The picture-word interference paradigm has been used to investigate the time course of processes involved in word retrieval, but is challenging to implement online due to dependence on measurements of vocal reaction time. We performed a series of four experiments to examine picture-word interference and facilitation effects in a form of covert picture naming, with and without gamification. A target picture was accompanied by an audio word distractor that was either unrelated, phonologically-related, associatively-related, or categorically-related to the picture. Participants were (...) instructed to judge whether the name of the target picture ended in the phoneme assigned to the block by pressing corresponding keys as quickly and accurately as possible. Experiments 1 and 2 successfully replicated categorical interference and phonological facilitation effects at different optimal stimulus-onset-asynchronies between words and pictures. Experiment 3 demonstrated that a key gamification feature motivated faster speed at the expense of accuracy in the gamified vs. experimental format of the task. Experiment 4 adopted the optimal SOAs and verified that the gamification reveals expected interference and facilitation effects despite the speed-accuracy tradeoff. These studies confirmed that categorical interference occurs earlier than phonological facilitation, while both processes are independent from articulation and inherent to word retrieval itself. The covert PWI paradigm and its gamification have methodological value for neuroimaging studies in which articulatory artifacts obscure word retrieval processes, and may be developed into potential online word-finding assessments that can reveal word retrieval difficulties with greater sensitivity. (shrink)

Moderate physiological or emotional arousal induced after learning modulates memory consolidation, helping to distinguish important memories from trivial ones. Yet, the contribution of subjective awareness or interpretation of arousal to this effect is uncertain. Alexithymia, which is an inability to describe or identify one’s emotional and arousal states even though physiological responses to arousal are intact, provides a tool to evaluate the role of arousal interpretation. Participants scoring high and low on alexithymia learned a list of 30 words, followed by (...) immediate recall. Participants then saw either an arousing or neutral video . Memory was tested 24-h later. Physiological response to arousal was comparable between groups, but subjective response to arousal was impaired in high alexithymia. Yet, delayed word recognition was enhanced by arousal regardless of alexithymia status. Thus, subjective response to arousal, i.e., cognitive appraisal, was not necessary for memory modulation to occur. (shrink)

Alexithymia is associated with emotion processing deficits, particularly for negative emotional information. However, also common are a high prevalence of somatic symptoms and the perception of somatic sensations as distressing. Although little research has yet been conducted on memory in alexithymia, we hypothesized a paradoxical effect of alexithymia on memory. Specifically, recall of negative emotional words was expected to be reduced in alexithymia, while memory for illness words was expected to be enhanced in alexithymia.Eighty-five high or low alexithymia participants viewed (...) and rated arousing illness-related , emotionally positive , negative , and neutral words . Recall was assessed 45 min later.High alexithymia participants recalled significantly fewer negative emotion words but also more illness-related words than low alexithymia participants. The results suggest that personal relevance can shape cognitive processing of stimuli, even to enhance retention of a subclass of stimuli whose retention is generally impaired in alexithymia. (shrink)

This paper offers an original argument for a Humean thesis about promising that generalises to the domain of normative powers. The Humean ‘natural unintelligibility’ thesis – prominently endorsed by Rawls, Hart, and Anscombe, and roundly rejected or forgotten by contemporary writers (conventionalists and non – conventionalists alike) – holds that a rational, suitably informed agent cannot so much as make a promise (much less a morally-binding promise) without exploiting conventional norms that confer promissory significance on act types (e.g., signing on (...) the dotted line) that would not otherwise have such significance. The argument (like Hume’s) is action-theoretic in character; its central premise is the Contribution Condition on acting with an aim: roughly, that doing X in order to (bring about) Y requires that the agent believe that their having X-ed on the occasion might come to fully or partly account for Y’s coming to pass. The argument generalises to the broader domain of exercises of normative powers, i.e., to acts that modify normative properties by ‘fiat’ or ‘stipulation’. This stipulative act has been characterised in three different ways, each of which is given due consideration. Finally, two different ways of accommodating the ‘natural unintelligibility’ thesis are considered, as is the thesis’s normative significance. (shrink)

A notable feature of our moral and legal practices is the recognition of privileges, powers, and entitlements belonging to a select group of individuals in virtue of their status as victims of wrongful conduct. A philosophical literature on relational normativity purports to account for this status in terms of such notions as interests, rights, and attitudes of disregard. This paper argues that such individualistic notions cannot account for prevailing and intuitive ways of demarcating the class of victims. The focus of (...) the discussion is the wrongful infliction of harm, and the mediating role played by impersonal “danger-making properties” in the determination of the class of victims. Beginning with a treatment of one of the most well-known discussions of negligently-inflicted harm — from the most famous case of the American common law tradition, Palsgraf v. Long Island Railroad Co. — the analysis is then extended to the morality of harm-doing more broadly, negligent and intentional alike. The paper’s chief targets are interest theories of rights — including contractualist theories of moral claim-rights of the kind defended by R. Jay Wallace — and neo-Strawsonian Quality of Will theories of “moral injury”. (shrink)

Controlling the movement of potentially infectious bodies has been central to Australian immigration law. Nowhere is this more evident than in relation to tuberculosis, which is named as a ground for refusal of a visa in the Australian context. In this paper, I critically examine the “will to knowledge” that this gives rise to. Drawing on a critical analysis of texts, including interviews with migrants diagnosed with TB and healthcare professionals engaged in their care, I argue that this focus on (...) border policing, rather than resettlement and the broader social determinants of health that drive current rates of TB, paradoxically renders migrants diagnosed with TB as liminal subjects in the post-arrival phase. This raises ethical issues about who “matters,” as well as dilemmas about what constitutes adequate care for the “Other,” both of which go to the heart of the political economy of migration. (shrink)

"Combining aspects of his acclaimed street work with an innovative approach to portraiture, Chicago-based photographer Jed Fielding has concentrated closely on these children's features and gestures, probing the enigmatic boundaries between surface and interior. Design, composition, and the play of light and shadow are central elements in these photographs, but the images are much more than formal experiments; they confront disability in a way that affirms life. Fielding's sightless subjects project a vitality that seems to extend beyond the limits of (...) self-consciousness. In collaborative, joyful participation with the children, he has made pictures that reveal essential gestures of absorption and the basic expressions of our creatureliness. Fielding's work achieves what only great art, and particularly great portraiture can: it launches and then complicates a process of identification across the barriers that separate us from each other. (shrink)

A prolific philosopher who also held Rome's highest political office, Cicero was uniquely qualified to write on political philosophy. In this book Professor Atkins provides a fresh interpretation of Cicero's central political dialogues - the Republic and Laws. Devoting careful attention to form as well as philosophy, Atkins argues that these dialogues together probe the limits of reason in political affairs and explore the resources available to the statesman given these limitations. He shows how Cicero appropriated and transformed Plato's thought (...) to forge original and important works of political philosophy. The book demonstrates that Cicero's Republic and Laws are critical for understanding the history of the concepts of rights, the mixed constitution and natural law. It concludes by comparing Cicero's thought to the modern conservative tradition and argues that Cicero provides a perspective on utopia frequently absent from current philosophical treatments. (shrink)

Should we try to live in the present? Such is the imperative of modernity, Jed Rubenfeld writes in this important and original work of political theory. Since Jefferson proclaimed that 'the earth belongs to the living', since Freud announced that mental health requires people to 'get free of their past', since Nietzsche declared that the happy man is the man who 'leaps into the moment', modernity has directed its inhabitants to live in the present, as if there alone could they (...) find happiness, authenticity, and above all freedom. But this imperative, Rubenfeld argues, rests on a profoundly inadequate, deforming picture of the relationship between freedom and time. Instead, Rubenfeld suggests, human freedom, indeed human being itself, necessarily extends into both past and future; self-government consists of giving our lives meaning and purpose over time. From this conception of self-government, Rubenfeld derives a new theory of constitutional law's place in democracy. Democracy, he writes, is not a matter of governance by the present 'will of the people'; it is a matter of a nation's laying down and living up to enduring political and legal commitments. Constitutionalism is not coun. (shrink)

Emily Dickinson's poetry is deeply philosophical. Recognizing that conventional language limited her thought and writing, Dickinson created new poetic forms to pursue the moral and intellectual issues that mattered most to her. This collection situates Dickinson within the rapidly evolving intellectual culture of her time and explores the degree to which her groundbreaking poetry anticipated trends in twentieth-century thought. Essays aim to clarify the ideas at stake in Dickinson's poems by reading them in the context of one or more relevant (...) philosophers, including near-contemporaries such as Nietzsche, Kierkegaard and Hegel, and later philosophers whose methods are implied in her poetry, including Levinas, Sartre and Heidegger. The Dickinson who emerges is a curious, open-minded interpreter of how human beings make sense of the world - one for whom poetry is a component of a lifelong philosophical project. (shrink)

The book introduces to readers the scope and nature of Meltzer’s contribution, and suggests the wider social context in which he saw psychoanalysis.

Academic misconduct runs rampant across higher education institutions in the US and internationally. Ample empirical research has identified myriad student variables that predict AM. However, two variables have been unexamined: the quality of conceptual knowledge university students have on AM and the relation between goals for going to university and reception to intervention on AM. Quantitative content analysis on written responses by 356 first-year university students reported surface-level knowledge of AM, frequent citation of extrinsic goals, and a lack of association (...) between goals and receptiveness to intervention. Results corroborate prior research on university students’ limited understanding of AM. Results suggest that efforts to address AM do not need to tailor intervention components to match students’ goals for attending university. (shrink)

Analogues between the coherentism-foundationalism debate in Western philosophy and Candrakīrti's critique of Dignāga's Pramāṇavāda approach are well attested.1 Many scholars who argue that Candrakīrti advocates a form of coherentism cite the following verse from Clear Words as evidence: Thus, knowledge of worldly objects is determined through the fourfold epistemic instruments. And those are established with respect to each other. When the epistemic instruments are correct, so are their objects, and when the objects to be validated are correct, so are their (...) epistemic instruments. It is not at all the case that the nature of the epistemic instrument or of the epistemic object is... (shrink)

An abrupt break in the prevailing modes of artistic expression, for many, marks the advent of modernism in the early twentieth century, but revisionary attempts to pin down a precise moment of its emergence remain disputed. History of a Shiver proffers a different approach, tracing the first inkling of modernism instead to the nineteenth century's fascination with music.As Jed Rasula deftly shows, melomania--the passion for music--gave rise to concepts like Richard Wagner's "endless melody" and the Gesamtkunstwerk, or total work of (...) art, which in turn infused the arts of the fin de siècle with an aura of expectancy, challenging them to induce musical effects by their own means. With each art aspiring to produce the effects of another artistic medium, a synesthetic yearning ran like a shiver through the body of art that would emerge over the next half century. Rasula traces this pan-arts polyphony from German Romantic theory to early experiments in "visual music," encompassing such diverse phenomena as American fixation on Arcadia, early film theory, and the lure of the fourth dimension. All the while, he keeps focus on the paramount historical consequence in elevating music to a new universal aesthetic standard, arguing that Wagnerism was first among modern "isms."In surveying this momentous interplay among arts, History of a Shiver ranges from literature, music and painting to theatre, cinema, dance, photography, and civic pageantry. It retells the story of modernism by recovering not an idea, but a feeling--the hair-raising potential for each painting, literary text, or musical composition to herald an unprecedented domain of human enterprise. (shrink)

Thomas S. Kuhn's singular voice was stilled by cancer on June 17, 1996, some 49 years after his initial encounters with past science had drawn him into a career in the history and philosophy of science. One of the most widely-read and influential academics of the 20th century, Kuhn was educated at Harvard University, where he received an S.B. in Physics in 1943 and a Ph.D. in the subject in 1949. He remained there until 1956, first as a Junior Fellow (...) in the Society of Fellows from 1948 to 1951, when he in effect retrained himself as a historian of science, and then as an Assistant Professor of General Education and History of Science. He joined the faculty of the University of California, Berkeley, in 1956, becoming Professor of History of Science in 1961. From 1964 to 1979 he was on the faculty of the History of Science Program of Princeton University, and from 1972 to 1979 also a member of the Institute for Advanced Study. He moved to the Department of Linguistics and Philosophy of Massachusetts Institute of Technology in 1979, where he became Professor Emeritus in 1991. He was President of the History of Science Society in 1968—70 and of the Philosophy of Science Association in 1988–90. He received the George Sarton Medal of the History of Science Society in 1982 and the John Desmond Bernal Award of the Society for the Social Studies of Science in 1983. (shrink)

The creditions model is incredibly powerful at explaining both how beliefs are formed and how they influence our perceptions. The model contains several cognitive loops, where beliefs not only influence conscious interpretations of perceptions downstream but are active in the subconscious construction of perceptions out of sensory information upstream. This paper shows how this model is mirrored in the epistemology of two central Buddhist figures, Dignāga and Dharmakı̄rti. In addition to showing these parallels, the paper also demonstrates that by drawing (...) on Dignāga and Dharmakı̄rti's theory, we can extend the explanatory power of the creditions model. Namely, while creditions explain how beliefs influence both the conscious interpretation and subconscious construction of sensory information, Dignāga and Dharmakı̄rti suggest beliefs can even be generative of sensory-like information. I recruit ancient Buddhist texts in conjunction with contemporary cognitive science scholarship to offer a hypothesis for the cognitive mechanisms responsible for this. (shrink)

From one of our most astute art critics, an impassioned and elegant book that questions the demand for art's political relevance or its need to deliver a message, and insists on its power to take us out of the everyday world, and its most important role: to excite, disturb, inspire or unsettle us. As more and more critics and enthusiasts insist that art needs to promote a particular idea or message, be it political or social, as a brand, a means (...) of education or entertainment, Jed Perl wants to remind us that the purpose of art lies not in our ability to define it, to place it in a context, whether a cause, an issue or an ideology. Instead the true power of art lies in its ability to shake our need for definitions, relevance or categories. He reminds us of the inherently uncategorizable nature of the artistic imagination, that a work of art is not merely a statement beamed out into the world, but the result of a dialogue between the artist and the tools and tradition of the medium, and that the fascination of the arts lies in their ability to be both dispassionate and impassioned. Perl explores the practices that are the foundation for the two catalysts of imaginative achievement: authority and freedom. He discusses the sense of vocation that give artists their purpose and focus, and how the interplay between authority and freedom underpin the creative process. (shrink)

Tibetan Buddhism, the Gelug school specifically, promotes a deep skepticism about the ability to know others’ minds. Its scripture is rife with cautionary tales allegorizing and extolling this skepticism in adherents, while claiming a buddha, by contrast, has eradicated this skepticism with their omniscience. I describe a buddha’s purported privileged epistemic access to others’ minds as “double-hiddenness.” On this skepticism, not just what a buddha knows, but if they know it is hidden, making their authority irreputable. I use critical theory (...) to investigate the ramifications of this double hiddenness, demonstrating that the resultant subjectivization brought about by this extreme skepticism—although the product of power—is not merely a type of subjugation, as suggested by Foucault, but also constitutes a robust agency. (shrink)

Cicero is one of the most important and influential thinkers within the history of Western philosophy. For the last thirty years, his reputation as a philosopher has once again been on the rise after close to a century of very low esteem. This Companion introduces readers to 'Cicero the philosopher' and to his philosophical writings. It provides a handy port-of-call for those interested in Cicero's original contributions to a wide variety of topics such as epistemology, the emotions, determinism and responsibility, (...) cosmopolitanism, republicanism, philosophical translation, dialogue, aging, friendship, and more. The international, interdisciplinary team of scholars represented in this volume highlights the historical significance and contemporary relevance of Cicero's writings, and suggests pathways for future scholarship on Cicero's philosophy as we move through the twenty-first century. (shrink)

Objective Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians’ attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. Design, Setting, Participants A survey of resident/fellow physicians and internal medicine (...) attendings at an academic medical center, May to August 2013. Measurements We used a 24-item, internet-based survey assessing physician-respondents’ demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. Main Results A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/ fellows. Only 32 percent of the respondents indicated that a surrogate’s consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate’s objection. Those who self-reported as “knowledgeable” about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VAECMO over a surrogate’s objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Conclusions Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/ critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians’ hesitance to cede authority to presumably less knowledgeable patients and surrogates, (2) stem from a stewardship of resources perspective, and/or (3) point to practical efforts to avoid futility and utility disputes. Whether these results indicate a more widespread reversion to paternalism or a more circumscribed usurping of decisional authority occasioned by VA-ECMO necessitates further study. (shrink)

ABSTRACTThis paper assesses to what extent the neo-Republican accounts of Quentin Skinner and Philip Pettit adequately capture the nature of political liberty at Rome by focusing on Cicero's analysis of the libera res publica. Cicero's analysis in De Republica suggests that the rule of law and a modest menu of individual citizens’ rights guard against citizens being controlled by a master's arbitrary will, thereby ensuring the status of non-domination that constitutes freedom according to the neo-Republican view. He also shows the (...) difficulty of anchoring an argument for citizens’ full political participation in the value of non-domination. While Cicero believed such full participation was essential for a libera res publica, he, like other elite Romans, argued for participation on the basis of liberty conceived as the space to contend for and enhance one's social status. The sufficiency of the rule of law and citizens’ rights for securing a status of non-domination taken together with their insufficiency for ensuring a libera res publica suggests that neo-Republican accounts of liberty do not fully capture the idea as articulated in Cicero's Republicanism. (shrink)

This commentary responds to Samuel Director's article “Dementia and Concurrent Consent to Sexual Relations,” in the May‐June 2023 issue of the Hastings Center Report. In the article, Director sets out a set of conditions for sexual consent after one partner in a committed, long‐term relationship develops dementia. While we share Director's view that dementia patients should not be categorically cut off from sexual intimacy, we caution against the use of his approach as a rigid test for allowing sexual activity. Director's (...) analysis does not address the full range of plausibly permissible sexual relationships, which is unfortunate, as intimacy has consistently been linked to physical and psychological well‐being. Moreover, because decisions about sex often carry moral and emotional overtones, we propose that a dementia patient's prior values should sometimes be considered by caregivers in a measured way. (shrink)

Most recent work on the nature of experiment in physics has focused on "big science"--the large-scale research addressed in Andrew Pickering's Constructing Quarks and Peter Galison's How Experiments End. This book examines small-scale experiment in physics, in particular the relation between theory and practice. The contributors focus on interactions among the people, materials, and ideas involved in experiments--factors that have been relatively neglected in science studies. The first half of the book is primarily philosophical, with contributions from Andrew Pickering, Peter (...) Galison, Hans Radder, Brian Baigrie, and Yves Gingras. Among the issues they address are the resources deployed by theoreticians and experimenters, the boundaries that constrain theory and practice, the limits of objectivity, the reproducibility of results, and the intentions of researchers. The second half is devoted to historical case studies in the practice of physics from the early nineteenth to the early twentieth century. These chapters address failed as well as successful experimental work ranging from Victorian astronomy through Hertz's investigation of cathode rays to Trouton's attempt to harness the ether. Contributors to this section are Jed Z. Buchwald, Giora Hon, Margaret Morrison, Simon Schaffer, and Andrew Warwick. With a lucid introduction by Ian Hacking, and original articles by noted scholars in the history and philosophy of science, this book is poised to become a significant source on the nature of small-scale experiment in physics. (shrink)

Incommensurability between successive scientific theories—the impossibility of empirical evidence dictating the choice between them—was Thomas Kuhn's most controversial proposal. Toward defending it, he directed much effort over his last 30 years into formulating precise conditions under which two theories would be undeniably incommensurable with one another. His first step, in the late 1960s, was to argue that incommensurability must result when two theories involve incompatible taxonomies. The problem he then struggled with, never obtaining a solution that he found entirely satisfactory, (...) was how to extend this initial line of thought to sciences like physics in which taxonomy is not so transparently dominant as it is, for example, in chemistry. This paper reconsiders incommensurability in the light of examples in which evidence historically did and did not carry over continuously from old laws and theories to new ones. The transition from ray to wave optics early in the nineteenth century, we argue, is especially informative in this regard. The evidence for the theory of polarization within ray optics did not carry over to wave optics, so that this transition can be regarded as a prototypical case of discontinuity of evidence, and hence of incommensurability in the way Kuhn wanted. Yet the evidence for classic geometric optics did carry over to wave optics, notwithstanding the fundamental conceptual readjustment that Fresnel's wave theory required. (shrink)

Summary Descartes's model for the invisible world has long seemed confined to explanations of known phenomena, with little if anything to offer concerning the empirical investigation of novel processes. Although he did perform experiments, the links between them and the Cartesian model remain difficult to pin down, not least because there are so very few. Indeed, the only account that Descartes ever developed which invokes his model in relation to both quantitative implications and to experiments is the one that he (...) provided for the rainbow. There he described in considerable detail the appearances of colours generated by means of prisms in specific circumstances. We have reproduced these experiments with careful attention to Descartes's requirements. The results provide considerable insight into the otherwise fractured character of his printed discovery narrative. By combining reproduction with attention to the rhetorical structure of Descartes's presentation, we can show that he worked his model in conjunction with experiments to reach a fully quantitative account of the rainbow, including its colours as well as its geometry. In this one instance at least, Descartes produced just the sort of explanatory novelties that the young Newton later did in optics. That Descartes's results in respect to colour are in hindsight specious is of course irrelevant. (shrink)

Kirchhoff’s 1882 theory of optical diffraction forms the centerpiece in the long-term development of wave optics, one that commenced in the 1820s when Fresnel produced an empirically successful theory based on a reinterpretation of Huygens’ principle, but without working from a wave equation. Then, in 1856, Stokes demonstrated that the principle was derivable from such an equation albeit without consideration of boundary conditions. Kirchhoff’s work a quarter century later marked a crucial, and widely influential, point for he produced Fresnel’s results (...) by means of Green’s theorem and function under specific boundary conditions. In the late 1880s, Poincaré uncovered an inconsistency between Kirchhoff’s conditions and his solution, one that seemed to imply that waves should not exist at all. Researchers nevertheless continued to use Kirchhoff’s theory—even though Rayleigh, and much later Sommerfeld, developed a different and mathematically consistent formulation that, however, did not match experimental data better than Kirchhoff’s theory. After all, Kirchhoff’s formula worked quite well in a specific approximation regime. Finally, in 1964, Marchand and Wolf employed the transformation of Kirchhoff’s surface integral that had been developed by Maggi and Rubinowicz for other purposes. The result yielded a consistent boundary condition that, while introducing a species of discontinuity, nevertheless rescued the essential structure of Kirchhoff’s original formulation from Poincaré’s paradox. (shrink)

The past decade has seen a vigorous debate in medical ethics over whether and under what conditions physicians can refuse requests from patients for medical interventions that the physician believes are morally inappropriate to perform. The debate has typically been framed in terms of "conscientious refusal": when, if ever, is the physician justified in refusing an intervention when the reasons of refusal have to do with the convictions of the physician's conscience? To this version of the question, a range of (...) answers have been given. At one extreme, scholars have argued for the so-called incompatibility thesis, that conscientious objection is a matter of personal morality and hence incompatible with the... (shrink)

Recent studies indicate that the processing of an unexpected word is costly when the initial, disconfirmed prediction was strong. This penalty was suggested to stem from commitment to the strongly predicted word, requiring its inhibition when disconfirmed. Additional studies show that comprehenders rationally adapt their predictions in different situations. In the current study, we hypothesized that since the disconfirmation of strong predictions incurs costs, it would also trigger adaptation mechanisms influencing the processing of subsequent strong predictions. In two experiments, participants (...) made speeded congruency judgments on two-word phrases in which the first word was either highly constraining or not. We manipulated the proportion of disconfirmed predictions in highly constraining contexts between participants. The results provide additional evidence of the costs associated with the disconfirmation of strong predictions. Moreover, they show a reduction in these costs when participants experience a high proportion of disconfirmed strong predictions throughout the experiment, indicating that participants adjust the strength of their predictions when strong prediction is discouraged. We formulate a Bayesian adaptation model whereby prediction failure cost is weighted by the participant’s belief about the likelihood of encountering the expected word, and show that it accounts for the trial-by-trial data. (shrink)

Background Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. Objective To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. Methods Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer an active role in clinical decision-making, (...) and (2) determine whether religious service attendance, the importance of religion, self-rated spirituality, Charlson Comorbidity Index, self-reported health, Vulnerable Elder Score and several demographic characteristics were associated with these preferences. Results Data were collected from 8308 of 11 620 possible participants. Ninety-seven per cent of respondents wanted doctors to offer them choices and to consider their opinions. However, two out of three (67%) preferred to leave medical decisions to the doctor. In multiple regression analyses, preferring to leave decisions to the doctor was associated with older age (per year, OR=1.019, 95% CI 1.003 to 1.036) and frequently attending religious services (OR=1.5, 95% CI 1.1 to 2.1, compared with never), and it was inversely associated with female sex (OR=0.6, 95% CI 0.5 to 0.8), university education (OR=0.6, 95% CI 0.4 to 0.9, compared with no high school diploma) and poor health (OR=0.6, 95% CI 0.3 to 0.9). Conclusions Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small. (shrink)

Normothermic Regional Perfusion, or NRP, is a method of donated organ reperfusion using cardiopulmonary bypass or a modified extracorporeal membrane oxygenation (ECMO) circuit after circulatory death while leaving organs in the dead donor’s corpse. Despite its potential, several key ethical issues remain unaddressed by this technology.

The terms complexity, complex adaptive systems, and sciences of complexity are found often in recent scientific literature, reflecting the remarkable growth in collaborative academic research focused on complexity from the origin and dynamics of organisms to the largest social and political organizations. One of the great challenges in this field of research is to discover which features are essential and shared by all of the seemingly disparate systems that are described as complex. Is there sufficient synthesis to suggest the possibility (...) of an overarching science of complexity? This report describes current views on this subject held by various eminent scholars associated with the Santa Fe Institute.The physical sciences have traditionally been concerned with “simple” systems whose dynamics can be described in mathematical terms with precision and certainty. In contrast, the biological and social sciences are inevitably concerned with self-organized or social “complex” systems whose detailed behaviors appear to be unpredictable. The two categories differ greatly in size and diversity, prompting the late mathematician Stanislaus Ulam to remark that research on complex systems might be compared to the study of non-elephants. Nevertheless, certain integrative themes have begun to emerge.Rising activity in this field of research runs completely counter to the trend toward increasing fragmentation and specialization in the sciences. It has stimulated a resurgence of interest in a broad synthesis involving mathematics, computational science, physics, chemistry, biology, neuroscience, and the social sciences. The growth of effort in this very extended field has been greatly stimulated by the development of new computational tools that are capable of dealing with vast, interrelated databases. Many of the participants in complexity research feel that it is now time to reintegrate the fragmented interests of much of the academic community. The reader is encouraged to consider whether such views are sparking a historic renaissance of scholarship or represent a passing scientific diversion. (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)