To prepare for potential human infection challenge studies involving SARS-CoV-2, we convened a multidisciplinary working group to address ethical questions regarding whether and how much SAR...

We agree with McCullough, Coverdale and Chervenak1 that ‘medical educators and academic leaders are in a pivotal and powerful position to role model’ to counter ‘incivility’ in medicine, which can include ‘dismissing’ or ‘demeaning others’. They note that ‘women may be at greater risk for experiencing incivility compared with men’, as may other individuals who experience ‘patterns of disrespect based on minority status’. The authors promote ‘professionalism’ and ‘etiquette’ to foster civility within medicine. Yet theory and experience suggest that medical (...) educators and academic leaders are also in powerful positions to mobilise these concepts to perpetuate exclusions from, and biases within, medicine, upholding racist, sexist and ableist norms. Feminist methodology reveals how ethical theorising historically excluded views and experiences of marginalised individuals and groups and provides frameworks for interrogating supposedly universal norms. Presuming dominant values and experiences reflect universal ones can further marginalise already oppressed groups and individuals. A feminist analysis reveals how ‘professionalism’ or ‘etiquette’ are historically shaped by white or male identity and experience, including norms of attire, hair, accessories, speech or behaviour. Part of the hidden curriculum of medicine becomes intuiting how leaders implicitly or explicitly define ‘professionalism’. McCullough et al define ‘professionalism’ in medicine as ‘sustained commitments to scientific and clinical excellence… making the protection and promotion of health-related interest the physician’s primary concern …. (shrink)

Since the 1980s, developed countries, led by the United States and the countries of the European Union, have sought to incorporate intellectual property rights provisions into global trade agreements. These countries successfully negotiated the World Trade Organization's 1994 Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), which required developing countries to adopt intellectual property provisions comparable to developed countries. In this manuscript, we review the policy controversy surrounding TRIPS and examine the two main ethical arguments articulated in its support (...) — a theory of natural rights and a utilitarian argument. We contend that these theories provide insufficient bases for an intellectual property rights regime that compromises access to essential medicines in the developing world. While the policy community has engaged in active debate around the policy effects of TRIPS, scholars have not thoroughly considered the full ethical underpinnings of those policy arguments. We believe that a more robust understanding of the ethical implications of the agreement should inform policy discussions in the future. (shrink)

In recent decades, advances in information technology have given rise to a post-industrial society in which emphasis on the manufacture of material goods has been supplanted by the creation of intellectual property. Indeed, this new “knowledge economy” can be tracked by the exponential growth in patented products across a range of sectors since the 1980s. According to the United States Patent and Trademark Office, the number of annual patent applications submitted grew from 112,379 to 520,277 over the past three decades, (...) a 464% increase.The transformation in the industrial markets has been accompanied by the rise of a new, global institution for coordinating intellectual property rights : the World Trade Organization. (shrink)

Psychiatric diagnosis depends, centrally, on the transmission of patients’ knowledge of their experiences and symptoms to clinicians by testimony. In the case of non-native speakers, the need for linguistic interpretation raises significant practical problems. But determining the best practical approach depends on determining the best underlying model of both testimony and knowledge itself. Internalist models of knowledge have been influential since Descartes. But they cannot account for testimony. Since knowledge by testimony is possible, and forms the basis of psychiatric diagnosis, (...) its very existence is a factor in support of an externalist model of knowledge in general. Internalist and externalist models of knowledge also suggest different ways of responding to the practical challenges of basing psychiatric diagnosis on testimony. Thus the argument in favour of externalism also supports a potentially empirically testable hypothesis about interpretation of non-native speakers for accurate psychiatric diagnosis: interpretation of non-English speakers should be as transparent and unhindered by specialised medical knowledge as possible. (shrink)

Background There is lack of consensus in the bioethics literature regarding the use of cardiopulmonary resuscitation (CPR) for organ-preserving purposes. In this study, we assessed the perspectives of clinicians in critical care settings to better inform donor management policy and practice.Methods An online anonymous survey of members of the Society of Critical Care Medicine that presented various scenarios about CPR for organ preservation.Results The email was sent to 10,340 members. It was opened by 5,416 (52%) of members and 405 members (...) (4%) completed the survey with few missing data. A majority of respondents (81%) answered that donation status should not influence whether CPR is performed on an imminently dying patient. There was very strong agreement (>85%) that 1) CPR should be performed on a registered donor who experiences a cardiac arrest with an unknown code status before death by neurological criteria (DNC) and 2) CPR should be performed if the patient is not a registered donor and experiences cardiac arrest but the surrogate/power of attorney (POA) has not yet been approached regarding code status and donation. When a registered donor with a DNR order experiences cardiac arrest before DNC, 98% of respondents would not perform CPR. However, after DNC, respondents were evenly divided on whether they would (49%) or would not (51%) perform CPR on a registered donor with an undocumented code status. When asked whether consent should be required for CPR for organ-preserving purposes, 39% answered “Yes” when a patient arrests before DNC and 48% answered “Yes” when a patient arrests after DNC (P = 0.2).Conclusions The majority of respondents did not consider donor status relevant to CPR decisions before DNC, and virtually all would respect a DNR order in a registered donor before DNC. Respondents were divided about the need for an affirmative consent for CPR for organ-preserving purposes both before and after DNC. (shrink)

Computer vision and human–computer interaction are essential in many technological fields. Researchers in CV are particularly interested in real-time object detection techniques, which have a wide range of applications, including inspection systems. In this study, we design and implement real-time object detection and recognition systems using the single-shoot detector algorithm and deep learning techniques with pre-trained models. The system can detect static and moving objects in real-time and recognize the object’s class. The primary goals of this research were to investigate (...) and develop a real-time object detection system that employs deep learning and neural systems for real-time object detection and recognition. In addition, we evaluated the free available, pre-trained models with the SSD algorithm on various types of datasets to determine which models have high accuracy and speed when detecting an object. Moreover, the system is required to be operational on reasonable equipment. We tried and evaluated several deep learning structures and techniques during the coding procedure and developed and proposed a highly accurate and efficient object detection system. This system utilizes freely available datasets such as MS Common Objects in Context, PASCAL VOC, and Kitti. We evaluated our system’s accuracy using various metrics such as precision and recall. The proposed system achieved a high accuracy of 97% while detecting and recognizing real-time objects. (shrink)

Various consequences of social networks in virtual space are expanding as a new phenomenon in Islamic societies in line with other societies. Social science thinkers point to the two-sided role of the Internet and virtual space in economic, cultural and religious development. Humans need to communicate collectively based on their inherent nature. The media and means of mass communication, which had a slow growth in the past, have faced significant changes in the present era, in such a way that the (...) present age is called the age of information and communication. At such a time when virtual space and social networks have turned the world into a small village and people with different cultures and beliefs are connected with each other, the issues of children’s education (especially in Islamic societies where the focus is on Islamic education) has faced the challenge, what is important for parents in this age is to get familiar with the basics of education and to pay attention to the educational challenges of social networks in the virtual space. One of the necessities of the era of information and communication in Islamic societies is the need for education in accordance with religious teachings that prepares people to face the changing and unpredictable challenges of life. New media are accused of creating new challenges in life from two perspectives. On the one hand, the media are competitors of educational activities in the field of education, and on the other hand, they are considered to be the foundation of many new challenges. In addition, it is worth mentioning that the religious teachings that form the basis of Islamic governments are the answer to all the problems of the human society and its requirements in every age. Contribution: This research presents the effectiveness of religious teachings (Qur’an, Sunnah and Hadiths) as the best sources of Islamic education, which can be used in the cultural policy of virtual space and raise the level of awareness of families and individuals in knowing the points of threat and opportunity in the virtual space. (shrink)

The peer commentaries on our Target Article, “Promoting Ethical Payment in Human Infection Challenge Studies,” offer a number of insights that will help advance the co...

Business Ethics, the Environment & Responsibility, EarlyView.

“It is this distancing of personal relationships, combined with their replacement by written contractual terms and conditions, which make the discussion of ethics within a corporate institutionalised context highly limited and problematic.’ The challenge is to find means of personalising modern corporations so as to encourage ethical behaviour. Atul K. Shah PhD ACA gained his doctorate from the London School of Economics and is Lecturer in the Department of Accounting and Financial Management, at the University of Essex, Wivenhoe Park, Colchester (...) CO4 3SQ; e‐mail [email protected]. This article was conceived while he was Visiting Assistant Professor at the College of Business, University of Maryland, USA. The author wishes to thank Dan Ostas, Lee Preston and Stephen Loeb for helpful comments on earlier drafts. (shrink)

The anthropological approach to mental competence is very interesting. I shall reason that the issue of mental competence and the determination best interests in the decision making process has been integrated together in this anthropological approach. I use the relatively recent Mental Capacity Act 2005 (MCA) for England and Wales (Department of Constitutional Affairs 2005) to illustrate this line of reasoning. I have deliberately chosen the phrase decision-making capacity (DMC) in this commentary to separate it from the concept of determination (...) of best interests. I am writing from the perspective of an old-age psychiatrist who frequently has to assess DMC and make decisions on behalf of those who lack .. (shrink)

The mental capacity Act 2005 (MCA; Department of Constitutional Affairs 2005) was partially implemented on April 1, 2007, and fully implemented on October 1, 2007, in England and Wales. The MCA provides a statutory framework for people who lack decision-making capacity (DMC) or who have capacity and want to plan for the future when they may lack DMC. Health care and social care providers need to be familiar with the MCA and the associated legal structures and processes. The MCA is (...) supported by a Code of Practice (Department of Constitutional Affairs 2007), which was developed after extensive consultation and includes case examples. Those involved in the assessment of DMC and the application of the MCA should .. (shrink)

Lower plasma levels of high-density lipoproteins in adolescents with type 2 diabetes have been associated with a higher pulse wave velocity, a marker of arterial stiffness. Evidence suggests that HDL proteins or particle subspecies are altered in T2D and these may drive these relationships. In this work, we set out to reveal any specific proteins and subspecies that are related to arterial stiffness in youth with T2D from proteomics data. Plasma and PWV measurements were previously acquired from lean and T2D (...) adolescents. Each plasma sample was separated into 18 fractions and evaluated by mass spectrometry. Then, we applied a validated network-based computational approach to reveal HDL subspecies associated with PWV. Among 68 detected phospholipid-associated proteins, we found that seven were negatively correlated with PWV, indicating that they may be atheroprotective. Conversely, nine proteins show positive correlation with PWV, suggesting that they may be related to arterial stiffness. Intriguingly, our results demonstrate that apoA-I and histidine-rich glycoprotein may reverse their protective roles and become antagonistic in the setting of T2D. Furthermore, we revealed two arterial stiffness-associated HDL subspecies, each of which contains multiple PWV-related proteins. Correlation and disease association analyses suggest that these HDL subspecies might link T2D to its cardiovascular-related complications. (shrink)