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In this article, we analyse the tensions associated with the emergence of microorganism-based agricultural inputs in two Latin American countries, Brazil and Mexico. More specifically, we examine the ways in which these technologies, which are based on the use of living organisms, leave public microbiology research laboratories and are further developed by manufacturers or farmers. To this end, we draw on the concept of the ‘laboratorisation’ of society, part of the actor-network theory. We show that the emergence of these technologies (...) is currently facing a number of challenges, due to the risks associated with their biological nature and the difficulty involved in establishing production processes as reliable as those used in reference laboratories. Whether produced by companies or on farms, the quality and safety of the practices and of these products are the subject of debate, as well as the focus of scientific, economic and political scrutiny. These microbiological inputs are evidence for the transformation of the relationship between science, industry, users and politics that is taking place around the emergence of alternatives to synthetic chemical inputs in agriculture, and more broadly, about the use of microbiological resources in agriculture. (shrink)

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The concept of affordances is rapidly gaining traction in the philosophy of mind and cognitive sciences. Affordances are opportunities for action provided by the environment. An important open question is whether affordances can be used to explain mental action such as attention, counting, and imagination. In this paper, we critically discuss McClelland’s (‘The Mental Affordance Hypothesis’, 2020, Mind, 129(514), pp. 401–427) mental affordance hypothesis. While we agree that the affordance concept can be fruitfully employed to explain mental action, we argue (...) that McClelland’s mental affordance hypothesis contain remnants of a Cartesian understanding of the mind. By discussing the theoretical framework of the affordance competition hypothesis, we sketch an alternative research program based on the principles of embodied cognition that evades the Cartesian worries. We show how paradigmatic mental acts, such as imagination, counting, and arithmetic, are dependent on sensorimotor interaction with an affording environment. Rather than make a clear distinction between bodily and mental action, the mental affordances highlight the embodied nature of our mental action. We think that in developing our alternative research program on mental affordances, we can maintain many of the excellent insights of McClelland’s account without reintroducing the very distinctions that affordances were supposed to overcome. (shrink)

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Health care organizations are constantly seeking ways to improve quality of care and one of the often-posed solutions to deliver ‘good care’ is reflexivity. Several authors stress that enhancing the organizations’ and caregivers’ reflexivity allows for more situated, and therefore better care. Within quality improvement initiatives, devices that guarantee quality are also seen as key to the delivery of good care. These devices do not solely aim at standardizing work practices, but are also of importance in facilitating reflexivity. In this (...) article, we study how quality improvement devices position the relationship between situated reflection and standardization of work processes. By exploring the work of Michel Callon, Michael Lynch, and Lucy Suchman on reflexivity in work practices, we study the development and introduction of the Care Living Plan. This device aimed to transform care organizations of older people from their orientation towards the system of care into organizations that take a client-centred approach. Our analysis of the construction of specific forms of reflexivity in quality devices indicates that the question of reflexivity does not need to be opposed to standardization and needs to be addressed not only at the level of where reflexivity is organizationally situated and who gets to do the reflecting, but also on the content of reflexivity, such as what are the issues that care workers can and cannot reflect upon. In this paper we point out the theoretical importance of a more detailed empirical study of the framing of reflexivity in care practices. (shrink)

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Ulrich Beck's best selling Risk Society established risk on the sociological agenda. It brought together a wide range of issues centering on environmental, health and personal risk, provided a rallying ground for researchers and activists in a variety of social movements and acted as a reference point for state and local policies in risk management. The Risk Society and Beyond charts the progress of Beck's ideas and traces their evolution. It demonstrates why the issues raised by Beck reverberate widely throughout (...) social theory and covers the new risks that Beck did not foresee, associated with the emergence of new technologies, genetic and cybernetic. The book is unique because it offers both an introduction to the main arguments in Risk Society and develops a range of critical discussions of aspects of this and other works of Beck. (shrink)

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Marie vanLoon | : In this paper, I argue that Alfred Mele’s conception of self-deception is such that it always fulfils the reasons-responsiveness condition for doxastic responsibility. This is because self-deceptive mechanisms of belief formation are such that the kind of beliefs they bring about are the kind of beliefs that fulfil the criteria for doxastic responsibility from epistemic reasons responsiveness. I explain why in this paper. Mele describes the relation of the subject to the evidence as a (...) biased relation. The subject does not simply believe on the basis of evidence, but on the basis of manipulated evidence. Mele puts forward four ways in which the subject does this. The subject could misinterpret positively or negatively, selectively focus, or gather evidence. Through these ways of manipulation, the evidence is framed such that the final product constitutes evidence on the basis of which the subject may believe a proposition that fits that subject’s desire that P. Whichever form of manipulation the subject uses, the evidence against P must be neutralized in one way or another. Successful neutralization of the evidence requires the ability to recognize what the evidence supports and the ability to react to it. These abilities consist precisely in the two parts of the reasons-responsiveness condition, reasons receptivity and reasons reactivity. In that sense, self-deceptive beliefs always fulfil the reasons-responsiveness condition for doxastic responsibility. However, given that reasons responsiveness is only a necessary condition for doxastic responsibility, this does not mean that self-deceived subjects are always responsible for their belief. | : Dans cet article, je soutiens que la conception d’auto-illusion chez Alfred Mele remplit toujours l’une des conditions de la responsabilité doxastique, à savoir la « sensibilité aux raisons ». Il en est ainsi car les mécanismes d’auto-illusion dans la formation de croyances produisent des types de croyances qui remplissent les critères pour la responsabilité doxastique quant à la sensibilité aux raisons épistémiques. J’explique pourquoi dans cet article. Mele décrit la relation du sujet à la preuve comme biaisée. Le sujet ne croit pas seulement sur la base de preuves, mais de preuves manipulées. Mele avance quatre façons qu’a le sujet de faire ceci. Le sujet peut mal interpréter positivement ou négativement, focaliser de façon sélective, ou accumuler des preuves. Par ces formes de manipulations, la preuve est formulée de sorte qu’elle produise un fondement pour la croyance en une proposition qui s’accorde avec le désir du sujet que P. Peu importe la forme de manipulation qu’emploie le sujet, la preuve contre P doit être neutralisée d’une façon ou d’une autre. Une neutralisation réussie de la preuve requiert la capacité de reconnaître ce que soutient la preuve et la capacité d’y réagir. Ces capacités consistent précisément en ces deux parties de la condition de la sensibilité aux raisons, soit la réceptivité et la réactivité aux raisons. En ce sens, les croyances d’auto-illusion remplissent toujours la condition de la sensibilité aux raisons pour la responsabilité doxastique. Toutefois, étant donné que la sensibilité aux raisons n’est une condition nécessaire que pour la responsabilité doxastique, cela ne veut pas dire que les sujets souffrant d’auto-illusion sont toujours responsables de leurs croyances. (shrink)

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This special issue arises from the observation that an exploration of the role of non-evidential considerations in epistemology through a broader lens is missing from the current landscape of philosophical research. The present collection of contributions fills this research gap by bringing together three central and much-discussed epistemological topics for which non-evidential considerations become relevant.

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According to a popular view, excuses undermine blameworthiness. At the same time, philosophers commonly accept that blameworthiness is composed of two necessary conditions: a moral objectionability condition and a responsibility condition. For excuses to do their job, they must undermine at least one of these conditions. In this paper, I conclude that excuses do neither. By inference to the best explanation, I propose a view that reconciles this conclusion with the function of excuses.

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It is widely believed that implicit bias is common and that it contributes, in part, to the perpetuation of systemic injustice. Hence, the existence of implicit bias raises the question: can individuals be blameworthy for their implicit bias? Here, I consider what it is about implicit bias that renders agents blameworthy. I defend the claim that, when individuals omit to engage in activities that could prevent the influence of implicit bias on their behavior, they may be blamed for their implicit (...) bias. The plausibility of my proposal depends on whether individuals are able to engage freely in such activities and on whether there exists an obligation not to be biased (broadly put). I will answer positively to the former question and open the way for an answer to the latter, and tougher, question. (shrink)

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In this paper I argue that a prominent account of doxastic responsibility, Epistemic Reasons-Responsiveness can be amended to avoid two problems with its treatment of delusions. I do so by appealing to Carolina Flores’ recent work on the evidence-responsiveness of delusions: by excluding what Flores calls masking factors from the mechanism of reasons-responsiveness, we are able to accommodate the possibility for individuals with delusions to be responsible for their belief. I conclude by motivating that this possibility is one we should (...) care about. (shrink)

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This article deals with the birth of `the virus' as an object of technoscientific analysis. The aim is to discuss the process of objectification of pathogen virulence in virological and medical discourses. Through a short excursion into the history of modern virology, it will be argued that far from being a matter of fact, pathogen virulence had to be `produced', for example in petri-dishes, test-kits and hyper-real signification-practices. The now commonly accepted objective status of `the virus' has been an accomplishment (...) of a complex ensemble of actors. Indeed, this illustrates why objectification rather than objectivity has become the main focus of science and technology studies. The objectification of `the' virus was by no means a smooth process. It involved more than five decades of highly speculative and fragmented research projects before it became actualized as a separate discipline under the heading of virology. The specific objectification of viruses took place through an inter-disciplinary de-differentiation of research questions, methodologies, techniques and technologies. The main argument of this article is that viruses only became intelligible after the establishment of a virology-assemblage. Its inauguration in the early 1950s was radical and sudden because only then could the various substrands of virological technoscience affect each other through deliberate enrolment, and engender a universal intelligibility. (shrink)

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Network is a device for organizing and conceptualizing non-linear complexity. Networks defy narrative, chronology and thus also genealogy because they entail a multiplicity of traces. Networks problematize boundaries and centrality but intensify our ability to think in terms of flows and simultaneity. As a concept, network has been highly conducive to theorizing phenomena and processes such as globalization, digital media (Internet), speed, symbiosis and complexity. This in turn enables us to rethink what constitutes the foundations of intelligence, knowledge and even (...) life itself. One particularly useful application of network as a concept is the notion of the gift, which is often seen as the archetypical figure for understanding the nature of economics and social relationships. (shrink)

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BackgroundRadiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve all patients who would benefit from it. Allocation systems are needed to guide patient prioritization for radiotherapy in resource-limited contexts. These systems should be informed by allocation principles deemed relevant to stakeholders. This study explores the ethical dilemmas and views of decision-makers engaged in real-world prioritization of scarce radiotherapy resources at a cancer center in Rwanda in order to identify relevant principles.MethodsSemi-structured interviews (...) were conducted with a purposive sample of 22 oncology clinicians, program leaders, and clinical advisors. Interviews explored the factors considered by decision-makers when prioritizing patients for radiotherapy. The framework method of thematic analysis was used to characterize these factors. Bioethical analysis was then applied to determine their underlying normative principles.ResultsParticipants considered both clinical and non-clinical factors relevant to patient prioritization for radiotherapy. They widely agreed that disease curability should be the primary overarching driver of prioritization, with the goal of saving the most lives. However, they described tension between curability and competing factors including age, palliative benefit, and waiting time. They were divided about the role that non-clinical factors such as social value should play, and agreed that poverty should not be a barrier.ConclusionsMultiple competing principles create tension with the agreed upon overarching goal of maximizing lives saved, including another utilitarian approach of maximizing life-years saved as well as non-utilitarian principles, such as egalitarianism, prioritarianism, and deontology. Clinical guidelines for patient prioritization for radiotherapy can combine multiple principles into a single allocation system to a significant extent. However, conflicting views about the role that social factors should play, and the dynamic nature of resource availability, highlight the need for ongoing work to evaluate and refine priority setting systems based on stakeholder views. (shrink)

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Background: Audio-visual teleconsultation is expected to help home-based palliative patients, hospital-based palliative care professionals, and family physicians to jointly design better, pro-active care. Consensual knowledge of the possibilities and limitations of teleconsultation in transmural palliative care is, however, largely lacking.This paper aims at describing elements of both the physical workplace and the cultural-social context of the palliative care practice, which are imperative for the use of teleconsultation technologies. Methods: A semi-structured expert meeting and qualitative, open interviews were deployed to explore (...) professionals’ assumptions and wishes, which are considered to contain latent presumptions about the practice’s physical workplace and latent elements of the cultural-social context, regarding (1) the mediating potential of audio-visual teleconsultation, (2) how the audio-visual teleconsultations will affect medical practice, and (3) the design and usage of the teleconsultation technology. We used a qualitative analysis to investigate how palliative care professionals interpret the teleconsultation package in preparation. The analysis entailed open and axial coding techniques developed in a grounded theory approach. Results: Respondents assume: 1. teleconsultation will hinder physical proximity, thereby compromising anamnesis and diagnosis of new or acutely ill patients as well as “real contact” with the person behind the patient; 2. teleconsultation will help patients becoming more of a pivotal figure in their own care trajectory; 3. they can use teleconsultation to keep a finger on the pulse; 4. teleconsultations have a healing effect of their own due to offered time and digital attention; 5. teleconsultation to open up an additional “gray” network outside the hierarchical structures of the established chain of transmural palliative care. This network could cause bypassing of caregivers and uncertainty about responsibilities; 6. teleconsultations lead to an extended flow of information which helps palliative care professionals to check the stories of patients and medical specialists. Conclusions: Professionals assume teleconsultation co-defines a new patient–professional relationship by extending hospital-based caregivers’ perceptions of as well as attention for their patients. At the cost, however, of clinical and personal connectedness. Secondly, a hermeneutics is needed to carefully interpret teleconsultation images. Thirdly, teleconsultations transform caregiving cultures as formerly separated care domains collide, demanding a redefinition of roles and responsibilities. (shrink)

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A variety of logical frameworks have been developed to study rational agents interacting over time. This paper takes a closer look at one particular interface, between two systems that both address the dynamics of knowledge and information flow. The first is Epistemic Temporal Logic (ETL) which uses linear or branching time models with added epistemic structure induced by agents’ different capabilities for observing events. The second framework is Dynamic Epistemic Logic (DEL) that describes interactive processes in terms of epistemic event (...) models which may occur inside modalities of the language. This paper systematically and rigorously relates the DEL framework with the ETL framework. The precise relationship between DEL and ETL is explored via a new representation theorem characterizing the largest class of ETL models corresponding to DEL protocols in terms of notions of Perfect Recall , No Miracles , and Bisimulation Invariance . We then focus on new issues of completeness . One contribution is an axiomatization for the dynamic logic of public announcements constrained by protocols, which has been an open problem for some years, as it does not fit the usual ‘reduction axiom’ format of DEL. Finally, we provide a number of examples that show how DEL suggests an interesting fine-structure inside ETL. (shrink)

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Current dynamic-epistemic logics model different types of information change in multi-agent scenarios. We generalize these logics to a probabilistic setting, obtaining a calculus for multi-agent update with three natural slots: prior probability on states, occurrence probabilities in the relevant process taking place, and observation probabilities of events. To match this update mechanism, we present a complete dynamic logic of information change with a probabilistic character. The completeness proof follows a compositional methodology that applies to a much larger class of dynamic-probabilistic (...) logics as well. Finally, we discuss how our basic update rule can be parameterized for different update policies, or learning methods. (shrink)

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Involving patients in decisions on primary prevention can be questioned from an ethical perspective, due to a tension between health promotion activities and patient autonomy. A nurse-led intervention for prevention of cardiovascular diseases, including counselling (risk communication, and elements of shared decision-making and motivational interviewing) and supportive tools such as a decision aid, was implemented in primary care. The aim of this study was to evaluate the nurse-led intervention from an ethical perspective by exploring in detail the experiences of patients (...) with the intervention, and their views on the role of both the nurse and patient. The study had a qualitative design. 18 patients who had received the intervention participated. Data were gathered by in-depth interviews. The interviews were analysed using directed content analysis. The findings revealed that patients perceived the consultations not as an infringement on their autonomy, but as supportive to risk reduction efforts they tried but found hard to realise. They specifically emphasised the role of the nurse, and appreciated the nurse's realistic advice, encouragement, and help in understanding. Patients' views on and experiences with risk management are in line with notions of relational autonomy, caring cooperation and communicative action found in the literature. We conclude that patients define the relationship with the nurse as shared work in the process of developing a healthier lifestyle. (shrink)

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An important and supposedly impactful form of clinical ethics support is moral case deliberation. Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. A systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science. Both the data collection and the (...) qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of our decisions. The qualitative analysis was supported by ATLAS.ti. Based on a qualitative analysis of 25 empirical papers, we identified four clusters of themes: 1) facilitators and barriers in the preparation and context of MCD, i.e., a safe and open atmosphere created by a facilitator, a concrete case, commitment of participants, a focus on the moral dimension, and a supportive organization; 2) changes that are brought about on a personal and inter-professional level, with regard to professional’s feelings of relief, relatedness and confidence; understanding of the perspectives of colleagues, one’s own perspective and the moral issue at stake; and awareness of the moral dimension of one’s work and awareness of the importance of reflection; 3) changes that are brought about in caring for patients and families; and 4) changes that are brought about on an organizational level. This review shows that MCD brings about changes in practice, mostly for the professional in inter-professional interactions. Most reported changes are considered positive, although challenges, frustrations and absence of change were also reported. Empirical evidence of a concrete impact on the quality of patient care is limited and is mostly based on self-reports. With patient-focused and methodologically sound qualitative research, the practice and the value of MCD in healthcare settings can be better understood, thus making a stronger case for this kind of ethics support. (shrink)

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Many logical systems today describe intelligent interacting agents over time. Frameworks include Interpreted Systems (IS, Fagin et al. [8]), Epistemic-Temporal Logic (ETL, Parikh & Ramanujam [22]), STIT (Belnap et al. [5]), Process Algebra and Game Semantics (Abramsky [1]). This variety is an asset, as different modeling tools can be fine-tuned to specific applications. But it may also be an obstacle, when barriers between paradigms and schools go up. This paper takes a closer look at one particular interface, between two systems (...) that both address the dynamics of knowledge and information flow in multi-agent systems. One is IS/ETL (IS and ETL are, from a technical point of view, the same up to model transformations, cf. [20]), which uses linear or branching time models with added epistemic structure induced by agents’ different capabilities for observing events. These models provide a Grand Stage where histories of some process unfold constrained by a protocol, and a matching epistemic-temporal language describes what happens. The other framework is Dynamic Epistemic Logic (DEL, [10, 4, 34]) that describes interactive processes in terms of epistemic event models which may occur inside modalities of the language. Temporal evolution is then computed from some initial epistemic model through a process of successive ‘product updates’. It has long been unclear how to best compare IS/ETL and DEL. Various aspects have been investigated in [10, 30, 32], but in this paper, we study the interface in a more systematic way. Often, DEL and ETL are presented as alternative ways of adding dynamics to multi-agent epistemic models. In this paper, we rather focus on how merging the two different modeling choices leads to interesting new questions. Our leading interest here will be a view of informational processes as evolving over time. To see what we mean, consider the simplest version of DEL, viz. the logic of public announcements PAL ([23]) which adds a very specific type of communicative 1 action to epistemic models: a public announcement.. (shrink)

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Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

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There is a claim that clinical ethics support services (CESS) improve healthcare quality within healthcare organisations. However, there is lack of strong evidence supporting this claim. Rather, the current focus is on the quality of CESS themselves or on individual learning outcomes. In response, this article proposes a theoretical framework leading to empirical hypotheses that describe the relationship between a specific type of CESS, moral case deliberation and the quality of care at the organisational level. We combine insights from the (...) literature on CESS, organisational learning and quality improvement and argue that moral case deliberation causes healthcare professionals to acquire practical wisdom. At the organisational level, where improving quality is a continuous and collective endeavour, this practical wisdom can be aggregated into morisprudence, which is an ongoing formulation of moral judgements across cases encountered within the organisation. Focusing on the development of morisprudence enables refined scrutinisation of CESS-related quality claims. (shrink)

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BackgroundVarious forms of Clinical Ethics Support (CES) have been developed in health care organizations. Over the past years, increasing attention has been paid to the question of how to foster the quality of ethics support. In the Netherlands, a CES quality assessment project based on a responsive evaluation design has been implemented. CES practitioners themselves reflected upon the quality of ethics support within each other’s health care organizations. This study presents a qualitative evaluation of this Responsive Quality Assessment (RQA) project.MethodsCES (...) practitioners’ experiences with and perspectives on the RQA project were collected by means of ten semi-structured interviews. Both the data collection and the qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of the decisions.ResultsThe main findings illustrate the relevance of the RQA with regard to fostering the quality of CES by connecting to context specific issues, such as gaining support from upper management and to solidify CES services within health care organizations. Based on their participation in the RQA, CES practitioners perceived a number of changes regarding CES in Dutch health care organizations after the RQA: acknowledgement of the relevance of CES for the quality of care; CES practices being more formalized; inspiration for developing new CES-related activities and more self-reflection on existing CES practices.ConclusionsThe evaluation of the RQA shows that this method facilitates an open learning process by actively involving CES practitioners and their concrete practices. Lessons learned include that “servant leadership” and more intensive guidance of RQA participants may help to further enhance both the critical dimension and the learning process within RQA. (shrink)

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Business Ethics: A European Review, Volume 30, Issue 2, Page 188-201, April 2021.

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