Medical Informatics and the Concept of Disease

This paper attempts to address the general questionwhether information technologies, as applied in thearea of medicine and health care, have or are likelyto change fundamental concepts regarding disease andhealth. After a short excursion into the domain ofmedical informatics I provide a brief overview of someof the current theories of what a disease is from amore philosophical perspective, i.e. the ``valuefree' and ``value laden' view of disease. Next, Iconsider at some length, whether health careinformatics is currently modifying fundamentalconcepts of disease. To this question I will answerlargely in the negative, and I will provide the sketchof some arguments from current research programs inmedical informatics why I think this is the case. Thisargumentation is supported by a detailed account ofhow the disease profile for beriberi heart disease,used in one of the major medical informaticsdiagnostic programs, QMR (and its ancestorINTERNIST-1), was developed, and why at least thisprogram essentially follows received views oftraditional medicine.The one main exception to theconformity of this program to ``received' views of adisease occurs when the program's designers need tofine-tune a disease definition. This fine-tuning is tocomport with the expert's perspective on the disease,including his or her epistemic values, as well as theprogram's other resources for diagnosing components ofa disease.     

WHAT DOES A PIGEON SEE IN A PICASSO?

The present paper is primarily a response to Watanabe, Sakamoto, and Wakita's 1995 paper “Pigeons' Discrimination of Paintings by Monet and Picasso.” Our main criticism is that the key term concept, and in particular the way in which a class of stimuli is specified, remains equivocal. We argue that it is only useful to study categorization if the organism in question can be expected to have access to the information that is used in defining the classes, and that evidence for categorization requires selective responses that cannot be attributed to similarity in features that are not essential to the classification.     

Stimulus class formation and concept learning: establishment of within- and between-set generalization and transitive relationships via conditional discrimination procedures

Three students with moderate mental retardation were taught a complex stimulus class with a two-choice conditional discrimination procedure applied across eight 10-member stimulus sets. Each set was composed of five age-appropriate and five age-inappropriate examples of clothing, accessories, and leisure items (e.g., a Walkman radio). Discrimination training was programmed serially across each set, and generalization probes were conducted concurrently among all sets. Generalization probes consisted of unreinforced conditional matching trials with comparison items being drawn from (a) the set undergoing training (within-set probes), (b) sets not undergoing training (between-set probes), and (c) both sample and comparison items from different sets (transitive stimulus control probes). Results indicate that within-set generalization, between-set generalization, and transitive stimulus relations controlled responding by all 3 students for items that had been contingently associated with reinforcement. However, items that gained control of responding through within-set and between-set generalization alone (i.e., not acquired through contingent reinforcement) remained at baseline levels during transitive stimulus control probes. Results are discussed in terms of a taxonomy of multiple sources of stimulus control that underlie socially defined and maintained stimulus classes.     

Number concepts for the concept empiricist

Dove (2009) and Machery (2007) both argue that recent findings about the nature of numerical representation present problems for Concept Empiricism (CE). I shall argue that, whilst this evidence does challenge certain versions of CE, such as Prinz (2002), it needn’t be seen as problematic to the general CE approach. Recent research can arguably be seen to support a CE account of number concepts. Neurological and behavioral evidence suggests that systems involved in the perception of numerical properties are also implicated in numerical cognition. Furthermore, the discovery of associations between spatial and numerical representations also lends independent support to a CE approach. Although these findings support CE in general, certain versions of the theory may need revising in order to accommodate them. In particular, it may be necessary to either jettison Prinz's (2002) Modal Specificity Hypothesis or to revise one’s method for individuating modal representational formats.     

Developmental stages,Piagetian stages in particular: A critical review

Developmental stages in general and Piaget's stages in particular have given rise to considerable controversy. Much of this controversy revolves around the responses that have been given to the following five central questions: (1) Do developmental stages exist? (2) If they exist, where are they? (3) What features define a developmental sequence as a sequence of developmental stages? (4) What psychological processes underlie developmental change? (5) Should we abandon the concept of developmental stages? The main goal of this paper is to present a critical review of such responses, while arguing for a strong conception of development and a “non-received” view of Piaget's theory. After an introduction section, we elaborate on each of the five questions. Finally, we present several reasons why this paper often appeals to Piaget's theory, and why his theory has been greatly misunderstood.     

从摩梭人的词汇看人类概念的发展

通过调查摩梭人的词汇研究人类概念的发展。摩梭人到本世纪七十年代还盛行母系家 庭,至今没有文字。调查方法是从小学汉语文课本中选出一批常用词汇,把当地摩梭和汉两种 语文水平最高的几个知识分子请到一起,逐词逐字地共同讨论,核实提供调查的词汇在摩梭 语中是否有对应词。不论有无对应词均以全体同意为准。结果表明,摩梭人词汇数量较少,范 围较窄,概括和具体化的程度都不高。作者认为,由摩梭词汇标志的概念发展状况,可作人类 概念发展早期的一个例证。     

医疗纠纷产生的法律根源及对策

当前,我国的医疗纠纷案件逐年增多。卫生立法滞后、违法现象严重、执法不统一、患者法律意识增强、鉴定程序不合理是产生医疗纠纷的重要法律根源。提出的对策：（１） 加快卫生立法,创建良好的法制环境;（２） 完善处理医疗纠纷的法律;（３） 严格执法;（４） 开展法制宣传工作,提高医患双方的法制观念。     

应当建立科学的医疗纠纷技术鉴定体制

现行的医疗纠纷技术鉴定模式年来在解决医疗纠纷中起到了重要作用,但随着卫生改革的进一步深化和法制的日趋健全,以及人们法律意识的不断提高它的缺陷也日益突出。应当建立新的医疗技术鉴定管理体制,鉴定委员会的人员鸺成,增强医疗技术透明度,建立时效制度和回避制度。     

On the Logical Positivists' Theory of Truth: The Fundamental Problem and a New Perspective

The present article purports to show that the protocol sentence debate, pursued by some leading members of the Vienna Circle in the mid-1930s, was essentially a controversy over the explanation and the real significance of the concept of truth. It is further shown that the fundamental issue underlying the discussions about the concept of truth was the relationship between form and content, as well as between logic/language and the world. R. Carnap was the philosopher who most explicitly and systematically attempted to come to grips with this problem. It is shown that the form-content distinction pervades the three most important phases of Carnap's philosophical development: the structuralist (in Der logische Aufbau der Welt), the syntactical and the semantical. His final semantical stance is essentially determined by the concept of linguistic frameworks. The article purports to demonstrate that this concept cannot be dispensed with in philosophy, but that Carnap failed to work out its ontological implications. Finally, the concept of an internal ontology is briefly delineated. This revised version was published online in August 2006 with corrections to the Cover Date.     

Formation of the sameness-difference concept by Japanese monkeys from a small number of color stimuli

Japanese monkeys were trained to form the sameness-difference concept. In Experiment 1, four monkeys were trained with two colors to discriminate matching stimulus pairs from nonmatching pairs by reinforcing only lever-pressing responses to matching pairs with a variable-interval schedule. Three monkeys showed successful transfer of this discrimination to two new colors, thus demonstrating that some Japanese monkeys are able to form this relational concept from a minimum number of stimuli. In Experiment 2, two monkeys were trained, in a Yes/No procedure with three colors, to press one lever under matching pairs and another lever under nonmatching pairs. Poor transfer performances to three new colors suggest that simultaneously establishing two different response patterns to matching and nonmatching pairs is ineffective in forming the concept. In Experiment 3, the amount of transfer to three new colors after mastering a standard three-color matching-to-sample task was compared with that of a modified task in which correct responses were reinforced with a within-trial variable-interval schedule. All three monkeys showed greater transfer with the modified procedure. The results suggest that the variable-interval schedule adopted within trials is effective in forming the sameness-difference concept.