We argue why interpretability should have primacy alongside empiricism for several reasons: first, if machine learning models are beginning to render some of the high-risk healthcare decisions instead of clinicians, these models pose a novel medicolegal and ethical frontier that is incompletely addressed by current methods of appraising medical interventions like pharmacological therapies; second, a number of judicial precedents underpinning medical liability and negligence are compromised when ‘autonomous’ ML recommendations are considered to be en par with human instruction in specific (...) contexts; third, explainable algorithms may be more amenable to the ascertainment and minimisation of biases, with repercussions for racial equity as well as scientific reproducibility and generalisability. We conclude with some reasons for the ineludible importance of interpretability, such as the establishment of trust, in overcoming perhaps the most difficult challenge ML will face in a high-stakes environment like healthcare: professional and public acceptance. (shrink)

There are a number of ethical issues that may arise in the care of patients with epilepsy. One approach, when attempting to summarize such information, may be to first carry out a systematic review...

This paper examines the institutional mechanisms supporting the ethical oversight of human participant research conducted by the United Nations (UN). The UN has served an instrumental role in shaping international standards on research ethics, which invariably require ethical oversight of all research studies with human participants. The authors’ experiences of conducting research collaboratively with UN agencies, in contrast, have led to concern that the UN frequently sponsors, or participates in, studies with human participants that have not received appropriate ethical oversight. (...) It is argued that the institutional mechanisms in place to prevent research with human participants from being undertaken by the UN without ethical oversight do not, at present, extend substantively beyond the provision of guidelines and online training offered by a minority of UN bodies. The WHO and UNICEF are identified as notable exceptions, having implemented various measures to prevent health research with human participants from being undertaken without ethical oversight. Yet, it is highlighted that the WHO and UNICEF are not the only UN bodies that undertake health research with human participants and there are countless actors under the umbrella of the UN system that are regularly involved in non-health research with human participants. Arguments for the pursuit of the highest standard of ethical oversight by UN bodies are presented. Moving forward, the paper asks the question: is it time for the UN to set the standards for the oversight of ethical oversight? (shrink)

BackgroundAttention deficit hyperactivity disorder is clinically diagnosed; however, quantitative analysis to statistically analyze the symptom severity of children with ADHD via the measurement of head movement is still in progress. Studies focusing on the cues that may influence the attention of children with ADHD in classroom settings, where children spend a considerable amount of time, are relatively scarce. Virtual reality allows real-life simulation of classroom environments and thus provides an opportunity to test a range of theories in a naturalistic and (...) controlled manner. The objective of this study was to investigate the correlation between participants’ head movements and their reports of inattention and hyperactivity, and to investigate how their head movements are affected by different social cues of different sensory modalities.MethodsThirty-seven children and adolescents with and without ADHD were recruited for this study. All participants were assessed for diagnoses, clinical symptoms, and self-reported symptoms. A virtual reality-continuous performance test was conducted under four conditions: control, no-cue, visual cue, and visual/audio cue. A quantitativecomparison of the participants’ head movements was conducted in three dimensions using a head-mounted display in a VR classroom environment. Task-irrelevant head movements were analyzed separately, considering the dimension of movement needed to perform the VR-CPT.ResultsThe magnitude of head movement, especially task-irrelevant head movement, significantly correlated with the current standard of clinical assessment in the ADHD group. Regarding the four conditions, head movement showed changes according to the complexity of social cues in both the ADHD and healthy control groups.ConclusionChildren and adolescents with ADHD showed decreasing task-irrelevant movements in the presence of social stimuli toward the intended orientation. As a proof-of-concept study, this study preliminarily identifies the potential of VR as a tool to understand and investigate the classroom behavior of children with ADHD in a controlled, systematic manner. (shrink)

In the mid-1980s, Dario Donatelli participated in a laboratory study of the effects of around 800 h of practice on digit-span and increased his digit-span from 8 to 104 digits. This study assessed changes in the structure of his memory skill after around 30 years of essentially no practice on the digit-span task. On the first day of testing, his estimated span was only 10 digits, but over the following 3 days of testing it increased to 19 digits. Further analyses (...) of his recall performance and verbal reports identified which mechanisms of the original memory skill he could retrieve or reacquire over the 3 days of practice. We discuss theoretical implications for the retention of skilled memory performance, the effects of age-related changes in memory on it, and for the future study of the effects of disuse on exceptional performance and complex skill. (shrink)

According to one interpretation, Montesquieu believed that laws should be suited to the particular physical and moral characteristics of a nation, and that political change should not be abruptly imposed. However, as Montesquieu nonetheless condemned despotism, he argued that change in despotic regimes should happen gradually through the noncoercive alternative of doux commerce. My aim is to challenge this interpretation of Montesquieu in two ways. First of all, Montesquieu was far more skeptical about the possibility of political change; so strong (...) was his physical determinism that Montesquieu himself thought that despotic states could not be reformed, even through commerce. Second, even though successors of Montesquieu—such as the Abbé Raynal—did view the use of force in reforming despotic states as futile and preferred commerce as a benign alternative, they had to acknowledge that even commerce could not take root in those supposedly despotic states without coercion. The two most representative doux commerce theorists of the eighteenth century, when confronted with the prevailing trope of Oriental despotism, were far less optimistic about the civilizing effect of commerce than today’s interpretations suggest. My reading of The Spirit of the Laws and The History of the Two Indies suggests the limits of turning to eighteenth-century doux commerce ideals to theorize political reform in so-called despotic governments today. (shrink)

Religion has become a new focus of study in the investigation of current crises and social conflicts in the post-modern world. This study seeks to examine the role of religion in social change and to discover possible alternatives to social problems. East Asian countries have followed a different path of development from Western societies, which is illustrated by the close affinity between religion and modernization, in contrast to the assumptions of secularization theories. The strong role of religion in modernization promotes (...) not only rapid economic development, but also social integration and a strong sense of cultural identity. Although East Asian development is often defined the model of Confucianism-led development, Christianity have been strongly involved in modernizing societies and restructuring social class in East Asia. In the complex nexus of social dynamics, social role of religion changes into another phase in the 21 st century. South Korea is the particular focus of this study because Korea illustrates the dynamic influence of religion in social development, and the drastic changes in the role of religion in the public domain among East Asian countries. This new religious phase reflects a power shift from religious institutions to the media. Spiritual life becomes mediatized when institutionalized religion declines. The mediatization of religion in South Korea demonstrates the double-edged sword of this process, by modifying spirituality into the media logic and, at the same time, by reviving native beliefs and cultural integrity alternative to Western capitalist development. (shrink)

Restorative justice, with its most prominent characteristic being rebuilding social relationships among victims, perpetrators and the community that was damaged by a crime, has been proposed as an alternative to the traditional retributive justice model to treat criminal acts. Both secular and religious groundings exist for restorative justice, and religious theorists have developed theological groundings for restorative justice based on scripture and other sources. In this article, I will explore how a theologically grounded restorative justice model, focusing on Christopher Marshall’s (...) theological exposition of restorative justice, can contribute to the thought and action of Christians and the larger public in the face of the moral injury caused by human trafficking. I will address how this model can also contribute to social structural change. In my analysis, I will employ a case study of North Korean stateless women who reside in China and who are victims of human trafficking. (shrink)

In pediatric emergency rooms (ERs), social workers must navigate diverse responsibilities including acting as advocates and liaisons between families and multidisciplinary treatment teams, providing compassionate support to families in crisis, and assessing for and reporting any suspicions of child abuse or neglect. These potentially contrasting roles can place social workers at the center of dealing with ethical dilemmas and advocating against ethical violations, such as bias and discrimination toward families. This qualitative study seeks to gain insight into ethical issues commonly (...) encountered in pediatric ERs by exploring the perspectives of 23 social workers at Level 1 trauma centers in the United States. Thematic analysis was used to develop major themes and subthemes related to ethical violations, dilemmas, and best practices in pediatric ERs. Major themes emerged related to unfair treatment of families (with subthemes of bias, discrimination, and compassion fatigue), ethical dilemmas (with subthemes of cultural issues, safety and system issues), and promoting ethical practices (with subthemes of self-awareness, advocacy, and efforts to change the system). This study provides important insights into ethical issues in pediatric ERs as experienced by social workers and can inform efforts to improve the quality and equity of care for all families in pediatric ERs. (shrink)

Korean biobanks are now adapting to integrate the new paradigm of precision medicine into their fundamental role of promoting health technology. Since the enactment of Bioethics and Safety Act in 2004, the Republic of Korea has developed a regulatory framework that reflects ethical principles. However, the existing regulation of biobanks has recently proven to be limited in responding to newer ethical and legal issues that have arisen. First, as there is an emerging trend for human biospecimens to be stored, managed (...) and distributed as digitalized data, the current role of the Distributive Review Committee may become less important compared to the Data Access Committee. Second, even if public health data is anonymized, the risk of identifiability is growing. This makes a third point relevant, informed consent is crucial to respect the autonomy of patients and research subjects, but current consent rules need to change to reflect the interactive and dynamic communication process, in which information and communication technology plays an increasingly prominent role. Fourth, even though data sharing for research is expected to be altruistic and the sale of human biospecimens and genome data remains prohibited, data sharing practices have become more complicated and are closer to commercial use and commercialization. Given these challenges, there is a pressing need for continuing and deeper deliberation in order to develop a more comprehensive and responsive governance framework. (shrink)

SignificanceElectrical burns can cause severe damage to the nervous system, resulting in autonomic dysfunction with reduced cerebral perfusion. However, few studies have investigated these consequences.AimTo elucidate changes in prefrontal cerebral hemodynamics using functional near-infrared spectroscopy (fNIRS) during the head-up tilt table test (HUT) for patients with electrical burns.ApproachWe recruited 17 patients with acute electrical burns within 1 week after their accidents and 10 healthy volunteers. The NIRS parameters acquired using an fNIRS device attached to the forehead were analyzed in five (...) distinct HUT phases.ResultsBased on their HUT response patterns, patients with electrical burns were classified into the group with abnormal HUT results (APG, n = 4) or normal HUT results (NPG, n = 13) and compared with the healthy control (HC, n = 10) participants. We found trends in hemodynamic changes during the HUT that distinguished HC, NPG, and APG. Reduced cerebral perfusion and decreased blood oxygenation during the HUT were found in both the NPG and APG groups. Patients with electrical burns had autonomic dysfunction compared to the HC participants.ConclusionsUsing fNIRS, we observed that acute-stage electrical burn injuries could affect cerebral perfusion. (shrink)

ABSTRACTAccording to some influential readings of the Groundwork of the Metaphysics of Morals, the view presented there of the kind of spontaneity we are conscious of through theoretical reason and...

The sustainability labeling on the front of a package featured in a print advertisement may influence consumers’ product evaluations and purchase decisions. The findings of this exploratory study suggest that consumers seem to evaluate the sustainability claim more favorably if the advertisement highlights the personal impact on them. Moreover, environmental involvement appears to further moderate the effects of sustainability claims and environmental impact framing. The interactions that emerged in this study suggest that sustainability labeling effects constitute a complex phenomenon that (...) warrants future research. (shrink)

This work critically builds on James K. A. Smith's postmodern Pentecostal epistemology with the aid of Reformed epistemology. The resulting postmodern Christian epistemology retains the central postmodern characteristics of perspectivalism and embodiment while integrating the truth element of Reformed epistemology’s warrant criteria.

This chapter explores what Kant means by “life”, the “feeling of life”, the “feeling of the promotion of life”, and related notions, such as the idea of a “vital power”, through the contrast between Kant’s account of the beautiful and his account of the sublime. We argue that it is significant that Kant characterizes the feeling of the beautiful as a feeling of the promotion of life but the feeling of the sublime in terms of vital powers. We account for (...) this difference by showing that in experiences of beauty, we are aware of ourselves as rational but embodied human beings, as part of nature. In the feeling of the sublime, by contrast, we are aware of ourselves as pure rational beings. This entails that in the beautiful, we experience nature as deeply life-promoting, while in the sublime, we experience the independence of our supersensible vocation from nature. (shrink)

A close reading of Simone Weil's philosophical and literary writings examining themes of ethical obligation, dispossession and vulnerability in relation to the works of Emmanuel Levinas, Maurice Blanchot and Judith Butler.

Autonomous vehicles (AVs) hold considerable promise for maintaining aging adults’ mobility as they develop impairments in driving skill. Nonetheless, attitudes can be a significant barrier to adoption as has been shown for other technologies. We investigated how different introductions to AV, video with a driver in the front seat, the rear seat, and a written description, affected attitudes, as well as how individual difference variables such as age, gender, prior knowledge, and personality traits predict attitudes within a middle-aged (Median age (...) = 34, IQR = 20, n = 441) Amazon Mechanical Turk sample. The 16-item attitude survey uncovered three factors: Concern with AV, Eagerness to Adopt AV technology, and Willingness to Relinquish Driving Control. ANOVAs showed that only age (younger less concerned) and gender, (females more concerned) were significant factors in Concern with AV. Only gender affected Willingness to Relinquish Driving Control, with males more willing. Multiple regressions that included previous knowledge level and personality traits showed a different pattern. Female gender and greater conscientiousness were associated with greater Concern about AV. Prior knowledge of AV was associated with less concern. Emotional stability and openness to experience were positive predictors of Eagerness to Adopt AV, whereas conscientiousness was a negative predictor. Prior knowledge and openness to experience, positively, and extraversion, negatively, were associated wi... (shrink)

ABSTRACTBy showing its organic linkage between theories of human nature and governance, this article illustrates that the Huainanzi is a scripture that holds a systematic and unique theory. The ideal governance of the Huainanzi is mystical transformation, i.e. the Daoist concept of non-action. Rule by simple Confucian rituals is not at odds with mystical transformation. However, mystical transformation does not include the rule by rituals. Moreover, excessively complicated rituals are incompatible with mystical transformation. Human nature in the Huainanzi does not (...) contradict humanity and righteousness. Human nature’s growth into humanity and righteousness is as natural as the approach of a butterfly to flowers. However, the humanity and righteousness of the Huainanzi are not innate to human nature. Likewise, unlike a flower, a butterfly is not part of a plant. Moreover, artificial flowers, which correspond to excessively complicated rituals, are incompatible wi... (shrink)

Background and objectives Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. Design A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee—whether the (...) doctor referred and whether the doctor disclosed their objection to the abortion. Participants and setting 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Measurement Physicians indicated their approval for the vignette doctor's decision. Main results Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. Conclusion OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor–patient relationship. (shrink)

The photosynthetic organelle of algae and plants (the plastid) traces its origin to a primary endosymbiotic event in which a previously non‐photosynthetic protist engulfed and enslaved a cyanobacterium. This eukaryote then gave rise to the red, green and glaucophyte algae. However, many algal lineages, such as the chlorophyll c‐containing chromists, have a more complicated evolutionary history involving a secondary endosymbiotic event, in which a protist engulfed an existing eukaryotic alga (in this case, a red alga). Chromists such as diatoms and (...) kelps then rose to great importance in aquatic habitats. Another algal group, the dinoflagellates, has undergone tertiary (engulfment of a secondary plastid) and even quaternary endosymbioses. In this review, we examine algal diversity and show endosymbiosis to be a major force in algal evolution. This area of research has advanced rapidly and long‐standing issues such as the chromalveolate hypothesis and the extent of endosymbiotic gene transfer have recently been clarified. BioEssays 26:50–60, 2004. © 2003 Wiley Periodicals, Inc. (shrink)