Kenneth Goodpaster has criticized ethicists like Feinberg and Frankena for too narrowly circumscribing the range of moral considerability, urging instead that “nothing short of the condition of being alive” is a satisfactory criterion. Goodpaster overlooks at least one crucial objection: that his own “condition of being alive” may aIso be too narrow a criterion of moral considerability, since “being in existence” is at least as plausible and nonarbitrary a criterion as is Goodpaster’s. I show that each of the arguments that (...) Goodpaster musters in support of his criterion can be used equally weIl to bolster “being in existence” as a test of moral considerability. Moreover, I argue that “being in existence” appears to be a stronger criterion overall, since it is broader. Until or unless a fuller justification is forthcoming of “being alive” as a satisfactory criterion of moral considerability-a justification which must demonstrate that “mere things,” included under the condition of “being in existence,” do not deserve moral consideration--Goodpaster’sthesis is confronted with a serious problem. (shrink)

In this issue of the American Journal of Bioethics, manuscripts focus on the obligations of clinicians and researchers in pragmatic clinical trials (Garland, Morain, and Sugarman 2023; Morain and L...

Andrews et al. attempt to clarify the standards for determining whether traits are adaptations. The authors argue that tests of adaptationist hypotheses best proceed by assessing the consistency of the traits with the proposed standards. Critical tests of such standards must assess inconsistency – hypotheses must be falsifiable. To fully understand trait evolution, we must consider both adaptive and nonadaptive hypotheses.

The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)

Combined oral contraceptives have been demonstrated to have significant benefits for the treatment and prevention of disease. These medications also are associated with untoward health effects, and they may be directly contraceptive. Prescribers and users must compare and weigh the intended beneficial health effects against foreseeable but unintended possible adverse effects in their decisions to prescribe and use. Additionally, those who intend to abide by Catholic teachings must consider prohibitions against contraception. Ethical judgments concerning both health benefits and contraception are (...) approached in this essay through an overview of the therapeutic, prophylactic, untoward, and contraceptive effects of COC and discussion of magisterial and traditional Catholic teachings from natural law. Discerning through the principle of double effect, proportionate reason, and evidence gathered from the sciences, medical and moral conclusions are drawn that we believe to be fully compliant with good medicine and Catholic teaching. (shrink)

The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates to (...) adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance. (shrink)

A broad evolutionary perspective is essential to fully reverse figure and ground in the rationality debate. Humans' evolved psychological architecture was designed to produce inferences that were adaptive, not normatively logical. This perspective points to several predictable sources of errors in modern laboratory reasoning tasks, including inherent, systematic biases in information-processing systems explained by Error Management Theory.

This article explores the significance that environments play in terms of the learning process. In the United States, the legacy of John Dewey's intellectual efforts left a theoretical understanding that views the architectural composition of learning environments as instrumental mediums which house the educational process. This understanding of learning environments is precipitated by a separation of human agents as subjects and their environments as objects. By contrast, Martin Heidegger's theory of ontology, and its reconfiguration of the subject and object relationship, (...) lends itself to an understanding of the architectural composition of learning environments as dwellings. (shrink)

This article details an interpretive, qualitative interview study that explored rationales developed by seven social studies graduate students, all experiencedteachers, at a large Midwestern university. Interviews revealed three common themes regarding the influence of the rationale development process. The threethemes were: providing structure, connecting purpose and practice, and improving professionalism. The themes demonstrate the complex nature of articulating a sense of purpose, even for experienced teachers. While similar, there were considerable differences in the ways the participants conceptualized their purposes. Untangling (...) these differences has implications for social studies teacher educators interested in integrating rationale development into their work with experienced teachers. (shrink)

The concept of autonomy has had a central place in the German aesthetic tradition since the eighteenth century, specifically, after Kant's Critique of the Power of Judgment. Although Kant denied that aesthetic judgments yield cognitive truth, aesthetic judgments are autonomous in that they do not rely on or presuppose a concern with the object's purpose, utility, or even its actual existence. For Theodor Adorno, the autonomy of art lies in the work of art, in its production, not specifically in the (...) aesthetic judgments of the subject. This article shows that by shifting autonomy from aesthetic judgments to art production, Adorno effectively makes art the reservoir for human freedom. Although this point is often eluded to in Adorno scholarship by individuals such as Tom Huhn and Lambert Zuidervaart, it is often passed over without additional explanation and discussion. (shrink)

Is time travel just a confusing plot device deployed by science fiction authors and Hollywood filmmakers to amaze and amuse? Or might empirical data prompt a scientific hypothesis of time travel? Structured on a fascinating dialogue involving  ...

Kenneth Burke : A Dialogue of Motives employs the philosophy of ethics of Emmanuel Levinas to develop a uniquely dramatistic philosophy of ethics. Jeffrey Murray analyzes Kenneth Burke 's A Grammar of Motives and A Rhetoric of Motives and offers the notion of "a dialogue of motives " as a completion of Burke 's proposed trilogy and as a supplement to Burke 's own tools for rhetorical criticism.

The new National Institutes of Health (NIH) Policy on the Use of a Single Institutional Review Board (sIRB) for Multi-Site Research was adopted primarily to simplify and speed the review of complex multisite clinical trials. However, speeding review requires overcoming a number of obstacles. Perhaps the most substantial obstacle is the time and effort needed to develop reliance agreements among the participating sites. We conducted 102 semistructured interviews with sIRB personnel, including directors, chairs, reviewers, and staff, from 20 IRBs that (...) acted as sIRBs for multisite research, including 6 commercial/independent sIRBs, and 10 university-based academic and 4 federal sIRBs. Almost without exception, the interviewees agreed that reliance agreements were complex, difficult to develop, and time-consuming. A major problem for relying sites was that different agreements specified different responsibilities for the relying sites. Attitudes differed about whether these problems will be resolved as IRB staff and managers become more experienced with sIRBs. However it is clear that the process of developing reliance agreements must be simplified. Federal assistance in standardizing at least some sections of reliance agreements might reduce the difficulties involved. (shrink)

ObjectiveTo prospectively study the cingulate cortex for the localization and role of the grasping action in humans during electrical stimulation of depth electrodes.MethodsAll the patients with intractable focal epilepsy and a depth electrode stereotactically placed in the cingulate cortex, as part of their pre-surgical epilepsy evaluation from 2015 to 2017, were included. Cortical stimulation was performed and examined for grasping actions. Post-implantation volumetric T1 MRIs were co-registered to determine the exact electrode position.ResultsFive patients exhibited contralateral grasping actions during electrical stimulation. (...) All patients had electrodes implanted in the ventral bank of the right cingulate sulcus adjacent to the vertical anterior commissure line. Stimulation of other electrodes in adjacent regions did not elicit grasping.ConclusionGrasping action elicited from a localized region in the mid-cingulate cortex directly supports the concept of the cingulate cortex being crucially involved in the grasping network. This opens an opportunity to explore this region with deep brain stimulation as a motor neuromodulation target for treatment in specific movement disorders or neurorehabilitation. (shrink)

This article explores the significance that environments play in terms of the learning process. In the United States, the legacy of John Dewey's intellectual efforts left a theoretical understanding that views the architectural composition of learning environments as instrumental mediums which house the educational process. This understanding of learning environments is precipitated by a separation of human agents as subjects and their environments as objects. By contrast, Martin Heidegger's theory of ontology, and its reconfiguration of the subject and object relationship, (...) lends itself to an understanding of the architectural composition of learning environments as dwellings. (shrink)

This volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organized around the main stages of the clinical encounter from the patient's perspective. They run from staying well and 'first contact' through to either recovery or to long-term illness, death and dying.

If someone claims that individuals behave as if they violate the independence axiom when making decisions over simple lotteries, it is invariably on the basis of experiments and theories that must assume the IA through the use of the random lottery incentive mechanism. We refer to someone who holds this view as a Bipolar Behaviorist, exhibiting pessimism about the axiom when it comes to characterizing how individuals directly evaluate two lotteries in a binary choice task, but optimism about the axiom (...) when it comes to characterizing how individuals evaluate multiple lotteries that make up the incentive structure for a multiple-task experiment. We reject the hypothesis about subject behavior underlying this stance: we find that preferences estimated with a model that assumes violations of the IA are significantly affected when one elicits choices with procedures that require the independence assumption, as compared to choices elicited with procedures that do not require the assumption. The upshot is that one cannot consistently estimate popular models that relax the IA using data from experiments that assume the validity of the RLIM. (shrink)