Randomized controlled clinical trials play an important role in the development of new medical therapies. There is, however, an ethical issue surrounding the use of randomized treatment allocation when the patient is suffering from a life threatening condition and requires immediate treatment. Such patients can only benefit from the treatment they actually receive and not from the alternative therapy, even if it ultimately proves to be superior. We discuss a novel new way to analyse data from such clinical trials based (...) on the use of the recently developed theory of imprecise probabilities. This work draws an explicit distinction between the related but nevertheless distinct questions of inference and decision in clinical trials. The traditional question of scientific interest asks 'Which treatment offers the greater chance of success?' and is the primary reason for conducting the clinical trial. The question of decision concerns the welfare of the patients in the clinical trial, asking whether the accumulated evidence favours one treatment over the other to such an extent that the next patient should decline randomization and instead express a preference for one treatment. Consideration of the decision question within the framework of imprecise probabilities leads to a mathematical definition of equipoise and a method for governing the randomization protocol of a clinical trial. This paper describes in detail the protocol for the conduct of clinical trials based on this new method of analysis, which is illustrated in a retrospective analysis of data from a clinical trial comparing the anti-emetic drugs ondansetron and droperidol in the treatment of postoperative nausea and vomiting. The proposed methodology is compared quantitatively using computer simulation studies with conventional clinical trial designs and is shown to maintain high statistical power with reduced sample sizes, at the expense of a high type I error rate that we argue is irrelevant in some specific circumstances. Particular emphasis is placed on describing the type of medical conditions and treatment comparisons where the new methodology is expected to provide the greatest benefit. (shrink)

1. HUME’S ARGUMENT, FLEW CORRECTLY EXPLAINS, IS NOT THAT MIRACLES CANNOT HAPPEN, BUT THAT THERE MUST BE A CONFLICT IN THE EVIDENCE TO SHOW THAT THEY DO. 2. (I) FLEW FURTHER APPEALS TO THE INHERENT WEAKNESS OF HISTORICAL AS OPPOSED TO SCIENTIFIC EVIDENCE. BUT ONE’S ASSESSMENT OF THE EVIDENCE MUST DEPEND ON WHETHER THE CONCEPT IS POSSIBLE. (II) FLEW CLAIMS THAT HUME CAN BE TAKEN TO MEAN THAT WHAT IS ALLOWED TO BE A LOGICAL POSSIBILITY SHOULD YET BE DISMISSED AS (...) IMPOSSIBLE IN FACT. BUT THIS DISTINCTION CANNOT BE APPLIED IN ADVANCE OF AN OCCURRENCE, WITHOUT BEGGING THE QUESTION AS TO WHETHER IT IS INDEED POSSIBLE OR NOT. 3. PACE HUME AND FLEW, ENTERTAINING THE CONCEPT IS NOT INCOHERENT. FOR (I) THE RELEVANT "LAW OF NATURE" CAN BE THOUGHT OF AS POTENTIALLY APPLICABLE, THOUGH NOT IN FACT SO; (II) ONE MAY CONCEIVE OF AN "UNCAUSED" EVENT, ONCE ONE SUPPOSES THAT IN MOST OTHER CASES THE UNIVERSE IS UNIFORM. THUS IT COULD BE RATIONAL TO JUDGE THAT A MIRACLE HAD OCCURRED, SINCE THIS WOULD NOT CAL. (shrink)

Hawthorne and Magidor's criticisms of the model of presupposition and assertion that I have used and defended are all based on a rejection of some transparency or introspection of assumptions about speaker presupposition. This response to those criticisms aims first to clarify, and then to defend, the required transparency assumptions. It is argued, first, that if the assumptions are properly understood, some prima facie problems for them do not apply, second, that rejecting the assumptions has intuitively implausible consequences, and third, (...) that the 'margin of error' argument against the principle of positive introspection has a false premiss. The paper concludes with a response to a criticism of what Hawthorne and Magidor call 'the uniformity principle' that is used in the model to explain some pragmatic phenomena. (shrink)

Vijf Nederlandse filosofen geven elk vanuit een andere filosofische achtergrond weer wat hun mensbeeld is.

The metaphorical nature of biological language is examined and the use of metaphors for providing the linguistic context in which similarities and differences are made is described. Certain pervasive metaphors which are characterised by systemic properties are noted, and in order to provide some focus to the study, systemic metaphors associated with machine, text and organism are discussed. Other systemic metaphors such as society and circuit are also reported. Some details concerning interrelations between automaton and organism are presented in the (...) light of the previous discussion.An approach towards the analysis of biosystem metaphors is outlined which relates part-whole, organisational level and systemic metaphors in a single model. Examples are provided throughout the discussion and mainly come from computing. The potential for metaphorical transfers between these domains is considered. (shrink)

Chalmers (2018) maintains that even if we understood every physical process in the brain we could still wonder why these processes give rise to conscious experience. The meta-problem is the challenge of explaining why we think this 'hard problem' exists. This response to the target paper endorses illusionist accounts of three 'problem intuitions' about consciousness: duality, presentation, and revelation. Subject–object duality is explained in terms of a clash between two compelling but contradictory convictions about consciousness. Phenomenal presence is understood in (...) relation to the configurational features of sensory experiences. And intuitions of revelation are explained as due to an unfounded belief in introspective ontological access. These illusionist analyses are used to bolster the case for physicalist realism rather than to support 'strong' illusionism. In addition to addressing the meta-problem they suggest a promising approach to the hard problem as wel. (shrink)

The argument of the Transcendental Deduction of the Categories in the Critique of Pure Reason is the deepest and most far-reaching in philosophy. In his new book, Robert Howell interprets main themes of the Deduction using ideas from contemporary philosophy and intensional logic, thereby providing a keener grasp of Kant's many subtleties than has hitherto been available. No other work pursues Kant's argument through every twist and turn with the careful, logically detailed attention maintained here. Surprising new accounts of apperception, (...) the concept of an object, the logical functions of thought, the role of the Metaphysical Deduction, and Kant's relations to his Aristotelian-Cartesian background are developed. Howell makes a precise contribution to the discussion of most of the disputed issues in the history of Deduction interpretation. Controversial in its conclusions, this book demands the attention of all who take seriously the task of understanding Kant's work and evaluating it dispassionately. (shrink)