A premise of Corballis's theory is that speech arose when vocalization co-opted existing gestural functions in the left ventral premotor cortex. Yet, visuomotor functions in this region remain largely unchanged between humans and macaques and have no discernible connection to gestural communication. This functional continuity suggests that language production is not the result of modifying existing motor functions in this region.

Glover suggests that representational systems for planning versus control are mapped exclusively to the inferior (IPL) versus superior (SPL) parietal lobules respectively. Yet, there is ample evidence that the IPL and SPL both contribute to action planning and control. Alternatively, I distinguish between the parietal-frontal systems involved in the representation of acquired manual skills versus nonskilled actions.

The ability to judge accurately whether or not an action can be accomplished successfully is critical for selecting appropriate response options that enable adaptive behaviors. Such affordance judgments are thought to rely on the perceived fit between environmental properties and knowledge of one's current physical capabilities. Little, however, is currently known about the ability of individuals to judge their own affordances following a stroke, or about the underlying neural mechanisms involved. To address these issues, we employed a signal detection approach (...) to investigate the impact of left or right hemisphere injuries on judgments of whether a visual object was located within reach while remaining still. Regarding perceptual sensitivity and accuracy in judging reachability, there were no significant group differences between healthy controls, right brain damaged and left brain damaged stroke patients. However, while healthy controls and RBD patients demonstrated a negative response criterion and thus overestimated their reach capability, LBD patients' average response criterion converged to zero, indicating no judgment tendency. Critically, the LBD group's judgment tendency pattern is consistent with previous findings in this same sample on an affordance judgment task that required estimating whether the hand can fit through apertures. Lesion analysis suggests that this loss of judgment tendency may be associated with damage to the left insula, the left parietal and middle temporal lobe. Based on these results, we propose that damage to the left ventro-dorsal stream disrupts the retrieval and processing of a stable criterion, leading to stronger reliance on intact on-line body-perceptive processes computed within the preserved bilateral dorsal network. (shrink)

Response to Mark Weinstein's "Reason and the Child." Questions the connection between "rationality" and children's moral status.

Antibiotic development and usage, and antibiotic resistance in particular, are today considered global concerns, simultaneously mandating local and global perspectives and actions. Yet such global considerations have not always been part of antibiotic policy formation, and those who attempt to formulate a globally coordinated response to antibiotic resistance will need to confront a history of heterogeneous, often uncoordinated, and at times conflicting reform efforts, whose legacies remain apparent today. Historical analysis permits us to highlight such entrenched trends and processes, helping (...) to frame contemporary efforts to improve access, conservation and innovation. (shrink)

Literary and philosophical reflections combine with true-life farm anecdotes to offer commentary on seeking the good life in the modern age.

Name der Zeitschrift: Cultura. International Journal of Philosophy of Culture and Axiology Jahrgang: 8 Heft: 2 Seiten: 85-104.

In November of 1959, William Bean published in the Archives of Internal Medicine a scathing review of Félix Martí-Ibañez’s Centaur: Essays on the History of Medical Ideas. Martí-Ibañez and Bean were two of the leading exponents of the importance of medical humanism during a formative period from the 1950s through the 1970s. But the two physicians differed fundamentally in their views of the ideal relationships among the pharmaceutical industry, the medical profession, and the medical humanities. We situate Bean’s review within (...) its historical context, shedding light on the history and diverging uses of the medical humanities. (shrink)

Luke Fildes's iconic painting The Doctor, first exhibited in 1891, has long served as a symbol of the caring, priest-like physician, watching over a sick child as the child's parents place their faith in his ministrations, technologically meager as they may be. As physicians acquired more visible and potent interventions—x-rays, antibiotics, the complex infrastructure of the hospital itself—the 19th-century British scene depicted by Fildes of an individual doctor's watchful waiting would be appropriated by the likes of the American Medical Association (...) in the 1940s to remind the American public of this idealized patient-doctor relationship, augmented by increasingly powerful curative tools at the disposal of... (shrink)

Orbell and Dawes develop a non-game theoretic heuristic that yields a ‘cooperator's advantage’ by allowing players to project their own ‘cooperate-defect’ choices onto potential partners (1991, p. 515). With appropriate parameter values their heuristic yields a cooperative environment, but the cooperation depends, simply, on optimism about others' behavior (1991, p. 526). In earlier work, Dawes (1989) established a statistical foundation for such optimism. In this paper, I adapt some of the concerns of Dawes (1989) and develop a game theoretic model (...) based on a modification of the Harsanyi structure of games with incomplete information (1967–1968). I show that the commonly made conjecture that strategic play is incompatible with cooperation and the cooperator's advantage is false. (shrink)

The effects of psycholinguistic variables on reading development are critical to the evaluation of theories about the reading system. Although we know that the development of reading depends on both individual differences (endogenous) and item-level effects (exogenous), developmental research has focused mostly on average-level performance, ignoring individual differences. We investigated how the development of word recognition in Chinese children in both Chinese and English is affected by (a) item-level, exogenous effects (word frequency, radical consistency, and curricular grade level); (b) subject-level, (...) endogenous individual differences (orthographic awareness and phonological awareness); and (c) their interactive effect. We tested native Chinese (Putonghua)-speaking children (n = 763) in grades 1 to 6 with both Chinese character and English word identification (lexical) decision tasks. Our findings show that (a) there were effects of both word frequency and age of acquisition in both Chinese and English, but these item-level effects generally weakened with increasing age; (b) individual differences in phonological and orthographic awareness each contributed to successful performance; and (c) in Chinese, item-level effects were weaker for more proficient readers. We contend that our findings can be explained by theoretical models that incorporate cumulative learning as the basis for development of item-level effects in the reading system. (shrink)

Despite being acknowledged as a major global health challenge, growing levels of antimicrobial resistance (AMR) in pathogenic and commensal organisms have proven an awkward fit for international health frameworks. This article surveys the history of attempts to coordinate international responses to AMR alongside the origins and evolution of the current international health regulations (IHR). It argues that AMR, which encompasses a vast range of microbial properties and ecological reservoirs, is an awkward fit for the ‘organismal’ philosophies that centre on the (...) rapid control of individual pathogens that have characterised international policy-making since the 19th century. (shrink)

The goal of the current study is to investigate the effects of the distractive textual information on the activation of predictive inference online, and how the readers with high or low working memory capacity differ in their online activation and text memory. To test the two hypothesis of attentional competition and semantic integration, we conducted three experiments to investigate whether a local prediction and a global prediction, both of which could be derived from the description of a critical event, are (...) generated in the mind of the reader, and how this generation process is influenced by contextual and cognitive factors of the reader. The results of Experiment 1 and 2 suggest that the elaboration of the global aspects in the narrative reduces the local prediction, but makes the global prediction more salient to occur. The evidence from Experiment 3 confirms the hypothesis that even automatic processes are constrained by distant contextual factors, in combination with differences in working memory, and examines how referentially local and global predictions are intertwined in text comprehension. Overall, these data support the immediate integration hypothesis across sentence boundaries at different representation levels, as well as interaction assumptions of different processing levels within referentially local and referentially global processing contexts. (shrink)

We investigated how two cues to contrast—beat gesture and contrastive pitch accenting—affect comprehenders' cognitive load during processing of spoken referring expressions. In two visual‐world experiments, we orthogonally manipulated the presence of these cues and their felicity, or fit, with the local (sentence‐level) referential context in critical referring expressions while comprehenders' task‐evoked pupillary responses (TEPRs) were examined. In Experiment 1, beat gesture and contrastive accenting always matched the referential context of filler referring expressions and were therefore relatively felicitous on the global (...) (experiment) level, whereas in Experiment 2, beat gesture and contrastive accenting never fit the referential context of filler referring expressions and were therefore infelicitous on the global level. The results revealed that both beat gesture and contrastive accenting increased comprehenders' cognitive load. For beat gesture, this increase in cognitive load was driven by both local and global infelicity. For contrastive accenting, this increase in cognitive load was unaffected when cues were globally felicitous but exacerbated when cues were globally infelicitous. Together, these results suggest that comprehenders' cognitive resources are taxed by processing infelicitous use of beat gesture and contrastive accenting to convey contrast on both the local and global levels. (shrink)

There is currently great controversy over the contribution antimicrobial use in animal agriculture has made to antimicrobial resistance in pathogenic bacteria with negative consequences for human health. In light of this, the approval process for antimicrobials used in US animal agriculture, known as New Animal Drug Application or NADA, is currently being revised by the federal government. We explore the public deliberations over the development of these new policies focusing our attention on the interaction between pharmaceutical companies and the U.S. (...) Food and Drug Administration. What appears to be an antagonistic public discourse is examined in terms of its ability to simultaneously legitimate the roles of the Food and Drug Administration as the official arbiter of policy on antimicrobial use in animal agriculture and as a protector of the public welfare, as well as the role of pharmaceutical companies as the producers of safe and effective products necessary for the protection of public well-being. (shrink)

Medicine today, as both art and science, embodies a split personality. The ensuing tension—between individualized consideration, experience, and judgment on the one hand, and standardization, objective evidence, and guidelines on the other—plays out in the simultaneous aspirations of the medical humanities and evidence-based medicine, and in a host of other telling terms and movements. This is not a new tension, however. We turn in this paper to the critical but complex history of the term “personal equation” as both reflective and (...) generative of this tension on both sides of the Atlantic during a formative period in medicine from the mid-19th through the mid-20th centuries. The term was featured in almost every... (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Florijn’s helpful discussion of the Heringa case illustrates the difficulties in drawing a boundary on eligibility conditions for EAS. In Heringa, the Dutch Supreme Court reaffirmed...

How do Dutch people let each other know that they disagree? What do they say when they want to resolve their difference of opinion by way of an argumentative discussion? In what way do they convey that they are convinced by each other’s argumentation? How do they criticize each other’s argumentative moves? Which words and expressions do they use in these endeavors? By answering these questions this short essay provides a brief inventory of the language of argumentation in Dutch.

Should the assessment of decision‐making capacity (DMC) be risk sensitive, that is, should the threshold for DMC vary with risk? The debate over this question is now nearly five decades old. To many, the idea that DMC assessments should be risk sensitive is intuitive and commonsense. To others, the idea is paternalistic or incoherent, or both; they argue that the riskiness of a given decision should increase the epistemic scrutiny in the evaluation of DMC, not increase the threshold for DMC. (...) We respond to the critics’ main concerns by providing a comprehensive account of how risk‐sensitive DMC is coherent, avoids paternalism, and best fulfills the epistemic goal of DMC evaluations. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

By the time this essay is published, it will be a matter of weeks before doctors and nurse practitioners in Canada can legally end the lives (by medical assistance in dying, or MAID) of non-dying p...

Western Kansas is one of the most important agricultural regions in the world. Most agricultural production in this semi-arid region depends on the consumption of nonrenewable groundwater from the High Plains Aquifer, which will be 70 % depleted by 2070. The problem of depletion has drawn significant attention from local citizens and policymakers at the federal, state, and local levels for at least 40 years, resulting in a variety of policies and institutions to manage groundwater from the aquifer as a (...) common pool resource. Yet depletion has persisted. We explain this conundrum as an outcome of a mismatch between the scale of resource management, which has become more intensively local, and the scale of resource exchange, which has rendered the High Plains Aquifer a global common pool resource. We then explain the deeper, structural origins of the management–exchange scale mismatch. Drawing on concepts from structural human ecology theory and empirical evidence from Southwest Kansas, we show that agriculture is predicated on local metabolic rift in the hydrological cycle that is exacerbated through ecological unequal exchange with higher-income, core areas beyond the region. We conclude by highlighting two key policies that, if implemented together, may lessen the deleterious effects of these structural dynamics and thus promote a more sustainable relationship between society and environment in this region and other water-scarce regions that are net-exporters of groundwater. (shrink)

The ethics literature has identified moral motivation as a factor in ethical decision-making. Furthermore, moral identity has been identified as a source of moral motivation. In the current study, we examine religiosity as an antecedent to moral identity and examine the mediating role of self-control in this relationship. We find that intrinsic and extrinsic dimensions of religiosity have different direct and indirect effects on the internalization and symbolization dimensions of moral identity. Specifically, intrinsic religiosity plays a role in counterbalancing the (...) negative impact of extrinsic religiosity on the internalization of moral identity. Further, intrinsic religiosity also counterbalances the negative and indirect impact of extrinsic religiosity on symbolization of moral identity via self-control. Lastly, self-control does not play a mediating role in the impact of religiosity on the internalization dimension of moral identity. We conclude that this study presents important findings that advance our understanding of the antecedents of moral identity, and that these results may have implications for the understanding of ethical decision-making. (shrink)

Volume 19, Issue 10, October 2019, Page 3-7.

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of (...) capacity, we previously developed a descriptive typology of justifications used in the application of the Mental Capacity Act criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA. No data are available. This paper does not report any original data. (shrink)

Abstract: Presentism is the view that whatever exists presently exists. Without defending Presentism, I argue first that Presentists should be Time-Free Presentists – Presentists whose views do not imply that there exist irreducible times. Second, I argue that Presentists should accept Limited Thick Presentism, the view that 'the present' has some extension and is thereby neither durationlessly thin nor unlimitedly 'thick'. Third, before addressing several objections to Limited Time-Free Thick Presentism [LTFTP], I argue that defenders of LTFTP should accept that (...) 'temporal becoming' involves an overlapping succession of present entities, not a 'skipping' from one set of present entities to the next discrete set. (shrink)

We are grateful to Jongsma et al 1 for their interest in our article analysing the case of ‘Mrs A’, a Dutch woman with Alzheimer’s disease who received euthanasia based on her advance euthanasia directive.2 Their commentary criticises two elements of our analysis. First, the authors believe our reasons for doubting that Mrs A had the capacity to write and revise an AED rely on ‘partial’ empirical data and rest on normative errors. Second, they use two of our statements to (...) suggest we must endorse some implausible claims, for example, that ‘… in all situations and for all people, current well-being should always take precedence over all other values’. Jongsma et al assert: ‘Miller et al argue that people with dementia are impaired to make decisions.’ This casts our probabilistic claim about Mrs A’s capacity as an absolute claim about persons with dementia in general. It also implies we are using an outdated diagnosis-based view of capacity. The accusation then becomes explicit : > … several empirical studies have shown that patients with dementia are able to actively participate in qualitative studies and can respond to open questions in a meaningful way,[2-8] as well that they are able to complete an advance directive in the early phases of dementia.[9, 10] One can therefore not simply conclude on the basis of the diagnosis of dementia …. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)