Dementia is an illness that raises important questions about our own attitudes to illness and aging. It also raises very important issues beyond the bounds of dementia to do with how we think of ourselves as people - fundamental questions about personal identity. Is the person with dementia the same person he or she was before? Is the individual with dementia a person at all? In a striking way, dementia seems to threaten the very existence of the self. This book (...) brings together philosophers and practitioners to explore the conceptual issues that arise in connection with this increasingly common illness. Drawing on a variety of philosophers such as Descartes, Locke, Hume, Wittgenstein, the authors explore the nature of personal identity in dementia. They also show how the lives and selfhood of people with dementia can be enhanced by attention to their psychosocial and spiritual environment. Throughout, the book conveys a strong ethical message, arguing in favour of treating people with dementia with all the dignity they deserve as human beings. The book covers a range of topics, stretching from talk of basic biology to talk of a spiritual understanding of people with dementia. Accessibly written by leading figures in psychiatry and philosophy, the book presents a unique and long overdue examination of an illness that features in so many of our lives. (shrink)

Dementia is an illness that raises important questions about our own attitudes to illness and aging. It also raises very important issues beyond the bounds of dementia to do with how we think of ourselves as people--fundamental questions about personal identity. Is the person with dementia the same person he or she was before? Is the individual with dementia a person at all? In a striking way, dementia seems to threaten the very existence of the self.LThis book brings together philosophers (...) and practitioners to explore the conceptual issues that arise in connection with this increasingly common illness. Drawing on a variety of philosophers such as Descartes, Lock, Hume, Wittgenstein, the authors explore the nature of personal identity in dementia. They also show how the lives and selfhood of people with dementia can be enhanced by attention to their psychological and spiritual environment. Throughout, the book conveys a strong ethical message, arguing in favor of treating people with dementia with all the dignity they deserve as human beings. The book covers a range of topics, stretching from talk of basic biology to talk of a spiritual understanding of people with dementia. Accessibly written by leading figures in psychiatry and philosophy, the book presents a unique and long overdue examination of an illness that features in so many of our lives. (shrink)

A good deal of concern is generated when a person with dementia wanders. One putatively easy technological remedy is to consider electronic tagging. This possibility, however, raises a dif erent set of ethical concerns. In this paper we report the results of a survey that was intended to elicit people’s views about the ethical issues surrounding the topic of tagging in dementia. There was broad agreement in response to the scenario used in the survey that electronic tagging could be an (...) ethically reasonable way to deal with wandering in people who are confused. It was seen as considerably better than locking doors as a way to maintain a person’s safety. There were, however, concerns and uncertainties about principles relating to civil liberties, stigma and dignity. And there appeared to be some weight behind the view that electronic tagging of confused people who wander requires professional involvement, the nature of which would need to be decided. population in general. (shrink)

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

We reflect, using a vignette, on conceptual tensions and the value judgements that lie behind difficult decisions about whether or not the older person with dementia should return home or move into long-term care following hospital admission. The paper seeks, first, to expose some of the difficulties arising from the assessment of residence capacity, particularly around the nature of evaluative judgements and conceptual tensions inherent in the legal approach to capacity. Secondly, we consider the assessment of best interests around place (...) of residence, which demonstrates significant conceptual tensions. In addition, ‘best interests’ raise issues around the perception of risk and the perceptions of the family and crucially involve the notions of autonomy and trust. Finally, we not only gesture at some practical considerations based on insights from values-based medicine, but also make the suggestion that we require tighter functional assessments of residence capacity coupled with broader judgements about best interests. (shrink)

Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of the disease typically mention (...) only the first of these suggestions. In this paper, we therefore revisit Whipple’s other theory. We argue that a diverse and often successful research programme was developed around this mechanism of disease causation which gave rise to many useful findings on the condition. In the later parts of this article, we then turn to discuss the surprising neglect of this period of Whipple disease research in the current literature, and conclude by offering a brief reconstruction of this early history suitable for use in a technical context. (shrink)

This paper consists of commentaries about and the reprint of an autobiographical essay authored by Italian medium Eusapia Palladino and published in 1910. The details of the essay are discussed in terms of the writings of other individuals about the life and performances of the medium. The essay conveys a view of Palladino as a person who has suffered much in life and has a mission to help scientific research into mediumship. Typical of the positive emphasis in autobiographies in general, (...) the medium did not discuss negative aspects of her performances. Due to the fact that the essay appeared during Palladino's visit to New York City in which many authors branded her as a fraud, it may be speculated that the purpose of this autobiography was to elicit sympathy from the American public. While some of the statements that Palladino made about phenomena are consistent with the statements of other authors who have written about her, there are several statements that show alternate or incomplete versions of particular events in her life. The differences suggests that Palladino's essay and other discussions about the medium's life are not reliable when it comes to specific details and to biographical accuracy. (shrink)

If evolutionary history were to be replayed from the beginning, what would be the same, and what would be likely different? Would there be a human-like species, multicellularity, or even DNA? There is a great variety in the answers biologists give to this question, despite having the same access to empirical data and biological theory. For instance, Stephen J. Gould has claimed that evolutionary history is radically contingent, while Conway Morris holds that it converges onto specific biological structures that (...) are favored by natural selection. Others such have proposed that evolutionary history is characterized by an inexorable increase in complexity, while others see it as an evolutionary arms race. In this dissertation I investigate the fundaments underlying claims biologists make about contingency and directionality in evolutionary history as a whole. The topics of convergence and contingency have received attention from philosophers of biology in recent years, but the foundations of interpretations of evolutionary history as a whole remains a relatively neglected field. Hence the primary objective of this dissertation was not to defend this or that account, but rather to show a method by which these fundamental issues can be identified and analyzed constructively. The dissertation is organized into two parts, each dedicated to a single problem. The first part concerns the problem of ‘description dependence’: claims about the contingency of evolutionary outcomes depend on how these outcomes and the evolutionary process itself are described. I set out to map the different ways in which the contingency of outcomes changes as the phenomena are described in more and in less detail, and as broader or narrower subsets of evolutionary history are taken into account. That such an analysis is useful to pursue, I attempt to show by applying it to two of the most prominent interpretations of evolutionary history, those of Gould and Conway Morris. According to how their claims about evolutionary history are analyzed, one can arrive at opposing conclusions about the contingency of evolutionary outcomes. The second part concerns the problem of ‘causal complexity’: evolutionary history is a complex mess of unrelated causal processes, and for every generalization there is an exception. This raises the question whether non-speculative generalizations over evolutionary history as a whole are even possible. Limiting the scope of the investigation to the mechanism of natural selection alone, I consider first whether and how natural selection may be expected to give rise to trends at all. Some philosophers reject that natural selection is a cause at all, and that all evolution is simply an accumulation of births and deaths. If any trend occurs at all, it is due to a confluence of unrelated causal processes that could easily not have occurred. I argue against this by showing that these philosophers overlook the issue of time-scale: causal processes may make a difference for reproductive outcome at a time-scale of a single generation without them making a difference at the time-scale of multiple generations. With this distinction in mind, one can argue that natural selection causes a population to tend towards equilibrium. If a yet longer time-scale is taken – not that of multiple generations in a single environment, but that of many species and genuses across many environments – the challenge of causal complexity becomes much more difficult to overcome. Drawing on the phenomenon of phenotypic plasticity and niche construction, I argue that selection for plasticity ‘feeds’ on this complexity and variability in the environment. The trend in plasticity is unique in this regard, since trends in other types of adaptation are interrupted by the variability of complex environments. (shrink)

The first volume of the Brandeis University Summer Institute lecture series of 1970 on theories of interacting elementary particles, consisting of four sets of lectures. Every summer since 1959 Brandeis University has conducted a lecture series centered on various areas of theoretical physics. The areas are sufficiently broad to interest a large number of physicists and the lecturers are among the original explorers of these areas. The 1970 lectures, presented in two volumes, are on theories of interacting elementary particles. The (...) four lecturers of Volume 1, and the range of the topics they cover, are as follows: Stephen L. Adler on "Perturbation Theory Anomalies": introduction and review of perturbation theory; the VVA triangle anomaly; absence of radiative corrections; generalizations of our results; connection between Ward identity anomalies and commutator anomalies; applications of the Bjorken limit; and breakdown of the Bjorken limit in perturbation theory. Stanley Mandelstam on "Dynamical Applications of the Veneziano formula for the four-point scalar amplitude; factorization; the operator formalism; Veneziano-type quark models; and higher-order Feynman-like diagrams. Steven Weinberg on "Dynamic and Algebraic Symmetries": Introduction; hadron electrodynamics; local symmetries; and chirality. Wolfhart Zimmermann on "Local Operator Products and Renormalization in Quantum Field Theory": introduction; renormalization; operator product expansions; and local field equations. The second volume contains lectures by Rudolf Haag on observables and fields, by Maurice Jacob on duality, by Michael Reed on non-Fock representations, and by Bruno Zumino on effective Lagrangians and broken symmetries. (shrink)

The Scottish logician Hugh MacColl is well known for his innovative contributions to modal and nonclassical logics. However, until now little biographical information has been available about his academic and cultural background, his personal and professional situation, and his position in the scientific community of the Victorian era. The present article reports on a number of recent findings.

Introduction Contrary to a widespread assumption the modern history of modal logic did not start with C. I. Lewis’ Survey of Symbolic Logic [Lewis 1918]. His eminent work was preceded by some 20 years by H. MacColl’s fifth article on ‘The Calculus of Equivalent Statements’. This article was read at the London Mathematical Society on 12 November 1896. Some months later it was published in the Society’s Proceedings [MacColl 1896-1897]. During the following years MacColl presented his logic prim...

Introduction Contrary to a widespread assumption the modern history of modal logic did not start with C. I. Lewis’ Survey of Symbolic Logic [Lewis 1918]. His eminent work was preceded by some 20 years by H. MacColl’s fifth article on ‘The Calculus of Equivalent Statements’. This article was read at the London Mathematical Society on 12 November 1896. Some months later it was published in the Society’s Proceedings [MacColl 1896-1897]. During the following years MacColl presented his logic prim...

Amirouche Moktefi and Stephen Read, Hugh MacColl after One Hundred Years. Special issue: Philosophia Scientiae, Studies in History of Sciences and Philosophy, Editions Kimé, Paris, vol. 15,...

[Stephen Yablo] The usual charge against Carnap's internal/external distinction is one of 'guilt by association with analytic/synthetic'. But it can be freed of this association, to become the distinction between statements made within make-believe games and those made outside them-or, rather, a special case of it with some claim to be called the metaphorical/literal distinction. Not even Quine considers figurative speech committal, so this turns the tables somewhat. To determine our ontological commitments, we have to ferret out all traces (...) of nonliterality in our assertions; if there is no sensible project of doing that, there is no sensible project of Quinean ontology. /// [Andre Gallois] I discuss Steve Yablo's defence of Carnap's distinction between internal and external questions. In the first section I set out what I take that distinction, as Carnap draws it, to be, and spell out a central motivation Carnap has for invoking it. In the second section I endorse, and augment, Yablo's response to Quine's arguments against Carnap. In the third section I say why Carnap's application of the distinction between internal and external questions runs into trouble. In the fourth section I spell out what I take to be Yablo's version of Carnap. In the last I say why that version is especially vulnerable to the objection raised in the second. (shrink)

I develop a broadly reliabilist theory of non-ideal epistemic rationality and argue that if it is correct we should reject the recently popular idea that the standards of non-ideal epistemic rationality are mere social conventions.