In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

Journal of Political Philosophy, EarlyView.

Based on anthropological fieldwork in Australia and Colombia, this collection of essays uses the workings of the human nervous system to illustrate concepts of culture.

The vast majority of health research resources are used to study conditions that affect a small, advantaged portion of the global population. This distribution has been widely criticized as inequitable and threatens to exacerbate health disparities. However, there has been little systematic work on what individual health research funders ought to do in response. In this article, we analyze the general and special duties of research funders to the different populations that might benefit from health research. We assess how these (...) duties apply to governmental, multilateral, nonprofit, and for-profit organizations. We thereby derive a framework for how different types of funders should take the beneficiaries of research into account when they allocate scarce research resources. (shrink)

Why do physicians who've taken the Hippocratic Oath willingly cut into seemingly healthy patients? How do you measure the success of surgery aimed at making someone happier by altering his or her body? Sander L. Gilman explores such questions in Creating Beauty to Cure the Soul, a cultural history of the connections between beauty of body and happiness of mind. Following these themes through an impressive range of historical moments and players, Gilman traces how aesthetic alterations of the (...) body have been used to "cure" dissatisfied states of mind. In his exploration of the striking parallels between the development of cosmetic surgery and the field of psychiatry, Gilman entertains an array of philosophical and psychological questions that underlie the more practical decisions rountinely made by doctors and potential patients considering these types of surgery. While surveying and incorporating the relevant theories of Sigmund Freud, Alfred Adler, Karl Menninger, Paul Schilder, contemporary feminist critics, and others, Gilman considers the highly unstable nature of cultural notions of health, happiness, and beauty. He reveals how ideas of race and gender structured early understandings of aesthetic surgery in discussions of both the "abnormality" of the Jewish nose and the historical requirement that healthy and virtuous females look "normal," thereby enabling them to achieve invisibility. Reflecting upon historically widespread prejudices, Gilman describes the persecutions, harrassment, attacks, and even murders that continue to result from bodily difference and he encourages readers to question the cultural assumptions that underlie the increasing acceptability of this surgical form of psychotherapy. Synthesizing a vast body of related literature and containing a comprehensive bibliography, Creating Beauty to Cure the Soul will appeal to a broad audience, including those interested in the histories of medicine and psychiatry, and in philosophy, cultural studies, Jewish cultural studies, and race and ethnicity. (shrink)

This article tells the story of the oil and gas origins of the Gaia hypothesis, the theory that the Earth is a homeostatic system. It shows how Gaia’s key assumption—that the climate is a fundamentally stable system, able to withstand perturbations—emerged as a result of a collaboration between the theory’s progenitor, James Lovelock, and Royal Dutch Shell in response to Shell’s concerns about the effects of its products on the climate. The article explains how Lovelock elaborated the Gaia hypothesis and (...) gave it evidential depth through a series of Royal Dutch Shell-funded research projects meant to identify organisms whose biological activities might double as climate-regulating mechanisms. The article goes on to show how this research subsequently laid the foundation for a distinct genre of climate change denialism, in which corporations sowed doubt not by denying the phenomenon of global warming but by naturalizing it. (shrink)

The need for greater privacy protections in the United States has never been greater. In their work, “Ethical Responsibilities for Companies That Process Personal Data”, McCoy et al. (2023) correct...

_K. al-Manām_ by Ibn Abī al-Dunyā is a compendium of 350 Muslim dream narratives in Arabic. The English introduction examines the function of dreams in classical Arabic literature with a focus on dreams as a means of edification.

BackgroundFunctional neurodiagnostics could allow researchers and clinicians to distinguish more accurately between the unresponsive wakefulness syndrome and the minimally conscious state. It remains unclear how it informs surrogate decision-making.ObjectiveTo explore how the next of kin of patients with disorders of consciousness interpret the results of a functional neurodiagnostics measure and how/why their interpretations influence their attitudes towards medical decisions.Methods and SampleWe conducted problem-centered interviews with seven next of kin of patients with DOC who had undergone a functional HD-EEG examination at (...) a neurological rehabilitation center in Germany. The examination included an auditory oddball paradigm and a motor imagery task to detect hidden awareness. We analyzed the interview transcripts using structuring qualitative content analysis.ResultsRegardless of the diagnostic results, all participants were optimistic of the patients’ meaningful recovery. We hypothesize, that participants deal with the results of examinations according to their belief system. Thus, an unfavorable evaluation of the patient’s state had the potential to destabilize the participant’s belief system. To re-stabilize or to prevent the destabilization of their belief system, participants used different strategies. Participants accepted a “positive” HD-EEG result since it stabilized their belief system.ConclusionWe hypothesize, that a group of next of kin of patients with DOC deals with functional neurodiagnostics results on the basis of the result’s value and their high hope that the patient will recover meaningfully. A psychological mechanism seems to moderate the impact of functional neurodiagnostics on surrogate treatment decisions. (shrink)

Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria for allocating health research resources. (...) Here, we analyse the criteria and processes that ten of the largest public and non-profit research funders use to choose between competing grant applications. Our data suggest that research funders rarely instruct reviewers to consider disease burden or to prioritise research for sicker or more disadvantaged populations, and typically only include scientists in the review processes. This is liable to undermine efforts to link research funding to health needs. (shrink)

Epistemic injustice sits at the intersection of ethics, epistemology, and social justice. Generally, this philosophical term describes when a person is wrongfully discredited as a knower; and within the clinical space, epistemic injustice is the underlying reason that some patient testimonies are valued above others. The following essay seeks to connect patterns of social prejudice to the clinical realm in the United States: illustrating how factors such as race, gender identity, and socioeconomic status influence epistemic credence and associatively, the quality (...) of healthcare a person receives. After describing how epistemic injustice disproportionately harms already vulnerable patients, I propose a narrative therapy intervention. This intervention can help providers re-frame their relationships with patients, in such that they come to view patients as valuable sources of unique knowledge. Though I identify this intervention as a valuable step in addressing clinical epistemic injustice, I call upon medical educators and practitioners to further uplift the voices, perspectives, and stories of marginalized patients. (shrink)

In his recent article “Ethical Criteria for Health-Promoting Nudges: A Case-by-Case Analysis,” Bart Engelen (2019) develops a useful framework for evaluating health-related nudges in an attempt to...

Two of the most influential theories about scientific inference are inference to the best explanation and Bayesianism. How are they related? Bas van Fraassen has claimed that IBE and Bayesianism are incompatible rival theories, as any probabilistic version of IBE would violate Bayesian conditionalization. In response, several authors have defended the view that IBE is compatible with Bayesian updating. They claim that the explanatory considerations in IBE are taken into account by the Bayesian because the Bayesian either does or should (...) make use of them in assigning probabilities to hypotheses. I argue that van Fraassen has not succeeded in establishing that IBE and Bayesianism are incompatible, but that the existing compatibilist response is also not satisfactory. I suggest that a more promising approach to the problem is to investigate whether explanatory considerations are taken into account by a Bayesian who assigns priors and likelihoods on his or her own terms. In this case, IBE would emerge from the Bayesian account, rather than being used to constrain priors and likelihoods. I provide a detailed discussion of the case of how the Copernican and Ptolemaic theories explain retrograde motion, and suggest that one of the key explanatory considerations is the extent to which the explanation a theory provides depends on its core elements rather than on auxiliary hypotheses. I then suggest that this type of consideration is reflected in the Bayesian likelihood, given priors that a Bayesian might be inclined to adopt even without explicit guidance by IBE. The aim is to show that IBE and Bayesianism may be compatible, not because they can be amalgamated, but rather because they capture substantially similar epistemic considerations. 1 Introduction2 Preliminaries3 Inference to the Best Explanation4 Bayesianism5 The Incompatibilist View : Inference to the Best Explanation Contradicts Bayesianism5. 1 Criticism of the incompatibilist view6 Constraint - Based Compatibilism6. 1 Criticism of constraint - based compatibilism7 Emergent Compatibilism7. 1 Analysis of inference to the best explanation7. 1. 1 Inference to the best explanation on specific hypotheses7. 1. 2 Inference to the best explanation on general theories7. 1. 3 Copernicus versus Ptolemy7. 1. 4 Explanatory virtues7. 1. 5 Summary7. 2 Bayesian account8 Conclusion. (shrink)

Journal Name: Philologus Issue: Ahead of print.

There has been considerable puzzlement over how to respond to higher-order evidence. The existing dilemmas can be defused by adopting a ‘two-dimensional’ representation of doxastic attitudes which incorporates not only substantive uncertainty about which first-order state of affairs obtains but also the degree of conviction with which we hold the attitude. This makes it possible that in cases of higher-order evidence the evidence sometimes impacts primarily on our conviction, rather than our substantive uncertainty. I argue that such a two-dimensional representation (...) is naturally developed by making use of imprecise probabilities. (shrink)

Psychological studies show that the beliefs of two agents in a hypothesis can diverge even if both agents receive the same evidence. This phenomenon of belief polarisation is often explained by invoking biased assimilation of evidence, where the agents’ prior views about the hypothesis affect the way they process the evidence. We suggest, using a Bayesian model, that even if such influence is excluded, belief polarisation can still arise by another mechanism. This alternative mechanism involves differential weighting of the evidence (...) arising when agents have different initial views about the reliability of their sources of evidence. We provide a systematic exploration of the conditions for belief polarisation in Bayesian models which incorporate opinions about source reliability, and we discuss some implications of our findings for the psychological literature. (shrink)

Hierarchical Bayesian models (HBMs) provide an account of Bayesian inference in a hierarchically structured hypothesis space. Scientific theories are plausibly regarded as organized into hierarchies in many cases, with higher levels sometimes called ‘paradigms’ and lower levels encoding more specific or concrete hypotheses. Therefore, HBMs provide a useful model for scientific theory change, showing how higher‐level theory change may be driven by the impact of evidence on lower levels. HBMs capture features described in the Kuhnian tradition, particularly the idea that (...) higher‐level theories guide learning at lower levels. In addition, they help resolve certain issues for Bayesians, such as scientific preference for simplicity and the problem of new theories. *Received July 2009; revised October 2009. †To contact the authors, please write to: Leah Henderson, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 32D‐808, Cambridge, MA 02139; e‐mail: [email protected]. (shrink)

We respond to open peer commentaries on our target article, "Health Research Priority Setting: The Duties of Individual Funders".

Sander Gilman and David Parent present a fascinating sellection of memoirs, anecdotes, and informal recollections by friends and acquaintances of Nietzsche, translated by Parent from the definitive German collection.

Background In 2001 a report on the provision of clinical ethics support in UK healthcare institutions identified 20 clinical ethics committees. Since then there has been no systematic evaluation or documentation of their work at a national level. Recent national surveys of clinical ethics services in other countries have identified wide variation in practice and scope of activities. Objective To describe the current provision of ethics support in the UK and its development since 2001. Method A postal/electronic questionnaire survey administered (...) to the chairs of all 82 clinical ethics services registered with the UK Clinical Ethics Network in July 2010. Results Response rate was 62% with the majority of responding services situated in acute trusts. All services included a clinical ethics committee with one service also having a clinical ethicist. Lay members were present in 72% of responding committees. Individual case consultation has increased since 2001 with 29% of chairs spending more than 50% of their time on this. Access to and involvement in the process of case consultation is less for patients and families than for clinical staff. There is wide variation in committee processes and levels of institutional support. Over half of the responding committees undertook some form of evaluation. Conclusion Clinical ethics services in the UK are increasing as is their involvement in case consultation. However, the significant variation in committee processes suggests that further qualitative research is needed to understand how these committees function and the role they play in their institution. (shrink)

The research we fund today will improve the health of people who will live tomorrow. But future people will not all benefit equally: decisions we make about what research to prioritize will predictably affect when and how much different people benefit from research. Organizations that fund health research should thus fairly account for the health needs of future populations when setting priorities. To this end, some research funders aim to allocate research resources in accordance with disease burden, prioritizing illnesses that (...) cause more morbidity and mortality. In this article, I defend research funders' practice of aligning research funding with disease burden but argue that funders should aim to align research funding with future—rather than present—disease burden. I suggest that research funders should allocate research funding in proportion to aggregated estimates of disease burden over the period when research could plausibly start to yield benefits until indefinitely into the future. (shrink)

Hierarchical Bayesian models (HBMs) provide an account of Bayesian inference in a hierarchically structured hypothesis space. Scientific theories are plausibly regarded as organized into hierarchies in many cases, with higher levels sometimes called ‘para- digms’ and lower levels encoding more specific or concrete hypotheses. Therefore, HBMs provide a useful model for scientific theory change, showing how higher-level theory change may be driven by the impact of evidence on lower levels. HBMs capture features described in the Kuhnian tradition, particularly the idea (...) that higher-level theories guide learning at lower levels. In addition, they help resolve certain issues for Bayesians, such as scientific preference for simplicity and the problem of new theories. (shrink)

Investigations of data-centered efforts in advocacy and activism are often cast in terms of a narrative of opposition between grassroots activists working through and with data, and corporations or institutions whose actions data might expose. The boundaries are, however, not so distinct in practice. Indeed, one outcome of successful advocacy efforts for opening big data to the public is that the activists may find themselves drawn into the institutions they critique or view as impediments in order to actualize those efforts (...) from the inside. Drawing on an ongoing ethnographic investigation of urban data initiatives inside city government, we explore the productive ambivalences of activism and advocacy that arise when those with data activist ideals find themselves operating within the government structure. (shrink)

There has of late been a revival of interest in the problem of practical reason. One of the causes of this revival has been, I think, a reaction against the radical subjectivism to which the emotive theory seemed to lead. Philosophers have wished to show that the method of linguistic analysis can account for that kind of objectivity, whatever kind that might be, which is possessed by our moral opinions, criticisms, etc. The question in what this objectivity consists has, however, (...) remained obscure and recent writing has failed to distinguish at least two quite distinct issues. I hope to show what these are and that they are distinct. (shrink)

It is probable that few critics, if directly challenged, would admit to believing that a work of literature which was, in some sense, morally objectionable was therefore necessarily totally lacking in literary merit. Nevertheless, it is not uncommon for a man—in the language he uses, in the conclusions he draws, in his obiter dicta—to seem yet to hold a view which, in its bald statement, he has denied. Certainly, those critics who most vehemently wish to dissociate themselves from any claims (...) that art exists for art's sake, or that there are peculiarly ‘aesthetic’ criteria, and who believe that such claims lead to irresponsibility, such critics often use moral concepts extensively in their criticism. Furthermore, they often do this in such a way as to suggest that if a work is morally objectionable, then there is no way of redeeming it aesthetically; for, it would seem, moral criticism exhausts the critical possibilities; no aesthetic saving graces are allowed. (shrink)

Philosophical and theological perspectives of faith.

This essay analyzes the prominent role played by first wave feminism and by women writers between 1898-1903 as the Jamaica Times articulated a broad-based, middle class nationalism and launched a campaign to establish a Jamaican national literature. Largely overlooked, this archival material is significant because it suggests a subtle yet significant modification of anglophone Caribbean feminist, literary and nationalist historiography: first wave feminism was not introduced to Jamaica exclusively through black nationalist organizations in the late nineteenth and early twentieth century, (...) but rather, it emerged in a broader phenomenon of respectable, middle class nationalism, encompassing the overlapping projects of Jamaican nationalism and Pan Africanism. Thus, it becomes clear that first wave feminism, including white women writers, played a key but brief role in the formation of the middle class nationalism that would later dominate Jamaica's transition to independence. During the first five years of publication of the Jamaica Times, women wrote a significant proportion of the short stories published. However, they became marginalized as black folk culture became the defining symbol of national authenticity. The marginalization of middle class women writers reflects a broader pattern. In adopting first wave feminism from Britain and the United States, Jamaican nationalists reproduced colonial race and class dynamics that established an unbridgeable divide between middle class women, who served as ‘ladies bountiful,’ and the usually darker-skinned compatriots to whom they ministered. This class division continued to limit feminist activism in Jamaica throughout the first and second waves. (shrink)

This book presents a systematic account of the role of the personal spiritual ideal of wu-wei--literally "no doing," but better rendered as "effortless action"--in early Chinese thought. Edward Slingerland's analysis shows that wu-wei represents the most general of a set of conceptual metaphors having to do with a state of effortless ease and unself-consciousness. This concept of effortlessness, he contends, serves as a common ideal for both Daoist and Confucian thinkers. He also argues that this concept contains within itself a (...) conceptual tension that motivates the development of early Chinese thought: the so-called "paradox of wu-wei," or the question of how one can consciously "try not to try." Methodologically, this book represents a preliminary attempt to apply the contemporary theory of conceptual metaphor to the study of early Chinese thought. Although the focus is upon early China, both the subject matter and methodology have wider implications. The subject of wu-wei is relevant to anyone interested in later East Asian religious thought or in the so-called "virtue-ethics" tradition in the West. Moreover, the technique of conceptual metaphor analysis--along with the principle of "embodied realism" upon which it is based--provides an exciting new theoretical framework and methodological tool for the study of comparative thought, comparative religion, intellectual history, and even the humanities in general. Part of the purpose of this work is thus to help introduce scholars in the humanities and social sciences to this methodology, and provide an example of how it may be applied to a particular sub-field. (shrink)

The no miracles argument is one of the main arguments for scientific realism. Recently it has been alleged that the no miracles argument is fundamentally flawed because it commits the base rate fallacy. The allegation is based on the idea that the appeal of the no miracles argument arises from inappropriate neglect of the base rate of approximate truth among the relevant population of theories. However, the base rate fallacy allegation relies on an assumption of random sampling of individuals from (...) the population which cannot be made in the case of the no miracles argument. Therefore the base rate fallacy objection to the no miracles argument fails. I distinguish between a “local” and a “global” form of the no miracles argument. The base rate fallacy objection has been leveled at the local version. I argue that the global argument plays a key role in supporting a base-rate-fallacy-free formulation of the local version of the argument. (shrink)

BackgroundWomen with gestational diabetes mellitus have higher rates of perinatal depressive symptoms, compared to healthy pregnant women. In the general population, maternal depressive symptoms have been associated with infant sleep difficulties during the first year postpartum. However, there is lack of data on infants of mothers with gestational diabetes mellitus.MethodsThis study assessed the prospective associations between maternal perinatal depressive symptoms and infant sleep outcomes. The study population consisted of 95 Swiss women with gestational diabetes mellitus and their infants, enrolled in (...) the control group of the MySweetheart trial. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale at the first gestational diabetes mellitus visit during pregnancy, at 6–8 weeks postpartum, and 1 year postpartum. The Brief Infant Sleep Questionnaire was used to assess infant sleep at 1 year postpartum. Relevant maternal and infant measurements were collected or extracted from medical records as covariates.ResultsAntenatal maternal depressive symptoms at the first gestational diabetes mellitus visit were inversely associated with infant nocturnal sleep duration at 1 year postpartum. This association became marginally significant when covariates were added. Maternal depressive symptoms at 6–8 weeks postpartum were negatively and prospectively associated with infant nocturnal sleep duration, even when controlling for covariates. The association between maternal depressive symptoms and maternal perception of infant sleep as not a problem at all was significant at 1 year postpartum, although it became non-significant when controlling for appropriate covariates. No other significant associations were found.LimitationsThis study solely included measures derived from self-report validated questionnaires.ConclusionOur findings suggest it is of utmost importance to support women with gestational diabetes mellitus as a means to reduce the detrimental impact of maternal perinatal depressive symptoms on infant sleep, given its predictive role on infant metabolic health. (shrink)