In the context of the motor skill literature on observational learning and hierarchical skill structuring, Byrne & Russon's findings call into question their standpoint that great apes imitate the behaviour of role models at the programme level. The authors impose a hierarchical model on their observations without properly considering alternative explanations. One such possibility, which stems from a constraints perspective that they dismiss, is put forward.

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be (...) of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. (shrink)

On September 1, 2023, Texas made important revisions to it its decades‐old statute granting legal safe harbor immunity to physicians who withhold or withdraw life‐sustaining treatment over the objection of critically ill patients’ surrogate decision‐makers. However, lawmakers left untouched glaring flaws in a key safeguard for patients—the transfer option. The transfer option is ethically important because, when no hospital is willing to accept the patient in transfer, that fact is taken as strong evidence that the surrogates’ treatment requests fall outside (...) accepted medical practice. But there are serious shortcomings in how the transfer option is carried out in Texas and many other states, which undermines the ethical usefulness of the process. We identify these shortcomings and recommend revisions to state statutes and professional guidelines to overcome them. (shrink)

Face transplantation—or, more properly, facial allograft transplantation —generates much public interest and academic debate. In this paper, we suggest that it is up to opponents of FAT to make the case for its impermissibility. We allow that there is a number of apparently strong arguments that might be deployed against FAT. However, all but one of these turn out not to be compelling after examination. The remaining argument is not so easily dismissed—but its central point is fairly workaday and certainly (...) does not tell us anything about FAT in particular. Therefore, qua argument about facial transplant surgery, it fails to hit its target. Overall, we conclude that a compelling case against FAT remains to be made. (shrink)

The increasing effort, both lay and academic, to encourage a transition from an “I-It” to an “I-Thou” relation to nature is located within a typology of ways of “knowing nature.” This typology provides the context for a particular understanding of human conversation which sees the relation as a cyclical process of “immersion” and “realization” from which a model of the dialectic between “I-It” and “I-Thou” relations to nature can be developed. This model can be used to identify practical measures that (...) can be taken as first steps toward a balance between these relations, both in general and in the context of science-oriented nature conservation organizations such as English Nature in Britain. (shrink)

As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities has published core knowledge (...) competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models—both objective and written—must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization. (shrink)

Hastings Center Report, Volume 51, Issue 5, Page 42-47, September‐October 2021.

The spectacular development of medical knowledge over the last two centuries has brought intrusive advances in the capabilities of medical technology. These advances have been remarkable over the last century, but especially over the last few decades, culminating in such high technology interventions as heart transplants and renal dialysis. These increases in medical powers have attracted societal interest in acquiring more such knowledge. They have also spawned concerns regarding the use of human subjects in research and regarding the byproducts of (...) basic research as in the recent recombinant DNA debate. As a consequence of the development of new biomedical knowledge, physicians and biomedical scientists have been placed in positions of new power and responsibility. The emergence of this group of powerful and knowledgeable experts has occasioned debates regarding the accountability of physicians and biomedical scientists. But beyond that, the very investment of resources in the acquisition of new knowledge has been questioned. Societies must decide whether finite resources would not be better invested at this juncture, or in general, in the alleviation of the problems of hunger or in raising general health standards through interventions which are less dependent on the intensive use of high technology. To put issues in this fashion touches on philosophical notions concerning the claims of distributive justice and the ownership of biomedical knowledge. (shrink)

This essay demonstrates proof-theoretically the consistency of a type-free theoryC with an unrestricted principle of comprehension and based on a predicate logic in which contraction (A (A B)) (A B), although it cannot holds in general, is provable for a wide range ofA's.C is presented as an axiomatic theoryCH (with a natural-deduction equivalentCS) as a finitary system, without formulas of infinite length. ThenCH is proved simply consistent by passing to a Gentzen-style natural-deduction systemCG that allows countably infinite conjunctions and in (...) which all theorems ofCH are provable.CG is seen to be a consistent by a normalization argument. It also shown that in a senseC is highly non-extensional. (shrink)

CHAPTER I POLITICAL FAITH AND UTOPIAN THOUGHT In the three and a half centuries since Bacon and the miller prayed for peace among the willows, countless men ...

In the specialized area of pediatric endocrinology, the use of human growth hormone (hGH) both for children who have a growth hormone abnormality and for the treatment of non-hGH-deficient children who are short is a current clinical reality that raises important ethical questions. Generally speaking, the use of hGH for those children who are clearly lacking it is an efficacious intervention based upon established clinical criteria. The use of hGH for children who are short, but have no growth hormone abnormality (...) is ethically and clinically more controversial. The moral conundrum of how to gain knowledge about new medical treatments that may be beneficial to children while, at the same time, ethically enrolling them in clinical trials with placebo arms in order to gain such knowledge will continue to be a contentious issue in the conduct of research and in the delivery of health care. In addition, there are questions about what ought to be studied and whether a physical characteristic such as short stature ought to be viewed as a circumstance of less than optimal health. (shrink)

This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with a clear justification of why it is important to take best standards, norms, and physician judgment seriously and a clear (...) justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

The attentive pupil who wishes to be attentive, his eyes riveted on the teacher, his ears open wide, so exhausts himself in playing the attentive role that he ends up by no longer hearing anything....

From beginning to end, the poem is literally made up of relations…[that] constitute a method of contemplation and criticism, a way of inviting the reader to think in terms of one thing in terms of another. Consider, for example, Odysseus' trip to Chryse in book 1, a passage I never read without surprise: in this tense and heavily charged world, in which everything seems to have been put into potentially violent contention, why are we given this slow and deliberate journey, (...) so heavily formulaic in texture? The answer is that this is a ritual of reconciliation, a kind of healing, which will receive its most ample performance at the great movement in book 24 when Achilles and Priam share their sorrows. A movement begins here that will run throughout the poem.It is by such an art of arrangement, by placing one thing against another, that Homer criticizes the world of book 1 with which he began; not, as we expect of a writer today, by elaborating competitive languages of motives and value but by ordering his materials into patterns of experience that teach the reader something different from anything the material itself seems to say.1 In a way the poem, as a whole thus has the form of argument; not, of course, argument in the ratiocinative sense of a thesis supported by propositions, from which it can be said to proceed by the rules of logic or the laws of probability, but argument as an activity of critical engagement, a definition of resources and a testing of limits, that results in the creation of a new position taken by the writer and offered to the reader. An argument goes on in the text, but its method is closer to that of music than debate.· 1. Cf. Cedric H. Whitman, Homer and the Heroic Tradition chap. 6, for another view of the ways that formula and image combine.James B. White is a professor in the law school, the college, and the committee on the ancient Mediterranean world at the University of Chicago. He is the author of The Legal Imagination, Constitutional Criminal Procedure, and a book on rhetoric and culture, from which the present article is drawn. (shrink)

It was probably Rousseau who first thought of dreams as ennobling experiences. Anyone who has ever read Reveries du Promeneur Solitaire must be struck by the dreamlike quality of Rousseau's meditations. This dreamlike quality is still with us, and those who experience it find themselves ennobled by it. Witness Martin Luther King's famous "1 have a dream. " Dreaming and inspiration raise the artist to the top rung in the ladder ofhuman relations. That is probably the prevailing view among educated (...) people of our time. Rousseau made that view respectable and predominant. Yet in another sense, the problem is much older. It is the problem of political philosophy and poetry, the problem of Socrates and Aristophanes, of Plato and Homer. Yet, while antiquity usually gives the crown to philosophy, since Rous seau, the alternative view tends to prevail. The distinction is not, however, a formal one. Sir Philip Sidney enlisted Plato on the side of poetry. The true distinction is between imagination and reason. If reason is to rule, as Aristotle points out,l the most architectonic of the sciences, that is political science, should rule. It is political philosophy which must determine the nature of the arts which will help or which will hinder the good of the city or the polity. That does not mean that a mere professor should stand in judgment of Shake speare, Bacon, and Rembrandt. It means that ifhe studies these three great artists, he is not over-stepping disciplinary limits. (shrink)