Goldberg notes that the relationship is a component of Conflicts of Interests. Networks of relationships and the simultaneous presence of several interests are not negative per se but become so when they generate a conflict that undermines impartiality. The solution to the problem of COIs, therefore, cannot be to abolish relationships and the interests that they necessarily express but rather to verify whether those relationships are such as to unduly affect an individual’s judgement. The evolution of an Italian legislation about (...) COIs is eloquent in this regard. (shrink)

After three proceedings in which neuroscience was a relevant factor for the final verdict in Italian courts, for the first time a recent case puts in question the legal relevance of neuroscientific evidence. This decision deserves international attention in its underlining that the uncertainty still affecting neuroscientific knowledge can have a significant impact on the law. It urges the consideration of such uncertainty and the development of a shared management of it.

Alzheimer’s disease is a very common, progressive and still incurable disease. Future possibilities for its cure lie in the promotion of research that will increase our knowledge of the disorder’s causes and lead to the discovery of effective remedies. Such research will necessarily involve individuals suffering from Alzheimer’s disease. This raises the controversial issue of whether patients with Alzheimer’s disease are competent to give their consent for research participation.

Public health emergencies such as pandemics can put health systems in a position where they need to ration medical equipment and interventions because the resources available are not sufficient to meet demand. In public health management, the fair allocation of resources is a permanent and cross-sector issue since resources, and especially economic resources, are not infinite. During the COVID-19 pandemic resources need to be allocated under conditions of extreme urgency and uncertainty. One very problematic aspect has concerned intensive care medicine (...) and age discrimination has been among the most hotly discussed issues, as age has been touted as a probable criterion for selection. In this paper we analyse some documents originating from scientific societies and medical associations, mainly related to EU sphere and available in English, French, Spanish and Italian, concerning the criteria for admission to the intensive care units. We highlights how, in most of these documents, it is explicitly stated that “age itself” is not a criterion for patient selection. Our conclusion is that these criteria should be defined in advance of a crisis situation and be grounded in clinical indicators. Establishing “cut-off” policies with regard to criteria such as age or chronic disability is definitely an unjustifiable form of discrimination even in the context of a public health emergency. (shrink)

PurposeThe aim of this paper is to assess the complex issue of responsibility in clinical practice. The paper focuses mainly on the relationship between personal- and medical-professional responsibility of practitioners and clinical guidelines.MethodsAfter a theoretical review of the different definitions of responsibility in selected bioethical and biojuridical literature, two recent juridical proceedings concerning medical responsibility from Italian Courts are discussed. Subsequently, a theoretical analysis of the definition of clinical practice guidelines is proposed in order to show their feasibility to assess (...) personal- and medical-professional responsibility.ResultsThe definitions of responsibility and the two Italian cases show the theoretical and practical difficulties of shared assessments of both personal-professional and medical-professional responsibility in clinical practice. Clinical practice guidelines cannot be assumed as an objective code of action stating exactly a rule of conduct in all situations, but as a tool suggesting how to decide what to do in different conditions.ConclusionsResponsibility in clinical practice is such a complex issue to deserve a special ethical assessment. The clinician’s personal-professional responsibility cannot be replaced or reduced by clinical practice guidelines, because medicine is as such a relationship focused on the expertize of practitioners. Nonetheless, a shared approach to different clinical conditions is needed in order to avoid a relativist outcome and protect patients’ and even clinicians’ rights. Formal guidelines (that describe not exactly what to do but how to decide what to do) are proposed as potential useful tool to achieve this aim. (shrink)

The American Journal of Bioethics, Volume 12, Issue 1, Page 37-38, January 2012.

According to Howick (2009a), the three main reasons for believing that placebo-controlled trials (PCTs) are methodologically superior to active-controlled trials (ACTs)—sensitivity, absolute effect...

Translational research is a main focus of current health policy (Albani and Prakken 2009; PLoS Medicine 2008). Translation of biomedical research knowledge to effective clinical treatment is essential to the public good (Lavis et al. 2003). Only 5% of basic science studies showing significant therapeutic promise are successfully translated into clinical application (Contopoulos-Ioannidis, Ntzani, and Ionannidis 2003; FDA 2004). As Hall (2001) observes, this is a problem: "When too many important discoveries lie dormant, the public good suffers" (p. G1127). Recent (...) health policy initiatives intended to foster the translation of basic science into clinical advances must consider the unique bioethical issues raised by .. (shrink)

Increases in international travel and migratory flows have enabled infectious diseases to emerge and spread more rapidly than ever before. Hence, it is increasingly easy for local infectious diseases to become global infectious diseases (GIDs). National governments must be able to react quickly and effectively to GIDs, whether naturally occurring or intentionally instigated by bioterrorism. According to the World Health Organisation, global partnerships are necessary to gather the most up-to-date information and to mobilize resources to tackle GIDs when necessary. Communicable (...) disease control also depends upon national public health laws and policies. The containment of an infectious disease typically involves detection, notification, quarantine and isolation of actual or suspected cases; the protection and monitoring of those not infected; and possibly even treatment. Some measures are clearly contentious and raise conflicts between individual and societal interests. In Europe national policies against infectious diseases are very heterogeneous. Some countries have a more communitarian approach to public health ethics, in which the interests of individual and society are more closely intertwined and interdependent, while others take a more liberal approach and give priority to individual freedoms in communicable disease control. This paper provides an overview of the different policies around communicable disease control that exist across a select number of countries across Europe. It then proposes ethical arguments to be considered in the making of public health laws, mostly concerning their effectiveness for public health protection. (shrink)

Clinical ethics refers to an emerging field in clinical medicine that focuses on the process of ethical decision-making in a clinicalsetting. It has developed as a result of a growing awareness that modern medicine – characterized by technological progress, culturaldiversity and social challenges – is posing a range of new “ethical dilemmas” that medical science alone cannot solve. For thisreason, clinical ethics is often linked to “ethics consultation,” which consists of services provided by an individual ethicist, ethicsteam or committee to (...) address the ethical issues involved in a specific clinical case. Although clinical ethics developed in the beginningmainly as a methodological analysis to arrive at a justification for clinical ethical decisions, it quickly has become clear thatthe difficulty in clinical decision-making is only one aspect of wider ethical problems pertaining to the doctor-patient relationshipas a whole and, most likely, to the core value of the medical profession. The principles method is usually presented as the mostpopular methodological approach to an analysis of clinical cases. However, strong criticism of this model has been voiced, and otheralternative approaches are referred to, such as the casuistry model. Recently, significant contributions have been made by narrativemedicine and virtue ethics. According to these methodologies, sound anthropology and a good relationship with the sick person arekey elements required of any person engaged in medical practice who aims to be genuinely appropriate from an ethical perspective. DOI: 10.5294/pebi.2016.20.1.3. (shrink)

The use of human biological materials involves a number of issues from both an ethical and a legal point of view. In recent decades, the purposes for which this material has been used have i...

Background On December 2017 the Italian Parliament approved law n. 219/2017 “Provisions for informed consent and advance directives” regarding challenging legal and bioethical issues related to healthcare decisions and end-of-life choices. The law does not contain an explicit reference to Ethics Committees (ECs), but they could still play a role in implementing the law. Methods A questionnaire-based survey was performed among the ECs of the Italian Institute for Research and Care belonging to the Network of neuroscience and neurorehabilitation, with the (...) aim of (1) knowing whether the ECs participated and, if so, how in the process of implementation of law n. 219/2017 in the referring institutes; (2) investigating the point of view of the ECs regarding their possible involvement in the process; (3) exploring the contribution ECs can provide to give effective implementation to the law principles and provisions. Results Seventeen ECs out of thirty took part in the survey; the characteristics of the responding and non-responding committees are similar, so the responding ECs can be regarded as representative of all ECs in the Network. Nine ECs did not discuss the law in anyway: the main reason for this is that the referring institutions (6) and the health care professionals (3) did not ask for an EC intervention. Nevertheless, the large majority of the ECs believe that their involvement in the implementation of the law as a whole is appropriate (8) or absolutely appropriate (6), while 3 of them are neutral. No EC believes that the involvement is inappropriate. The aspect of the law on which the 14 ECs converge in considering the EC involvement appropriate/absolutely appropriate is the one related to the health facilities obligation to guarantee the full and proper implementation of the principles of the law. Conclusions Our survey confirms that ECs believe they can play a role in the implementation of law n. 219/2017, although this does not entirely correspond to what the committees have actually done in reality. This role could be better exercised by ECs specifically established for clinical practice, which would have a composition, functioning and a mandate better suited to the purpose. This supports the call for a national regulation of ECs for clinical practice. (shrink)

Notwithstanding fundamental methodological advancements, scientific information about disorders of consciousness (DOCs)—e.g. Vegetative State/Unresponsive Wakefulness Syndrome (VS/UWS) and Minimally Conscious State (MCS)—is incomplete. The possibility to discriminate between different levels of consciousness in DOC states entails treatment strategies and ethical concerns. Here we attempted to investigate Italian clinicians’ and basic scientists’ opinions regarding some issues emerging from the care and the research on patients with DOCs. From our survey emerged that Italian physicians working with patients with DOCs give a central role (...) to ethics. Current Italian regulation regarding basic research conducted in patients with DOCs apparently risks to be inadequate to support scientific advancement, and would deserve a different assessment compared to ordinary treatments. We think the results of our survey deserve attention from an international audience because they exemplify the difficulty to define a shared approach to the issues related to patients with DOCs and the necessity to better assess both the ordinary and experimental treatment of patients with DOCs at the ethical and legal level. (shrink)

The majority of literature on Slow Food focuses on the organization or actors involved in the movement. There is a dearth of material analyzing Carlo Petrini’s aspirations for Slow Food, particularly in light of his desire within Slow Food Nation (2007) and Terra Madre (2010) to make “freewill giving a part of economic discourse.” This essay corrects the literature gap through historicizing and critiquing Petrini’s alternative to global capitalism while rooting it in actually existing practices. First, (...) class='Hi'>Petrini’s problematic conceptualization of freewill giving will be compared to feminist theorizations and documentations of the gift economy. Second, Petrini’s avoidance of the toxic mimic of the gift, its subsumption to capitalism, will be amended by discussing how the gifting of food aid and emergency food networks actually reproduces inequality, poverty, and hunger. Third, Petrini’s example of gifting by a Trappist Monastery will be juxtaposed to the ongoing direct action strategies of Food Not Bombs, a much stronger example of an oppositional gift economy, one that is subsequently repressed by the state. In doing so, this essay seeks to expand discussion of the gift economy within the alternative food movement while amending many of the theoretical, historical, and political problems embedded within Petrini’s work, which performs a strong disservice to the politics of possibility embedded within gifting. (shrink)

Minding Time: A Philosophical and Theoretical Approach to the Psychology of Time offers an innovative philosophical account of the most fundamental kinds of time representation.

As a result of the coronavirus (COVID‐19) pandemic, health professionals are faced with situations they have not previously encountered and are being forced to make difficult ethical decisions. As the first group to experience challenges of caring for patients with coronavirus, Chinese nurses endure heartbreak and face stressful moral dilemmas. In this opinion piece, we examine three related critical questions: Whether society has the right to require health professionals to risk their lives caring for patients; whether health professionals have the (...) right to refuse to care for patients during the coronavirus pandemic; and what obligations there are to protect health professionals? Value of care, community expectations, legal obligations, professional and codes of practice may compel health professionals to put themselves at risks in emergency situations. The bioethical principles of autonomy, justice, beneficence and non‐maleficence, as well as public health ethics, guide nurses to justify their decisions as to whether they are entitled to refuse to treat COVID‐19 patients during the pandemic. We hope that the open discussion would support the international society in addressing similar ethical challenges in their respective situations during this public health crisis. (shrink)

Interferon stimulated gene 15 (ISG15) encodes a ubiquitin‐like protein that is highly induced upon activation of interferon signaling and cytoplasmic DNA sensing pathways. As part of the innate immune system ISG15 acts to inhibit viral replication and particle release via the covalent conjugation to both viral and host proteins. Unlike ubiquitin, unconjugated ISG15 also functions as an intracellular and extra‐cellular signaling molecule to modulate the immune response. Several recent studies have shown ISG15 to also function in a diverse array of (...) cellular processes and pathways outside of the innate immune response. This review explores the role of ISG15 in maintaining genome stability, particularly during DNA replication, and how this relates to cancer biology. It puts forth the hypothesis that ISG15, along with DNA sensors, function within a DNA replication fork surveillance pathway to help maintain genome stability. (shrink)

This monograph addresses the question of the increasing irrelevance of philosophy, which has seen scientists as well as philosophers concluding that philosophy is dead and has dissolved into the sciences. It seeks to answer the question of whether or not philosophy can still be fruitful and what kind of philosophy can be such. The author argues that from its very beginning philosophy has focused on knowledge and methods for acquiring knowledge. This view, however, has generally been abandoned in the last (...) century with the belief that, unlike the sciences, philosophy makes no observations or experiments and requires only thought. Thus, in order for philosophy to once again be relevant, it needs to return to its roots and focus on knowledge as well as methods for acquiring knowledge. Accordingly, this book deals with several questions about knowledge that are essential to this view of philosophy, including mathematical knowledge. Coverage examines such issues as the nature of knowledge; plausibility and common sense; knowledge as problem solving; modeling scientific knowledge; mathematical objects, definitions, diagrams; mathematics and reality; and more. This monograph presents a new approach to philosophy, epistemology, and the philosophy of mathematics. It will appeal to graduate students and researchers with interests in the role of knowledge, the analytic method, models of science, and mathematics and reality. (shrink)

Many of the computing systems programmed using Machine Learning are opaque: it is difficult to know why they do what they do or how they work. Explainable Artificial Intelligence aims to develop analytic techniques that render opaque computing systems transparent, but lacks a normative framework with which to evaluate these techniques’ explanatory successes. The aim of the present discussion is to develop such a framework, paying particular attention to different stakeholders’ distinct explanatory requirements. Building on an analysis of “opacity” from (...) philosophy of science, this framework is modeled after accounts of explanation in cognitive science. The framework distinguishes between the explanation-seeking questions that are likely to be asked by different stakeholders, and specifies the general ways in which these questions should be answered so as to allow these stakeholders to perform their roles in the Machine Learning ecosystem. By applying the normative framework to recently developed techniques such as input heatmapping, feature-detector visualization, and diagnostic classification, it is possible to determine whether and to what extent techniques from Explainable Artificial Intelligence can be used to render opaque computing systems transparent and, thus, whether they can be used to solve the Black Box Problem. (shrink)

In his new book, Carlos Alberto Torres, an internationally renowned critical theorist of education, explores the early writings of Paulo Freire whose ideas have had a tremendous and long-lasting impact on the world of pedagogy and politics. Torres analyzes Freire's works, from the 1960s and 1970s, before Freire gained worldwide recognition for his Pedagogy of the Oppressed. Offering an in-depth look into the formative thinking of Freire, Torres identifies how his ideas produced frameworks for educating global citizens, building community and (...) mutual respect, creating social responsibility, instilling an appreciation for diversity, promoting multiple literacies, and social justice education. This volume is the result of more than 3 decades of research with access to Freire's personal library and the archives of the Paulo Freire Institute, as well as the author's extensive conversations with Paulo Freire over two decades--Dr. Torres was Freire's adviser during his tenure as Secretary of Education in the Municipality of São Paulo, Brazil, 1989-1991. (shrink)

I am a theoretical physicist, and, following Aristotles' injunction (Aristotle, Physics III, 202b 34), I do consider it my responsibility to discuss the problem of the notion of infinity in the world--in particular, to "inquire whether there is such a thing or not." I will do so here by illustrating some aspects of the notion of infinity in the natural sciences.

Why do we remember the past and not the future? What does it mean for time to "flow"? Do we exist in time or does time exist in us? In lyric, accessible prose, Carlo Rovelli invites us to consider questions about the nature of time that continue to puzzle physicists and philosophers alike. For most readers this is unfamiliar terrain. We all experience time, but the more scientists learn about it, the more mysterious it remains. We think of it (...) as uniform and universal, moving steadily from past to future, measured by clocks. Rovelli tears down these assumptions one by one, revealing a strange universe where at the most fundamental level time disappears. He explains how the theory of quantum gravity attempts to understand and give meaning to the resulting extreme landscape of this timeless world. Weaving together ideas from philosophy, science and literature, he suggests that our perception of the flow of time depends on our perspective, better understood starting from the structure of our brain and emotions than from the physical universe. (shrink)

The use of genetic testing and neuroscientific evidence in legal trials raises several issues. Often their interpretation is controversial: the same evidence can be used to sustain both the prosecution’s and defense’s argument. A recent Italian case confirms such concerns and stresses other relevant related questions.

Introduction -- Youth, a contradictory formation: 1910-18 -- Workers' democracy and factory-councils: 1919-20 -- Passage to maturity: 1921-6 -- Methodological observations on the prison notebooks -- The 'extended' theory of the state -- The party as 'collective intellectual' -- The current relevance and universality of Gramsci.

All human civilizations have thought that the world was made of sky above and the Earth below. All except one. For the Greeks, the Earth was a rock floating in space, and under the earth there was no ground, no turtles, nor the gigantic columns of which the Bible speaks. How did the Greeks understand that the Earth is suspended in nothingness? Who understood this and how? It is this unique "scientific revolution" of Anaximander of which the author speaks, which (...) Karl Popper called "one of the most daring ideas, revolutionary and portentous in the entire history of human thought" The concern is with the conflict that was opened, still burning, with the nature of scientific thought, its critical and rebellious character, the force with which it subverts the order of things and our image of the world of scientific knowledge, and the highly effective "error" at the same time --as we teach physics in the twentieth century. Speaking of Anaximander, the author invites us to reflect on what his ideas mean to the scientific revolution opened by Einstein. (shrink)

The importance of epistemic values in science is universally recognized, whereas the role of non-epistemic values is sometimes considered disputable. It has often been argued that non-epistemic values are more relevant in applied sciences, where the goals are often practical and not merely scientific. In this paper, we present a case study concerning earthquake engineering. So far, the philosophical literature has considered various branches of engineering, but very rarely earthquake engineering. We claim that the assessment of seismic hazard models is (...) sensitive to both epistemic and non-epistemic values. In particular, we argue that the selection and evaluation of these models are justified by epistemic values, even if they may be contingently influenced by non-epistemic values. By contrast, the aggregation of different models into an ensemble is justified by non-epistemic values, even if epistemic values may play an instrumental role in the attainment of these non-epistemic values. A careful consideration of the different epistemic and non-epistemic values at play in the choice of seismic hazard models is thus practically important when alternative models are available and there is uncertainty in the scientific community about which model should be used. (shrink)

v. 1. Ensino secundário e médio -- v. 2. Estudos sobre o ensino primário -- Planejamento educacional e contribuições à educação do futuro.

This article aims to clarify the sharp contrast between the “short path” of Heideggerian ontology and the “long path” adopted by Ricoeur as a representation of the many necessary mediations in the constitution of his philosophical anthropology. Heidegger breaks into contemporary thought with the publication of his treatise “Being and Time” (1927) as a kind of direct settlement in the field of ontology. In contrast, Ricoeur is seen - and sees himself - as a thinker of conceptual mediations in his (...) long itinerary, since adherence to Husserlian phenomenology and subsequent hermeneutic inflection, passing through confrontations with Freudian psychoanalysis, structuralism and analytical philosophy, to the creation of the book “Oneself as Another” (1990). However, the two philosophers built their works on the common horizon of hermeneutics; therefore, are there possible points of convergence between them? And how could we interpret the relevance of this possible interlocution? These questions cannot be answered without a thorough comparative reading. This text does not intend to answer them, but only to suggest elements for further investigations. (shrink)

The received view of dynamical explanation is that dynamical cognitive science seeks to provide covering law explanations of cognitive phenomena. By analyzing three prominent examples of dynamicist research, I show that the received view is misleading: some dynamical explanations are mechanistic explanations, and in this way resemble computational and connectionist explanations. Interestingly, these dynamical explanations invoke the mathematical framework of dynamical systems theory to describe mechanisms far more complex and distributed than the ones typically considered by philosophers. Therefore, contemporary dynamicist (...) research reveals the need for a more sophisticated account of mechanistic explanation. (shrink)