Armed with expanded federal funding for human embryonic stem cell research and new methods for deriving pluripotent stem cells, stem cell researchers in the U.S. are poised to proceed with unprecedented speed toward the development of new clinical therapies. Staring into the new dawn of regenerative medicine, many observers may assume that the only responsible route to the clinic, both scientifically and ethically, is through FDA-approved clinical trials processes. Conventional wisdom dictates that, like pharmaceutical drugs and the use of biological (...) therapeutics, stem cell-based therapies will have to pass through a series of controlled studies — initially to assess safety and toxicity, then efficacy and comparative efficacy — before they can be justifiably administered to patients outside a clinical trials context. (shrink)

This paper discusses exceptional circumstances under which patients outside of clinical trials are likely to receive innovative stem cell-based interventions. These circumstances involve: (1) stem cell interventions not initially amenable to a clinical trials approach; (2) expanded access to investigational stem cell products (“compassionate use”); and (3) off-label uses of FDA approved stem cell products. This paper proposes a new approach to regulating these exceptional cases.

To be autonomous, a person must also have authentic moral values. She must act on her own values, not on values that were improperly pressed upon her. To respect a patient's autonomy, then, a caregiver must do more than carry out her requests. The caregiver must honor the patient's authentic requests. But how to do that?

Taking seriously the value of cultural competence in healthcare requires at least three general commitments. First, it involves accepting the view that patients' health beliefs and behaviors are influenced to a significant degree by their own social and cultural practices. Second, it requires careful attention to how health professionals typically respond to patients' different social and cultural standards at various levels of the healthcare delivery system. And third, it calls for developing interventions that are sensitive to these first two issues (...) to assure the delivery of quality healthcare for culturally diverse patients. This much is plain, insofar as we are talking about the broadest of commitments necessary to support the value of cultural competence in healthcare. But what other, more specific commitments are implied in accepting the value of cultural competence? (shrink)

: Many adolescent patients with chronic medical conditions do not manage their illnesses very closely and often put themselves at risk for serious health complications. Setting aside cases of nonadherence that are due to practical difficulties involving the implementation of a management plan, a deeply problematic question remains. How should health care providers respond to adolescent patients who express a conscious and value-driven decision to pursue other goals and interests that are incompatible with their doctors' recommended directives? Using two guiding (...) ethical principles, the "relevant difference principle" and the "principle of noninterference," as well as available empirical data on adolescent decision making and risk perception, the paper concludes that most adolescents ages 14 and older should be allowed to make self-determining decisions regarding the management of their chronic medical conditions. (shrink)

Over the past decade or so, the predominant patient-centered ethos in American bioethics has come under attack by critics who claim that it is morally deficient in certain respects, particularly when viewed in the context of acute-care decisionmaking. One line of criticism has been that the current ethic of patient autonomy gives an individual competent patient far too much decisional authority over the terms of his own treatment so that the patient is at complete liberty to neglect the ways in (...) which his medical decisions can drastically and negatively affect the lives of other family members. Given that family members must help shoulder the financial, emotional, and rehabilitative burdens involved in the patient's care, it has been argued that they too have a legitimate interest in choosing what sort of medical treatment the patient eventually receives. Another closely related line of criticism is that the prevailing focus on patient autonomy gives short shrift to the moral significance of the family as a genuine community. Echoing a view of the person advanced by most communitarian political theorists, some commentators have argued that the patient comes to the clinic so thoroughly embedded in a complex web of familial relationships and obligations that it does not make sense to identify him as the only person in the family to make decisions about treatment. (shrink)

This article is the lead piece in a special report that presents the results of a bioethical investigation into chimeric research, which involves the insertion of human cells into nonhuman animals and nonhuman animal embryos, including into their brains. Rapid scientific developments in this field may advance knowledge and could lead to new therapies for humans. They also reveal the conceptual, ethical, and procedural limitations of existing ethics guidance for human‐nonhuman chimeric research. Led by bioethics researchers working closely with an (...) interdisciplinary work group, the investigation focused on generating conceptual clarity and identifying improvements to governance approaches, with the goal of helping scholars, funders, scientists, institutional leaders, and oversight bodies (embryonic stem cell research oversight [ESCRO] committees and institutional animal care and use committees [IACUCs]) deliver principled and trustworthy oversight of this area of science. The article, which focuses on human‐nonhuman animal chimeric research that is stem cell based, identifies key ethical issues in and offers ten recommendations regarding the ethics and oversight of this research. Turning from bioethics’ previous focus on human‐centered questions about the ethics of “humanization” and this research's potential impact on concepts like human dignity, this article emphasizes the importance of nonhuman animal welfare concerns in chimeric research and argues for less‐siloed governance and oversight and more‐comprehensive public communication. (shrink)

Research suggests that cloning is incapable of producing a viable embryo when it is used on primate eggs. In fact, the entity created may not qualify as an embryo at all. If the results stand, cloning avoids the moral objections typically lodged against it, and cloning is itself an “alternative source” of stem cells.

Ranging from miniaturized biological robots to organoids, multi-cellular engineered living systems (M-CELS) pose complex ethical and societal challenges. Some of these challenges, such as how to best distribute risks and benefits, are likely to arise in the development of any new technology. Other challenges arise specifically because of the particular characteristics of M-CELS. For example, as an engineered living system becomes increasingly complex, it may provoke societal debate about its moral considerability, perhaps necessitating protection from harm or recognition of positive (...) moral and legal rights, particularly if derived from cells of human origin. The use of emergence-based principles in M-CELS development may also create unique challenges, making the technology difficult to fully control or predict in the laboratory as well as in applied medical or environmental settings. In response to these challenges, we argue that the M-CELS community has an obligation to systematically address the ethical and societal aspects of research and to seek input from and accountability to a broad range of stakeholders and publics. As a newly developing field, M-CELS has a significant opportunity to integrate ethically responsible norms and standards into its research and development practices from the start. With the aim of seizing this opportunity, we identify two general kinds of salient ethical issues arising from M-CELS research, and then present a set of commitments to and strategies for addressing these issues. If adopted, these commitments and strategies would help define M-CELS as not only an innovative field, but also as a model for responsible research and engineering. (shrink)

The use of nonhuman animals in research has long been a source of bioethical and scientific debate. We consider the oversight and use of nonhuman animals in chimeric research. We conducted interviews with twelve members of embryonic stem cell research oversight committees, nine members of institutional animal care and use committees, and fourteen scientists involved in human–nonhuman‐animal chimeric research in different areas of the United States. Interviews addressed animal welfare and conceptual issues associated with moral status and humanization of nonhuman (...) animals that contain human cells. Our findings suggest that concepts of enhanced moral status and consciousness are not very useful in human–nonhuman‐animal chimeric research in part because their meanings are not easily defined, which presents challenges to applying the concepts in research. Instead, scientists and oversight committee members we interviewed seemed to rely on standard assessments of changes in animal welfare when focusing on the ethics of human‐animal chimeric research. (shrink)

The two mythical tales from the Samguk yusa, “Lady Suro” and “Monk Hyet’ong Defeats the Dragon” reveal the little-known evil character of the Korean dragons. The second story presents a particular scene of a confrontation between a hero and a malicious dragon; this story leads us to reflect on the question of the symbolism of evil embodied by the Dragon who has a vengeful character. The dragon symbol and its semantic variations were constructed specifically within the singular Korean context and (...) cannot be limited to Chinese Buddhist heritage. (shrink)

This study explores the transhuman from an East Asian perspective. In terms of cognitive science, mathematics, and theology, we define the transhuman system as characterized by transcendence, extension by compactification, and samtaegeuk. Compactification is conceptualized here in mathematical terms, as adding one or more elements so that a system becomes more complete—as one might join both ends of a line, and thereby create a circle. We assert that the East Asian transhuman could be defined as a three-point compactification: as an (...) extension of biophysical objects and events such as robots, cyborgs, and environments ; as an extension of culture, science, and art ; and as an extension of the interaction between the human and Cosmic Absolute such as in religions. Such a notion of the Transhuman might be associated with God, but any description of God, the Absolute Infinite, will apply to something less than God. (shrink)

The structure of the deep artificial neural network is similar to the structure of the biological neural network, which can be well applied to the 3D visual image recognition of aerobics movements. A lot of results have been achieved by applying deep neural networks to the 3D visual image recognition of aerobics movements, but there are still many problems to be overcome. After analyzing the expression characteristics of the convolutional neural network model for the three-dimensional visual image characteristics of aerobics, (...) this paper builds a convolutional neural network model. The model is improved on the basis of the traditional model and unifies the process of aerobics 3D visual image segmentation, target feature extraction, and target recognition. The convolutional neural network and the deep neural network based on autoencoder are designed and applied to aerobics action 3D visual image test set for recognition and comparison. We improve the accuracy of network recognition by adjusting the configuration parameters in the network model. The experimental results show that compared with other simple models, the model based on the improved AdaBoost algorithm can improve the final result significantly when the accuracy of each model is average. Therefore, the method can improve the recognition accuracy when multiple neural network models with general accuracy are obtained, thereby avoiding the complicated parameter adjustment process to obtain a single optimal network model. (shrink)

The importance of the notion of common knowledge in sustaining cooperative outcomes in strategic situations is well appreciated. However, the systematic analysis of the extent to which small departures from common knowledge affect equilibrium in games has only recently been attempted.We review the main themes in this literature, in particular, the notion of common p-belief. We outline both the analytical issues raised, and the potential applicability of such ideas to game theory, computer science and the philosophy of language.

In his recent article entitled ‘Can We Believe the Error Theory?’ Bart Streumer argues that it is impossible (for anyone, anywhere) to believe the error theory. This might sound like a problem for the error theory, but Streumer argues that it is not. He argues that the un-believability of the error theory offers a way for error theorists to respond to several objections commonly made against the view. In this paper, we respond to Streumer’s arguments. In particular, in sections 2-4, (...) we offer several objections to Streumer’s argument for the claim that we cannot believe the error theory. In section 5, we argue that even if Streumer establishes that we cannot believe the error theory, this conclusion is not as helpful for error theorists as he takes it to be. (shrink)

schaften vorkommenden Aussagen deskriptiv und empirisch nachprüfbar sind, besteht zwischen Realisten und Strukturalisten keine Meinungsdifferenz."33 Aber was die Theorie selbst betrifft, vertritt der Strukturalismus die instrumentalistische ...

Jonathan Edwards was a preacher, theologian, and missionary to the Native Americans. This book asserts that Jonathan Edwards stood firmly on the Reformed tradition in the doctrine of justification.

This paper has attempted to present Wonch'uk's Ban-ya pa-ra-mil-da sim gyeong chan (般若波羅蜜多心經贊) or Commentary on the Heart Sūtra which was written in classical Chinese in the 7th century. As an example of the intellectual analysis of a sūtra, Wonch'uk's Commentary is an important text that has exerted asignificant influence on East Asian Buddhist thought. A prominent Korean Yogācāra scholar, Wonch'uk authored twenty-three works during his lifetime; unfortunately, all but three have been lost. The Commentary on the Heart Sūtra is (...) the shortest among his extant writings, yet it clearly reflects his incomparable erudition. To date, there has been very limited research on Wonch'uk and his thought in both the East and West. Utilizing Wonch'uk's original Chinese text,this paper will examine the distinctive features of Wonch'uk's Commentary which may offer the contemporary readers an opportunity to remind the importance of sūtra study and the engagement in sūtra exegesis. (shrink)

Siger conçoit sa critique à l’encontre de la théorie thomasienne de l’intellect en s’appuyant sur les adages tels que « agere sequitur formam » et « potentia non potest esse simplicior aut immaterialior quam eius substantia ». Structurant son argumentation autour de ces deux principes, il tente de démontrer que la position de Thomas d’Aquin se réduit finalement à une position matérialiste ou, se révèle encore être philosophiquement intenable lorsque ce dernier soutientces deux thèses qui, pour Siger, sont contradictoires, à (...) savoir que l’intellect est, d’une part, une des parties de l’âme humaine et d’autre part une puissance indépendante et séparée du corps. Or, Siger semble faire l’économie de l’une de ses arguments les plus puissants qui peut, a priori saper le fondement même de la théorie de l’intellect chez Thomas, à savoir le problème de se séparation du corps. Cependant, une analyse détaillée de la terminologie thomasienne nousrévèle la raison qui a poussé Siger à ne pas utiliser cette critique majeure ; en effet, il était conscient que cet argument qui semblait indiquer un possible incompatibilité entre l’intellect et le corps ne se réduisait en réalité qu’à un problème unsinnig. Cette retenue et cette maîtrise témoignent de de la perspicacité de Siger qui a su précisément demeurer à l’intérieur de la limite conceptuelle où il lui est possible de se présenter non pas comme un critique manqué deThomas d’Aquin, mais comme un véritable philosophe capable de mettre sa position en parallèl avec celle thomasienne concernant l’homme pensant ou « cet homme-ci qui pense ». (shrink)

Siger conçoit sa critique à l’encontre de la théorie thomasienne de l’intellect en s’appuyant sur les adages tels que « agere sequitur formam » et « potentia non potest esse simplicior aut immaterialior quam eius substantia ». Structurant son argumentation autour de ces deux principes, il tente de démontrer que la position de Thomas d’Aquin se réduit finalement à une position matérialiste ou, se révèle encore être philosophiquement intenable lorsque ce dernier soutientces deux thèses qui, pour Siger, sont contradictoires, à (...) savoir que l’intellect est, d’une part, une des parties de l’âme humaine et d’autre part une puissance indépendante et séparée du corps. Or, Siger semble faire l’économie de l’une de ses arguments les plus puissants qui peut, a priori saper le fondement même de la théorie de l’intellect chez Thomas, à savoir le problème de se séparation du corps. Cependant, une analyse détaillée de la terminologie thomasienne nousrévèle la raison qui a poussé Siger à ne pas utiliser cette critique majeure ; en effet, il était conscient que cet argument qui semblait indiquer un possible incompatibilité entre l’intellect et le corps ne se réduisait en réalité qu’à un problème unsinnig. Cette retenue et cette maîtrise témoignent de de la perspicacité de Siger qui a su précisément demeurer à l’intérieur de la limite conceptuelle où il lui est possible de se présenter non pas comme un critique manqué deThomas d’Aquin, mais comme un véritable philosophe capable de mettre sa position en parallèl avec celle thomasienne concernant l’homme pensant ou « cet homme-ci qui pense ». (shrink)

The purpose of this study was to investigate the relationship between organizational ethical context and the individual ethical decision-making process. In addition, a new statistical approach combining cluster and discriminant analyses was developed to overcome violations of regression assumptions, which are commonly not identified and/or ignored in behavioral and psychological research. Using regressions and this new alternative method, the findings indicated that ethical context does indeed influence the various components of ethical reasoning. However, social desirability was the strongest predictor of (...) ethical decision making, which raises new concerns about how this bias can confound business ethics research. Finally, the findings showed that the alternative method provided more useful and interpretive results, indicating that it has the capacity to influence future empirical work in the field of business ethics, particularly when dealing with data that do not satisfy regression assumptions. The implications and limitations of the study are discussed, and several noteworthy suggestions for future research are provided. (shrink)