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The central purpose of this chapter is to explore the implications of wedding the sensitivity principle in epistemology to the content externalism that serves as the engine of Putnam's brain-in-a-vat (BIV) argument. To a first approximation, the sensitivity principle says that S knows that p only if, were p false, S would not believe that p. Numerous criticisms of and counterexamples to sensitivity have appeared in the literature since it was first fully developed and defended by Nozick (1981). Most of these problems are well known, opinions differ on which if any are devastating, and it would take the space of a lengthy essay just to describe the objections and possible replies, let alone elucidate and assess them. So I won't do that. Instead, I aim to execute two tasks. In Section 8.1, I simply draw out the most direct anti-skeptical implications of sensitivity and content externalism, taken together. Many tangled questions arise about the cogency of arguments from content externalism and sensitivity to conclusions about knowledge of the external world. Particularly germane are questions about self-knowledge of thought contents. In Section 8.2, I focus on these questions. As we will see, on (what I shall call) the standard externalist view (Burge 1988), self-knowledge of content is possible even when one cannot distinguish one's actual thoughts from certain possible twin thoughts. Some philosophers are dubious, claiming that the standard view fails to account for the importance of a discriminating ability for self-knowledge of content. One might naturally think to turn to the sensitivity principle to illuminate self-knowledge of content, insofar as sensitivity appears both to imply a discrimination requirement on knowledge and to generate an account of the relevant alternatives that one's grounds for belief must be able to rule out in order for one's true belief to count as knowledge. I shall argue that this is a mistake. Sensitivity tells us no more about self-knowledge, and perhaps considerably less, than the standard externalist view.
Before moving on to the main program, let me elaborate on why one might think to turn to sensitivity in response to perceived deficiencies in the standard view of self-knowledge, which, again, and as I will explain below, accounts for non-empirical knowledge of the contents of one's own thoughts without requiring the capacity to discriminate, for example, the thought that water is wet from the Twin Earth thought that twater is wet.
Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. This article describes some of the common situations with ethical underpinnings encountered by EMS personnel and managers including denying or delaying transport of patients with non-emergency conditions, use of lights and sirens for patient transport, determination of medical futility in the field, termination of resuscitation, restriction of EMS provider duty hours to prevent fatigue, substance abuse by EMS providers, disaster triage and difficulty in switching from individual care to mass-casualty care, and the challenges of child maltreatment recognition and reporting. A series of ethical questions are proposed, followed by a review of the literature and, when possible, recommendations for management.
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
Longitudinal study.
Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
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