Background Prenatal genetic testing, in particular non-invasive prenatal testing (NIPT), as well as screening for risks associated with pregnancy, and counseling, play pivotal roles in reproductive healthcare, offering valuable information about the health of the fetus to expectant parents. This study aims to delve into the perspectives and experiences of women considering genetic testing and screening during pregnancy, focusing on their decision-making processes and the implications for informed consent. Methods A nationwide qualitative study was conducted in Switzerland, involving in-depth interviews (...) with women who were 1 to 2 years post-partum, covered by basic compulsory Swiss insurance, including women with a migration background. Thematic analysis was employed to identify key themes and patterns in the data. Results The findings underscore the significance of effective communication during prenatal counseling, suggesting that healthcare providers could not only convey technical information but also support women in their decision-making processes. Women need comprehensive information about genetic testing and its implications, as well as the reasons for screening during pregnancy, as there might be a need to bridge knowledge gaps and clarify misconceptions. Furthermore, the study highlights the multifaceted nature of decision-making, with women considering factors such as uncertainty, values, emotional responses, and societal support systems. The concept of acceptance emerged as a crucial theme, with some women expressing their readiness to love and accept their child, regardless of genetic anomalies or disabilities. Conclusion This study offers valuable insights into the perspectives and needs of women regarding prenatal genetic testing, screening, and counseling in Switzerland. It underscores the importance of enhancing the clinical interaction and informed consent process by providing comprehensive information, addressing misconceptions, and supporting women in decision-making about pregnancy management and the management of the child’s health, following prenatal genetic testing, including NIPT. These findings can inform healthcare providers and policymakers in improving the quality of prenatal counseling, ensuring informed consent, and supporting women in making well-informed and meaningful decisions about genetic testing, and on the use of screening during pregnancy. (shrink)

One of the central points of contention in the epistemology of testimony concerns the uniqueness (or not) of the justification of beliefs formed through testimony--whether such justification can be accounted for in terms of, or 'reduced to,' other familiar sort of justification, e.g. without relying on any epistemic principles unique to testimony. One influential argument for the reductionist position, found in the work of Elizabeth Fricker, argues by appeal to the need for the hearer to monitor the testimony for credibility. (...) Fricker (1994) argues, first, that some monitoring for trustworthiness is required if the hearer is to avoid being gullible, and second, that reductionism but not anti-reductionism is compatible with ascribing an important role to the process of monitoring in the course of justifiably accepting observed testimony. In this paper we argue that such an argument fails. (shrink)

Marina Sbisà has long advocated that we think of the illocutionary force of a speech act in terms of the act’s (predictable) systematic effects on the normative relationship between a speaker and her audience. Building on this idea, I argue that the hypothesis of distinctive speech act norms can be used to explain how participants in a conversation coordinate the normative expectations they have of one another in conversation. Such an explanation earns its keep by explaining how speakers render themselves (...) illocutionarily intelligible to their audiences—thereby enabling us to articulate the sense of mutuality that characterizes speech exchanges. One important upshot of my reflections is that we should reject both Austin’s thesis that the successful performance of an illocutionary act depends on audience uptake and Sbisà’s claim that Austin’s thesis is required if we are to make sense of the illocutionary dimension of speech in terms of an act’s systematic effects on participants’ normative expectations of one another. (shrink)

It has been alleged that the demands of friendship conflict with the norms of epistemology—in particular, that there are cases in which the moral demands of friendship would require one to give a friend the benefit of the doubt, and thereby come to believe something in violation of ordinary epistemic standards on justified or responsible belief :329–351, 2004; Stroud in Ethics 116:498–524, 2006; Hazlett in A luxury of the understanding: on the value of true belief, Oxford University Press, Oxford, 2013). (...) The burden of this paper is to explain these appearances away. I contend that the impression of epistemic partiality in friendship dissipates once we acknowledge the sorts of practical and epistemic reasons that are generated by our values: value-reflecting reasons. The present proposal has several virtues: it requires fewer substantial commitments than other proposals seeking to resist the case for epistemic partiality ; it is independently motivated, as it cites a phenomenon—value-reflecting reasons—we have independent reasons to accept; it provides a single, unified account of how various features of friendship bear on belief-formation; and makes clear how it is the very value we place on friendship itself that ensures against epistemic partiality. (shrink)

Miranda Fricker's Epistemic Injustice is a wide-ranging and important book on a much-neglected topic: the injustice involved in cases in which distrust arises out of prejudice. Fricker has some important things to say about this sort of injustice: its nature, how it arises, what sustains it, and the unhappy outcomes associated with it for the victim and the society in which it takes place. In the course of developing this account, Fricker also develops an account of the epistemology of testimony. (...) Focusing my attention on that account, my central claims are two. First, at least some of Fricker's arguments against existing (inferentialist and non-inferentialist) views in the epistemology of testimony are less than fully persuasive, and the (non-inferentialist) view she ends up endorsing is not all that different from the views she criticizes. Second, her reasons for harboring doubts regarding the role of a principle of default entitlement within a non-inferentialist account are not persuasive. Neither of these claims affects the overall argument Fricker is trying to run. Rather, they suggest that Fricker may have picked more fights than she needed to in the epistemology of testimony. If so, we have reason to detach Fricker's important work on epistemic injustice from some of the details of the story she tells regarding the epistemology of testimony. (shrink)

Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 editions. This (...) update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

Recently, we proposed a fundamental subdivision of the human cortex into two complementary networks—an “extrinsic” one which deals with the external environment, and an “intrinsic” one which largely overlaps with the “default mode” system, and deals with internally oriented and endogenous mental processes. Here we tested this hypothesis by contrasting decision making under external and internally-derived conditions. Subjects were presented with an external cue, and were required to either follow an external instruction or to ignore it and follow a voluntary (...) decision process . Our results show that a well defined component of the intrinsic system—the right inferior parietal cortex—was preferentially activated during the “free-will” condition. Importantly, this activity was significantly higher than the base-line resting state. The results support a self-related role for the intrinsic system and provide clear evidence for both hemispheric and regional specialization in the human intrinsic system. (shrink)

In this paper I argue, first, that the most influential (and perhaps only acceptable) account of the epistemology of self-knowledge, developed and defended at great length in Wright (1989b) and (1989c) (among other places), leaves unanswered a question about the psychology of self-knowledge; second, that without an answer to this question about the psychology of self-knowledge, the epistemic account cannot be considered acceptable; and third, that neither Wright's own answer, nor an interpretation-based answer (based on a proposal from Jacobsen (1997)), (...) will suffice as an acceptable answer to the psychological question. My general ambition is thus to establish that more work is needed if we are to have a full account of self-knowledge in both its epistemological and psychological aspects. I conclude by suggesting how my thesis bears on those who aim to provide an empirical account of the cognition involved in self-knowledge. (shrink)

This study examined whether having attended a public, private or religious affiliated grade and/or high school influenced a college student’s ethical decision making process. We also examined whether having taken an ethics course in college influences a student’s ethical decision making process. Our sample included 508 accounting students (237 men and 271 women) from Albania, Ecuador, Ireland and the United States. Our analyses indicated no differences in ethical decision making that associated with either grade-or-high-school education. While our data showed no (...) difference in the reported attitudes between students from Ecuador and the United States after controlling for social desirability response bias, we found significant differences between the attitudes students from the United States and students from both Albania and Ireland. While gender was also significant for six of our seven scenarios, social desirability response bias was significant in all of our scenarios. (shrink)

Substance addiction affects millions of individuals worldwide and yet there is no consensus regarding its conceptualisation. Recent neuroscientific developments fuel the view that addiction can be classified as a brain disease, whereas a different body of scholars disagrees by claiming that addictive behaviour is a choice. These two models, the Brain Disease Model and the Choice Model, seem to oppose each other directly. This article contends the belief that the two models in the addiction debate are polar opposites. It shows (...) that it is not the large amount of addiction research in itself what sets the models apart, but rather their extrapolated conclusions. Moreover, some of the most fiercely debated aspects - for instance, whether or not addiction should be classified as a disease or disorder - are irrelevant for the conceptualisation of addiction. Instead, the real disagreement is shown to revolve around capacities. Discussing addiction-related capacities, especially regarding impaired control, rather than the assumed juxtaposition of the two models can be considered the true addiction debate. More insight into the extent to which the capacities of the addicted individual were affected would be highly useful in various other areas, especially legal responsibility. (shrink)

Substance addiction affects millions of individuals worldwide and yet there is no consensus regarding its conceptualisation. Recent neuroscientific developments fuel the view that addiction can be classified as a brain disease, whereas a different body of scholars disagrees by claiming that addictive behaviour is a choice. These two models, the Brain Disease Model and the Choice Model, seem to oppose each other directly. This article contends the belief that the two models in the addiction debate are polar opposites. It shows (...) that it is not the large amount of addiction research in itself what sets the models apart, but rather their extrapolated conclusions. Moreover, some of the most fiercely debated aspects - for instance, whether or not addiction should be classified as a disease or disorder - are irrelevant for the conceptualisation of addiction. Instead, the real disagreement is shown to revolve around capacities. Discussing addiction-related capacities, especially regarding impaired control, rather than the assumed juxtaposition of the two models can be considered the true addiction debate. More insight into the extent to which the capacities of the addicted individual were affected would be highly useful in various other areas, especially legal responsibility. (shrink)

Substance addiction affects millions of individuals worldwide and yet there is no consensus regarding its conceptualisation. Recent neuroscientific developments fuel the view that addiction can be classified as a brain disease, whereas a different body of scholars disagrees by claiming that addictive behaviour is a choice. These two models, the Brain Disease Model and the Choice Model, seem to oppose each other directly. This article contends the belief that the two models in the addiction debate are polar opposites. It shows (...) that it is not the large amount of addiction research in itself what sets the models apart, but rather their extrapolated conclusions. Moreover, some of the most fiercely debated aspects - for instance, whether or not addiction should be classified as a disease or disorder - are irrelevant for the conceptualisation of addiction. Instead, the real disagreement is shown to revolve around capacities. Discussing addiction-related capacities, especially regarding impaired control, rather than the assumed juxtaposition of the two models can be considered the true addiction debate. More insight into the extent to which the capacities of the addicted individual were affected would be highly useful in various other areas, especially legal responsibility. (shrink)

The idea that correspondences relating grammatical relations and semantics (argument structure constructions) are needed to account for simple sentence types is reviewed, clarified, updated and compared with two lexicalist alternatives. Traditional lexical rules take one verb as ‘input’ and create (or relate) a different verb as ‘output’. More recently, invisible derivational verb templates have been proposed, which treat argument structure patterns as zero derivational affixes that combine with a root verb to yield a new verb. While the derivational template perspective (...) can address several problems that arise for traditional lexical rules, it still faces problems in accounting for idioms, which often contain specifications that are not appropriately assigned to individual verbs or derivational affixes (regarding adjuncts, modification, and inflection). At the same time, it is clear that verbs play a central role in determining their distribution. The balance between verbs and phrasal argument structure constructions is addressed via the Principles of Semantic Coherence and Correspondence together with a usage‐based hierarchy of constructions that contains entries which can include particular verbs and other lexical material. (shrink)

Marks individually or in combination constitute images that represent objects. How do those images represent those objects? Marks vary in style, both between and within images. Images also vary in style. How do those styles relate to each other and to the objects that those images represent? Referencing a diverse range of images, we answer the first question with a response-dependence theory of image representation derived from Mark Johnston, differentiating Lockean primary qualities of marks from secondary qualities of images. We (...) answer the second question with a perceptual theory of style derived from Paul Grice, differentiating physical style from image style, and representing conventionally from representing conversationally. (shrink)

Recent controversy surrounding the Surfactant Positive Airway Pressure and Pulse Oximetry Trial and the Office for Human Resource Protection’s judgment that its informed consent procedures were inadequate has unmasked considerable confusion about OHRP’s definition of research risks. The controversy concerns application of that definition to trials comparing multiple treatments within the existing standard of care. Some have argued that it is impossible for such trials to pose research risks on the grounds that all risks associated with a standard-of-care treatment should (...) instead be considered risks of treatment. However, analysis of OHRP’s definition demonstrates that some risks in such trials can be research risks. (shrink)

This essay represents a reflection on the nature of shufa, the Chinese “art of writing,” and its ontological grounding as a continuous, “durational transcription,” of an inscriptional event, producing a phenomenology of “viewing.” This distinguishes it from ordinary writing (xiezi) in which attention is focused on the lexical meaning of the written characters (i.e., an experience of “reading”). Viewing a calligraphic inscription actually unfolding in time (i.e., as a dynamical structure or “temporal object event”), however, raises an interesting theoretical question (...) concerning the two complementary aspects of temporal consciousness of calligraphy as both duration and unity. This will be addressed in terms of recent discussions of a dynamical approach to Edmund Husserl’s theory of time consciousness. (shrink)

In this paper we evaluate how to effectively use the crowdsourcing service, Amazon’s Mechanical Turk (MTurk), to content analyze textual data for use in psychological research. MTurk is a marketplace for discrete tasks completed by workers, typically for small amounts of money. MTurk has been used to aid psychological research in general, and content analysis in particular. In the current study, MTurk workers content analyzed personally-written textual data using coding categories previously developed and validated in psychological research. These codes were (...) evaluated for reliability, accuracy, completion time, and cost. Results indicate that MTurk workers categorized textual data with comparable reliability and accuracy to both previously published studies and expert raters. Further, the coding tasks were performed quickly and cheaply. These data suggest that crowdsourced content analysis can help advance psychological research. (shrink)

No political, economic, or cultural segment of society has escaped the universal impact of recent cataclysmic change. Physicians were no exception. During the 20th century, all members of society, including physicians, have experienced change of enormous speed and magnitude. Futurist Alvin Toffler noted that global societal transformation has created a of personal malaise that poses difficulty for both individual and group adaptation. Toffler further described current change as a fundamental shift and conflict in all aspects of civilization (how we live, (...) work, and relate to each other). Toffler also noted major alterations in the basis for distribution of societal power (who controls what, why, and how). One manifestation of recent change directly affecting all members of society, includingphysicians, has been the social transformation of medicine that has been a power shift from the individual physicians to control by organizations and management. (shrink)

(2000). Commentary: A well regulated militia, or a volatile militancy? Criminal Justice Ethics: Vol. 19, No. 1, pp. 2-55. doi: 10.1080/0731129X.2000.9992079.

It is my hope that the book will be widely read and debated."--Axel Leijonhufvud, UCLA and the University of Trento "This is a major and controversial contribution to macroeconomics that cannot fail to make an impact in several areas.

Recent anthologizing of Davidson’s articles from the 1980s and 1990s encourages us to reconsider arguments contained in them. One such argument is Davidson’s omniscient-interpreter argument (“OIA”) in “A Coherence Theory of Truth and Knowledge,” first published 20 years ago. The OIA allegedly establishes that it is necessary that most beliefs are true. Thus the omniscient interpreter, now 20 years old, was born to answer the skeptic. In §1 of this paper, I consider charges that the OIA establishes only that it (...) is possible that most beliefs are true; if correct, then it is also possibly the case that most beliefs are false—the skeptic’s very position. Next, I consider two responses on Davidson’s behalf, showing that each fails. In §2, I show that the OIA establishes neither that it is necessarily nor possibly but actually the case that most beliefs are true. I then conclude that this is enough to answer the skeptic. (shrink)

If funding allocation is an indicator of a field’s priorities, then the priorities of the field of bioethics are misaligned because they perpetuate injustice. Social justice mandates priority for the factors that drive systematic disadvantage, which tend not to be the areas supported by funding within academic bioethics. Current funding priorities violate social justice by overemphasizing technologies that aim to enhance the human condition without addressing underlying structural inequalities grounded in racism, and by deemphasizing areas of inquiry most frequently pursued (...) by Scholars of Color. This lack of attention to upstream determinants of health in bioethics research perpetuates a gap in the resources needed to understand the experiences of communities disproportionately experiencing poor health, which is itself a form of epistemic injustice. Both social and epistemic injustices are apparent in the impact of these funding priorities on people of color, both in the public and in the bioethics community. (shrink)

This volume will acquaint novice philosophers with one of the most important debates in twentieth-century philosophy, and will provide seasoned readers with a ...

For many years there has been a debate about the role of the parietal lobe in the generation of behavior. Does it generate movement plans (intention) or choose objects in the environment for further processing? To answer this, we focus on the lateral intraparietal area (LIP), an area that has been shown to play independent roles in target selection for saccades and the generation of visual attention. Based on results from a variety of tasks, we propose that LIP acts as (...) a priority map in which objects are represented by activity proportional to their behavioral priority. We present evidence to show that the priority map combines bottom-up inputs like a rapid visual response with an array of top-down signals like a saccade plan. The spatial location representing the peak of the map is used by the oculomotor system to target saccades and by the visual system to guide visual attention. (shrink)

In China creativity is construed as an ethico‐aesthetic practice in which signifying acts of self‐presentation (yi) are evaluated as to their efficacy in fostering harmonious relations of social exchange within specific historical occasions. To say this is to call attention to the performative dimension of aesthetic creativity; to recognize, beyond its constative meaning, the force of an expressive act to produce effects that profoundly affect its recipients.

Current approaches to formal representation in biomedicine are characterized by their focus on either the static or the dynamic aspects of biological reality. We here outline a theory that combines both perspectives and at the same time tackles the by no means trivial issue of their coherent integration. Our position is that a good ontology must be capable of accounting for reality both synchronically (as it exists at a time) and diachronically (as it unfolds through time), but that these are (...) two quite different tasks, whose simultaneous realization is by no means trivial. The paper is structured as follows. We begin by laying out the methodological and philosophical background of our approach. We then summarize the structure and elements of the Basic Formal Ontology on which it rests, in particular the SNAP ontology of objects and the SPAN ontology of processes. Finally, we apply the general framework to the specific domain of biomedicine. (shrink)

To what extent are meaning, on the one hand, and knowledge, on the other, determined by aspects of the 'outside world'? Internalism and Externalism in Semantics and Epistemology presents twelve specially written essays exploring these debates in metaphysics and epistemology and the connections between them. In so doing, it examines how issues connected with the nature of mind and language bear on issues about the nature of knowledge and justification. Topics discussed include the compatibility of semantic externalism and epistemic internalism, (...) the variety of internalist and externalist positions, semantic externalism's implications for the epistemology of reasoning and reflection, and the possibility of arguments from the theory of mental content to the theory of epistemic justification. (shrink)

This paper proposes the ‘AGENCY model’ of conscious state attribution, according to which an entity's displaying certain relatively simple features (e.g. eyes, distinctive motions, interactive behavior) automatically triggers a disposition to attribute conscious states to that entity. To test the model's predictions, participants completed a speeded object/attribution task, in which they responded positively or negatively to attributions of mental properties (including conscious and non-conscious states) to different sorts of entities (insects, plants, artifacts, etc.). As predicted, participants responded positively to conscious (...) state attributions only for those entities that typically display the simple features identified in the AGENCY model (eyes, distinctive motion, interaction) and took longer to deny conscious states to those entities. (shrink)

The generation of animals was a difficult phenomenon to explain in the seventeenth century, having long been a problem in natural philosophy, theology, and medicine. In this paper, I explore how generation, understood as epigenesis, was directly related to an idea of rational nature. I examine epigenesis—the idea that the embryo was constructed part-by-part, over time—in the work of two seemingly dissimilar English philosophers: William Harvey, an eclectic Aristotelian, and Margaret Cavendish, a radical materialist. I chart the ways that they (...) understood and explained epigenesis, given their differences in philosophy and ontology. I argue for the importance of ideas of harmony and order in structuring their accounts of generation as a rational process. I link their experiences during the English Civil war to how they see nature as a possible source for the rationality and concord sorely missing in human affairs. (shrink)

Sandford C. Goldberg puts forward a theory of epistemic normativity that is grounded in the things we properly expect of one another as epistemic subjects. This theory has far-reaching implications not only for the theory of epistemic normativity, but also for the nature of epistemic assessment itself.

We performed a qualitative analysis of the Thesaurus in order to assess its conformity with principles of good practice in terminology and ontology design. We used both the on-line browsable version of the Thesaurus and its OWL-representation (version 04.08b, released on August 2, 2004), measuring each in light of the requirements put forward in relevant ISO terminology standards and in light of ontological principles advanced in the recent literature. Version 04.08b of the NCI Thesaurus suffers from the same broad range (...) of problems that have been observed in other biomedical terminologies. For its further development, we recommend the use of a more principled approach that allows the Thesaurus to be tested not just for internal consistency but also for its degree of correspondence to that part of reality which it is designed to represent. (shrink)

Sanford C. Goldberg presents a novel account of the speech act of assertion. He argues that this type of speech act is answerable to an epistemic, context-sensitive norm. On this basis he shows the philosophical importance of assertion for key debates in philosophy of language and mind, epistemology, and ethics.

We present an ontology of pain and of other pain-related phenomena, building on the definition of pain provided by the International Association for the Study of Pain (IASP). Our strategy is to identify an evolutionarily basic canonical pain phenomenon, involving unpleasant sensory and emotional experience based causally in localized tissue damage that is concordant with that experience. We then show how different variant cases of this canonical pain phenomenon can be distinguished, including pain that is elevated relative to peripheral trauma, (...) pain that is caused neuropathically (thus with no necessary peripheral stimulus), and pain reports arising through deception either of self or of others. We describe how our approach can answer some of the objections raised against the IASP definition, and sketch how it can be used to support more sophisticated discrimination of different types of pain resulting in improved data analysis that can help in advancing pain research. (shrink)

This paper draws on findings from qualitative interviews with queer and trans patients and with physicians providing care to queer and trans patients in Halifax, Nova Scotia, Canada, to explore how routine practices of health care can perpetuate or challenge the marginalization of queers. One of the most common “measures” of improved cultural competence in health care practice is self-reported increases in confidence and comfort, though it seems unlikely that an increase in physician comfort levels with queer and trans patients (...) will necessarily mean better health care for queers. More attention to current felt discomfort in patient–provider encounters is required. Policies and practices that avoid discomfort at all costs are not always helpful for care, and experiences of shared discomfort in queer health contexts are not always harmful. (shrink)