In modern academic article repositories, we find many papers on what Heidegger thought, but few papers that attempt to decipher how Heidegger thought. This article purports to show one aspect of the “how?” question of Heidegger’s thought. In the works of interpreters, historians of philosophy and thinkers, the prevailing view is that the question of being is the central question of the “what?” of Heidegger’s thought. Since the question of “how?” is more original than the question of “what?”, and since (...) the history of thought indicates that the content of thought is always thought according to a given system of thought, this paper aims to prove the hypothesis of a more original, primal, present, and continuous phenomenon than the question of being in Heidegger’s work; a phenomenon on which the question of battle itself is based. We can call this phenomenon “the dialectic of confrontations”. The task is to prove that the answer to the question “How?” is given by Heidegger’s thought in the dialectic of confrontation, by which the “shepherd of being” becomes the “shepherd of confrontations”. (shrink)

Chelicerates (scorpions, horseshoe crabs, spiders, mites and ticks) are the second largest group of arthropods and are of immense importance for fundamental and applied science. They occupy a basal phylogenetic position within the phylum Arthropoda, and are of crucial significance for understanding the evolution of various arthropod lineages. Chelicerates are vectors of human diseases, such as ticks, and major agricultural pests, such as spider mites, thus this group is also of importance for both medicine and agriculture. The developmental genetics of (...) chelicerates is poorly understood and a challenge for the future progress for many aspects of chelicerate biology is the development of a model organism for this group. Toward this end, we are developing a chelicerate genetic model: the two‐spotted spider mite Tetranychus urticae. T. urticae has the smallest genome of any arthropod determined so far (75 Mbp, 60% of the size of the Drosophila genome), undergoes rapid development and is easy to maintain in the laboratory. These features make T. urticae a promising reference organism for the economically important, poorly studied and species‐rich chelicerate lineage. BioEssays 29:489–496, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

The beta thymosins are a highly conserved family of strongly polar 5 kDa polypeptides that are widely distributed among vertebrate classes; most are now known to bind to monomeric actin and inhibit its polymerization. One beta thymosin, beta four, (Tβ4) is the predominant form in mammalian cells, present at up to 0.5 mM. Many species are known to produce at least two beta thymosin isoforms, in some cases in the same cell. Their expression can be separately regulated. When present outside (...) the cell, the N‐terminal tetrapeptide of beta four appears to affect cell cycle regulation; beta thymosins or smaller fragments derived from them may have additional regulatory functions. We suggest that many developmental changes in beta thymosin levels within cells and tissues may be related to changes in G‐actin pool size. (shrink)

How do we teach medical students to protect patients? My initial reaction to the question posed by Taylor and Goodwin was like first glimpsing ‘Jaws’: we’re going to need a bigger boat. The authors’ answer makes two important claims: first, that safety should be ethically sourced by better integration between teaching of safety and ethics; second, that teaching should encourage students to think about organisational failure rather than focusing on individual blame and personal responsibility to whistleblow.1 On the first, they (...) highlight how ethics teaching often sits apart from that on safety. For the second, they use the concept normalisation of deviance, with its contained idea of structural secrecy, to depict organisational failure that is argued as largely immune to whistleblowing. Why wouldn’t these challenges warrant a bigger boat? On their first claim: it is not just for safety, but throughout the curriculum that ethics teaching needs to be integral. Given coming challenges, it should become the cake rather than the icing. Consider, for example, that artificial intelligence stands to transform many knowledge-based professions, medicine among them. Tomorrow’s doctors will have a surfeit of data and automated decision aids at their fingertips. So, as far as they remain necessary, doctors will …. (shrink)

Psychiatric patients may try (or express a desire) to injure themselves in hospital in order to cope with overwhelming emotional pain. Some health care practitioners and patients propose allowing a controlled amount of self-injury to occur in inpatient facilities, so as to prevent escalation of distress. Is this approach an example of professional assistance with harm? Or, is the approach more likely to minimise harm, by ensuring safer self-injury? In this article, I argue that health care practitioners who use (...) harm-minimisation can be considered to be helping physical injury to occur, although they do not encourage the act. I consider why there are compelling reasons to believe that a patient who self-injures is not maximally autonomous in relation to that choice. However, I then move onto argue that allowing a degree of self-injury may enable engagement with psychotherapy (enhancing autonomy) and behavioural change. In these circumstances, allowing injury (with precautions) may not be harm, all things considered. (shrink)

When you’re on call as a chaplain, you live on the edge. One side is simple, a Bible or a quick prayer. But the other side.... My pager went off: “Ten-year-old stabbed in head with a screwdriver.” The pager blinked. I saw the doors spring open in the ER. The stretcher vaulted through the door as the EMTs wasted no time. The 10-year-old girl appeared then disappeared from sight, a squid-like creature sprouting plastic tubes instead of tentacles. She was swallowed (...) by Trauma Room One. Speed forecasts serious trouble. Bill the EMT was pushing the cart, and his expression startled me. ER vets rarely openly react to tough situations. We are like arrogant college professors surveying our... (shrink)

The debate on “safer by design” has primarily been focused on strategies to render products safer during the design process. This article focuses on correlated basic legal rights of citizens. The reference to “trump rights” is helpful in highlighting two normative claims: Firstly, products that are “safer by design” are suitable instruments to protect the bodily integrity and health of potential users. Both figure as trump rights in Ronald Dworkin’s sense. In this perspective, “safer by design” (...) strategies can guarantee some most basic rights of citizens. Secondly, the debate on trump rights also suggests that safety needs to be regarded as part of a more comprehensive normative framework. Even trump rights are competitive in that a plurality of rights needs to be respected. A final section gives evidence that both claims resonate with recent insights in debate on the precautionary principle. This section also highlights the recent emphasis on environmental concerns. (shrink)

In 1987 Uppingham School celebrates the centenary of the death of its best known headmaster, Edward Thring. When Thring arrived at the Rutland market town in 1853 he inherited a small country grammar school of purely local renown, but by the time of his death in 1887 Uppingham was a thriving public school of national reputation. As the school flourished, so too did the headmaster's standing, and in the decade before his death he was a much consulted authority on educational (...) matters. Thring's contributions to educational theory and practice are numerous, but it is in the field of moral education that his influence has lasted longest. This paper examines that contribution. (shrink)

With the rapid advancement of AI, there exists a possibility of rogue human actor(s) taking control of a potent AI system or an AI system redefining its objective function such that it presents an existential threat to mankind or severely curtails its freedom. Therefore, some suggest an outright ban on AI development while others profess international agreement on constraining specific types of AI. These approaches are untenable because countries will continue developing AI for national defense, regardless. Some suggest having an (...) all-powerful benevolent one-AI that will act as an AI nanny. However, such an approach relies on the everlasting benevolence of one-AI, an untenable proposition. Furthermore, such an AI is itself subject to capture by a rogue actor. We present an alternative approach that uses existing mechanisms and time-tested economic concepts of competition and marginal analysis to limit centralization and integration of AI, rather than AI itself. Instead of depending on international consensus it relies on countries working in their best interests. We recommend that through regulation and subsidies countries promote independent development of competing AI technologies, especially those with decentralized architecture. The Sherman Antitrust Act can be used to limit the domain of an AI system, training module, or any of its components. This will increase the segmentation of potent AI systems and force technological incompatibility across systems. Finally, cross-border communication between AI-enabled systems should be restricted, something countries like China and the US are already inclined to do to serve their national interests. Our approach can ensure the availability of numerous sufficiently powerful AI systems largely disconnected from each other that can be called upon to identify and neutralize rogue systems when needed. This setup can provide sufficient deterrence to any rational human or AI system from attempting to exert undue control. (shrink)

Analyzing two harm reduction comics campaigns—one early in the AIDS crisis and one more recent, I explore tensions between queer safer sexual erotics and national discourses of sexual norms/deviation raised by Cindy Patton and William Haver at the height of AIDS discourse theory in 1996, approximately halfway between the comics. Using these theorists’ reflections on the history of AIDS activism/representation as a hinge, I explore the manifestation/transformation a decade later of the ethical, educational, and erotic issues they raise. Both (...) foreground the ways that HIV, safer sex, and/or eroticism pose difficulties for systems of linguistic and visual representation. Combining text and image, comics—a common harm reduction medium—epitomize this representational issue. While the GMHC addresses an immediate need for information about safer sex, Alex attempts to tackle the unrepresentability/unthinkability of safer and/or seropositive sex. Safer Sex Comix, while largely prioritizing directness above formal experimentation, employ strategies of transgressing the borders of the comics panel to emphasize a plethora of lower-risk sexual acts. The most visually inventive moments in Alex represent Alex’s feelings of unintelligbility post-diagnosis, but the comic restricts its representation of sex only to anal intercourse, and it proves unable to visualize alternative formulations of the erotic, turning to more normative narratives and images as earlier, visually explicit unsafe sexual encounters are replaced with more a/illusive representations post-conversion, literalizing the unrepresentability of seropositive erotic life. (shrink)

The pandemic of SARS-CoV-2 has led to unprecedented changes to society, causing unique problems that call for extraordinary solutions. We consider one such extraordinary proposal: ‘safer infection sites’ that would offer individuals the opportunity to be intentionally infected with SARS-CoV-2, isolate, and receive medical care until they are no longer infectious. Safer infection could have value for various groups of workers and students. Health professionals place themselves at risk of infection daily and extend this risk to their family (...) members and community. Similarly, other essential workers who face workplace exposure must continue their work, even if have high-risk household members and live in fear of infecting. When schools are kept closed because of the fear that they will be sites of significant transmission, children and their families are harmed in multiple ways and college students who are living on campus, whether or not they are attending classes in person, are contributing to high rates of transmission and experiencing high rates of exposure. We consider whether offering safer infection sites to these groups could be ethically defensible and identify the empirical unknowns that would need to resolve before reaching definitive conclusions. This article is not an endorsement of intentional infection with the coronavirus, but rather is meant to spark conversation on the ethics of out-of-the-box proposals. Perhaps most meaningfully, our paper explores the value of control and peace of mind for those among us most impacted by the pandemic: those essential workers risking the most to keep us safe. (shrink)

The proposal to allow assisted dying for people who are not severely ill reignited the Dutch end‐of‐life debate when it was submitted in 2016. A key criticism of this proposal is that it is too radical a departure from the safe and well‐functioning system the Netherlands already has. The goal of this article is to respond to this criticism and question whether the Dutch system really can be described as safe and well functioning. I will reconsider the usefulness of the (...) suffering criterion, and I will ultimately argue this criterion should be rejected altogether. Instead, we should consider moving towards an autonomy‐only approach to assisted dying. This would resolve some significant issues occurring under the current system of assisted dying in the Netherlands and ultimately make the process safer and better functioning. I will then consider some possible objections to adopting an autonomy‐only approach and provide some preliminary responses to these also. I will finally highlight some potential areas where further research may be necessary, namely, how to mitigate the effect of external factors such as poverty or other life aspects that may have the potential to distort the individual's ability to make autonomous decisions. I will also consider some possible international lessons that can be taken from both current as well as the proposed practice in the Netherlands. (shrink)

Are automated vehicles really safer than manually driven vehicles? If so, how would we know? Answering this question has spurred a contentious debate. Unfortunately, several issues make answering this question difficult for the foreseeable future. First, how do we measure safety? Second, how can we keep track of automated vehicle safety? Finally, how do we determine what is or what is not an AV? Until these questions are addressed, it will continue to be difficult to determine whether or when (...) AVs might really be safer than manually driven vehicles. (shrink)

Let the marriage bond be the set of extralegal obligations to one another that individuals acquire in getting married. And let a conception of the marriage bond be an account of the nature and content of these. Here, I argue that the conception of this bond dominant among us is uncongenial to romantic love among individuals of a certain psychological type. Then, after articulating a conception more congenial to romantic love among such individuals, I argue that if we wish to (...) make marriage safer for love, we should make room in our thinking and practice for this conception, embracing a form of marital pluralism. (shrink)

Approximately one in three adults has reported being abused or neglected by a caregiver during their childhood (i.e., they have experienced child maltreatment), though the exact prevalence differs...

In order to reduce the death toll of road traffic it is necessary to focus on how vehicles and roads can be improved. Like other dangerous machines, motor vehicles should be equipped with safety devices that prevent mistakes by the operator from leading to serious consequences. Speed limiters that prevent driving at illegal speeds would save many lives, and so would alcohol interlocks. Meshi Ori's proposal that most cars should be replaced by motorcycles would not lead to the moral improvement (...) that he hopes for. We need motor vehicles with better, not worse, protection of the driver and passengers than the cars presently in use. (shrink)

The American Journal of Bioethics, Volume 11, Issue 9, Page 33-35, September 2011.

Global health has long been characterized by injustice, with certain populations marginalized and made vulnerable by social, economic, and health disparities within and among countries. The pandemic only amplified inequalities. In response to it, the World Health Organization and the United Nations have embarked on transformative normative and financial reforms that could reimagine pandemic prevention, preparedness, and response (PPPR). These reforms include a new strategy to sustainably finance the WHO, a UN political declaration on PPPR, a fundamental revision to the (...) International Health Regulations, and negotiation of a new, legally binding pandemic agreement (popularly called the “Pandemic Treaty”). We revisit the cavernous shortcomings of the global Covid‐19 response, explain potentially transformative legal reforms and the ethical values that underpin them, and propose actionable solutions to advance both health and justice. (shrink)

Major concerns about privacy have limited health professionals’ usage of popular social networking sites such as Facebook. However, the landscape of social media is changing in favor of more sophisticated privacy controls that enable users to more carefully manage public and private information. This evolution in technology makes it potentially less hazardous for health professionals to consider accepting colleagues and patients into their online networks, and invites medicine to think constructively about how social media may add value to contemporary healthcare.

The authors take a hard and critical look at the gospel of market economy and its long-term consequences. They examine its major assumptions, its major policy imperatives and their consequen tial impacts on ecology, society, human beings and organizations. The paper urges a redefinition of this dominant paradigm of today, and advocates the need for it to be subjected to the wider considerations of a caring and ecologically sound belief system. The appendices offer descriptive accounts of actual cases which show (...) the real and repeated crisis-producing potential of this paradigm. (shrink)

The ethical obligation to provide a reasonably safe discharge option from the inpatient setting is often confounded by the context of homelessness. Living without the security of stable housing is a known determinant of poor health, often complicating the safety of discharge and causing unnecessary readmission. But clinicians do not have significant control over unjust distributions of resources or inadequate societal investment in social services. While physicians may stretch inpatient stays beyond acute care need in the interest of their patients (...) who are experiencing homelessness, they must also consider the implications of using an inpatient hospital bed for someone without the attendant level of medical need. Caring for patients in an inpatient setting when they no longer require acute care means fewer beds for acute care patients. And when a patient who is experiencing homelessness declines a medically safer option such as a skilled nursing facility, then clinicians may be faced with the sole option of discharge to the street, which raises troubling questions of nonmaleficence and social justice. Here we investigate the different forms of injustice that play out when patients are discharged to the street, and offer a map of the interwoven ethical responsibilities of clinicians, hospitals, and skilled nursing facilities. (shrink)

Background In this qualitative analysis we aimed to explore addiction physicians’ perspectives on safer injection education for people who inject drugs, especially: (1) on possible means of introducing safer injection education in the medical environment, (2) on the compatibility of safer injection education with each physician’s core values and goals, and (3) on possible reasons for the ethical dilemma in safer injection education. Methods We conducted semi-structured interviews with eleven physicians practicing addiction medicine in France in (...) clinical and harm reduction settings. Results All participants were in favor of educational interventions for people who inject drugs. Nonetheless, these interventions varied from simple advice to injection supervision and they were seen as less acceptable when they concerned the practical and material aspects of injection. Some participants found that physicians practicing in clinical settings, where patients consult mostly to stop their drug use, should not practice safer injection education. On the contrary, other participants claimed that safer injection education was essential in all settings and was not a choice but rather a duty for addiction physicians. The ethical dilemma of such intervention when delivered by medical staff was viewed as a complex phenomenon, related to the representations of intravenous drug use and to societal expectations from physicians. Conclusion Physicians’ views on safer injection education for people who inject drugs reveal an emotionally charged subject related to the structural organization of addiction management in France. Such education is marked by an arduous history of harm reduction policies in France. IRB registration: #00011928. (shrink)

Safer sex has emerged as a collection of practices and ideas deployed to combat the spread of AIDS. Prevention messages and rituals of safer sex each rely on constructing a potential user's relationship to latex devices. This article is based on an analysis of twenty-seven interviews conducted with people in the sex trade. Since sex workers make it their business to exchange sexual services for economic compensation, many have become extremely sophisticated in their innovations and expressions of eroticism (...) using safer sex techniques. Sex workers are one of a group of key knowledge producers focused on safer sexual practices. Their worlds are metaphoric laboratories for empiri cal studies of emergent sexual practices. This article describes the innovations of the use of technologies of safer sex and the configuration of users. (shrink)

Critical-thinking skills are essential for life in the 21st century. In this follow-up to his introductory guide Think, and continuing his trademark of hopeful skepticism, Guy Harrison demonstrates in a detailed fashion how to sort through bad ideas, unfounded claims, and bogus information to drill down to the most salient facts. By explaining how the human brain works, and outing its most irrational processes, this book provides the thinking tools that will help you make better decisions, ask the right questions (...) (at the right time), know what to look for when evaluating information, and understand how your own brain subconsciously clouds your judgment. Think you're too smart to be easily misled? Harrison summarizes scientific research showing how easily even intelligent and well-educated people can be fooled. We all suffer from cognitive biases, embellished memories, and the tendency to kowtow to authority figures or be duped by dubious 'truths' packaged in appealing stories. And as primates we are naturally status seekers, so we are prone to irrational beliefs that seem to enhance our sense of belonging and ranking. Emotional impulses and stress also all too often lead us into traps of misperception and bad judgment. Understanding what science has discovered about the brain makes you better equipped to cope with its built-in pitfalls. Good Thinking--the book and the practice-- makes clear that with knowledge and the right thinking skills, anyone can lead a safer, wiser, more efficient, and productive life. (shrink)

Ethical foundations of patient safety -- Vigilance -- Mindfulness -- Compliance -- Humility -- Some theoretical aspects of vigilance and risk acceptability -- Fifty shades of error -- The standard care and medical malpractice law as an ethical achievement -- The present and the future.

: The system of policing in the United States is costly and ineffective, perhaps because of the government monopoly on residentially assigned police departments. A system of private or public police choice could introduce competitive pressures into the market for policing and improve overall quality levels. I discuss current and historical examples of private policing and […].

Too many patients are injured in the course of medical care. This truth is as distressing now as it was four years ago when it began an article in this journal’s last similar symposium. Many or most injuries seem preventable. Yet today’s systems of care and of oversight of care too often fail to prevent them, despite generations of increasing legal intervention. Few injuries are litigated, even fewer addressed through medical peer review or state disciplinary authorities. The Institute of Medicine’s (...) landmark report To Err Is Human brought patient safety to national attention when released in late 1999. Half a decade later, significant reduction of injury remains a distant prospect, despite some apparent progress. (shrink)

Too many patients are injured in the course of medical care. This truth is as distressing now as it was four years ago when it began an article in this journal’s last similar symposium. Many or most injuries seem preventable. Yet today’s systems of care and of oversight of care too often fail to prevent them, despite generations of increasing legal intervention. Few injuries are litigated, even fewer addressed through medical peer review or state disciplinary authorities. The Institute of Medicine’s (...) landmark report To Err Is Human brought patient safety to national attention when released in late 1999. Half a decade later, significant reduction of injury remains a distant prospect, despite some apparent progress. (shrink)

Millions of Americans access the Internet forhealth information, which is changing the waypatients seek information about, and oftentreat, certain medical conditions. It isestimated that there may be as many as 100,000health-related Web sites. Theavailability of so much health informationpermits consumers to assume more responsibilityfor their own health care. At the same time,it raises a number of issues that need to beaddressed. The health information available toInternet users may be inaccurate orout-of-date. Potential conflicts of interestresult from the blurring of the distinctionbetween (...) advertising and professional healthinformation. Also, potential threats to privacymay result from data mining. Health care consumers need to be able toevaluate the quality of the informationprovided on the Internet. Various evaluativemechanisms such as codes of ethics, ratingsystems, and seals of approval have beendeveloped to aid in this process. Theeffectiveness of these solutions is evaluated inthis paper. Finally, the paper addresses theimportance of including patients in developingstandardized quality assurance systems for online health information. (shrink)

While even today lesbian, gay, bisexual and transgender people might have cause to distrust the healthcare establishment, how much more fragile was the relationship between sexual minorities and health professionals in the first decade of the AIDS epidemic. Dissent from consensus healthcare and health research then was a question of survival in the face of political and medical intransigence. This article focuses on one version of AIDS dissent: The narrative representations of AIDS in fiction by the gay African-American fantasy writer (...) Samuel R. Delany, which rejected the rigid binarism of “safe” and “unsafe” sex practices, Delany’s evidence-based dissent. He also engaged in a related form of cultural dissent: speaking the unspeakably obscene, at a time when Silence = Death. Delany called into question both the inferential leaps based on limited epidemiological research that were represented in safer sex guidelines and the widespread public reticence about sexual behavior. (shrink)