In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually. Following from (...) this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three “models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer, and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve understanding of what exactly EPR use does to the doctor-patient relationship. (shrink)

In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually. Following from (...) this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three “models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer, and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve understanding of what exactly EPR use does to the doctor-patient relationship. (shrink)

Maternal–fetal surgery (MFS) encompasses a range of innovative procedures aiming to treat fetal illnesses and anomalies during pregnancy. Their development and gradual introduction into healthcare raise important ethical issues concerning respect for pregnant women’s bodily integrity and autonomy. This paper asks what kind of ethical framework should be employed to best regulate the practice of MFS without eroding the hard-won rights of pregnant women. I examine some existing models conceptualising the relationship between a pregnant woman and the fetus to (...) determine what kind of framework is the most adequate for MFS, and conclude that an ecosystem or maternal–fetal dyad model is best suited for upholding women’s autonomy. However, I suggest that an appropriate framework needs to incorporate some notion of fetal patienthood, albeit a very limited one, in order to be consistent with the views of healthcare providers and their pregnant patients. I argue that such an ethical framework is both theoretically sound and fundamentally respectful of women’s autonomy, and is thus best suited to protect women from coercion or undue paternalism when deciding whether to undergo MFS. (shrink)

We show that every model of IΔ0 has an end extension to a model of a theory where log-space computable function are formalizable. We also show the existence of an isomorphism between models of IΔ0 and models of linear arithmetic LA.

Human persons can act with libertarian freedom in heaven according to one prominent view, because they have freely acquired perfect virtue in their pre-heavenly lives such that acting rightly in heaven is volitionally necessary. But since the character of human persons is not perfect at death, how is their character perfected? On the unilateral model, God alone completes the perfection of their character, and, on the cooperative model, God continues to work with them in purgatory to perfect their own character. (...) I argue that although both models can make sense of all human persons enjoying free will in heaven on various assumptions, the cooperative model allows all human persons in heaven to enjoy a greater degree of freedom. This consideration about the degree of heavenly freedom provides a reason for God to implement the cooperative model. (shrink)

To evaluate Hume's thesis that causal claims are always empirical, I consider three kinds of causal statement: ?e1 caused e2 ?, ?e1 promoted e2 ?, and ?e1 would promote e2 ?. Restricting my attention to cases in which ?e1 occurred? and ?e2 occurred? are both empirical, I argue that Hume was right about the first two, but wrong about the third. Standard causal models of natural selection that have this third form are a priori mathematical truths. Some are obvious, (...) others less so. Empirical work on natural selection takes the form of defending causal claims of the first two types. I provide biological examples that illustrate differences among these three kinds of causal claim. (shrink)

Biomedical researchers claim there is significant biomedical information about humans which can be discovered only through experiments on intact animal systems (AMA p. 2). Although epidemiological studies, computer simulations, clinical investigation, and cell and tissue cultures have become important weapons in the biomedical scientists' arsenal, these are primarily "adjuncts to the use of animals in research" (Sigma Xi p. 76). Controlled laboratory experiments are the core of the scientific enterprise. Biomedical researchers claim these should be conducted on intact biological systems, (...) whole animals. By observing the effects of various stimuli in non-human animals, we can form legitimate expectations about the likely effects of these stimuli in humans. Perhaps more importantly, we can understand the biomedical condition's causal mechanisms. (shrink)

We generalize the construction of lattice-valued models of set theory due to Takeuti, Titani, Kozawa and Ozawa to a wider class of algebras and show that this yields a model of a paraconsistent logic that validates all axioms of the negation-free fragment of Zermelo-Fraenkel set theory.

Vector-based models of word meaning have become increasingly popular in cognitive science. The appeal of these models lies in their ability to represent meaning simply by using distributional information under the assumption that words occurring within similar contexts are semantically similar. Despite their widespread use, vector-based models are typically directed at representing words in isolation, and methods for constructing representations for phrases or sentences have received little attention in the literature. This is in marked contrast to experimental (...) evidence (e.g., in sentential priming) suggesting that semantic similarity is more complex than simply a relation between isolated words. This article proposes a framework for representing the meaning of word combinations in vector space. Central to our approach is vector composition, which we operationalize in terms of additive and multiplicative functions. Under this framework, we introduce a wide range of composition models that we evaluate empirically on a phrase similarity task. (shrink)

In computer simulations of physical systems, the construction of models is guided, but not determined, by theory. At the same time simulations models are often constructed precisely because data are sparse. They are meant to replace experiments and observations as sources of data about the world; hence they cannot be evaluated simply by being compared to the world. So what can be the source of credibility for simulation models? I argue that the credibility of a simulation model (...) comes not only from the credentials supplied to it by the governing theory, but also from the antecedently established credentials of the model building techniques employed by the simulationists. In other words, there are certain sorts of model building techniques which are taken, in and of themselves, to be reliable. Some of these model building techniques, moreover, incorporate what are sometimes called “falsifications.” These are contrary-to-fact principles that are included in a simulation model and whose inclusion is taken to increase the reliability of the results. The example of a falsification that I consider, called artificial viscosity, is in widespread use in computational fluid dynamics. Artificial viscosity, I argue, is a principle that is successfully and reliably used across a wide domain of fluid dynamical applications, but it does not offer even an approximately “realistic” or true account of fluids. Artificial viscosity, therefore, is a counter-example to the principle that success implies truth – a principle at the foundation of scientific realism. It is an example of reliability without truth. (shrink)

Games of chance are developed in their physical consumer-ready form on the basis of mathematical models, which stand as the premises of their existence and represent their physical processes. There is a prevalence of statistical and probabilistic models in the interest of all parties involved in the study of gambling – researchers, game producers and operators, and players – while functional models are of interest more to math-inclined players than problem-gambling researchers. In this paper I present a (...) structural analysis of the knowledge attached to mathematical models of games of chance and the act of modeling, arguing that such knowledge holds potential in the prevention and cognitive treatment of excessive gambling, and I propose further research in this direction. (shrink)

Internalism says that if an agent judges that it is right for her to φ, then she is motivated to φ. The disagreement between Internalists and Externalists runs deep, and it lingers even in the face of clever intuition pumps. An argument in Michael Smith’s The Moral Problem seeks some leverage against Externalism from a point within normative theory. Smith argues by dilemma: Externalists either fail to explain why motivation tracks moral judgment in a good moral agent or they attribute (...) a kind of fetishism to good moral agents. I argue that there are alternative models of moral motivation available to Externalists, in particular a model according to which a good moral agent is one who is effectively regulated by a second order desire to desire to do what is right. (shrink)

In this study, Bethany Somma argues for a dichotomous interpretation of human desire developed by late ancient Greek and medieval Islamic philosophers in response to an ambiguity in Aristotle’s account of desire.

The medial prefrontal cortex (mPFC) has been the subject of intense interest as a locus of cognitive control. Several computational models have been proposed to account for a range of effects, including error detection, conflict monitoring, error likelihood prediction, and numerous other effects observed with single-unit neurophysiology, fMRI, and lesion studies. Here, we review the state of computational models of cognitive control and offer a new theoretical synthesis of the mPFC as signaling response–outcome predictions. This new synthesis has (...) two interacting components. The first component learns to predict the various possible outcomes of a planned action, and the second component detects discrepancies between the actual and intended responses; the detected discrepancies in turn update the outcome predictions. This single construct is consistent with a wide array of performance monitoring effects in mPFC and suggests a unifying account of the cognitive role of medial PFC in performance monitoring. (shrink)

In this paper we investigate computable models of -categorical theories and Ehrenfeucht theories. For instance, we give an example of an -categorical but not -categorical theory such that all the countable models of except its prime model have computable presentations. We also show that there exists an -categorical but not -categorical theory such that all the countable models of except the saturated model, have computable presentations.

This paper is about mechanisms and models, and how they interact. In part, it is a response to recent discussion in philosophy of biology regarding whether natural selection is a mechanism. We suggest that this debate is indicative of a more general problem that occurs when scientists produce mechanistic models of populations and their behaviour. We can make sense of claims that there are mechanisms that drive population-level phenomena such as macroeconomics, natural selection, ecology, and epidemiology. But talk (...) of mechanisms and mechanistic explanation evokes objects with well-defined and localisable parts which interact in discrete ways, while models of populations include parts and interactions that are neither local nor discrete in any actual populations. This apparent tension can be resolved by carefully distinguishing between the properties of a model and those of the system it represents. To this end, we provide an analysis that recognises the flexible relationship between a mechanistic model and its target system. In turn, this reveals a surprising feature of mechanistic representation and explanation: it can occur even when there is a mismatch between the mechanism of the model and that of its target. Our analysis reframes the debate, providing an alternative way to interpret scientists’ mechanism-talk , which initially motivated the issue. We suggest that the relevant question is not whether any population-level phenomenon such as natural selection is a mechanism, but whether it can be usefully modelled as though it were a particular type of mechanism. (shrink)

Subjects exposed to strings of letters generated by a finite state grammar can later classify grammatical and nongrammatical test strings, even though they cannot adequately say what the rules of the grammar are (e.g., Reber, 1989). The MINERVA 2 (Hintzman, 1986) and Medin and Schaffer (1978) memory‐array models and a number of connectionist outoassociator models are tested against experimental data by deriving mainly parameter‐free predictions from the models of the rank order of classification difficulty of test strings. (...) The importance of different assumptions regarding the coding of features (How should the absence of a feature be coded? Should single letters or digrams be coded?), the learning rule used (Hebb rule vs. delta rule), and the connectivity (Should features be predicted only by previous features in the string, or by all features simultaneously?) is investigated by determining the performance of the models with and without each assumption. Only one class of connectionist model (the simultaneous delta rule) passes all the tests. It is shown that this class of model can be regarded by abstracting a set of representative but incomplete rules of the grammar. (shrink)

This paper looks closely at previously enunciated axioms that specifically include phenomenology as the sense of a self in a perceptual world. This, we suggest, is an appropriate way of doing science on a first-person phenomenon. The axioms break consciousness down into five key components: presence, imagination, attention, volition and emotions. The paper examines anew the mechanism of each and how they interact to give a single sensation. An abstract architecture, the Kernel Architecture, is introduced as a starting point for (...) building computational models. The thrust of the paper is to relate the axioms to the kernel architecture and indicate that this opens a way of discussing some first-person issues: tests for consciousness, animal consciousness and Higher Order Thought. (shrink)

Remarkable progress in the mathematics and computer science of probability has led to a revolution in the scope of probabilistic models. In particular, ‘sophisticated’ probabilistic methods apply to structured relational systems such as graphs and grammars, of immediate relevance to the cognitive sciences. This Special Issue outlines progress in this rapidly developing field, which provides a potentially unifying perspective across a wide range of domains and levels of explanation. Here, we introduce the historical and conceptual foundations of the approach, (...) explore how the approach relates to studies of explicit probabilistic reasoning, and give a brief overview of the field as it stands today. (shrink)

This is an exciting time for brain science. Recent progress has been such that it now seems realistic to look toward an explanation of mind in terms of the brain's anatomy and physiology. Models based on artificially symmetrical arrays of idealized neurons are now being superseded by ones which properly take into account the brain's actual circuitry. This book presents a comprehensive overview of the current state of brain modeling, containing contributions from many leading researchers in this field. It (...) will be of interest not only to researchers in the fields of brain science and neurobiology, but also to psychologists and those involved in the study of artificial intelligence. (shrink)

The purpose of this paper is to describe some limitations on scientific behaviorist and computational models of the mind. These limitations stem from the inability of either model to account for the integration of experience and behavior. Behaviorism fails to give an adequate account of felt experience, whereas the computational model cannot account for the integration of our behavior with the world. Both approaches attempt to deal with their limitations by denying that the domain outside their limits is a (...) part of psychology. These attempts to turn the shortcomings of the two models into virtues would be more convincing if their limitations were not diametrically opposed. I will argue that in each case the limitations are too restrictive unless the theories are augmented by physiology. (shrink)

We show that true first-order arithmetic is interpretable over the real-algebraic structure of models of intuitionistic analysis built upon a certain class of complete Heyting algebras. From this the undecidability of the structures follows. We also show that Scott's model is equivalent to true second-order arithmetic. In the appendix we argue that undecidability on the language of ordered rings follows from intuitionistically plausible properties of the real numbers.

Empirical evidence suggests that while people hold the capacity to control their data in high regard, they increasingly experience a loss of control over their data in the online world. The capacity to exert control over the generation and flow of personal information is a fundamental premise to important values such as autonomy, privacy, and trust. In healthcare and clinical research this capacity is generally achieved indirectly, by agreeing to specific conditions of informational exposure. Such conditions can be openly stated (...) in informed consent documents or be implicit in the norms of confidentiality that govern the relationships of patients and healthcare professionals. However, with medicine becoming a data-intense enterprise, informed consent and medical confidentiality, as mechanisms of control, are put under pressure. In this paper we explore emerging models of informational control in data-intense healthcare and clinical research, which can compensate for the limitations of currently available instruments. More specifically, we discuss three approaches that hold promise in increasing individual control: the emergence of data portability rights as means to control data access, new mechanisms of informed consent as tools to control data use, and finally, new participatory governance schemes that allow individuals to control their data through direct involvement in data governance. We conclude by suggesting that, despite the impression that biomedical big data diminish individual control, the synergistic effect of new data management models can in fact improve it. (shrink)

Genomic research—including whole genome sequencing and whole exome sequencing—has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research—historically referred to as “incidental findings”—has generated considerable discussion as to how this information should be handled—that is, whether incidental results should be returned, and if so, which ones.Federal regulations governing most human subjects research in the United States require the disclosure of “the procedures to be followed” in (...) the research as part of the informed consent process. It seems reasonable to assume—and indeed, many commentators have concluded—that genomic investigators will be expected to inform participants about, among other procedures, the prospect that incidental findings will become available and the mechanisms for dealing with them. Investigators, most of whom will not have dealt with these issues before, will face considerable challenges in framing meaningful disclosures for research participants.To help in this task, we undertook to identify the elements that should be included in the informed consent process related to incidental findings. We did this by surveying a large number of genomic researchers (n = 241) and by conducting in‐depth interviews with a smaller number of researchers (n = 28) and genomic research participants (n = 20). Based on these findings, it seems clear to us that routine approaches to informed consent are not likely to be effective in genomic research in which the prospect of incidental findings exists. Ensuring that participants’ decisions are informed and meaningful will require innovative approaches to dealing with the consent issue. We have identified four prototypical models of a consent process for return of incidental findings. (shrink)

The aim of cognitive neuropsychology is to articulate the functional architecture underlying normal cognition, on the basis of congnitive performance data involving brain-damaged subjects. Throughout the history of the subject, questions have been raised as to whether the methods of neuropsychology are adequate to its goals. The question has been reopened by Glymour [1994], who formulates a discovery problem for cognitive neuropsychology, in the sense of formal learning theory, concerning the existence of a reliable methodology. It appears that the discovery (...) problem may be insoluble in principle! I propose a modified formulation of Glymour's discovery problem and argue that a sceptical conclusion about the possiblity of cognitive neuropsychology as an empirical science is not warranted. (shrink)