of A Theory of Justice, attention was focused on the distributive implications of `justice as fairness'. Next, the `liberalism-communitarianism debate' (...) came to the fore. More recently, Kantian aspects of Rawls's theory have been discussed. A fourth, also more recent debate relates to problems of multiculturalism. Finally, in recent years, and more or less in conjunction with the debate on multiculturalism, the current situation of the Dutch welfare state has been discussed. Here we get back to the core of Rawlsian theory, its distributive implications. But now it is argued that this theory focuses too much on equality at the expense of responsibility and incentives. (shrink)

Symbol and existence will prove fascinating to Walker Percy scholars and fans who wish to decipher Percy's authentic philosophical stance. Percy, an existentialist Catholic at his core, was also a scientist seeking an objective paradigm to portray his views. Symbol and existence demonstrates that Percy was quite methodical and logical in his thought and provides an entirely new perspective on his scholarship. Much of this book is unique and has never been published before; however, some sections (...) were revised and published as isolated journal articles or book chapters, never presented as the unified whole that Percy intended. The orderly unity of Percy's work has not previously been accessible to scholars and fans. Symbol and existences systematic presentation and its new material offer fresh insight and a more accurate view of Percy's ideas. His early philosophical writings were often revised and significantly modified by outside editorial intent to conform to prevailing intellectual currents of the time. Readers of some published articles with corresponding passages in Symbol and Existence will be surprised to discover major changes in meaning from Percy's initial writing due to editorial intrusion and loss of context upon their removal from Symbol and existence. As the only known systematic representation of Percy's general working theory, Symbol and existence gives an important framework for his diverse intellectual background--philosophy and psychology, medicine and anthropology, semiotic and zoology--creating a coherent view of Percy's "radical anthropology. (shrink)