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Propositional attitude verbs, such as think and want, have long held interest for both theoretical linguists and language acquisitionists because their syntactic, semantic, and pragmatic properties display complex interactions that have proven difficult to fully capture from either perspective. This paper explores the granularity with which these verbs’ semantic and pragmatic properties are recoverable from their syntactic distributions, using three behavioral experiments aimed at explicitly quantifying the relationship between these two sets of properties. Experiment 1 gathers a measure of 30 (...) propositional attitude verbs’ syntactic distributions using an acceptability judgment task. Experiments 2a and 2b gather measures of semantic similarity between those same verbs using a generalized semantic discrimination task and an ordinal scale task, respectively. Two kinds of analyses are conducted on the data from these experiments. The first compares both the acceptability judgments and the semantic similarity judgments to previous classifications derived from the syntax and semantics literature. The second kind compares the acceptability judgments to the semantic similarity judgments directly. Through these comparisons, we show that there is quite fine-grained information about propositional attitude verbs’ semantics carried in their syntactic distributions—whether one considers the sorts of discrete qualitative classifications that linguists traditionally work with or the sorts of continuous quantitative classifications that can be derived experimentally. (shrink)

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Decisions regarding life-sustaining medical treatments for young children with profound disabilities can be extremely challenging for families and clinicians. In this study, Brick and colleagues1 surveyed adult residents of the UK about their attitudes regarding withdrawal of treatment using a series of vignettes of infants with varying levels of intellectual and physical disability, based on real and hypothetical cases.1 This is an interesting study on an important topic. We first highlight the limitations of using these survey data to inform public (...) policy and then offer a different interpretation from the authors’ regarding their findings about the value the public appears to place on relational capacity. The authors asked members of the lay public to interpret a disabled child’s best interest in a series of vignettes. The respondents were 92%white; 59% were atheist or reported no religious affiliation. Though the authors note this lack of diversity as a limitation, we would add that this limitation is particularly problematic in this context. Minority views on this issue may differ significantly from the majority perspective. When the stakes are high (as is the case for questions about withdrawing life-sustaining therapy from infants over parental objections), use of public opinion data to directly inform policy requires, at a minimum, a representative sample reflecting both the true diversity of views within the public and a method to justly account for the alternate views of the minority. Even if the sampled population were more …. (shrink)

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If you consult a medical textbook to learn about the pathogenesis of Lyme disease, you will find a standard narrative. You will learn the disease is caused by the spirochete Borrelia burgdorferi, which is transmitted to people by blacklegged ticks . You will also learn that the natural reservoir for spirochetes in the Northeast is thewhite-footed mouse , and also likely be told thatwhite-tailed deer are the primary host for gravid female ticks. And that is pretty (...) much the whole story. This limited perspective that considers only four species—spirochetes, mice, ticks, and deer—is entrenched by a reductionist paradigm, one that belies the nature of a .. (shrink)

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In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume XXVI, Number 1, April 2000, pp. 171-177 Hume's Revised Racism RevisitedAARON GARRETT John Immerwahr's brief note "Hume's Revised Racism" is doubtless one of the most intriguing recent discussions of Hume and racism.1 Immerwahr presents a thesis as to why Hume revised a footnote originally added to his essay "Of National Characters" (hereafter "ONC") in 1753. In this note I will examine and dispute Immerwahr's (...) thesis, which I believe can be shown to be seriously flawed. It is important to do so, as Immerwahr's note has been quoted a number of times in books and articles on Hume, and his thesis has been taken as gospel without sufficient examination of the grounds for his claims.2 As a consequence, Immerwahr's thesis is in danger of becoming a stubborn belief, even if not properly supportable. The controversy about Hume's racism centers on one infamous footnote added to the essay "Of National Characters" in the 1753-1754 edition of Essays and Treatises on Several Subjects. Why should we care about one footnote? We should care because the footnote seems to go against the image of a philosopher we thought we knew, and whom we likely esteem. In addition, it is shockingly bigoted. It reads in its entirety: I am apt to suspect the negroes, and in general all the other species of men (for there are four or five different kinds) to be naturally inferior to the whites. There never was a civilized nation of any other complexion thanwhite, nor even any individual eminent either in action or speculation. No ingenious manufactures amongst them, no arts, noAaron Garrett is at the Department of Philosophy, Boston University, 745 Commonwealth Avenue, Boston, MA 02215, USA. e-mail:[email protected] 172Aaron Ganett sciences. On the other hand, the most rude and barbarous of the whites, such as the ancient Germans, the present Tartars, have still something eminent about them, in their valour, form of government, or some other particular. Such a uniform and constant difference could not happen, in so many countries and ages, if nature had not made an original distinction betwixt these breeds of men. Not to mention our colonies, there are Negroe slaves dispersed all over Europe, of which none ever discovered any symptom of ingenuity; tho' low people, without education, will start up amongst us, and distinguish themselves in every profession. In Jamaica, indeed, they talk of one negroe as a man of parts and learning; but 'tis likely he is admired for very slender accomplishments, like a parrot, who speaks a few words plainly.3 The footnote was not present in the 1748 edition of the Essays, Moral and Political, or Three Essays, Moral and Political, where ONC first saw light. In the 1768 edition there is one very minor alteration (from "tho' low people" to "though low people"). In the 1770 edition the footnote becomes an endnote, M,4 and there are again a few minor changes (from "betwixt these breeds of men" to "between these breeds of men"; from "of which never discovered" to "of whom never discovered"; for "'tis likely he is admired," read "it is likely he is admired") and one interesting substantive change (for "admired for very slender accomplishments," read "admired for slender accomplishments"). The most important change from the 1753 version of the note is in the 1777 posthumous edition, which Hume had corrected before he died. Hume rewrote the first two lines of 177OM, to read in 1777M: I am apt to suspect the negroes to be naturally inferior to the whites. There scarcely ever was a civilized nation of that complexion, nor even any individual eminent either in action or speculation.5 In "Hume's Revised Racism," Immerwahr argues that it is likely that Hume, after reading James Beattie's "Essay On Truth" and in light of his criticisms, revised the footnote in the 1777 edition of ONC. Immerwahr cites two pieces of evidence, a letter from Hume to Strahan to which he refers but does not quote, and Beattie's criticisms of Hume, which Hume may have read (although how much of it he read... (shrink)

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At the head of The Colbert Report, one of the most popular shows on television, Stephen Colbert is a pop culture phenomenon. More than one million people backed his fake candidacy in the 2008 U.S. presidential election on Facebook, a testament to the particularly rich set of issues and emotions Colbert brings to mind. Stephen Colbert and Philosophy is crammed with thoughtful and amusing chapters, each written by a philosopher and all focused on Colbert's inimitable reality — from his word (...) creations (truthiness, wikiality, freem, and others) to his position as a faux-pundit who openly mocks Fox News and CNN. Although most of the discussion is centered around The Colbert Report, this collection does not neglect either his best-selling book, I Am America (And So Can You!), or his public performances, including his incendiary 2006White House Press Correspondents' Dinner speech. (shrink)

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Controlled elicitation of linguistic and psycholinguistic experimental data facilitate strong inferences about phonological, syntactic, semantic and pragmatic structures and functions, yet neglect the ecological validity of responses. Ecological validity in this paper refers to whether data gathered under controlled conditions are commensurate with routine problem solving and language use in natural settings. All methods produce "white room" effects that compromise data gathering and analysis. Unexamined folk knowledge and experiences also guide the investigator s interpretation of data from field research, (...) laboratories, testing sessions, and target sentences. Story recall data from children in a combined second-third grade classroom and their narrative responses to cartoons without sound are used to illustrate ecological validity issues. The child's spontaneous, imaginative narratives about the story and cartoons resemble adult folk theory, and their semantic content reveal sociocultural knowledge essential for understanding subjects ' reasoning and information processing skills. (shrink)

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The State You See uncovers a racial gap in the way the American government appears in people's lives. It makes it clear that public policy changes over the last fifty years have driven all Americans to distrust the government that they see in their lives, even though Americans of different races are not seeing the same kind of government. Forwhite people, these policy changes have involved a rising number of generous benefits submerged within America's tax code, which taken (...) together cost the government more than Social Security and Medicare combined. Political attention focused on this has helped make welfare and taxes more visible representations of government forwhite Americans. As a result,white people are left with the misperception that government does nothing for them, apart from take their tax money to spend on welfare. Distrust of government is the result. For people of color, distrust is also rampant but for different reasons. Over the last fifty years, America has witnessed increasingly overbearing policing and swelling incarceration numbers. These changes have disproportionately impacted communities of color, helping to make the criminal legal system a unique visible manifestation of government in these communities. While distrust of government emerges in both cases, these different roots lead to different consequences.White people are mobilized into politics by their distrust, feeling that they must speak up in order to reclaim their misspent tax dollars. In contrast, people of color are pushed away from government due to a belief that engaging in American elections will yield the same kind of unresponsiveness and violence that comes from interactions with the police. The result is a perpetuation of the same kind of racial inequality that has always been present in American democracy. The State You See is essential reading for anyone interested in understanding how the American government engages in subtle forms of discrimination and how it continues to uphold racial inequality in the present day. (shrink)

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In the “Qiwulun” 齊物論 chapter of the Zhuangzi, the author recommends a better way of arguing for a conclusion in the debates that are recorded in the books Discourse on Pointing at Things andWhite Horse Discourse 1:To use an attribute to show that attributes are not attributes is not as good as using a non-attribute to show that attributes are not attributes. To use a horse to show that a horse is not a horse is not as good (...) as using a non-horse to show that a horse is not a horse. Heaven and earth are one attribute; the ten thousand things are one horse.2Later in the same chapter, Zhuangzi gives a lengthy, disparaging speech on discerning the real winner in.. (shrink)

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Genomics research is regularly appropriated in social and political contexts to publicly legitimize unjust and malicious political views, policies, and actions. In recent years, there have been high‐profile cases of mass shooters, public intellectuals, and political insiders using genomics findings to convince audiences that deadly force and coercive policies against racial minorities are warranted. To create a just genomics, geneticists must consider what makes their research so attractive and adaptable for the legitimization of unjust ends and what they can do (...) to counter such appropriations. We offer insights and recommendations drawing from our research into the many ways onlinewhite nationalist and far‐right political movements mobilize genetics research to promote their racist, sexist, antisemitic, and homophobic views. First, geneticists should identify and change routine research practices that feed eugenic thinking. Second, geneticists should adopt creative extra‐scholarly communication efforts to counter the use of their field's research that occurs in nonscholarly spaces. Third, we identify permissive epistemological and professional practices within the genetics field that have enabled such unjust appropriations to thrive, and we recommend strategies for institutional reform. (shrink)

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A prominent way of explaining how race is socially constructed appeals to social positions and social structures. On this view, the construction of a person’s race is understood in terms of the person occupying a certain social position in a social structure. The aim of this paper is to give a metaphysically perspicuous account of this form of race construction. Analogous to functionalism about mental states, I develop an account of a ‘race structure’ in which various races (Black,White, (...) Asian, etc.) are functionally defined social positions. Individual persons occupy these social positions by ‘playing the role’ characteristic of those positions. The properties by which a person plays a race role, are the realizers for one’s race. I characterize the social construction of a person’s race in terms of a realization relation that satisfies a ‘subset’ condition on the social powers of raced persons. Races, on this view, are functionally defined, multiply realizable social kinds. The final section of the paper outlines some explanatory benefits of the account. (shrink)

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Patient report of functioning is one component of the neurocognitive exam following traumatic brain injury, and standardized patient-reported outcomes measures are useful to track outcomes during rehabilitation. The Traumatic Brain Injury Quality of Life measurement system is a TBI-specific extension of the PROMIS and Neuro-QoL measurement systems that includes 20 item banks across physical, emotional, social, and cognitive domains. Previous research has evaluated the responsiveness of the TBI-QOL measures in community-dwelling individuals and found clinically important change over a 6-month assessment (...) interval in a sample of individuals who were on average 5 years post-injury. In the present study, we report on the responsiveness of the TBI-QOL Cognition–General Concerns and Executive Function item bank scores and the Cognitive Health Composite scores in a recently injured sample over a 1-year study period. Data from 128 participants with complicated mild, moderate, or severe TBI within the previous 6 months were evaluated. The majority of the sample was male,white, and non-Hispanic. The participants were 18–92 years of age and were first evaluated from 0 to 5 months post-injury. Eighty participants completed the 1-year follow-up assessment. Results show acceptable standard response mean values for all measures and minimal detectable change values ranging from 8.2 to 8.8 T-score points for Cognition–General Concerns and Executive Functioning measures. Anchor rating analysis revealed that changes in scores on the Executive Function item bank and the Cognitive Health Composite were meaningfully associated with participant-reported changes in the areas of attention, multitasking, and memory. Evaluation of change score differences by a variety of clinical indicators demonstrated a small but significant difference in the three TBI-QOL change scores by TBI injury severity grouping. These results support the responsiveness of the TBI-QOL cognition measures in newly injured individuals and provides information on the minimal important differences for the TBI-QOL cognition measures, which can be used for score interpretation by clinicians and researchers seeking patient-reported outcome measures of self-reported cognitive QOL after TBI. (shrink)

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In Sounds, Ecologies, Musics, authors pose exciting challenges and provide fresh opportunities for scholars, scientists, environmental activists, and musicians to consider music and sound from ecological standpoints. The book covers topics such as how environment enables music and sound, how music and sound relate to Western environmental science, and mutidisciplinary collaborations among scholars.

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Svirsky, Howard, and Berman address the U.S. Food and Drug Administration ’s oversight of tobacco products, the newest major area of regulation Congress assigned to the FDA. They discus...

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The US government supports drug innovation. It is therefore crucial that it distinguish between high-value and low-value innovation in purchasing expensive prescription drugs and medical devices and ensure the continued discovery of transformative drugs and that patient and taxpayer funds are not wasted.

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Through an absorbing investigation into recent, high-profile scandals involving one of the largest kosher slaughterhouses in the world, located unexpectedly in Postville, Iowa,Aaron S. Gross makes a powerful case for elevating the category of the animal in the study of religion. Major theorists have almost without exception approached religion as a phenomenon that radically marks humans off from other animals, but Gross rejects this paradigm, instead matching religion more closely with the life sciences to better theorize human nature. (...) Gross begins with a detailed account of the scandals at Agriprocessors and their significance for the American and international Jewish community. He argues that without a proper theorization of "animals and religion," we cannot fully understand religiously and ethically motivated diets and how and why the events at Agriprocessors took place. Subsequent chapters recognize the significance of animals to the study of religion in the work of Ernst Cassirer, Emile Durkheim, Mircea Eliade, Jonathan Z. Smith, and Jacques Derrida and the value of indigenous peoples' understanding of animals to the study of religion in our daily lives. Gross concludes by extending the Agribusiness scandal to the activities at slaughterhouses of all kinds, calling attention to the religiosity informing the regulation of "secular" slaughterhouses and its implications for our relationship with and self-imagination through animals. (shrink)

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Only 19 new molecular entities and 3 biologics were approved by the Food and Drug Administration in 2007, the lowest rate in 24 years. This disappointing output occurred despite steady clinical trial and regulatory review times, the FDA maintaining high approval rates, and the pharmaceutical industry consistently reporting increasing revenues. A government report suggests that fewer new drug applications have been submitted to the FDA by the pharmaceutical industry in recent years. These data have rekindled the debate as to the (...) origins of pharmaceutical innovation and the comparative importance of public and private sources in contributing to drug discovery. The pharmaceutical industry contends that its research is responsible for most new medicines, and that the primary public institution supporting U.S. biomedical research, the National Institutes of Health, supports medical innovation “distinct from the process of drug development.”. (shrink)

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Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

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Teachers not only serve as caretakers for the students in their classroom but also serve as stewards for society's next generation. In this way, teachers are charged with responsibility for the present and the future of their world. Shouldering this responsibility is no less than an existential dilemma that requires not only professional solutions but also personal responsibility rooted in subjective authenticity. In the edited volume, authors will explore how the philosophy of Existentialism can help teachers, teacher educators, educational researchers, (...) and policymakers better understand the existential responsibility that teachers shoulder. The core concepts of Existential philosophy explored in this edited volume imply that a teacher's lived experience cannot be defined solely by professional knowledge or dictates. Teachers have the capacity to create subjective meaning through their own agency, and there is no guarantee that those subjective meanings will accord with professional dictates. Furthermore, there is no guarantee that professional dictates are more valid than the existential realities of individual teachers. The philosophy of Existentialism encourages individuals to reflect on the existential realities of isolation, freedom, meaninglessness, and death in an effort to propel individuals towards more authentic ways of engaging in the world. The chapters of this edited volume advance the argument that being and becoming a teacher must be understood - at least in part - from the subjective perspective of the individual and that teachers are responsible for authoring the meaning of their lives and of their work. (shrink)

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Glenberg's theory is rich and provocative, in our view, but we find fault with the premise that all memory representations are embodied. We cite instances in which that premise mispredicts empirical results or underestimates human capabilities, and we suggest that the motivation for the embodiment idea – to avoid the symbol-grounding problem – should not, ultimately, constrain psychological theorizing.

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From the earliest application of modern randomized controlled trials in medical research, scientists and observers have deliberated the ethics of randomly allocating study participants to trial control arms. Adaptive RCT designs have been promoted as ethically advantageous over conventional RCTs because they reduce the allocation of subjects to what appear to be inferior treatments. Critical assessment of this claim is important, as adaptive designs are changing medical research, with the potential to significantly shift how clinical trials are conducted. Policy-makers are (...) swiftly moving to encourage greater use of adaptive designs. In 2016, the newly enacted 21st Century Cures Act instructed the Food and Drug Administration to help product sponsors incorporate adaptive methods into proposed clinical trial protocols and applications for investigational drugs and also biological products. In this article, we review the ethical justifications commonly offered for adaptive designs, explore these arguments in the context of actual trials, and contend that clinical equipoise is a useful standard for adaptive-trial ethics. We distinguish between theoretical and clinical equipoise and explain why ethical arguments related to adaptive trials tend to focus on the former. Yet we contend that theoretical equipoise can be an unreliable standard for adaptive ethics. While we contend that clinical equipoise is the most critical principle for the primary ethical concerns posed by adaptive trials, we suggest ethical approaches to deal with some additional concerns unique to adaptive designs. (shrink)

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In recent years new discourses have emerged to inform philosophy and pedagogy in early childhood. These range from various postfoundational perspectives to objectivist accounts such as neuroscience in relation to brain development. Given the variety of competing narratives, the field is complex and multifaceted with potential to revision early childhood pedagogy through varied paradigms and philosophical orientations. This special issue sought scholarship on a range of philosophical perspectives about early childhood education, particularly those related to issues of pedagogy. In this (...) article, we develop an argument for philosophically informed pedagogy to balance some of the psychological and empirical approaches that dominate the field. Based on the provocations of the seven articles that comprise this issue, we argue for greater attention to subjective and even mysterious approaches to learning that call for ontological orientations to pedagogy as a relationship rather than a response or an intervention. (shrink)

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Legal challenges to the FDA’s approval of mifepristone have destabilized patients’ ability to access controversial medicines like medication abortion. We argue that federal courts’ receptiveness to this litigation undermines the coherence and integrity of prescription drug regulation in the U.S.

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The rising cost of the opioid antagonist and overdose reversal agent naloxone is an urgent public health problem. The recent and dramatic price increase of Evzio, a naloxone auto-injector produced by Kaléo, shows how pharmaceutical manufacturers entering the naloxone marketplace rely on market exclusivity guaranteed by the patent system to charge prices at what the market can bear, which can restrict access to life-saving medication. We argue that 28 U.S.C. § 1498, a section of the federal code that allows the (...) government to use patent-protected products for its own purposes in exchange for reasonable compensation, could be used to procure generic naloxone auto-injectors, or at least bring Kaléo to the negotiating table. Precedent exists for the use of § 1498 to procure pharmaceuticals, and it could give meaning to the federal government's recent declaration of a public health emergency around the opioid epidemic, discourage new market entrants from charging exorbitant prices, and yield important public health benefits. (shrink)

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I provide a brief précis ofAaron Zimmerman’s book, Belief: A Pragmatic Picture, then explore two possible problems for the view. The first concerns whether the account of belief can successfully intervene in the debate between those who hold emotions are partly constituted by evaluative beliefs and those who deny this. The second concerns whether the view can explain that distinctive form ofwhite ignorance that is manifest in an unwillingness to draw relatively obvious action-guiding beliefs from widely (...) shared information. Thinking about cases of this kind raises the question of whether Zimmerman’s account is problematically individualist, because of downplaying the importance of converging on an account of belief given the role of belief attribution in a suite of critical practices that are essential to communities of inquiry. If we, collectively, must commit to converging on an account of belief, but different accounts serve the interests of different groups, then the meta-level thesis that we should choose an account on pragmatic grounds raises the question of whose interests such an account should serve. (shrink)

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In many countries, health technology assessment organizations determine the economic value of new drugs and make recommendations regarding appropriate pricing and coverage in national health systems. In the US, recent policy proposals aimed at reducing drug costs would link drug prices to six countries: Australia, Canada, France, Germany, Japan, and the UK. We reviewed these countries’ methods of HTA and guidance on price and coverage recommendations, analyzing methods and guidance documents for differences in the methodologies HTA organizations use to conduct (...) their evaluations and considerations they use when making recommendations. We found important differences in the methods, interpretations of HTA findings, and condition-specific carve-outs that HTA organizations use to conduct evaluations and make recommendations. These variations have ethical implications because they influence the recommendations of HTA organizations, which affect access to the drug through national insurance and price negotiations with manufacturers. The differences in HTA approaches result from the distinct political, social, and cultural contexts of each organization and its value judgments. New cost-containment policies in the US should consider the ethical implications of the HTA reviews that they are considering relying on to negotiate drug prices and what values should be included in US pricing policy. (shrink)

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The US has found it hard to establish competition in the market for biologics, which are therapeutics derived from living cells. In the case of small-molecule drugs, the emergence of direct competition from generic drugs at the end of the exclusivity period has provided the impetus for price competition, leading to lower spending. In 2010, to spur competition in the biologics market, Congress created a simplified pathway for the US Food and Drug Administration (FDA) to approve comparable versions of biologic (...) drugs called biosimilars. Biosimilar competition in the US has nonetheless remained weaker than in European peer countries. For example, as of August 2020, there were 52 biosimilars available in Germany, and only 15 in the US.1 An important contributor to this “biosimilar gap” has been the fact that biosimilars to biologic blockbusters such as adalimumab (Humira) and etanercept (Enbrel) were only (or will only become) commercially available in the US several years after receiving FDA approval, while they were available in Europe years earlier.2 Through the end of 2021, it took biosimilars a median of 301 days between receiving FDA approval and becoming available for use.3 In one recent study, the median length of time between when a biologic drug was approved and when its first biosimilar was made available to US patients was 21.5 years.4 This paucity of competition has contributed to high US spending on biologics. According to the Department of Health and Human Services, in 2022 41% of US drug expenditures was spent on biologics, which represented 16% of US prescriptions.5. (shrink)

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The discovery and development of new therapeutics has always been central to improving health worldwide. However, there is ongoing concern regarding the current state of medical innovation. Output from the pharmaceutical industry has been criticized for not being “transformative,” that is, offering substantial improvements in patient outcomes over existing therapeutics. While the cost of drug development continues to rise, breakthrough therapies remain elusive and one half of Phase 3 studies fail. Venture capital, a traditional source of funding for new breakthrough (...) biomedical innovations, has decreased investment by 30% in the biotechnology and medical device sectors from 2007 to 2013. Stakeholders question whether the new drugs approved each year by the FDA —many criticized as marginal improvements over existing therapies — justify the enormous investment. (shrink)

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The way we refer to things in the world is shaped by the immediate physical context as well as the discourse history. But what part of the discourse history is relevant to language use in the present? In four experiments, we combine the study of task‐based conversation with measures of recognition memory to examine the role of physical contextual cues that shape what speakers perceive to be a part of the relevant discourse history. Our studies leverage the differentiation effect, a (...) phenomenon in which speakers are more likely to use a modified expression to refer to an object (e.g., dotted sock) if they had previously described a similar object (e.g., striped sock) than when they had not described a similar object. Two physical cues—the background that framed the to‐be‐described pictures and the position of the pictures in the display—were manipulated to alter perceptions about the relevant discourse context. We measured the rate with which speakers modify referring expressions to differentiate current from past referents. Recognition memory measures following the conversation probed what was and was not remembered about past discourse referents and contexts. Analysis of modification rates indicated that these contextual grouping cues shaped perceptions about the relevant discourse context. The contextual cues did not affect memory for the referents, but the memory for past referents was better for speakers than for listeners. Our findings show that perceptions about the relevant discourse history are a key determinant of how language is used in the moment but also that conversational partners form asymmetric representations of the discourse history. (shrink)

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We describe two unusual cases of cardiopulmonary death in mechanically ventilated patients in the neurological intensive care unit. After cardiac arrest, both patients were pulseless for a protracted period. Upon extubation, both developed agonal movements (gasping respiration) resembling life. We discuss these cases and the literature on the ethical and medical controversies associated with determining time of cardiopulmonary death. We conclude that there is rarely a single moment when all of a patient’s physiological functions stop working at once. This can (...) pose a challenge for determining the exact moment of death. (shrink)

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Many hold that the so-called golden era of antibiotic discovery has passed, leaving only a limited clinical pipeline for new antibiotics. A logical conclusion of such arguments is that we need to reform the current system of antibiotic drug research—including clinical trials and regulatory requirements—to spur activity in discovery and development. The United States Congress in the past few years has debated a number of bills to address this crisis, including the 2012 Generating Antibiotic Incentives Now Act and the 2016 (...) 21st Century Cures Act. Experts have also sought to advance antibiotic development by encouraging greater use of trials with noninferiority hypotheses, which are thought to be easier to conduct. The goal underlying these proposals is to stave off the post-antibiotic era by expanding the pharmaceutical armamentarium as quickly as possible. But although new antibiotic agents are necessary to combat the long-term threat of drug-resistant disease, we argue that these research policies, which effectively lower the bar for antibiotic approval, are ethically problematic. Rather, given broader public health considerations related to the full lifecycle of antibiotic use—including development of resistance—we should reject an overly permissive approach to new antibiotic approval and instead set the bar for regulatory approval at a point that will naturally direct research resources toward the most transformative chemical or social interventions. (shrink)

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Over-the-counter drugs are ubiquitous in the US. Policymakers have long debated how to modernize the system for making determinations of safety and effectiveness and addressing safety issues with OTC drugs.

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The “right to repair” movement highlights opportunities to reduce health care costs and promote public health resilience through increased competition in the way in which medical devices are serviced and updated over their lifespan. We review legislative and legal facets of third-party repair of medical devices, and conclude with specific recommendations to help this market function more efficiently to the benefit of patients and health care systems.

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The phrase military ethics is sometimes regarded as a contradiction in terms. To some, the idea of ethics seems out of touch with modern realities and sensibilities. "How can an external moral standard dictate one's actions?" some might ask. Ethics can therefore bring up memories of bygone eras that seem irrelevant. Coupled with the qualifier military, ethics can seem even more puzzling. Ethics is not merely a concern for past eras, but is increasingly relevant in an age of rapid technological (...) and societal development. From its beginning, our nation's military leaders have viewed ethics as imperative to the task of warfighting. This is a refrain echoed by contributions to this book who address a range of issues concerning political actors, technological capabilities, and societal shifts of the past and the present. And in commemorating the centenary of World War I, it is appropriate to consider the ethics of warfare. This book helpfully relates lessons from the past to the major ethical issues of modern warfare. By providing diverse reflections on the history of military ethics and challenges of contemporary and future warfare, this book serves as a repository of meaningful material for a new generation of warfighters to develop their own faculties of ethical judgment. (shrink)

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