The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

Karl Rahner (1904–1984) has exercised a profound influence on Catholic theology. This paper reconstructs both why and how Rahner’s ideas were received in the United States since the 1950s. American theologians did much more than simply repeat what the German Jesuit had outlined. Rather, they made use of his thought in order to do theology constructively. Thus, even today Rahner’s influence in the US is quite noticeable.

Wright’s “adaptive landscape” has been influential in evolutionary thinking but controversial, especially because the landscape that organisms encounter is altered by the evolutionary process itsel...

In addition to considering sociocultural, political, economic, and ethical factors, effectively engaging socioscientific issues requires that students understand and apply scientific explanations and the nature of science. Promoting such understandings can be achieved through immersing students in authentic real-world contexts where the SSI impacts occur and teaching those students about how scientists comprehend, research, and debate those SSI. This triangulated mixed-methods investigation explored how 60 secondary students’ trophic cascade explanations changed through their experiencing place-based SSI instruction focused on the Yellowstone (...) wolf reintroduction, including scientists’ work and debates regarding that issue. Furthermore, this investigation determined the association between the students’ post place-based SSI instruction trophic cascade explanations and NOS views. Findings from this investigation demonstrate that through the place-based SSI instruction students’ trophic cascade explanations became significantly more accurate and complex and included more ecological causal mechanisms. Also, significant and moderate to moderately large correlations were found between the accuracy and contextualization of students’ post place-based SSI instruction NOS views and the complexity of their trophic cascade explanations. Empirical substantiation of the association between the complexity of students’ scientific explanations and their NOS views responds to an understudied area in the science education research. It also encourages the consideration of several implications, drawn from this investigation’s findings and others’ prior work, which include the need for NOS to be forefront alongside and in connection with science content in curricular standards and through instruction focused on relevant and authentic place-based SSI. (shrink)

Angelaki, Volume 16, Issue 1, Page 1-3, 01Mar2011.

We applaud Dienes & Perner's efforts while raising some concerns regarding their assimilation of diverse data into a unifying framework. Some of the findings need not fit the framework they suggest. It is also not always clear what, above logico-semantic consistency, assimilation adds to the data that do fit their framework. These concerns are highlighted with reference to their arguments regarding the developmental data and the neuropsychological data, respectively.

The brain's reliance on glucose as a primary fuel source is well established, but psychological models of cognitive processing that take energy supply into account remain uncommon. One exception is research on self-control depletion, where debate continues over a limited-resource model of self-control depletion. This model argues that transient reduction in self-control after exertion of prior self-control is caused by the depletion of brain glucose, and that self-control processes are special, perhaps unique, in this regard. This model has been argued (...) to be physiologically implausible in several recent reviews. This paper attempts to correct some inaccuracies that have occurred during debate over the physiological plausibility of this model. We contend that not only is such limitation of cognition by constraints on glucose supply plausible, it is well established in the neuroscience literature across several cognitive domains. Conversely, we argue that there is no evidence that self-control is special in regard to its metabolic cost. Mental processes require physical energy, and the body is limited in its ability to supply the brain with sufficient energy to fuel mental processes. This article reviews current findings in brain metabolism and seeks to resolve the current conflict in the field regarding the physiological plausibility of the self-control glucose-depletion hypothesis. (shrink)

Fox’s update of her pivotal 2007 study on ethics consultations in U.S. hospitals found that the gap in ethics consultations is widening between large teaching hospitals and small community hospital...

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

The rise of multi-stakeholder institutions (MIs) involving the ultra-processed food (UPF) industry has raised concerns among food and public health scholars, especially with regards to enhancing the legitimacy and influence of transnational food corporations in global food governance (GFG) spaces. However, few studies have investigated the governance composition and characteristics of MIs involving the UPF industry, nor considered the implications for organizing global responses to UPFs and other major food systems challenges. We address this gap by conducting a network analysis (...) to map global MIs involving the UPF industry, drawing data from web sources, company reports, business and market research databases, and academic and grey literature. We identified 45 such global food system MIs. Of these, executives from the UPF industry or affiliated interest groups held almost half (_n_ = 263, or 43.8%) of the total 601 board seat positions. Executives from a small number of corporations, especially Unilever (_n_ = 20), Nestlé (_n_ = 17), PepsiCo Inc (_n_ = 14), and The Coca-Cola Company (_n_ = 13) held the most board seat positions, indicating centrality to the network. Board seats of these MIs are dominated by executives from transnational corporations (_n_ = 431, or 71.7%), high-income countries (_n_ = 495, or 82.4%), and four countries (United States, Switzerland, United Kingdom, and the Netherlands) (_n_ = 350, or 58.2%) in particular. This study shows that MIs involving the UPF industry privilege the interests of corporations located near exclusively in the Global North, draw legitimacy through affiliations with multi-lateral agencies, civil society groups and research institutions, and represent diverse corporate interests involved in UPF supply chains. Corporate-anchored multi-stakeholderism, as a form of GFG governance, raises challenges for achieving food systems transformation, including the control and reduction of UPFs in human diets. (shrink)

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

Reducing health disparities and improving health outcomes are fundamental principles in global health. Environmental justice remains underrecognized and undervalued as a key driver of health dispar...

BioPortal is a Web portal that provides access to a library of biomedical ontologies and terminologies developed in OWL, RDF(S), OBO format, Protégé frames, and Rich Release Format. BioPortal functionality, driven by a service-oriented architecture, includes the ability to browse, search and visualize ontologies (Figure 1). The Web interface also facilitates community-based participation in the evaluation and evolution of ontology content.

Marking the centenary of Walter Benjamin's immensely influential essay, "Toward the Critique of Violence," this critical edition presents readers with an altogether new, fully annotated translation of a work that is widely recognized as a classic of modern political theory. The volume includes twenty-one notes and fragments by Benjamin along with passages from all of the contemporaneous texts to which his essay refers. Readers thus encounter for the first time in English provocative arguments about law and violence advanced (...) by Hermann Cohen, Kurt Hiller, Erich Unger, and Emil Lederer. A new translation of selections from Georges Sorel's Reflections on Violence further illuminates Benjamin's critical program. The volume also includes, for the first time in any language, a bibliography Benjamin drafted for the expansion of the essay and the development of a corresponding philosophy of law. An extensive introduction and afterword provide additional context. With its challenging argument concerning violence, law, and justice-which addresses such topical matters as police violence, the death penalty, and the ambiguous force of religion-Benjamin's work is as important today as it was upon its publication in Weimar Germany a century ago. (shrink)

It is unclear whether the regulatory distinction between non-identifiable and identifiable information—information used to determine informed consent practices for the use of clinically derived samples for genetic research—is meaningful to patients. The objective of this study was to examine patients' attitudes and preferences regarding use of anonymous and identifiable clinical samples for genetic research. Telephone interviews were conducted with 1,193 patients recruited from general medicine, thoracic surgery, or medical oncology clinics at five United States academic medical centers. Wanting to know (...) about research being done was important to 72% of patients when samples would be anonymous and to 81% of patients when samples would be identifiable. Only 17% wanted to know about the identifiable scenario but not the anonymous scenario. Curiosity-based reasons were the most common among patients who wanted to know about anonymous samples. Of patients wanting to know about either scenario, approximately 57% would require researchers to seek permission, whereas 43% would be satisfied with notification only. Patients were more likely to support permission in the anonymous scenario if they had more education, were Black, less religious, in better health, more private, and less trusting of researchers. The sample, although not representative of the general population, does represent patients at academic medical centers whose clinical samples may be used for genetic research. Few patients expressed preferences consistent with the regulatory distinction between non-identifiable and identifiable information. Data from this study should cause policy-makers to question whether this distinction is useful in relation to research with previously collected clinically derived samples. (shrink)

Returning genomic research results to family members raises complex questions. Genomic research on life-limiting conditions such as cancer, and research involving storage and reanalysis of data and specimens long into the future, makes these questions pressing. This author group, funded by an NIH grant, published consensus recommendations presenting a framework. This follow-up paper offers concrete guidance and tools for implementation. The group collected and analyzed relevant documents and guidance, including tools from the Clinical Sequencing Exploratory Research Consortium. The authors then (...) negotiated a consensus toolkit of processes and documents. That toolkit offers sample consent and notification documents plus decision flow-charts to address return of results to family of living and deceased participants, in adult and pediatric research. Core concerns are eliciting participant preferences on sharing results with family and on choice of a representative to make decisions about sharing after participant death. (shrink)

Exploring the Illusion of Free Will and Moral Responsibility is an edited collection of new essays by an internationally recognized line-up of contributors. It is aimed at readers who wish to explore the philosophical and scientific arguments for free will skepticism and their implications.

Kant’s notion of (what I will call) rational sympathy solves a problem about how we can voluntarily fulfill our imperfect duty to adopt those ends of others which have value only because they have been set by rational agents, ends which I will refer to as merely permissible ends (MPEs). Others’ MPEs are individuated in terms of their own concepts of their MPEs, and we can only adopt their MPEs in terms of their concepts, since to adopt them in terms (...) of different concepts would be to adopt different ends. Others’ concepts of their MPEs may contain marks of the first person, and should contain no marks of law apart from permissibility. Rational sympathy allows us to adopt ends individuated in terms of concepts with marks of these kinds because rational sympathy allows us to voluntarily adopt others’ first-person perspectives in imagination, and to voluntarily shape our contingent feelings so that such concepts motivate us despite their underdetermination by law. (shrink)

Broadening access to both computational and educational resources is crit- ical to diffusing machine learning (ML) innovation. However, today, most ML resources and experts are siloed in a few countries and organizations. In this article, we describe our pedagogical approach to increasing access to applied ML through a massive open online course (MOOC) on Tiny Machine Learning (TinyML). We suggest that TinyML, applied ML on resource-constrained embedded devices, is an attractive means to widen access because TinyML leverages low-cost and globally (...) accessible hardware and encourages the development of complete, self-contained applications, from data collection to deployment. To this end, a collaboration between academia and industry produced a four part MOOC that provides application-oriented instruction on how to develop solutions using TinyML. The series is openly available on the edX MOOC platform, has no prerequisites beyond basic programming, and is designed for global learners from a variety of backgrounds. It introduces real-world applications, ML algorithms, data-set engineering, and the ethi- cal considerations of these technologies through hands-on programming and deployment of TinyML applications in both the cloud and on their own microcontrollers. To facili- tate continued learning, community building, and collaboration beyond the courses, we launched a standalone website, a forum, a chat, and an optional course-project com- petition. We also open-sourced the course materials, hoping they will inspire the next generation of ML practitioners and educators and further broaden access to cutting-edge ML technologies. (shrink)

Structural history, Conceptual history, Theory of historical time, Semantics of History: the work of Reinhart Koselleck is associated with a wide spectrum of methodological orientations that emerged during the post-war period and originated from the in-depth reflection on the significance of historical sciences. Koselleck shared with numerous West-German historians the observation that historical science was experiencing a profound crisis exacerbated by the increasing influence of social sciences. However, unlike his contemporary historians, who advocated the criticism of historicism as a prerequisite (...) for reforming their discipline, Koselleck championed a radically different path to remedy to this crisis. In this paper, we shall outline the major stages of the critical dialogue between Koselleck and the West-German historiography of his time. Two distinct historical intervals emerge from this analysis: the first is marked by the influence of the structural historical model, developed by Werner Conze during the 1950s, on Koselleck’s theoretical vision; the second, which started in the 1970s, is characterized by the refusal to consider the critical social history as the basis for a holistic explanation of national history. (shrink)

This article seeks to decentre the proprietary author in copyright law by attending to some peripheral matters of Immanuel Kant’s periodical essay, ‘On the Wrongfulness of Reprinting’ (1785), as indices of its medial-material conditions of possibility. We consider not only the epitextual background of the German Enlightenment in which the Berlinische Monatsschrift was produced, but also the peritextual specimens of catchwords, signature marks, and various front matter of Kant’s essay. This medial reading suggests the periodical to be deeply involved (...) in the operations of a print machinery preceding the authorial figure, the existence of which perturbs copyright law’s attachment to original authorship. (shrink)

The overwhelming consensus amongst epistemologists is that there is no salient epistemological difference between the addressees of a speaker’s testimony and non-addressees. I argue that this overwhelming consensus is mistaken. Addressees of a speaker’s testimony are entitled to pass the epistemic buck or defer justificatory responsibility for their beliefs back to the testimonial speaker, while non-addressees are not. I then develop a provisional account of address that is in a position to mark this epistemic distinction between addressees and non-addressees.

This paper is written in response to the planetary times in which we live, marked as they are by the interwoven realities of political polarisation and environmental degradation. Looking to Hannah Arendt’s political writings for a response to this reality, in this paper I challenge the predominance of natality as a revolutionary concept and turn instead to Arendt’s discussion of love. After an initial rereading of the temporality of love at work in her concept of amor mundi, the paper develops (...) the idea of “amor terra,” or love for the pre-political and planetary constitution of politics. Taking seriously Arendt’s claim that what is required in times of crisis is a renewed conception of human dignity, I offer amor terra in precisely these terms. Developed in dialogue with Arendt’s writings on the earthly condition of responsibility, politics, and care, I ultimately argue that what amor terra offers is a renewed setting from which the integrity of the political can be reimagined. (shrink)

ABSTRACT The little-studied presidency of Benjamin Harrison offers valuable insights into the surprising role that political ideas can play in government. Harrison was a highly qualified president who demonstrated energetic leadership and political skill, but whose ideological commitment to the Republican party as a quasi-sacred enterprise overrode other important considerations, thereby contributing to one of the greatest economic catastrophes in U.S. history: the Depression of 1893-1897. His ideas about the Republican party were forged in its early years, when it (...) led the political battle against slavery; but when Harrison became president, the party’s interests in trade protectionism, veterans’ pensions, and silver drove him to support policies that eventually sent the economy into a tailspin from which it took years to recover. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps, and other notations in the work. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may (...) freely copy and distribute this work, as no entity has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This excellent book focuses on a decisive moment in Schelling's philosophical development: his 1801 dispute with Eschenmayer shortly before publishing Presentation of My System, the inaugural text of his identity philosophy. Carl August Eschenmayer was a German physician whose Kant-inspired writings in the philosophy of nature greatly influenced Schelling, especially with respect to the doctrine of the potencies. As Berger and Whistler demonstrate, the 1801 controversy has significant implications for understanding the trajectory of German Idealism and its debates on methodology, (...) the meaning of identity, and the place of nature in philosophy. (shrink)

Adaptations made by agrarian households in the face of global change risks are largely dependent on their livelihood goals. I argue that adaptation-limit research is crucial to many agrarian development programs because a focus on adaptation limits may allow researchers and practitioners to better understand and support successful adaptation and allow smallholders to pursue their goals. In this study of smallholder farming in Northwest Costa Rica, I found that security and the unique parcelero identity of rice farmers in this region (...) define livelihood goals. I show that an understanding of the multidimensionality and fluidity of farmer livelihood goals may enrich our current understanding of actor-centered adaptation limits as insurmountable thresholds. In response to worsening global change risks, farmers in this study traded off certain goals to pursue others. In this way, farmers do not perceive adaptation limits as insurmountable. Alternative indicators of adaptation limits did exist; irreversibility in adaptation and the great hardship associated with tradeoffs among livelihood goals may mark adaptation limits. (shrink)

This dissertation offers a phenomenology of that mode of self-interpretation in which it becomes possible for an interpreter to intentionally participate in the production of moral norms to which the interpreter himself or herself feels bound. Part One draws on Richard Rorty's notion of the "ironist" in order to thematize the phenomenon I call "moral friction"; a condition in which an interpreter becomes explicitly aware of the historical and cultural contingencies of their own moral vocabularies, practices, and concerns and as (...) a result find themselves incapable of feeling the normative weight implicit in these. Part Two draws on Heidegger's existential analytic of human being, Gadamer's development of Hermeneutic Phenomenology, and Hegel's notion of "sublation" in order to map how novel interpretations can irreversibly displace the coherence of older interpretations. I call this form of interpretation "moral phenomenology." Finally, in Part Three, I utilize a selective phenomenology of musical improvisation to plot the unique temporal orientation of self-interpretation that results from intentionally deploying this irreversible displacement of older interpretations that involve normative moral implications. I call the form of life that is marked by this hermeneutic mode the "improviser." The result is a description of a form of life in which it becomes possible to explicitly participate in the production of moral norms within a historical and culturally contingent context that nevertheless preserves standards of rational justification for normative moral judgment without the need for atemporal first principles. The availability of this mode of self-interpretation displaces the sharp distinction between non-normative descriptive phenomenology and normative moral reasoning by placing the latter within a non-teleological historical practice that engages in the production of interpretations which irreversibly displace older interpretations--a practice that is governed by the critical cultivation of contingent moral norms within the open investigation into the good life for human being. (shrink)

Alfred Schutz elaborated Edmund Husserl’s term of appresentation to a particular theory of appresentational relations comprising “marks”, “signs”, “symbols” and “indications”. Even though Schutz implied the existence of other such relations, it was Husserl who drew a line between appresentation and proof. Following this differentiation, this paper aims to constitutionally analyse the everyday life phenomenon of proof and to describe its structure by consulting William James’ term of “knowledge about” as well as by discussing Schutz’ theory of relevance. With (...) reference to Husserl’s Logical Investigation and by contrasting proof with indication it is shown that proof is appresentationally constituted through reflectively bringing the polythetical elements of clear, distinctive and consistent knowledge about, functioning as interpretational relevance, into the centre of topical awareness. (shrink)