82 research outputs found

    The New Paradox of the Stone

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    Why neuroscience does not disprove free will

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    While the question whether free will exists or not has concerned philosophers for centuries, empirical research on this question is relatively young. About 35 years ago Benjamin Libet designed an experiment that challenged the common intuition of free will, namely that conscious intentions are causally efficacious. Libet demonstrated that conscious intentions are preceded by a specific pattern of brain activation, suggesting that unconscious processes determine our decisions and we are only retrospectively informed about these decisions. Libet-style experiments have ever since dominated the discourse about the existence of free will and have found their way into the public media. Here we review the most important challenges to the common interpretation of Libet-style tasks and argue that the common interpretation is questionable. Brain activity preceding conscious decisions reflects the decision process rather than its outcome. Furthermore, the decision process is configured by conditional intentions that participants form at the beginning of the experiment. We conclude that Libet-style tasks do not provide a serious challenge to our intuition of free will

    Free Will, Moral Responsibility, and Scientific Epiphenomenalism

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    This article addresses two influential lines of argument for what might be termed “scientific epiphenomenalism” about conscious intentions – the thesis that neither conscious intentions nor their physical correlates are among the causes of bodily motions – and links this thesis to skepticism about free will and moral responsibility. One line of argument is based on Benjamin Libet’s neuroscientific work on free will. The other is based on a mixed bag of findings presented by social psychologist Daniel Wegner. It is argued that both lines of argument are unsuccessful

    Have Compatibilists Solved the Luck Problem for Libertarians?

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    A pair of compatibilists, John Fischer (2012: ch. 6; n.d.) and Manuel Vargas (2012) have responded to a problem about luck that Alfred Mele (2005, 2006) posed for incompatibilist believers in free will and moral responsibility. They offer assistance to libertarians - at least on this front. In this paper, we assess their responses and explain why what they offer is inadequate for libertarian purposes

    The BCN Challenge to Compatibilist Free Will and Personal Responsibility

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    Many philosophers ignore developments in the behavioral, cognitive, and neurosciences that purport to challenge our ideas of free will and responsibility. The reason for this is that the challenge is often framed as a denial of the idea that we are able to act differently than we do. However, most philosophers think that the ability to do otherwise is irrelevant to responsibility and free will. Rather it is our ability to act for reasons that is crucial. We argue that the scientific findings indicate that it is not so obvious that our views of free will and responsibility can be grounded in the ability to act for reasons without introducing metaphysical obscurities. This poses a challenge to philosophers. We draw the conclusion that philosophers are wrong not to address the recent scientific developments and that scientists are mistaken in formulating their challenge in terms of the freedom to do otherwise

    Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

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    Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research
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