The idea that our conscious decisions determine our actions has been challenged by a report suggesting that the brain starts to prepare for a movement before the person concerned has consciously decided to move . Libet et al. claimed that their results show that our actions are not consciously initiated. The current article describes two experiments in which we attempted to replicate Libet et al.'s comparison of participants' movement-related brain activity with the reported times of their decisions to move and (...) also the reported times of their decisions of which hand to move. We also looked at the distribution of participants' reports over time to evaluate an alternative explanation of Libet et al.'s results. Although the Readiness Potential was usually present before all of the decisions to move, consistent with the findings of Keller and Heckhausen and Libet et al. , we found that many reported decision times were before the onset of the Lateralized Readiness Potential, which measures hand-specific movement preparation. The latter finding is consistent with the conclusion that the LRP always started after the conscious decision to move. We conclude that even though activity related to movement anticipation may be present before a conscious decision to move, the cortical preparation necessary for the movement to happen immediately may not start until after the conscious decision to move. (shrink)

Hypocrites are often thought to lack the standing to blame others for faults similar to their own. Although this claim is widely accepted, it is seldom argued for. We offer an argument for the claim that nonhypocrisy is a necessary condition on the standing to blame. We first offer a novel, dispositional account of hypocrisy. Our account captures the commonsense view that hypocrisy involves making an unjustified exception of oneself. This exception-making involves a rejection of the impartiality of morality and (...) thereby a rejection of the equality of persons, which we argue grounds the standing to blame others. (shrink)

ABSTRACTConventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life‐sustaining treatment from the forbidden practice of active euthanasia by means of a lethal injection. When clinicians justifiably withdraw life‐sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a lethal dose of medication. We argue that the differential moral assessment of these two practices (...) is based on a series of moral fictions – motivated false beliefs that erroneously characterize withdrawing life‐sustaining treatment in order to bring accepted end‐of‐life practices in line with the prevailing moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end‐of‐life decisions is radically mistaken. (shrink)

It is widely agreed that hypocrisy can undermine one’s moral standing to blame. According to the Nonhypocrisy Condition on standing, R has the standing to blame some other agent S for a violation of some norm N only if R is not hypocritical with respect to blame for violations of N. Yet this condition is seldom argued for. Macalester Bell points out that the fact that hypocrisy is a moral fault does not yet explain why hypocritical blame is standingless blame. (...) She raises a challenge: one must explain what is distinct about hypocritical blame such that the hypocritical blamer lacks the standing to blame, even if the arrogant or petty blamer does not. Of those writing on hypocrisy, only we offer a direct response to Bell’s challenge. Recently, however, our account has come under criticism. We argue here that (1) our account can handle these criticisms and that (2) no other rival account adequately addresses Bell’s challenge of explaining what is uniquely objectionable about hypocritical blame. Because answering Bell’s challenge is a necessary component of any plausible account of the relationship between hypocrisy and standing, our account remains the best on offer. (shrink)

Sometimes it is not one’s place to blame or forgive. This phenomenon is captured under the philosophical notion of standing. However, there is an asymmetry to be explained here. One can successfully blame, even if one lacks the standing to do so. Yet, one cannot successfully forgive if one lacks the standing to do so. In this article we explain this asymmetry. We argue that a complete explanation depends on not only a difference in the natures of the standing to (...) blame and forgive but also a difference in the natures of blame and forgiveness themselves. (shrink)

In our 2018 paper, “Hypocrisy and the Standing to Blame,” we offer an argument justifying the Nonhypocrisy Condition on the standing to blame. Benjamin Rossi (2018) has recently offered several criticisms of this view. We defend our account from Rossi’s criticisms and emphasize our account’s unique advantage: explaining why hypocritical blamers lack the standing to blame.

Floridi and Sanders, seminal work, “On the morality of artificial agents” has catalyzed attention around the moral status of computer systems that perform tasks for humans, effectively acting as “artificial agents.” Floridi and Sanders argue that the class of entities considered moral agents can be expanded to include computers if we adopt the appropriate level of abstraction. In this paper we argue that the move to distinguish levels of abstraction is far from decisive on this issue. We also argue that (...) adopting certain levels of abstraction out of context can be dangerous when the level of abstraction obscures the humans who constitute computer systems. We arrive at this critique of Floridi and Sanders by examining the debate over the moral status of computer systems using the notion of interpretive flexibility. We frame the debate as a struggle over the meaning and significance of computer systems that behave independently, and not as a debate about the ‘true’ status of autonomous systems. Our analysis leads to the conclusion that while levels of abstraction are useful for particular purposes, when it comes to agency and responsibility, computer systems should be conceptualized and identified in ways that keep them tethered to the humans who create and deploy them. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President’s Council on Bioethics*Franklin G. Miller** (bio) and Robert D. Truog (bio)Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological changes (...) in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment?In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation. [End Page 185] Because they are dead, it is appropriate, indeed imperative, to stop mechanical ventilation. And because they are dead, it becomes ethical to procure vital organs for transplantation before stopping what otherwise would be life-sustaining treatment. Remarkably, this innovative neurological determination of death became, with little debate or controversy, the established position in medical ethics and the law throughout the United States.The Harvard Committee articulated the diagnosis of “irreversible coma,” but merely asserted that this condition constituted death. No explanatory rationale was provided. It fell to the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research to provide an authoritative rationale in its 1981 report, Defining Death. The second paragraph of the report set the stage as follows: “The question addressed here is not inherently difficult or complicated. Simply, it is whether the law ought to recognize new means for establishing that the death of a human being has occurred” (President’s Commission 1981, p. 3). The Commission claimed that “death is a unitary phenomenon” (p. 7) and that the determination of death by neurological criteria, in terms of the absence of all brain function, is consistent with the traditional conception of death as the cessation of vital functioning of the organism as a whole. The key issue is the integrative functioning of the human organism, which ceases to exist, according to the Commission, when the whole brain, including higher cortical areas and the brain stem, fails to function. Although “brain-dead” patients do not appear to be dead—i.e., the reality of their death is “masked” by the activity of mechanical ventilation—the patient’s body has irreversibly lost all capacity for integrative functioning. In the words of the Commission: “When artificial means of support mask this loss of integration as measured by the old methods [cessation of respiration and heart beat], brain-oriented criteria and tests provide a new window on the same phenomenon” (p. 33). The President’s Commission was instrumental in developing and establishing “The Uniform Definition of Death Act”: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead” (p. 2).Although the question posed by the President’s Commission was easy to articulate, the answer, over time, has proved complicated and controversial. The coherence and cogency of determining death by neurological criteria has been challenged. Various experts have demonstrated that “brain-dead” patients maintained on mechanical ventilation display a range of vital, integrative, functioning, which conflicts with the judgment that they are dead (Truog and... (shrink)

Traditionally, those writing on blame have been concerned with blaming others, including when one has the standing to blame others. Yet some alleged problems for such accounts of standing arise when we focus on self-blame. First, if hypocrites lack the standing to blame others, it might seem that they also lack the standing to blame themselves. But this would lead to a bootstrapping problem, wherein hypocrites can only regain standing by doing that which they lack the standing to do. Second, (...) in addition to hypocrites, there may be hypercrites, who blame themselves more severely than others. Leading accounts for why hypocrites lack standing to blame others would also seem to imply that hypercrites lack the standing to blame others, but some may find this counterintuitive. We argue that neither of these problems from self-blame poses a unique threat to leading accounts of standing. (shrink)

Male provisioning ability may have evolved as a “good dad” indicator through sexual selection, whereas male creativity may have evolved partly as a “good genes” indicator. If so, women near peak fertility (midcycle) should prefer creativity over wealth, especially in short-term mating. Forty-one normally cycling women read vignettes describing creative but poor men vs. uncreative but rich men. Women’s estimated fertility predicted their short-term (but not long-term) preference for creativity over wealth, in both their desirability ratings of individual men (r=.40, (...) p<.01) and their forced-choice decisions between men (r=.46, p<.01). These preliminary results are consistent with the view that creativity evolved at least partly as a good genes indicator through mate choice. (shrink)

Traditionally, those writing on blame have been concerned with blaming others, including when one has the standing to blame others. Yet some alleged problems for such accounts of standing arise when we focus on self-blame. First, if hypocrites lack the standing to blame others, it might seem that they also lack the standing to blame themselves. But this would lead to a bootstrapping problem, wherein hypocrites can only regain standing by doing that which they lack the standing to do. Second, (...) in addition to hypocrites, there may be hypercrites, who blame themselves more severely than others. Leading accounts for why hypocrites lack standing to blame others would also seem to imply that hypercrites lack the standing to blame others, but some may find this counterintuitive. We argue that neither of these problems from self-blame poses a unique threat to leading accounts of standing. (shrink)

The first topic of concern is anonymity, specifically the anonymity that is available in communications on the Internet. An earlier paper argues that anonymity in electronic communication is problematic because: it makes law enforcement difficult ; it frees individuals to behave in socially undesirable and harmful ways ; it diminishes the integrity of information since one can't be sure who information is coming from, whether it has been altered on the way, etc.; and all three of the above contribute to (...) an environment of diminished trust which is not conducive to certain uses of computer communication. Counterbalancing these problems are some important benefits. Anonymity can facilitate some socially desirable and beneficial behavior. For example, it can eliminate the fear of repercussions for behavior in contexts in which repercussions would diminish the availability or reliability of information, e.g., voting, personal relationships between consenting adults, and the like. Furthermore, anonymity can be used constructively to reduce the effect of prejudices on communications. Negative aspects of anonymity all seem to point to a tension between accountability and anonymity. They suggest that accountability and anonymity are not compatible, and they even seem to suggest that since accountability is a good thing, it would be good to eliminate anonymity. In other words, the problems with anonymity suggest that individuals are more likely to behave in socially desirable ways when they are held accountable for their behavior, and they are more likely to engage in socially undesirable behavior when they are not held accountable. I am not going to take issue with the correlation between accountability and anonymity, but rather with the claim that accountability is good. To examine this problem, let's look at a continuum that stretches from total anonymity at one end, and no anonymity at all at the other end. At the opposite extreme of anonymity is a panopticon society. The panopticon is the prison environment described by Foucault in which prison cells are arranged in a large circle with the side facing the inside of the circle open to view. The guard tower is placed in the middle of the circle so that guards can see everything that goes on in every cell. In a recent article on privacy, Jeffrey Reiman, reflecting on the new intelligent highway systems, suggests that we are moving closer and closer to a panopticon society. When we contemplate all the electronic data that is now gathered about each one of us as we move through our everyday lives- intelligent highway systems, consumer transactions, traffic patterns on the internet, medical records, financial records, and so on- we see the trend that Reiman identifies. Electronic behavior is recorded and the information is retained. While actions/transactions in separate domains are not necessarily combined, it seems obvious that the potential exists for combining data into a complete portfolio of an individual's day to day life. So it would seem that as more and more activities and domains are moved into a IT-based medium, the closer we will come to a panopticon society. A panopticon society gives us the ultimate in accountability. Everything an individual does is observable and therefore available to those to whom we are accountable. Of course, in doing this, it puts us, in effect, in prison. The prison parallel is appropriate here because what anonymity allows us is freedom; prison is the ultimate in lack of freedom. In this way the arguments for a free society become arguments for anonymity. Only when individuals are free will they experiment, try new ideas, take risks, and learn by doing so. Only in an environment that tolerates making mistakes will individuals develop the active habits that are so essential for democracy. In a world without information technology, individuals have levels or degrees and various kinds of anonymity and consequently different levels and kinds of freedom. Degrees and kinds of anonymity vary with the domain: small town social life versus urban social life, voting, commercial exchanges, banking, automobile travel, airplane travel, telephone communication, education, and so on. Drawing from our experience before IT-based institutions, we might believe that what we need is varying levels or degrees and kinds of anonymity. This seems a good starting place because it suggests an attempt to re-create the mixture that we have in the physical, non-IT-based world. Nevertheless, there is a danger. If we think in terms of levels and degrees of anonymity, we may not see the forest from the trees. We may not acknowledge that in an electronic medium, levels and kinds of anonymity mean, in an important sense, no anonymity. If there are domains in which we can be anonymous but those domains are part of a global communication infrastructure in which there is no anonymity at the entry point, then it will always be possible to trace someone's identity. We delude ourselves when we think we have anonymity on-line or off-line. Rather, what we have both places is situations in which it is more and less difficult to identify individuals. We have a continuum of situations in which it is easy and difficult to link behavior to other behavior and histories of behaviors. In the physical world, we can go places and do things where others don't know us by name and have no history with us, though they see our bodies, clothes, and behavior. If we do nothing unusual, we may be forgotten. On the other hand, if we do something illegal, authorities may attempt to track us down and figure out who we are. For example, law enforcement officials, collection agencies, those who want to sue us may take an active interest in removing our anonymity, ex post facto. Think of Timothy McVeigh and Terry Nichols-the men who apparently bombed the federal building in Oklahoma City. Much of what they did, they did anonymously, but then law enforcement officials set out to find out who had done various things, e.g., rented a car, bought explosives, etc. The shrouds of anonymity under which McVeigh and Nichols had acted were slowly removed. Is this any different than behavior on the internet? Is there a significant difference in the kind or degree of anonymity we have in the physical world versus what we have in an IT-based world? The character of the trail we leave is different; in the one case, its an electronic trail; while in the other it involves human memories, photographs, and paper and ink. What law enforcement officials had to do to track down McVeigh is quite different from tracking down an electronic law breaker. Also, the cost of electronic information gathering, both in time and money, can be dramatically lower than the cost of talking to people, gathering physical evidence, and the other minutia required by traditional detective work. We should acknowledge that we do not and are never likely to have anonymity on the Internet. We would do better to think of different levels or kinds of identity. There are important moral and social issues arising as a result of these varying degrees and kinds of identity. Perhaps the most important matter is assuring that individuals are informed about the conditions in which they are interacting. Perhaps, even more important is that individuals have a choice about the conditions under which they are communicating. In the rest of this paper we explore a few examples of levels and kinds of identity that are practical on the Internet. We discuss the advantages and disadvantages that we see for these "styles" of identity for individuals, and we examine the costs and benefits of these styles for society as a whole. (shrink)

Electronic communication and commerce facilitate the collection of information about individual use of the Internet. Focusing on the case of Comet Systems Inc. and its data gathering practices, this paper explores the technical details of gathering personal information in databases in general and the special character of the privacy issue raised by 'anonymous' information about individual behavior on the Internet. The case analysis suggests new insights for our understanding of privacy and frames a discussion of policy alternatives with respect to (...) the privacy of Internet communication. (shrink)

The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting (...) Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core. (shrink)

Benjamin Libet has argued that electrophysiological signs of cortical movement preparation are present before people report having made a conscious decision to move, and that these signs constitute evidence that voluntary movements are initiated unconsciously. This controversial conclusion depends critically on the assumption that the electrophysiological signs recorded by Libet, Gleason, Wright, and Pearl are associated only with preparation for movement. We tested that assumption by comparing the electrophysiological signs before a decision to move with signs present before a decision (...) not to move. There was no evidence of stronger electrophysiological signs before a decision to move than before a decision not to move, so these signs clearly are not specific to movement preparation. We conclude that Libet’s results do not provide evidence that voluntary movements are initiated unconsciously. (shrink)

This article reports four subliminal perception experiments using the relationship between confidence and accuracy to assess awareness. Subjects discriminated among stimuli and indicated their confidence in each discrimination response. Subjects were classified as being aware of the stimuli if their confidence judgments predicted accuracy and as being unaware if they did not. In the first experiment, confidence predicted accuracy even at stimulus durations so brief that subjects claimed to be performing at chance. This finding indicates that subjects's claims that they (...) are ''just guessing'' should not be accepted as sufficient evidence that they are completely unaware of the stimuli. Experiments 2-4 tested directly for subliminal perception by comparing the minimum exposure duration needed for better than chance discrimination performance against the minimum needed for confidence to predict accuracy. The latter durations were slightly but significantly longer, suggesting that under certain circumstances people can make perceptual discriminations even though the information that was used to make those discriminations is not consciously available. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President’s Council on Bioethics*Franklin G. Miller** (bio) and Robert D. Truog (bio)Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological changes (...) in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment?In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation. [End Page 185] Because they are dead, it is appropriate, indeed imperative, to stop mechanical ventilation. And because they are dead, it becomes ethical to procure vital organs for transplantation before stopping what otherwise would be life-sustaining treatment. Remarkably, this innovative neurological determination of death became, with little debate or controversy, the established position in medical ethics and the law throughout the United States.The Harvard Committee articulated the diagnosis of “irreversible coma,” but merely asserted that this condition constituted death. No explanatory rationale was provided. It fell to the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research to provide an authoritative rationale in its 1981 report, Defining Death. The second paragraph of the report set the stage as follows: “The question addressed here is not inherently difficult or complicated. Simply, it is whether the law ought to recognize new means for establishing that the death of a human being has occurred” (President’s Commission 1981, p. 3). The Commission claimed that “death is a unitary phenomenon” (p. 7) and that the determination of death by neurological criteria, in terms of the absence of all brain function, is consistent with the traditional conception of death as the cessation of vital functioning of the organism as a whole. The key issue is the integrative functioning of the human organism, which ceases to exist, according to the Commission, when the whole brain, including higher cortical areas and the brain stem, fails to function. Although “brain-dead” patients do not appear to be dead—i.e., the reality of their death is “masked” by the activity of mechanical ventilation—the patient’s body has irreversibly lost all capacity for integrative functioning. In the words of the Commission: “When artificial means of support mask this loss of integration as measured by the old methods [cessation of respiration and heart beat], brain-oriented criteria and tests provide a new window on the same phenomenon” (p. 33). The President’s Commission was instrumental in developing and establishing “The Uniform Definition of Death Act”: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead” (p. 2).Although the question posed by the President’s Commission was easy to articulate, the answer, over time, has proved complicated and controversial. The coherence and cogency of determining death by neurological criteria has been challenged. Various experts have demonstrated that “brain-dead” patients maintained on mechanical ventilation display a range of vital, integrative, functioning, which conflicts with the judgment that they are dead (Truog and... (shrink)

Cosmetic surgery is a fast-growing medical practice. In 1997 surgeons in the United States performed the four most common cosmetic procedures443,728 times, an increase of 150% over the comparable total for 1992. Estimated total expenditures for cosmetic surgery range from $1 to $2 billion. As managed care cuts into physicians' income and autonomy, cosmetic surgery, which is not covered by health insurance, offers a financially attractive medical specialty.

Prevailing ethical thinking about informed consent to clinical research is characterized by theoretical confidence and practical disquiet. On the one hand, bioethicists are confident that informed consent is a fundamental norm. And, for the most part, they are confident that what makes consent to research valid is that it constitutes an autonomous authorization by the research participant. On the other hand, bioethicists are uneasy about the quality of consent in practice. One major source of this disquiet is substantial evidence of (...) the “therapeutic misconception”—the tendency of patient-subjects in clinical trials to confuse participating in research with receiving personalized medical care. This .. (shrink)

Neuroscientific studies have shown that brain activity correlated with a decision to move can be observed before a person reports being consciously aware of having made that decision . Given that a later event cannot cause an earlier one , such results have been interpreted as evidence that decisions are made unconsciously . We argue that this interpretation depends upon an all-or-none view of consciousness, and we offer an alternative interpretation of the early decision-related brain activity based on models in (...) which conscious awareness of the decision to move develops gradually up to the level of a reporting criterion. Under this interpretation, the early brain activity reflects sub-criterion levels of awareness rather than complete absence of awareness and thus does not suggest that decisions are made unconsciously. (shrink)

Debriefing is a standard ethical requirement for human research involving the use of deception. Little systematic attention, however, has been devoted to explaining the ethical significance of debriefing and the specific ethical functions that it serves. In this article, we develop an account of debriefing as a tool of moral accountability for the prima facie wrong of deception. Specifically, we contend that debriefing should include a responsibility to promote transparency by explaining the deception and its rationale, to provide an apology (...) to subjects for infringing the principle of respect for persons, and to offer subjects an opportunity to withdraw their data. We also present recommendations concerning the discussion of deception in scientific articles reporting the results of research using deception. (shrink)

Four experiments examined how accurately participants can report the times of their own decisions. Within an auditory reaction time task, participants reported the time at which the tone was presented, they decided on the response, or the response key was pressed. Decision time reports were checked for plausibility against the actual RTs, and we compared the effects of experimental manipulations on these two measures to see whether the reported decision times showed appropriate effects. In addition, we estimated the amount of (...) error associated with individual decision time reports by checking how often participants’ decision time reports were implausibly early or late , and by using several quantitative models. Overall, the results suggest that decision time reports are not very accurate but they may be usable for some purposes. (shrink)

Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it (...) does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers. (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)