This paper reviews the concept of professional autonomy from anhistorical perspective. It became formalised in the United Kingdom onlyafter a long struggle throughout most of the nineteenth century. In itspure form professional autonomy implies unlimited powers to undertakemedical investigations and to prescribe treatment, irrespective of cost.Doctors alone should determine the quality of care and the levels ofremuneration to which they should be entitled. In the second half of thetwentieth century a steady erosion of professional autonomy occurred inthe United Kingdom. The (...) level of remuneration has been restricted formost doctors for nearly fifty years, whilst the costs of health carehave steadily reduced the doctor's ability to provide unrestricted carewithin the health care system. Reorganisation of the National HealthService in 1983 and 1991 has substantially eroded professional autonomy,to the point where research developments, clinical judgement and ethicalstandards are all now being placed at risk. (shrink)

This paper applies theory and research examining errors in complex organizational systems to the problem of individual and collective morality in organizations. It is proposed that because of the nature of complex organizations, unjust outcomes can (and will) result from organizational actions even when all organization members have acted responsibly. The argument that complex organizations are therefore immoral is considered and rejected. Instead, the paper argues that morality in complex organizations begins with "heedful interrelating" among individual organization members. The paper (...) concludes with a discussion of organizational processes and structures that promote heedful interrelating. (shrink)

Originally published in 1957, this book collects together large sections of important tracts from a variety of political documents, particularly those concerned with democracy, communism, Protestantism or Catholicism. The extracts come from a wide range of authors including Bertrand Russell, Karl Marx, John Locke and Pope Pius XII. This book will be of value to anyone seeking an overview of the key political divisions in the late 20th century or who is interested in political theory generally.

We explore psychological contracts as mechanisms by which individuals gain influence in organizations. Using two distinct research settings and longitudinal analysis, we demonstrate that ideological contracts endow individuals with increased centrality in the organization’s influence network. More generally, we propose that an important outcome of different psychological contract types may be how they affect the nature of influence in organizations.

This book is the first comprehensive report and analysis of the Dutch euthanasia experience over the last three decades. In contrast to most books about euthanasia, which are written by authors from countries where the practice is illegal and therefore practised only secretly, this book analyzes empirical data and real-life clinical behavior. Its essays were written by the leading Dutch scholars and clinicians who shaped euthanasia policy and who have studied, evaluated and helped regulate it. Some of them have themselves (...) practised euthanasia. The book will contribute to the world literature on physician-assisted death by providing a comprehensive examination of how euthanasia has been practised and how it has evolved in one specific national and cultural context. It will greatly advance the understanding of euthanasia among both advocates and opponents of the practice. (shrink)

One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.

In recent years we have seen a dramatic shift, in several different areas of communication studies, from an information-theoretic to a dynamic systems paradigm. In an information processing system, communication, whether between cells, mammals, apes, or humans, is said to occur when one organism encodes information into a signal that is transmitted to another organism that decodes the signal. In a dynamic system, all of the elements are continuously interacting with and changing in respect to one another, and an aggregate (...) pattern emerges from this mutual co-action. Whereas the information-processing paradigm looks at communication as a linear, binary sequence of events, the dynamic systems paradigm looks at the relation between behaviors and how the whole configuration changes over time. One of the most dramatic examples of the significance of shifting from an information processing to a dynamic systems paradigm can be found in the debate over the interpretation of recent advances in ape language research (ALR). To some extent, many of the early ALR studies reinforced the stereotype that animal communication is functional and stimulus bound, precisely because they were based on an information-processing paradigm that promoted a static model of communicative development. But Savage-Rumbaugh's recent results with bonobos has introduced an entirely new dimension into this debate. Shifting the terms of the discussion from an information-processing to a dynamic systems paradigm not only highlights the striking differences between Savage-Rumbaugh's research and earlier ALR studies, but further, it sheds illuminating light on the factors that underpin the development of communication skills in great apes and humans, and the relationship between communicative development and the development of language. Key Words: apes; ape language research (ALR); brain development; co-regulation; communication; dynamic systems; language development; symbols. (shrink)

Computational systems biologists create and manipulate computational models of biological systems, but they do not always have straightforward epistemic access to the content and behavioural profile of such models because of their length, coding idiosyncrasies, and formal complexity. This creates difficulties both for modellers in their research groups and for their bioscience collaborators who rely on these models. In this paper we introduce a new kind of visualization that was developed to address just this sort of epistemic opacity. The visualization (...) is unusual in that it depicts the dynamics and structure of a computer model instead of that model’s target system, and because it is generated algorithmically. Using considerations from epistemology and aesthetics, we explore how this new kind of visualization increases scientific understanding of the content and function of computer models in systems biology to reduce epistemic opacity. (shrink)

Cognitive agents, whether human or computer, that engage in natural-language discourse and that have beliefs about the beliefs of other cognitive agents must be able to represent objects the way they believe them to be and the way they believe others believe them to be. They must be able to represent other cognitive agents both as objects of beliefs and as agents of beliefs. They must be able to represent their own beliefs, and they must be able to represent beliefs (...) as objects of beliefs. These requirements raise questions about the number of tokens of the belief representation language needed to represent believers and propositions in their normal roles and in their roles as objects of beliefs. In this paper, we explicate the relations among nodes, mental tokens, concepts, actual objects, concepts in the belief spaces of an agent and the agent's model of other agents, concepts of other cognitive agents, and propositions. We extend, deepen, and clarify our theory of intensional knowledge representation for natural-language processing, as presented in previous papers and in light of objections raised by others. The essential claim is that tokens in a knowledge-representation system represent only intensions and not extensions. We are pursuing this investigation by building CASSIE, a computer model of a cognitive agent and, to the extent she works, a cognitive agent herself. CASSIE's mind is implemented in the SNePS knowledge-representation and reasoning system. (shrink)

Furthermore, adults with decision-making capacity, including pregnant women, can currently accept interventions with moderate net risks for themselves in other settings (e.g., open f...

How can we be certain that software is reliable? Is there any method that can verify the correctness of software for all cases of interest? Computer scientists and software engineers have informally assumed that there is no fully general solution to the verification problem. In this paper, we survey approaches to the problem of software verification and offer a new proof for why there can be no general solution.

Every action, touch, utterance, and look, every listening, taste, smell, and feel is a living question; but it is no ordinary propositional one-by-one question, rather it is a plenisentient sensing and probing non-propositional enquiry about how our world is, in its present continuous sense, and in relation to how we anticipate its becoming. I will take this assumption as my first premise and, by using the notion of enkinaesthesia, I will explore the ways in which an agent’s affectively-saturated co-engagement with (...) its world establishes patterns of co-articulation of meaning within the anticipatory affective dynamics and the experiential entanglement necessary for expedient action and adaptation. In advancing this thesis I will reject the minimalist notions of embodiment by amplifying and extending the claims made by the most radical of the embodied mind theories. Crucially, I will offer a new wave of embodiment theory which has at its core the radical extension of sensorimotor affect into the life and being of other agents where their experience is for us both direct and immediate. This I will present as an immanent intercorporeality. (shrink)

Clinical ethics literature typically presents ethics consultations as having clear beginnings and clear ends. Experience in actual clinical ethics practice, however, reflects a different characterization, particularly when the moral experiences of ethics consultants are included in the discussion. In response, this article emphasizes listening and learning about moral experience as core activities associated with clinical ethics consultation. This focus reveals that responsibility in actual clinical ethics practice is generated within the moral scope of an ethics consultant's activities as she or (...) he encounters the unique and specific features that emerge from interactions with a specific patient, or family, or practitioner within a given situation and over time. A long-form narrative about an ethics consultant's interactions is interwoven with a more didactic discussion to highlight the theme of responsibility and to probe questions that arise regarding follow-up within the practice of clinical ethics consultation. (shrink)

Working within the tradition of continental philosophy, this article argues in favour of a phenomenological understanding of language as a crucial component of bioethical inquiry. The authors challenge the ‘commonsense’ view of language, in which thinking appears as prior to speaking, and speech the straightforward vehicle of pre-existing thoughts. Drawing on Maurice Merleau-Ponty's (1908–1961) phenomenology of language, the authors claim that thinking takes place in and through the spoken word, in and through embodied language. This view resituates bioethics as a (...) matter of bodies that speak. It also refigures the meaning of ethical self-reflexion, and in so doing offers an alternative view on reflexivity and critique. Referring to the Kantian critical tradition and its reception by Hannah Arendt and Michel Foucault, we advance a position we call ‘critical ethical reflexivity’. We contend that Merleau-Ponty's phenomenology of language offers valuable insight into ethical reflexivity and subject formation. Moreover, his understanding of language may foster new qualitative empirical research in bioethics, lead to more nuanced methods for interpreting personal narratives, and promote critical self-reflexion as necessary for bioethical inquiry. (shrink)

This article recounts the evolution of a global debate on the development of a common international code of journalistic ethics that would apply to East and West, Developed and Developing Countries. It sees as unlikely universal principles and prescriptions for professionals can be adopted across the divergent sociopolitical philosophies involved. Even common ground for constructive discussion on the topic is limited. Scholars, journalists, and educators are encouraged to instill an appreciation for the differences and to help create an understanding of (...) the special problems involved in media relationships among countries. (shrink)

This Open Access book about the Zadeh Project demonstrates and explores a core question in clinical ethics: how can ethics consultants be accountable in the face of a robust plurality of ethical standpoints, especially those that underwrite practices and methods for doing ethics consultation as well as those viewpoints and values encountered in daily clinical ethics practice? Underscoring this question is the recognition that the field of clinical ethics consultation has arrived at a crucial point in its maturation. Many efforts (...) are underway to more formally “professionalize” the field, with most aimed toward stabilizing a specific set of institutional considerations. Stretched between these institutional and practical initiatives resides a crucial set of of ethical considerations, chief among them the meaning and scope of responsibility for clinical ethics consultants. Developed around a long-form case scenario, the Zadeh Project provides a multi-layered series of “peer-reviews”: critique of the actions of the case scenario’s ethics consultant; reflection on clinical ethics method; examination of the many ways that commitments to method and practice can, and do, intersect, overlap, and alter one another. The design and format of this book thus models a key element for clinical ethics practice: the need and ability to provide careful and thoughtful explanation of core moral considerations that emerge among diverse standpoints. Specifically designed for those studying to become and those who are ethics consultants, this book, with its innovative and multi-layered approach, allows readers to share a peer-review-like experience that shows accountability to be what it is, an ethical, not merely procedural or administrative, undertaking. (shrink)

Machine consciousness exists already in organic systems and it is only a matter of time -- and some agreement -- before it will be realised in reverse-engineered organic systems and forward- engineered inorganic systems. The agreement must be over the preconditions that must first be met if the enterprise is to be successful, and it is these preconditions, for instance, being a socially-embedded, structurally-coupled and dynamic, goal-directed entity that organises its perceptual input and enacts its world through the application of (...) both a cognitive and kinaesthetic imagination, that I shall concentrate on presenting in this paper. It will become clear that these preconditions will present engineers with a tall order, but not, I will argue, an impossible one. After all, we might agree with Freeman and Núñez's claim that the machine metaphor has restricted the expectations of the cognitive sciences (Freeman & Núñez, 1999); but it is a double-edged sword, since our limited expectations about machines also narrow the potential of our cognitive science. (shrink)

The current study examined whether Callous-Unemotional (CU) traits, a core component of psychopathy, modulate neural responses of participants engaged in a social exchange game. In this task, participants were offered an allocation of money and then given the chance to punish the offerer. Twenty youth participated and responses to both offers and the participant’s punishment (or not) of these offers were examined. Increasingly unfair offers were associated with increased dorsal anterior cingulate cortex (dACC) activity but this responsiveness was not modulated (...) by CU traits. Increasing punishment of unfair offers was associated with increased dACC and anterior insula activity and this activity was modulated by CU traits. Higher CU trait participants showed a weaker association between activity and punishment level. These data suggest that CU traits are associated with appropriate expectations of other individual’s normative behavior but weaker representations of such information when guiding behavior of the self. (shrink)

In this short paper I will introduce an idea which, I will argue, presents a fundamental additional challenge to the machine consciousness community. The idea takes the questions surrounding phenomenology, qualia and phenomenality one step further into the realm of intersubjectivity but with a twist, and the twist is this: that an agent’s intersubjective experience is deeply felt and necessarily co-affective; it is enkinaesthetic, and only through enkinaesthetic awareness can we establish the affective enfolding which enables first the perturbation, and (...) then the balance and counter-balance, the attunement and co-ordination of whole-body interaction through reciprocal adaptation. (shrink)

We contest two claims: (1) that language, understood as the processing of abstract symbolic forms, is an instrument of cognition and rational thought, and (2) that conventional notions of turn-taking, exchange structure, and move analysis, are satisfactory as a basis for theorizing communication between living, feeling agents. We offer an enkinaesthetic theory describing the reciprocal affective neuro-muscular dynamical flows and tensions of co- agential dialogical sense-making relations. This “enkinaesthetic dialogue” is characterised by a preconceptual experientially recursive temporal dynamics forming the (...) deep extended melodies of relationships in time. An understanding of how those relationships work, when we understand and are ourselves understood, when communication falters and conflict arises, will depend on a grasp of our enkinaesthetic intersubjectivity. (shrink)

Context: Neurophenomenology is a relatively new field, with scope for novel and informative approaches to empirical questions about what structural parallels there are between neural activity and phenomenal experience. Problem: The overall aim is to present a method for examining possible correlations of neurodynamic and phenodynamic structures within the structurally-coupled work of Alexander Technique practitioners with their pupils. Method: This paper includes the development of an enkinaesthetic explanatory framework, an overview of the salient aspects of the Alexander Technique, and the (...) presentation of an elicitation interview technique as part of a neurophenomenological method. It will propose a way of testing the hypothesis that if, in the effective practice of Alexander Technique, there is a union between the nervous systems of teacher and pupil, it should be visible neurologically and affective phenomenologically, and thus it should be possible to investigate both its neural and phenomenal signatures. Results: The proposed means of testing the hypothesis is to use the elicitation interview technique alongside neural monitoring during the teaching of the Alexander Technique in four paired sets of subjects. Constructivist content: At the heart of this paper is the claim that all activity is co-activity. I make no assumption of an ontological primacy of mental or physical, or explanatory primacy of any methodology. Implications: This has important ramifications for somatic education and therapies, for establishing frameworks of co-engagement and care in health-care situations, and for understanding empathy. (shrink)

Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making and information (...) attainment. Decision-making comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. Information ascertainment comprised: professional responsibilities ; parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs. (shrink)

Since the Harvard Committees bold and highly successful attempt to redefine death in 1968 (Harvard Ad Hoc committee, 1968), multiple controversies have arisen. Stimulated by several factors, including the inherent conceptual weakness of the Harvard Committees proposal, accumulated clinical experience, and the incessant push to expand the pool of potential organ donors, the lively debate about the definition of death has, for the most part, been confined to a relatively small group of academics who have created a large body of (...) literature of which this issue of the Journal of Medicine and Philosophy is an example. Law and public policy, however, have remained essentially unaffected. This paper will briefly review the multiple controversies about defining death in an attempt to explain why they have and will remain unresolved in the academic community and have even less chance of being understood and resolved by politicians, legislators, and the general public. Considering this, we will end by suggesting the probable course of public policy and clinical practice in the decades ahead. (shrink)

(2001). Activities, Not Rules: The Need for Responsive Practice (On the Way Toward Responsibility) The American Journal of Bioethics: Vol. 1, No. 4, pp. 52-54.

SNePS, the Semantic Network Processing System 45, 54], has been designed to be a system for representing the beliefs of a natural-language-using intelligent system (a \cognitive agent"). It has always been the intention that a SNePS-based \knowledge base" would ultimatelybe built, not by a programmeror knowledge engineer entering representations of knowledge in some formallanguage or data entry system, but by a human informing it using a natural language (NL) (generally supposed to be English), or by the system reading books or (...) articles that had been prepared for human readers. Because of this motivation, the criteria for the development of SNePS have included: it should be able to represent anything and everything expressible in NL; it should be able to represent generic, as well as speci c information; it should be able to use the generic and the speci c information to reason and infer information implied by what it has been told; it cannot count on any particular order among the pieces of information it is given; it must continue to act reasonably even if the information it is given includes circular de nitions, recursive rules, and inconsistent information. (shrink)