In June 1993, conjoined twins Amy and Angela Lakeberg became the focus of national attention. They shared a complex six‐chambered heart and one liver; only one could survive separation surgery, and even her chances were slim. The medical challenge was great and the ethical challenges were even greater.

As the Zika virus pandemic continues to bring worry and fear to health officials and medical scientists, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have recommended that residents of the Zika-infected countries, e.g., Brazil, and those who have traveled to the area should delay having babies which may involve artificial contraceptive, particularly condom. This preventive policy, however, is seemingly at odds with the Roman Catholic Church’s position on the contraceptive. As least since the promulgation of (...) Paul VI’s 1968 encyclical, Humanae Vitae, the Church has explicitly condemned artificial birth control as intrinsic evil. However, the current pontiff, Pope Francis, during his recent visit to Latin America, remarked that the use of artificial contraception may not be in contradiction to the teaching of Humanae Vitae while drawing a parallel between the current Zika Crisis and the 1960’s Belgian Congo Nun Controversy. The pope mentioned that the traditional ethical principle of the lesser of two evils may be the doctrine that justified the exceptions. The authors of this paper attempt to expand the theological rationale of the pope’s suggestion. In so doing, the authors rely on casuistical reasoning as an analytic tool that compares the Belgian Congo Nun case and the given Zika case, and suggest that the former is highly similar to, if not the same as, the latter in terms of normative moral feature. That is, in both cases the use of artificial contraception is theologically justified in reference to the criteria that the doctrine of the lesser of two evils requires. The authors wish that the paper would provide a solid theological-ethical ground based on which condom-use as the most immediate and effective preventive measure can be recommended in numerous Catholic hospitals as well as among Catholic communities in the world, particularly the most Zika-affected and largest Catholic community in the world, Brazil – 123 million present Brazilian citizens are reported to be Roman Catholic. (shrink)

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...) in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

The study seeks to determine the influence of economic reward on unethical behavior with the help of a Reward Punishment Model. The model postulates that ethical or unethical behavior depends on the relationship among three factors: economic reward or benefit that a businessperson receives from the unethical practice, the severity of punishment the society imposes for such wrong-doing, and the probability of receiving the punishment. A short survey, which contained a hypothetical ethical situation, was administered to 251 respondents. The findings (...) indicate that the probability of risk-taking decreases as the level of punishmentand the chance of being caught increases. (shrink)

Traditionally, philosophers have been skeptical that the imagination can justify beliefs about the actual world. After all, how could merely imagining something give you any reason to believe that it is true? However, within the past decade or so, a lively debate has emerged over whether the imagination can justify empirical belief and, if so, how. This paper provides a critical overview of the recent literature on the epistemology of imagination and points to avenues for future research.

Lee emphasizes the need to better understand the moral relationship between researchers and participants connoted by precision medicine, with the framework of “the gift” offering bioethics a...

Context: Although ethics consultation is commonplace in United States hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the “best informant” within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services were found in 81% of all general hospitals in the U.S., and in 100% (...) of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians, nurses, social workers, or chaplains. Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

The emergence of new obstetrical and neonatal technologies, as well as more aggressive clinical management, has significantly improved the survival of extremely low birth weight infants. This development has heightened concerns about the limits of viability. ELBW infants, weighing less than 1,000 grams and no larger than the palm of one's hand, are often described as of late twentieth century technology. Improved survivability of ELBW infants has provided opportunities for long-term follow-up. Information on their physical and emotional development contributes to (...) developing standards of practice regarding their care. (shrink)

Davidson's theory of radical interpretation, and his principle of charity, are well known in their application to beliefs and meanings, but rarely discussed in their application to desires and values. This is a pity, for they provide the makings of an argument for normative realism that is definitely worth exploring. After introducing Davidson's interpretation argument, I work through some familiar grounds for doubting that it applies to desires and values. Foremost among these are doubts about the extent to which holism (...) is true of desires and about the sense in which values or reasons could be thought to be objective. I conclude that while Davidson does not always address these doubts as thoroughly or as carefully as one might wish, he clearly sees how the argument here has to go, and he has at his disposal plausible responses to a good number of the challenges that are likely to arise. (shrink)

A collection of original comics engaging fundamental issues in medical ethics, including patient autonomy, informed consent, unconscious bias, mandated reporting of suspected abuse, confidentiality, medical mistakes, surrogate decision-making, and futility.

In team-based tasks, successful communication and mutual understanding are essential to facilitate team coordination and performance. It is well-established that an important component of human conversation is the maintenance of common ground. Maintaining common ground has a number of associated processes in which conversational participants engage. Many of these processes are lacking in current synthetic teammates, and it is unknown to what extent this lack of capabilities affects their ability to contribute during team-based tasks. We focused our research on how (...) teams package information within a conversation, by which we mean specifically whether information is explicitly mentioned or implied, and how multiple pieces of information are ordered both within single communications and across multiple communications. We re-analyzed data collected from a simulated remotely-piloted aerial system task in which team members had to specify speed, altitude, and radius restrictions. The data came from three experiments: the “speech” experiment, the “text” experiment, and the “evaluation” experiment. We asked first whether teams settled on a specific routine for communicating the speed, altitude, and radius restrictions, and whether this process was different if the teams communicated in speech compared to text. We then asked how receiving special communication instructions in the evaluation experiment impacted the way the human teammates package information. We found that teams communicating in either speech or text tended to use a particular order for mentioning the speed, altitude, and radius. Different teams also chose different orders from one another. The teams in the evaluation experiment, however, showed unnaturally little variability in their information ordering and were also more likely to explicitly mention all restrictions even when they did not apply. Teams in the speech and text experiments were more likely to leave unnecessary restrictions unmentioned, and were also more likely to convey the restrictions across multiple communications. The option to converge on different packaging routines may have contributed to improved performance in the text experiment compared some of the conditions in the evaluation experiment. (shrink)

Successfully explaining and replicating the complexity and generality of human and animal learning will require the integration of a variety of learning mechanisms. Here, we introduce a computational model which integrates associative learning (AL) and reinforcement learning (RL). We contrast the integrated model with standalone AL and RL models in three simulation studies. First, a synthetic grid‐navigation task is employed to highlight performance advantages for the integrated model in an environment where the reward structure is both diverse and dynamic. The (...) second and third simulations contrast the performances of the three models in behavioral experiments, demonstrating advantages for the integrated model in accounting for behavioral data. (shrink)

Unlike many of his contemporaries John Henry Newman was comfortable with evolution. Newman had also, of course, thought deeply about religion. When, in the late 1850s and early 1860s, he began speculating about the nature of reality he saw the need to combine a scientific understanding of the physical universe with a Christian understanding of the human person. The Notes he left about this difficult topic are hard to make sense of. This book presents a readable version of the Notebook (...) and locates them in the cultural and intellectual context of the age. (shrink)

This paper develops a theory of analog representation. We first argue that the mark of the analog is to be found in the nature of a representational system’s interpretation function, rather than in its vehicles or contents alone. We then develop the rulebound structure theory of analog representation, according to which analog systems are those that use interpretive rules to map syntactic structural features onto semantic structural features. The theory involves three degree-theoretic measures that capture three independent ways in which (...) a system can be more or less analog. We explain how our theory improves upon prior accounts of analog representation, provides plausible diagnoses for novel challenge cases, extends to hybrid systems that are partially analog and partially symbolic, and accounts for some of the advantages and disadvantages of representing analogically versus symbolically. (shrink)

Background Despite the growth of biomedical research in South Africa, there are few insights into the operation of Research Ethics Committees (RECs) in this setting. We investigated the composition, operations and training needs of health RECs in South Africa against the backdrop of national and international guidelines. Methods The 12 major health RECs in South Africa were surveyed using semi-structured questionnaires that investigated the composition and functions of each REC as well as the operational issues facing committees. Results Health RECs (...) in SA have an average of 16 members and REC members are predominantly male and white. Overall, there was a large discrepancy in findings between under-resourced RECs and well resourced RECs. The majority of members (56%) are scientists or clinicians who are typically affiliated to the same institution as the health REC. Community representatives account for only 8% of membership. Training needs for health REC members varied widely. Conclusion Most major health RECs in South Africa are well organized given the resource constraints that exist in relation to research ethics in developing countries. However, the gender, racial and occupational diversity of most of these RECs is suboptimal, and most RECs are not constituted in accordance with South African guidelines. Variability in the operations and training needs of RECs is a reflection of apartheid-entrenched influences in tertiary education in SA. While legislation now exists to enforce standardization of research ethics review systems, no provision has been made for resources or capacity development, especially to support historically-disadvantaged institutions. Perpetuation of this legacy of apartheid represents a violation of the principles of justice and equity. (shrink)

Twelve essays in literary theory, philosophy, and religion--about atheism, freedom, and "the Jesus thought experiment"--connect, but don't conclude. A recurring theme is the "nothing" at the heart of the deep atheism of George Eliot, Walter Pater, Oscar Wilde, Rudyard Kipling, and Thomas Hardy, who approach "nothing" with a directness lacking in their English-speaking philosophical contemporaries. How does being in the world--Thomas Nagel's "what-it's-likeness"--and how do values--Alasdair MacIntyre's justice and misericordia--fare in the face of the mindless "It" that Hardy finds at (...) the heart of things? A pivotal essay compares the theism of Paul Ricoeur and the atheism of Daniel Dennett--the subtitle is a response to the latter's latest book. Writing and Freedom defends (a strong version of) free will as necessarily interpersonal: my freedom is nothing but my acceptance of yours. This is how Milton, Rossetti, and Dickinson treat their readers, and how scientists and philosophers ideally treat each other. The book's open-ended essays model freedom so understood. Moreover, both "nothing" and "freedom" are fundamental to biblical and religious narratives (Mark and Newman). God, being "out of all relation" with the finite, cannot be known from the text of the world. Yet as "nothing," God may be said to grant unconditional autonomy to his creatures, and therefore to be present in his absence. It is round "nothing," therefore, that atheists and theists endlessly circulate. But that is what the deep atheism of European thinkers--Nietzsche, Freud, Lacan, and Zizek--say we all do anyway, however excitedly we pretend to ourselves that we don't. (shrink)