Background: Moral distress has been described as a major problem for the nursing profession, and in recent years, a considerable amount of research has been undertaken to examine its causes and effects. However, few research projects have been performed that examined the moral distress of an entire nation’s nurses, as this particular study does. Aim/objective: The purpose of this study was to determine the frequency and intensity of moral distress experienced by registered nurses in New Zealand. Research design: The research (...) involved the use of a mainly quantitative approach supported by a slightly modified version of a survey based on the Moral Distress Scale–Revised. Participants and research context: In total, 1500 questionnaires were sent out at random to nurses working in general areas around New Zealand and 412 were returned, giving an adequate response rate of 27%. Ethical considerations: The project was evaluated and judged to be low risk and recorded as such on 22 February 2011 via the auspices of the Massey University Human Ethics Committee. Findings: Results indicate that the most frequent situations to cause nursing distress were (a) having to provide less than optimal care due to management decisions, (b) seeing patient care suffer due to lack of provider continuity and (c) working with others who are less than competent. The most distressing experiences resulted from (a) working with others who are unsafe or incompetent, (b) witnessing diminished care due to poor communication and (c) watching patients suffer due to a lack of provider continuity. Of the respondents, 48% reported having considered leaving their position due to the moral distress. Conclusion: The results imply that moral distress in nursing remains a highly significant and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators. (shrink)

Louis de La Forge and the Development of Occasionalism: Continuous Creation and the Activity of the Soul STEVEN NADLER THE DOCTRINE OF DIVINE CONSERVATION is a dangerous one. It is not theologi- cally dangerous, at least not in itself. From the thirteenth century onwards, and particularly with the Summa Theologiae of St. Thomas, the notion of the continuous divine sustenance of the world of created things was, if not univer- sally accepted, a nonetheless common feature of theological orthodoxy, Chris- (...) tian and otherwise. Rather, the danger is philosophical in nature . The philosophical problem I am concerned with is not some logical incoherence at the heart of the doctrine; nor does it lie in any objections that can be raised against the arguments that, historically, have been given for the thesis that God, as a causa secundum esse, must continually act in order to conserve the world in being. The question I address -- and it is a pressing one for any seventeenth-century Cartesianmis whether the doctrine of divine conservation establishes too much. I believe that, under certain circumstances, it does, and that the ultimate ramifications of the doctrine for natural causality must be unacceptable to an orthodox Cartesian such as Louis de La Forge , perhaps the most strict follower of Descartes of the.. (shrink)

Si la tradition analytique cautionne en general la preference moderne pour une rationalite de type mathematique, et demeure mefiante vis-a-vis de la causalite formelle et de l'intuition eidetique, la tradition phenomenologique, en revanche, privilegie l'intuition intellectuelle plutot que les procedures techniques, et propose de rehabiliter nombre des categories meprisees par les penseurs modernes. La these developpee dans cette etude soutient que la phenomenologie offre une explication a la fois plus equilibree et plus coherente de l'objectivite de la connaissance. La vulnerabilite (...) de la philosophie analytique face aux versions contemporaines de l'historicisme et du relativisme est l'aboutissement logique des premisses empiristes communes a la critique fregeenne du psychologisme et a la critique wittgensteinienne de la representation. Le point de vue phenomenologique a pour clef la theorie husserlienne de l'intuition categoriale qui retrouve et renouvelle l'explication aristotelicienne de l'origine des predicats classificatoires a partir des aspects des choses. (shrink)

This article deals with the aesthetics of the art documentary of the 1940s and 1950s, which can be considered as the Golden Age of the genre. Prior to the breakthrough of television in Europe, which would usurp and standardize the art documentary, cinematic reproductions of artworks resulted in experimental shorts that were highly self-reflexive. These films became visual laboratories to investigate the tensions between movement and stasis, the two- and three-dimensional, and the real and the artificial—a film on art was (...) self-consciously presented as an art film. Focusing on La Leggenda di Sant’Orsola by Luciano Emmer and Le Monde de Paul Delvaux by Henri Storck, this article also investigates how the animation of the static image by the film medium relates to Surrealist practices. (shrink)

RÉSUMÉ Hélène Cixous a écrit de nombreux essais, consacrés pour la plupart à l’écriture, la sienne et celle d’autres auteurs. Pourtant la place que le genre de l’essai occupe dans l’œuvre de l’auteure est loin d’être claire. Face aux fictions cixousiennes appréciées comme étant les véritables “essais” au sens montaignien du terme, se trouvent les essais en question, souvent écrits à la suite d’une demande extérieure. L’essai même constitue-t-il un genre cixousien à part entière? Une analyse diachronique, qui nous mènera (...) des grands textes qu’Hélène Cixous a écrits en réponse aux urgences de son époque aux textes plus récents dédiés à l’intimité du processus de l’écriture, situera l’essai et son évolution à l’intérieur du développement de son œuvre. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Deux cartésiens: La polémique Arnauld MalebrancheSteven NadlerDenis Moreau. Deux cartésiens: La polémique Arnauld Malebranche. Paris: J. Vrin, 1999. Pp. 353. NP.The Arnauld-Malebranche debate is one of the great intellectual events of the seventeenth-century. Taking place over an eleven-year time span, and brought to a conclusion only by Arnauld's death, the debate ranged over a wide variety of philosophical and theological issues. At stake were some of the most (...) important questions faced by early modern thinkers: the nature of human knowledge and its relationship to the divine understanding; the appropriate conception of human and divine freedom; the problem of causality; the ontology of evil and the possibility of engaging in theodicean speculation; even the nature of God itself. It is thus very surprising that there has not been, until now, a full-scale (but by no means exhaustive) study of the debate, especially its rich philosophical dimensions.Many readers approaching the documents of the affaire are, of course, put off by the unpleasant personal invective that characterizes many of the principals' exchanges, as well as by what appears to be the repetitive nature of much of the dialogue. Philosophers, as well, have probably been deterred by the debate's theological dimensions, especially the wrangling over questions of grace. More importantly, contemporary philosophers in the Anglo-American tradition have been led to believe that the philosophical side of the debate is fairly one-dimensional, centered only on the nature of representational ideas and the problems surrounding our perception of the external [End Page 595] world. In fact, as Denis Moreau shows in this learned, highly-readable and illuminating study of the debate, the controversy over ideas was only the opening round, Arnauld's point of entry into Malebranche's complex, systematic, but (to Arnauld's mind) highly objectionable philosophical theology.The title of this book is important. Part of Moreau's thesis is that much of the passion of the debate, especially on Arnauld's side, has its origin in the familial context. What is at stake, at least in Arnauld's mind, is the legacy of Cartesianism. Arnauld, Moreau argues convincingly (and contrary to a good deal of scholarly opinion), was a sincere and committed (but not uncritical) disciple of Descartes' (177). His attack on Malebranche was motivated, in part, by a desire to prevent "la philosophie cartésienne" from being transformed for posterity into "la philosophie malebranchiste." It was also motivated, of course and perhaps more importantly, by his desire to defend what he took to be the true Christian conception of God.Part One of the book is devoted to showing how Arnauld's polemical persistence was the result not just of a pugnacious character or personal animus towards his opponent, but rather of a principled approach to philosophical inquiry. His beliefs on the nature and validity of evidence, the proper method to be used in the search after truth, and especially philosophy as a social enterprise all demanded a personal and dialectical confrontation with a heavy dose of rhetoric. Malebranche, on the other hand, preferred a more solitary and meditative mode of inquiry, and was thus unprepared for Arnauld's agonistic onslaught. Thus, Moreau insists with great originality, "on peut ainsi lire cette polémique comme le conflit de deux théories de l'acquisition et de la constitution du savoir."The occasional cause of Arnauld's attack on Malebranche's theory of ideas and his doctrine of vision in God (in Des vraies et des fausses idées) was the publication of the Traité de la nature et de la grace (1680). The epistemological and ontological objections raised in the initial discussion over "êtres représentatifs" was meant ultimately to undermine Malebranche's theodicy by attacking the foundational principles upon which it rested. In Part Two of the book, Moreau looks at what, in Arnauld's eyes, was the essential flow in Malebranche's account: the assertion of the reality of evil. Evil, Malebranche insisted, was not to be explained away as merely illusory, or as forming an essential contributing ingredient of a larger, more perfect whole. Evil is irreducibly real; there is imperfection... (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

One of the welcome features of Leibniz research over the past quarter century has been the abandonment of the old "chicken vs. egg" debate about whether Leibniz's logic precedes and grounds his metaphysics or vice versa. Scholars such as Robert M. Adams, Daniel Garber, and Donald Rutherford, among others, have brought our attention to what might be called the systematic "holism" of Leibniz's thought and the way in which its various elements—logical, physical, metaphysical, and theological—reinforce each other. Rutherford, in particular, (...) has argued persuasively that if anything is central to Leibniz's project and its systematicity, it is his philosophical theology, and especially his theodicy.Paul Rateau's book is an important contribution to our understanding of Leibniz's thinking about the problem of evil and the way in which it relates to so many other aspects—philosophical, political, theological—of his system. It is, without question, the most thorough, careful, and philosophically astute study to date of Leibniz's theodicy and its ramifications. It is also an exceedingly well-written and fascinating book. (shrink)

La séduction apporte du liant aux relations humaines, du lien social à la relation amoureuse. Mais elle comporte aussi une ambiguïté structurelle, que l’auteur analyse ici à partir des outrances de la séduction.

Since publication of the 1986 Carnegie Commission report, A Nation Prepared: Teachers for the 21st Century, the professional teaching standards movement has gained noticeable momentum. The professional standards movement in teaching has been fueled by national organizations such as the National Council for Accreditation of Teacher Education, the Interstate New Teachers Assessment and Support Consortium, the National Board for Professional Teaching Standards, the National Commission on Teaching and America's Future, and by close collaboration among these four entities. Further, nearly all (...) of the fifty states are embracing the professional standards movement through formal participation in the work of one or more of these organizations. Although the professional standards movement in teaching is strong and growing stronger, its implications are not clear for instructional programs in social foundations of education, either at the teacher preparation or the advanced graduate levels. In response to the standards movement, social foundations educators have a number of options before them, three of which are to (1) largely ignore these developments, as "this too shall pass"; (2) critically interpret and resist these developments through scholarship and collective professional action, as social foundations scholars did with Competency Based Teacher Education in the 1970s; and (3) critically interpret these developments while working to strengthen the potential of the professional teaching standards movement to achieve its stated goal of providing caring and qualified teachers for every classroom in the nation. Of these three options, the last is most advisable, but it presents a considerable challenge to social foundations educators. Although the absence of social foundations skills, perspectives, and understanding should make it very difficult for teacher candidates and teachers to perform well on standards-based teaching assessments, there is no guarantee that these assessments will hold candidates accountable for social foundations learning. Implications for social foundations educators and activists are significant. (shrink)

This paper investigates how the business models adopted by single-owner women farmers are impacted by the entrepreneurial ecosystem in which they operate. We explored these interactions from the perspective of entrepreneurial capital to better understand the challenges faced by women entrepreneurs starting their own farms. We conducted semi-structured interviews with 19 single-owner women farmers in Quebec. Our results indicate that single-owner women farmers often start farming at a mid-point in their careers, are motivated by strong social and agroecological values, but (...) must navigate a traditional and gendered entrepreneurial ecosystem that limits opportunities to leverage financial, social and symbolic capital to grow their mostly alternative business models. However, single-owner women farmers also mobilize entrepreneurial capital and innovative business strategies to assert their identity as women farmers and grow their businesses with varying degrees of success. This was often achieved by developing strong partnerships with key stakeholders and by marketing through alternative channels, such as short food supply chains. We derive several research propositions to guide future research on this topic. (shrink)

The concept of "the flesh" (la chair) derives from the writings of Maurice Merleau-Ponty. This was the word he used to name the concrete realm of sentient bodies and life processes that has been eclipsed by the abstractions of science, technology, and modern culture. Topology, to conventional understanding, is the branch of mathematics that concerns itself with the properties of geometric figures that stay the same when the figures are stretched or deformed. Topologies of the Flesh blends continental thought and (...) mathematical imagination, opening up a new area of philosophical inquiry: topological phenomenology. Through its unique application of qualitative mathematics, this work extends the approaches of Merleau-Ponty and Heidegger so as to offer a detailed exploration of previously uncharted dimensions of human experience and the natural world. (shrink)

A biographical and philosophical study of Louis de La Forge (1632-1666) and his contributions to the fortunes of Cartesianism in the seventeenth century. La Forge was instrumental in making Descartes' philosophy the dominant philosophical paradigm of the period. He contributed illustrations and a commentary to the 1664 edition of Descartes' Traité de l'homme; and then, in 1666, he published his own account of the human mind and its relation to the body on Cartesian principles, the Traité de l'esprit de l'homme. (...) La Forge's most innovative and influential philosophical contribution consists in his doctrine of occasionalism, which accords God a substantial, if not unique, causal role in the world. (shrink)

With this significant work from 1932, The Self-Conscious Determination of Nothingness, we have the third important book of Nishida’s period of philosophical maturity. Here, Nishida has moved beyond the unconvincing essays of the previous periods, such as the ingenuous psychologism of A Study of Good or the epistemological theorization of the hesitant neo-Kantian period. Nishida is now developing the consequences of his major philosophical notion, the “logic of place”. Thanks to the translation work of Jacynthe Tremblay, the whole production of (...) this decisive period is now... (shrink)

Depuis l'avenement de la physique moderne, la physique d'Aristote a perdu son ancien prestige, voire sa credibilite. Pour beaucoup elle ne constitue plus qu'un objet d'etude pouvant interesser uniquement l'histoire des sciences ou de la philosophie. Cette pauvrete dans l'utilisation d'un texte pourtant essentiel de la pensee du Stagirite contraste avec le succes d'autres de ses oeuvres, comme les traites de logique, d'ethique, de metaphysique ou de poetique. Ce phenomene se poursuit au XXe siecle, puisque les livres sur la Physique (...) sont rares et, le plus souvent ne tiennent compte que de certains problemes. Cette nouvelle traduction souhaite permettre aux regards de se tourner a nouveau vers un livre central de la pensee d'Aristote. (shrink)

Three general accounts of causation stand out in early modern philosophy: Cartesian interactionism, occasionalism, and Leibniz's preestablished harmony. The contributors to this volume examine these theories in their philosophical and historical context. They address them both as a means for answering specific questions regarding causal relations and in their relation to one another, in particular, comparing occasionalism and the preestablished harmony as responses to Descartes's metaphysics and physics and the Cartesian account of causation. Philosophers discussed include Descartes, Gassendi, Malebranche, Arnauld, (...) Leibniz, Bayle, La Forge, and other, less well-known figures. (shrink)

A rapidly growing body of scholarship shows that we can gain new insights into theories and policies by understanding and increasing their systemic structure. This paper will present an overview of this expanding field and discuss how concepts of structure are being applied in a variety of contexts to support collaboration, decision making, learning, prediction, and results. Next, it will delve into the underlying structures of logic that may be found within those theories and policies. Here, we will go beyond (...) Toulmin’s logics of claim and proof that have not proven useful for advancing the social sciences and focus on five structures of “causal logic.” The results suggest a useful and more comprehensive approach to developing deeper understanding of our conceptual systems such as theory and policy. (shrink)

In Life Beyond the Gene, Steven Rose offers a theory of life which insists that we as humans -- and indeed all living creatures -- create our own futures, though in circumstances not of our own choosing. Placing the organism at the center of life, Rose confronts the ideology of reductionism and ultra-Darwinism, with its insistence that all aspects of human life from sexual preference to infanticide, political orientation to violence, male domination to alcoholism, are in our genes and (...) are the inevitable consequences of natural selection. These claims, Rose asserts, are not only socially naive, but fundamentally misunderstand the active and irreducible nature of living processes. Rose argues that life depends on the elaborate web of interactions that occur within cells, organisms, and ecosystems, in which DNA has one part to play. From early in their development, living organisms have to be capable of quasi-independent existence while growing to maturity. If we are to understand life, we must recapture an understanding of the entire living organism and its trajectory through time and space. Rose calls these trajectories lifelines. Provocative and incisive, Life Beyond the Gene provides a compelling response to those enthusiasts of the gene who would deny the complexity of life. (shrink)

L'ouvrage a pour but d'introduire le lecteur à la philosophie japonaise contemporaine, en portant l'attention sur son représentant le plus célèbre : Nishida Kitarô, fondateur de l'Ecole de Kyôto. Au fil d'un décryptage des notions cardinales de sa pensée, il s'agit de montrer en quoi a consisté l'effort philosophique de Nishida et quel peut être son intérêt intrinsèque au milieu du paysage intellectuel international. C'est ici la proximité avec le courant phénoménologique qui est soulignée. Mais par-delà l'œuvre propre de Nishida, (...) il s'agit également d'exposer le contexte intellectuel dans lequel est née sa pensée, les sources de celle-ci dans la tradition orientale et l'influence que son travail philosophique a pu avoir sur l'évolution des idées au japon, au cœur du XXe siècle. Sont ainsi brièvement abordées, dans la foulée de la percée nishidienne, la dialectique praxique de Tanabe, l'ontologie religieuse de Nishitani, l'éthique de Watsuji et l'esthétique de Kuki. (shrink)

The literature on affective determinants of physical activity is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Framework, including: affective response to PA; incidental affect; affect processing; and affectively charged motivational states. After defining each category of affective construct, we provide examples of relevant research showing how each construct may (...) relate to PA behavior. We conclude each section with a discussion of future directions for research. (shrink)

Partant du constat qu’il existe à la fois une très grande similitude entre les philosophies de la perception d’Aristote et de Merleau-Ponty, et une revendication de ce dernier de s’affranchir du cadre ontologique hérité, cet article cherche à définir où se situe exactement la différence entre les deux conceptions. Il écarte d’abord l’hypothèse d’une assimilation ontologique totale entre sentant et sensible dans l’indistinction de la chair, dans la mesure où ce tissu n’est pas un uniforme mais peut toujours présenter la (...) dualité adhérente de l’envers et de l’endroit. Ensuite se pose la question de savoir si la Visibilité en général, comme puissance indéterminée, était impensable pour Aristote en raison de sa théorie de la substance – et il est montré que celle-ci, bien comprise, admet la pure puissance, tout en favorisant la détermination. Dès lors, la différence entre les deux auteurs se manifeste plutôt dans la conception de l’être, qui pour Merleau-Ponty demeure en retrait, tandis que pour Aristote il est toujours a priori déterminable, quoique selon des modalités irréductiblement multiples.Starting from the observation that there is at once a great similarity between the perception philosophy of Aristotle and Merleau-Ponty, and a claiming from the latter to emancipate oneself from the inherited ontological frame, this article tries to define where exactly stands the difference between the two conceptions. It first dismisses the hypothesis of a complete ontological assimilation between perceptive and perceptible in the indistinction of the « flesh », as far as this « web » is not a uniform but can always produce the adhering duality of inside and outside. Then comes the question whether the general Visibility, as indeterminable potency, was unthinkable by Aristotle because of his substance theory – and it is showed that this theory, if well understood, admits the pure potency even favouring the determination. Finally, the difference between the two thinkers appears rather in the conception of Being, that, according to Merleau-Ponty, stands in the background, while, according to Aristotle, it is always a priori determinable although in irreducibly multiple modes. (shrink)

The rapid development of quantum technologies, such as quantum computing, quantum internet, and quantum sensing, has led to a growing awareness of the ethical issues surrounding these technologies. This literature review aims to analyze the existing research on these ethical issues using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) literature review approach. The literature search was conducted using the following databases: Scopus ArXiv, and IEEE Xplore, and the search terms used were “quantum computing,” “quantum internet,” “quantum sensing,” (...) “quantum technology,” AND “ethics.” Inclusion criteria were: (1) articles that addressed ethical issues related to quantum technologies and (2) articles that were written in English. A total of 14 articles were included in the review. The majority of the articles (64 percent) were published in the last 5 years. The majority of the articles (78 percent) focused on the potential impact of quantum technologies on privacy and security, with a particular emphasis on the potential for quantum computers to break encryption and the subsequent impact on privacy and security. Approximately 50 percent of the articles focused on the accessibility and responsibility dimensions of quantum technologies. This scoping review has demonstrated that there is a growing awareness of the ethical issues surrounding quantum technologies and an increasing number of researchers, policymakers, and industry leaders working to address them. Future research should continue to explore these ethical issues in more depth and develop recommendations for addressing them. (shrink)

This article explores the potential of Bernard Lonergan’s philosophy of subjectivity as objectivity as a grounding for value sensitive design (VSD) and the design turn in applied ethics. The rapid pace of scientific and technological advancement has created a gap between technical abilities and our moral assessments of those abilities, calling for a reflection on the philosophical tools we have for applying ethics. In particular, applied ethics often presents interconnected problems that require a more general framework for ethical reflection. Lonergan’s (...) philosophy, which emphasizes the importance of self-understanding and self-transcendence in achieving objectivity, can provide a valuable perspective on VSD and the design turn in applied ethics. The article examines how Lonergan’s philosophy can be applied to VSD and the design turn, and how scientific knowledge can be integrated into an ethics of science without reducing it to an external reflection. By adopting Lonergan’s perspective, we can address the ethical challenges arising from scientific and technological advancements while promoting a more holistic approach to applied ethics. (shrink)