In the space of reasonable doubt

This paper explores ‘reasonable doubt’ as an enlightening notion to think of reasoning and decision-making generally, beyond the judicial domain. The paper starts from a decision-theoretic understanding of the notion, whereby it can be defined in terms of degrees of belief and a probabilistic confirmation threshold for action. It then highlights some of the limits of this notion, and proposes a richer analysis of epistemic states and reasoning through the lens of ‘reasonable doubt’, which in turn is likely to supplement the DT framework. The strategy consists in fighting on two fronts: with DT, the paper claims that there is no absolute (i.e. decision-independent) notion of ‘reasonable doubt’ but, pace DT, it shows that reasonable doubt cannot be accounted for only in terms of degrees of belief and probabilistic threshold. We argue that the lens of reasonable doubt sheds light on aspects of belief dynamics, as well as of the nature of epistemic attitudes, which are often obscured by belief-centred approaches. In particular, when it comes to acknowledging the necessary ignorance and irreducible uncertainty that we face in our everyday-life decisions, studying the various facets of doubt rather than focusing on what can be believed, enables one to do justice to the richness and diversity of the mental states in play

Biological Staging of Incipient, in Situ, and Invasive Breast Carcinomas

The objective of breast cancer staging is to help define the natural history of tumor progression and clinical behavior. Experimental models showed different pathways for the development of breast tumors.’.’ In human breast cancer, the histological studies performed gave limited information about the molecular mechanisms of the cancerogenetic multistep process. The earliest morphologically recognizable lesions constitute a heterogeneous group with different progression potential; carcinoma in situ comprises, in fact, different entities: one (incipient tumors) with low and others with intermediate (ductal carcinoma in situ non-. comedo, lobular carcinoma in situ) or high (ductal carcinoma in situ comedo) risk of progression, respectively. At present, the most important problem is tounderstand the different biological meaning of precancerous proliferative lesions and invasive tumors. Several biological parameters, such as estrogen and progesterone receptors (ER, PK), proliferation index (PI), and oncogene and suppressor gene overexpression, are becoming increasingly important as prognostic adjuncts to standard morphological eval~ation.~-T*h is could be useful to characterize early lesions (carcinoma in situ) as well as invasive tumors detected by screening mammography (small size, special types, and node-negative). In recent years, the immunohistochemical (ICA) demonstration of biological markers has brought about considerable advantages, allowing their direct visualization in tissue and cytological pecimens. Moreover, the development of computerized image analysis systems has provided a quantitative evaluation of biological markers. In this study, 1895 primary invasive (collected since 1985) and 49 in situ (collected since 1991) carcinomas were biologically characterized and ICA assays were measured by an image analysis system (CAS 200 BD).”-I4 The relationships between biological and pathological parameters (node status, size, histotype) were studied with a multivariate analysis. A cluster analysis was performed with the aim to classify cases into subgroups, according to their biological profile. Clinical usefulness of biological assessment was evaluated in 461 patients (median follow-up of 71.6 months). This study underlines the importance of the biological profile, which may be used in concert with other factors to help identify tumor outcome