Despite growing interest in improving cognitive abilities across the lifespan through training, the benefits of cognitive training are inconsistent. One powerful contributor may be that individuals arrive at interventions with different baseline levels of the cognitive skill being trained. Some evidence suggests poor performers benefit the most from cognitive training, showing compensation for their weak abilities, while other evidence suggests that high performers benefit most, experiencing a magnification of their abilities. Whether training leads to compensation or magnification effects may depend (...) upon the specific cognitive domain being trained and the training approach implemented. To clarify the association between individual differences in baseline cognitive ability and training gains as well as potential moderators, we conducted a systematic meta-analysis of the correlation between these two variables. We found evidence of a significant meta-correlation demonstrating a compensatory effect, a negative association between initial ability on a trained cognitive process and training gains. Too few papers met our search criteria across the levels of proposed moderators of cognitive domain and training approach to conduct a reliable investigation of their influence over the meta-analytic effect size. We discuss the implications of a compensatory meta-correlation, potential reasons for the paucity of qualifying papers, and important future directions for better understanding how cognitive trainings work and for whom. (shrink)

This dissertation investigates the metaphysics of human body parts; particularly, the epistemic conditions under which something can be said to be a “body part of” some particular human being. In this dissertation I draw on the hylomorphism of Aristotle and John Duns Scotus to argue that a necessary and sufficient condition on human bodily parthood is an object’s functioning for the sake of the whole human being and the maintenance of her biological life. I argue that, on this view of (...) bodily parthood, at least some prostheses or artificial organs are truly body parts of the human beings in whom they operate. I defend this view in reference to both Aristotelian and Scotistic hylomorphism, as well as answering objections raised by some contemporary views of bodily parthood as merely conventional. I argue that this has important implications for medical ethics, including potentially restricting medical interventions in end-of-life care and heightening the legal ramification of damage done to prostheses. I argue that investigation into the metaphysical questions surrounding body parts and their composition can illuminate hitherto underappreciated dimensions of ethical questions in medicine. (shrink)

Studies of reasoning have often invoked a distinction between a natural or ordinary consideration of the premises, in which they are interpreted, and even distorted, in the light of empirical knowledge, and an analytic or logical consideration of the premises, in which they are analysed in a literal fashion for their logical implications. Two or three years of schooling have been seen as critical for the spontaneous use of analytic reasoning. In two experiments, however, 4-year-olds who were given brief instructions (...) that prompted use of an analytic approach continued to adopt this approach one week later. Thus, when given syllogistic problems in which the major premise was incongruent with their empirical knowledge (e.g. "All snow is black"), instructed children reasoned more accurately from that premise both immediately and a week later as compared to children given only a basic introduction. A third experiment showed that instructions also improved 4-year-olds' performance on hard-to-imagine, abstract material (e.g."All mib is white"). Similarities between the effects of brief instruction and of schooling are discussed. (shrink)

False “Aha!” moments can be elicited experimentally using the False Insight Anagram Task (FIAT), which combines semantic priming and visual similarity manipulations to lead participants into having “Aha!” moments for incorrect anagram solutions. In a preregistered experiment (N = 255), we tested whether warning participants and explaining to them exactly how they were being deceived, would reduce their susceptibility to false insights. We found that simple warnings did not reduce the incidence of false insights. On the other hand, participants who (...) were given a detailed explanation of the methods used to deceive them experienced a small reduction in false insights compared to participants given no warning at all. Our findings suggest that the FIAT elicits a robust false insight effect that is hard to overcome, demonstrating the persuasive nature of false insights when the conditions are ripe for them. (shrink)

The devastating toll of gun violence has given rise to hundreds of lawsuits seeking justice on behalf of victims and their families. A significant number of challenges against gun companies, however, are blocked by courts' broad reading of the Protection of Lawful Commerce in Arms Act — a federal statute often interpreted to shield the gun industry from civil liability. This article reexamines PLCAA in light of the Supreme Court's recent federalism caselaw, which counsels courts to narrowly construe federal laws (...) that could otherwise upset the balance of power between states and the federal government. Since PLCAA infringes on traditional areas of state authority, the Supreme Court's federalism jurisprudence requires lower courts to interpret PLCAA narrowly, to not bar states from imposing negligence, nuisance, product liability, or other common law liability on gun companies. Reading PLCAA in line with federalism principles would preserve states' traditional authority over their civil justice laws, and enable gun violence victims, and their families, to hold gun companies responsible for wrongdoing. (shrink)

Insight experiences are sudden, persuasive, and can accompany valuable new ideas in science and art. In this preregistered experiment, we aim to validate a novel visceral and continuous measure of insight problem solving and to test whether real-time and embodied feelings of insight can predict correct solutions. We report several findings. Consistent with recent work, we find a strong positive relationship between Aha moments and accuracy for problems that demand implicit processing. We also found that the intensity of the insight (...) experience further predicted the accuracy of solutions and participants naturally embodied the intensity of their insight experiences by squeezing the dynamometer more tightly. Intriguingly, this unintentional embodiment further predicted the accuracy of solutions. We suggest that the dynamometer complements previous measures by (1) simultaneously capturing both process and feeling in real-time, (2) highlights the value of measuring Aha moments on a continuum of intensity, and (3) firmly establishes that the impulsive feeling of Aha can carry information about the veracity of an idea. We discuss the findings in light of a recent theoretical account of how feelings of insight may act as a heuristic to select ideas from the stream of consciousness. (shrink)

The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of ongoing (...) intensive intervention. These cases highlight important ethical issues in organ transplantation, including the nature and requirements of transplant informed consent, the limits of physician prognostication, patient autonomy and decision-making capacity following transplant, obligations to organ donors and to other potential recipients, and the impact of program metrics on individualized recipient care. We outline general ethical principles for the care of lung transplant recipients with prolonged hospitalization and give regulatory, research, and patient-centered recommendations for these cases. (shrink)

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

This book brings together some of the best minds in neurology and philosophy to discuss the concept of personal identity and the moral dimensions of treating ...

Effective documentation is considered a core competency for clinical ethics consultation. Ethics consultants within the Cleveland Clinic in Cleveland, Ohio, observed variation in the formatting of ethics chart notes across consultants and realized that this formatting was based on their own views of effectiveness. To minimize variation and optimize the readability and understandability of ethics chart notes for end users, a team undertook a quality improvement project to assess the formatting preferences of healthcare professionals who rely on ethics consultation notes. (...) The team developed three sample templates and conducted interviews with stakeholders to understand their preferences. A single standardized template was developed based on the preferences that emerged, which all consultants on the ethics consultation service then utilized. In the first five months of implementation, the percentage of end user respondents marking the highest Likert scale option on a post-consultation survey regarding whether the ethics consultation service provided helpful documentation increased from 60 percent to 72 percent compared to the same five-month period in the year prior. (shrink)

Given dramatic increases in recent decades in the pace of scientific discovery and understanding of the functional organization of the brain, it is increasingly clear that engagement with the neuroscientific literature and research is central to making progress on philosophical questions regarding the nature and scope of human freedom and responsibility. While patterns of brain activity cannot provide the whole story, developing a deeper and more precise understanding of how brain activity is related to human choice and conduct is crucial (...) to the development of realistic, just, and intellectually rigorous models of human agency and moral responsibility. In this special issue, we acknowledge that “free will” and “moral responsibility” are not concepts with which neuroscience can directly engage, and instead focus on self-governance, and the capacities that contribute to self-governance, which are more tractable for scientific investigation and are prerequisites for the presence of moral responsibility. (shrink)

Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents (...) in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/protective highlights counter normative consequences and opposes the use enhancers. The Individual/proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern. (shrink)

Purpose Medical students receive a varying amount of training in medical ethics and are expected to navigate clinical ethical dilemmas innately. There is little literature on attempts to navigate ethical dilemmas experienced during early clinical experiences and whether current curricula prepare students for these dilemmas. This study explores the different ethical dilemmas experienced by medical students on their third-year clerkships and analyzes the factors, sources, and resolutions proposed by them.Methods From 2016 to 2018, third-year medical students completed a written assignment (...) to describe, analyze, and reflect on a clinical situation in which they experienced an ethical dilemma. They identified specific ethical dilemmas present, potential preventative and aftermath solutions, and reflected on their professional development from their experience. The research team utilized applied thematic analysis to identify themes and patterns in the data. A thematic matrix was utilized to examine similarities and differences across medical students.Results Of the 162 reflections, 144 (88.9%) students indicated an ethical dilemma that included issues related to autonomy and beneficence. Of these, 116 (71.6%) students found the two ethical principles in direct conflict. Students identified three common sources of this conflict: lack of communication; unclear understanding of clinical policies regarding family authority and psychiatric capacity; and medical negligence. Lastly, students suggested different solutions for dealing with and preventing this conflict.Conclusion Our findings suggest that an overwhelming number of students face ethical challenges when confronted with medical situations that raise conflicts between autonomy and beneficence. Their recommended solutions reveal an appeal among students to have tools and strategies in place to ease the need to make difficult decisions. Medical students might be better served by learning about the complexities of ethical decision-making and the likelihood of experiencing moral distress when they feel an inability to implement what they envision as the best solution. (shrink)

In an effort to create new synergies to fill gaps in evaluation of value, assessment of quality, and definition of roles in clinical ethics programs we convened a meeting entitled Innovations in Clinical Ethics: A Working Un-Conference (the Un-Conference) in August 2018. The Un-Conference was conceived to be a working event aimed at promoting cross pollination and idea generation for innovative practices in clinical ethics. The event was attended by 95 individuals from 62 institutions, representing a wide diversity of healthcare (...) systems, who believed in the concept and brought their enthusiasm and expertise to share with others. As a product of the Un-Conference, whitepaper groups developed summaries and broad overviews of areas that need to be further addressed within our field. The whitepapers are being published in this issue of The Journal of Clinical Ethics. The first three whitepapers highlight the broad themes of demonstrating value to the institution, quality assessment, and emerging roles for clinical ethics programs and ethicists. The final whitepaper offers guidance to clinical ethicists engaged in pediatric ethics work and, in conversation with the emerging roles article, thoughtfully reflects on the role of pediatric ethicists. (shrink)

Despite an abundance of academic conferences, clinical ethicists lacked a forum to share innovative practices with peers and to generate solutions to common challenges. Organizers of the first Clinical Ethics Un-Conference developed a working event centered on active participation and problem solving through peer learning, with the goal of improving realworld practice. Registrants included 95 individuals from 64 institutions. Attendees were surveyed immediately after the Un-Conference, and again eight months later. After eight months, 85 percent (n = 33/39) of the (...) survey respondents reported that they found the event “highly impactful” or “some-what impactful” to their clinical practice, and 23 attendees reported that they had implemented ideas or projects inspired by the event. Three sets of best practice guidelines and four white papers were published from the event. As the field of clinical ethics continues to advance and evolve, this working event format offers an innovative, disruptive alternative to a traditional conference format and may serve as a model for future efforts aimed at improving real-world clinical ethics practice. (shrink)

Scholarship flourishes in inclusive environments where open deliberations and generative feedback expand both individual and collective thinking. Many researchers, however, have limited access to such settings, and most conventional academic conferences fall short of promises to provide them. We have written this Field Report to share our methods for cultivating a vibrant intellectual community within the Science and Technology Studies Food and Agriculture Network (STSFAN). This is paired with insights from 21 network members on aspects that have allowed STSFAN to (...) thrive, even amid a global pandemic. Our hope is that these insights will encourage others to cultivate their own intellectual communities, where they too can receive the support they need to deepen their scholarship and strengthen their intellectual relationships. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Recipes from the Garden of Contentment. By Yuan Mei, translated and annotated by Sean J. S. Chen. Great Barrington, MA: Berkshire, 2019. Pp. xxxiii + 428. $125.

What is the relationship between our perceptions and reality? What is the relationship between the mind and the body? These are questions with which philosophers have grappled for centuries, and they are topics of considerable contemporary debate as well. Hilary Putnam has approached the divisions between perception and reality and between mind and body with great creativity throughout his career. Now, in _The Threefold Cord: Mind, Body, and World,_ he expounds upon these issues, elucidating both the strengths and weaknesses (...) of current schools of thought. With his characteristic wit and acuity, Putnam offers refreshing solutions to some of philosophy's most vexing problems. Putnam first examines the problem of realism: is objective truth possible? He acknowledges the deep impasse between empirical and idealist approaches to this question, critiquing them both, however, by highlighting the false assumption they share, that we cannot perceive the world directly. Drawing on the work of J. L. Austin and William James, Putnam develops a subtle and creative alternative, which he calls "natural realism." The second part of the book explores the mind-body question: is the mind independent of our interactions with the physical world? Again, Putnam critically assesses two sharply antithetical contemporary approaches and finds them both lacking. _The Threefold Cord_ shows the entire mind-body debate to be miscast and draws on the later work of Wittgenstein, once more advancing original views on perception and thought and their relationship with both the body and the external world. Finally, Putnam takes up two related problems--the role of causality in human behavior and whether or not thoughts and sensations have an "existence" all their own. With Putnam's lucid prose and insightful examples, _The Threefold Cord_ loosens the Gordian knots into which philosophy has bound itself over the issue of epistemology. (shrink)

During the 'sixties and 'seventies, Hilary Putnam, Jerry Fodor, and Richard Boyd, among others, developed a type of materialism that eschews reductionist claims.¹ In this view, explana- tions, natural kinds, and properties in psychology do not reduce to counterparts in more basic sciences, such as neurophysiology or physics. Nevertheless, all token psychological entities-- states, processes, and faculties--are wholly constituted of physical entities, ultimately out of entities over which microphysics quantifies. This view quickly became the standard position in philosophy of (...) mind, and reductionism fell out of favor. Recently, however, reductionism has been experiencing a rebirth, and many have suggested that the non-reductive approach was accepted too quickly and too uncritically. In this paper, we attempt to provide a more thorough account of the anti-reductionist position, and, in the process, to defend it against its recent critics. (shrink)

A number of philosophers, from Thomas Reid1 through C. A. J. Coady2, have argued that one is justified in relying on the testimony of others, and furthermore, that this should be taken as a basic epistemic presumption. If such a general presumption were not ultimately dependent on evidence for the reliability of other people, the ground for this presumption would be a priori. Such a presumption would then have a status like that which Roderick Chisholm claims for the epistemic principle (...) that we are justified in believing what our senses tell us. (shrink)