Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.

Char et al. describe an interesting and useful approach in their paper, “Identifying ethical considerations for machine learning healthcare applications.” Their proposed framework, which see...

BackgroundResearch proactively and deliberately aims to bring about specific changes to how societies function and individual lives fare. However, in the ever-expanding field of ethical regulations and guidance for researchers, one ethical consideration seems to have passed under the radar: How should researchers act when pursuing actual, societal changes based on their academic work?Main textWhen researchers engage in the process of bringing about societal impact to tackle local or global challenges important concerns arise: cultural, social and political values and institutions (...) can be put at risk, transformed or even hampered if researchers lack awareness of how their ‘acting to impact’ influences the social world. With today’s strong focus on research impacts, addressing such ethical challenges has become urgent within in all fields of research involved in finding solutions to the challenges societies are facing. Due to the overall goal of doing something good that is often inherent in ethical approaches, boundaries to researchers’ impact of something good is neither obvious, nor easy to detect. We suggest that it is time for the field of bioethics to explore normative boundaries for researchers’ pursuit of impact and to consider, in detail, the ethical obligations that ought to shape this process, and we provide a four-step framework of fair conditions for such an approach. Our suggested approach within this field can be useful for other fields of research as well.ConclusionWith this paper, we draw attention to how the transition from pursuing impact within the Academy to trying to initiate and achieve impact beyond the Academy ought to be configured, and the ethical challenges inherent in this transition. We suggest a stepwise strategy to identify, discuss and constitute consensus-based boundaries to this academic activity. This strategy calls for efforts from a multi-disciplinary team of researchers, advisors from the humanities and social sciences, as well as discussants from funding institutions, ethical committees, politics and the society in general. Such efforts should be able to offer new and useful assistance to researchers, as well as research funding agencies, in choosing ethically acceptable, impact-pursuing projects. (shrink)

Efficiency is an important value for all publicly funded healthcare systems. Limited resources need to be used prudently and wisely in order to ensure best possible outcomes and waste avoidance. Since 2010, the drive for efficiency, in the UK, has acquired a new impetus, as the country embarked on an ‘age of austerity’ purportedly to balance its books and reduce national deficit. Although the NHS did not suffer any direct budget cuts, the austerity policies imposed on the welfare system, including (...) social and mental healthcare, have had a direct and detrimental impact on the healthcare service. This paper draws from a qualitative study conducted in three A&E Departments in England to explore the effects of austerity policies on the everyday experiences of doctors and nurses working in Emergency Departments. It discusses the operationalisation of efficiency in A&E, in a climate of austerity, and its effects on the experiences and practices of healthcare professionals. It uses the empirical data as a springboard to highlight the role of structures and regulations, in this case targets and protocols, in how core healthcare ethical values, such as empathy, are exercised in practice. It provides an analysis of the normative role structures and regulations can play on the perception and practice of professional duties and obligations in healthcare. (shrink)

Vor einiger Zeit hatte Angeliki E. Laiou den aktuellen Forschungsstand zu Maria der Jüngeren und ihrer Vita (BHG 1164) in einer äußerst nützlichen und ausgewogenen Studie zusammengefaßt und durch eigene Gedanken ergänzt. Obwohl sie bezüglich der Chronologie des Lebens der Maria feststellte, daß sich diese in vernünftiger Weise, wenn nicht gar genau, rekonstruieren ließe, blieb sie doch in Hinsicht auf das Todesdatum der Heiligen, wohl in Anlehnung an die ältere Forschung, eher zurückhaltend: “she died ca. 903”. Und auch (...) schon François Halkin hatte sich in der dritten Auflage der BHG nicht genau festlegen wollen: “Maria iunior Bizyae in Thracia † c. 902 – Febr. 16”. Das Todesdatum der Maria läßt sich jedoch mit ausreichender Sicherheit genau bestimmen. (shrink)

The recent book of Angeliki DELIKARI (D.) devoted to the life and the religious activity of St. Gregory the Sinaite is a fine example of a profound knowledge of the problems that such kind of study always implies. It is also a good illustration of what a perfect command of both mediaeval Greek and Slavonic can render as a scholarly result. One should acknowledge that, except for the works of A.-E. TACHIAOS, D. GONIS and K. PAVLIKIANOV, such Greek-Slavic philological (...) studies, which also combine features of historical and archaeological analysis, were extremely rare until now. (shrink)

In biomedical research lack of trust is seen as a great threat that can severely jeopardise the whole biomedical research enterprise. Practices, such as informed consent, and also the administrative and regulatory oversight of research in the form of research ethics committees and Institutional Review Boards, are established to ensure the protection of future research subjects and, at the same time, restore public trust in biomedical research. Empirical research also testifies to the role of trust as one of the decisive (...) factors in research participation and lack of trust as a barrier for consenting to research. However, what is often missing is a clear definition of trust. This paper seeks to address this gap. It starts with a conceptual analysis of the term trust. It compares trust with two other related terms, those of reliance and trustworthiness, and offers a defence of Baier’s attribute of ‘good will’ a basic characteristic of trust. It, then, proceeds to consider trust in the context of biomedical research by examining two questions: First, is trust necessary in biomedical research?; and second, do increases in regulatory oversight of biomedical research also increase trust in the field? This paper argues that regulatory oversight is important for increasing reliance in biomedical research, but it does not improve trust, which remains important for biomedical research. It finishes by pointing at professional integrity as a way of promoting trust and trustworthiness in this field. (shrink)

The aim of this article is to investigate the impact neoliberalism has in shaping the discourse of the European Union’s policy of Lifelong Learning. The literature review initially presents the theoretical framework of neoliberalism as the dominant ideological and economic paradigm of our time. Thereafter, it takes a view on how neoliberalism perceives the four objectives of the European Union’s Lifelong Learning policy, namely employability/adaptability, personal fulfillment, social inclusion, and active citizenship. Through the analysis of European Commission’s policy documents on (...) Lifelong Learning, this article explores whether these objectives, with focus on social inclusion and active citizenship, can be realized within the ideological, political, and economic framework set by the neoliberal paradigm. The data underwent Qualitative Analysis using the methods of Critical Discourse Analysis and Qualitative Content Analysis as well as Quantitative Analysis of textual data. The results indicate that only employability and adaptability seem to be compatible with the neoliberal rhetoric since the flexible and adaptable employee better serves the needs of the markets. The role neoliberalism holds for the individual is that of the consumer, product user, and voter. Therefore, the non-economic objectives of Lifelong Learning cannot be equally developed as they constitute the complete antithesis of neoliberalism’s basic principles. (shrink)

Galleries, libraries, archives and museums are striving to retain audience attention to issues related to cultural heritage, by implementing various novel opportunities for audience engagement through technological means online. Although born-digital assets for cultural heritage may have inundated the Internet in some areas, most of the time they are stored in “digital warehouses,” and the questions of the digital ecosystem’s sustainability, meaningful public participation and creative reuse of data still remain. Emerging technologies, such as artificial intelligence, are used to bring (...) born-digital archives to light, aiming to enhance the public’s engagement and participation. At the core of this debate lies both the openness of data and issues of privacy. How open to the public should born-digital archives be? Should everything be open and available online, and what does it take to achieve balance between openness and privacy, especially through AI initiatives? The study is qualitative and builds on the rationale of grounded theory. The role of AI development is critically investigated in relation to opening up born-digital archives online, by considering privacy and ethics issues. Grounded in the context of the author’s PhD research, the paper proposes a human-centred approach to AI development for democratising its development towards fairness and social inclusion, contrary to the stereotypical cliché of blackboxing, allowing space for the plurality of born-digital archives to flourish. (shrink)

Collaborations in global health research are on the rise because they enhance productivity, facilitate capacity building, accelerate output and make tackling big, multifactorial research questions possible. In this paper, I examine the concepts of trust and reliance in scientific collaborations in general, but also in the particular context of collaborations in global health research between high‐income countries and low‐and‐middle income countries (LMIC). I propose and defend the argument that given the particular characteristics of collaborations and demands of trust relationships, reliance (...) is a better relational mode for successful collaborations. Although reliance can be difficult to establish in situations where asymmetry of power exists, trust should not be the only relational mode available to LMIC researchers because of the type of vulnerability it introduces to the relationship. I conclude that the promotion of good collaborations requires addressing the power imbalances between partners, and establishing an even playing field in global health research. (shrink)

_Time and Timelessness_ examines the development of Jung's understanding of time throughout his opus, and the ways in which this concept has affected key elements of his work. In this book Yiassemides suggests that temporality plays an important role in many of Jung's central ideas, and is closely interlinked with his overall approach to the psyche and the cosmos at large. Jung proposed a profound truth: that time is relative at large. To appreciate the whole of our experience we must (...) reach beyond causality and temporal linearity, to develop an approach that allows for multidimensional and synchronistic experiences. Jung’s understanding surpassed Freud's dichotomous approach which restricted timelessness to the unconscious; his time theory allows us to reach beyond the everyday time-bound world into a greater realm, rich with meaning and connection. Included in the book: -Jung’s time theory -the death of time -time and spatial metaphors -the role of time in precognition, telepathy and synchronicity -_Unus mundus_ and time -a comparison of Freud’s and Jung’s time theories: temporal directionality, dimensionality, and the role of timelessness. This book is the first to explore time and timelessness in a systematic manner from a Jungian perspective, and the first to investigate how the concept of time affected the overall development of Jung's theory. It will be key reading for psychoanalytic scholars and clinicians, as well as those working in the field of phenomenological philosophy. (shrink)

By the time they reach early adulthood, English speakers are familiar with the meaning of thousands of words. In the last decades, computational simulations known as distributional semantic models have demonstrated that it is possible to induce word meaning representations solely from word co-occurrence statistics extracted from a large amount of text. However, while these models learn in batch mode from large corpora, human word learning proceeds incrementally after minimal exposure to new words. In this study, we run a set (...) of experiments investigating whether minimal distributional evidence from very short passages suffices to trigger successful word learning in subjects, testing their linguistic and visual intuitions about the concepts associated with new words. After confirming that subjects are indeed very efficient distributional learners even from small amounts of evidence, we test a DSM on the same multimodal task, finding that it behaves in a remarkable human-like way. We conclude that DSMs provide a convincing computational account of word learning even at the early stages in which a word is first encountered, and the way they build meaning representations can offer new insights into human language acquisition. (shrink)

BackgroundThe academic and medical literature highlights the positive effects of empathy for patient care. Yet, very little attention has been given to the impact of the requirement for empathy on the physicians themselves and on their emotional wellbeing.DiscussionThe medical profession requires doctors to be both clinically competent and empathetic towards the patients. In practice, accommodating both requirements can be difficult for physicians. The image of the technically skilful, rational, and emotionally detached doctor dominates the profession, and inhibits physicians from engaging (...) emotionally with their patients and their own feelings, which forms the basis for empathy. This inhibition has a negative impact not only on the patients but also on the physicians. The expression of emotions in medical practice is perceived as unprofessional and many doctors learn to supress and ignore their feelings. When facing stressful situations, these physicians are more likely to suffer from depression and burnout than those who engage with and reflect on their feelings. Physicians should be supported in their emotional work, which will help them develop empathy. Methods could include questionnaires that aid self-reflection, and discussion groups with peers and supervisors on emotional experiences. Yet, in order for these methods to work, the negative image associated with the expression of emotions should be questioned. Also, the work conditions of physicians should improve to allow them to make use of these tools.SummaryEmpathy should not only be expected from doctors but should be actively promoted, assisted and cultivated in the medical profession. (shrink)

Background In the UK, the solidaristic character of the NHS makes it one of the most trusted public institutions. In recent years, the introduction of data-driven technologies in healthcare has opened up the space for collaborations with private digital companies seeking access to patient data. However, these collaborations appear to challenge the public’s trust in the. Main text In this paper we explore how the opening of the healthcare sector to private digital companies challenges the existing social contract and the (...) NHS’s solidaristic character, and impacts on public trust. We start by critically discussing different examples of partnerships between the NHS and private companies that collect and use data. We then analyse the relationship between trust and solidarity, and investigate how this relationship changes in the context of digital companies entering the healthcare system. Finally, we show ways for the NHS to maintain public trust by putting in place a solidarity grounded partnership model with companies seeking to access patient data. Such a model would need to serve collective interests through, for example, securing preferential access to goods and services, providing health benefits, and monitoring data access. Conclusion A solidarity grounded partnership model will help establish a social contract or licence that responds to the public’s expectations and to principles of a solidaristic healthcare system. (shrink)

The academic and medical literature highlights the positive effects of empathy for patient care. Yet, very little attention has been given to the impact of the requirement for empathy on the physicians themsel..

Returning research results to participants is recognised as an obligation that researchers should always try to fulfil. But can we ascribe the same obligation to researchers who conduct genomics research producing only aggregated findings? And what about genomics research conducted in developing countries? This paper considers Beskow's et al. argument that aggregated findings should also be returned to research participants. This recommendation is examined in the context of genomics research conducted in developing countries. The risks and benefits of attempting such (...) an exercise are identified, and suggestions on ways to avoid some of the challenges are proposed. I argue that disseminating the findings of genomic research to participating communities should be seen as sharing knowledge rather than returning results. Calling the dissemination of aggregate, population level information returning results can be confusing and misleading as participants might expect to receive individual level information. Talking about sharing knowledge is a more appropriate way of expressing and communicating the outcome of population genomic research. Considering the knowledge produced by genomics research a worthwhile output that should be shared with the participants and approaching the exercise as a ‘sharing of knowledge’, could help mitigate the risks of unrealistic expectations and misunderstanding of findings, whilst promoting trusting and long lasting relationships with the participating communities. (shrink)

Biomedical research is an increasingly multidisciplinary activity bringing together a range of different academic fields and forms of expertise to investigate diseases that are increasingly understood to be complex and multifactorial. Recently the discipline of ethics has been starting to find a place in large-scale biomedical collaborations. In this article we draw from our experience of working with the Malaria Genomic Epidemiology Network and other research projects to reflect upon the integration of ethics into biomedical research. We examine the way (...) in which ethics input may be valuable to research, the forms it tends to take, and also the problems and limitations of such collaborations. (shrink)

The role of ethics committees is to protect and safeguard the rights and welfare of participants, and promote good research by providing ethical guidance to researchers. In order for ethics committees to fulfil their role and obligations, they need to have adequate understanding of the science and scientific methods used in research. Genomics is a novel and rapidly evolving research field, and identifying the ethical issues raised by it is not straightforward. Limited understanding of, and expertise in, reviewing genomic research (...) may lead ethics committees to either hamper novel research, or overlook important ethical problems. Researchers are in the best position to assist ethics committees in their efforts to remain informed about scientific advancements. (shrink)

Olive tree cultivation in theMediterranean goes back to ancient times. Evensince the Roman Age, olive cultivation spreadto the entire Mediterranean basin. Thislongevous tree integrates and identifieseconomically, socially, and culturally theinhabitants of this basin and determines itsrural landscape. For the residents of theMediterranean, olive oil constituted the mainsource of nutritional fats, their most valuableexport product, and was identified with theirculture. Even now, olive cultivation has amultiple importance for the Mediterranean. Theolive groves, which grow mostly on inclined,shallow, and low fertility soils, and (...) onhand-made stone terraces, have limited wateringrequirements and sustain the fragile naturalresources of the Mediterranean. Today,olive cultivation in the Mediterranean is anadditional income source and supports thepopulation in rural areas during the winterperiod, which profit from summer and seatourism activity. Although anagro-ecosystem, the olive grove resembles thenatural Mediterranean ecosystem and abandonmenttransforms them into natural Mediterranean typeforests. Their change of use from olivecultivation to pasture degrades the ecosystemand decreases the natural resources, because ofover-grazing. At this time, two major factorsthreaten the traditional olive cultivation (i)the competition of the intensive olive grovesin plain and irrigated areas and (ii) thecheaper seed-oils, which intensify theabandonment of traditional olive groves andchange them into pasture, resulting in thedeterioration of the ecosystem. Olivecultivation has left its mark on life in theMediterranean and has contributed to thesustainability of natural resources.Nevertheless, it succumbs under the pressure ofcurrent socioeconomic situations. Today, theconservation of olives in productionconstitutes a necessity for the fragileMediterranean ecosystems and a challenge foreverybody involved. (shrink)

Summary The study examined the relation between possible selves, academic performance, motivation, self?esteem and persistence on task. The assumption was that envisioning a desired end?state produces information processing favouring the desired state and, as a consequence, the action seems more likely and people are able to construct more efficient plans. We hypothesized that academic performance is best for subjects who are able to produce well?elaborated, vivid pictures of future selves. The sample consisted of 289 students, 14 and 15 years old, (...) of both sexes. The statistical analysis revealed that those who endorsed specific, elaborated positive selves outperformed the other groups in academic achievement. There was also indication that this group of students showed more persistence on task. The results are discussed in terms of their importance for the motivational role of possible selves in achievement situations. (shrink)

BackgroundDespite the recognition that developing artificial intelligence (AI) that is trustworthy is necessary for public acceptability and the successful implementation of AI in healthcare contexts, perspectives from key stakeholders are often absent from discourse on the ethical design, development, and deployment of AI. This study explores the perspectives of birth parents and mothers on the introduction of AI-based cardiotocography (CTG) in the context of intrapartum care, focusing on issues pertaining to trust and trustworthiness.MethodsSeventeen semi-structured interviews were conducted with birth parents (...) and mothers based on a speculative case study. Interviewees were based in England and were pregnant and/or had given birth in the last two years. Thematic analysis was used to analyze transcribed interviews with the use of NVivo. Major recurring themes acted as the basis for identifying the values most important to this population group for evaluating the trustworthiness of AI.ResultsThree themes pertaining to the perceived trustworthiness of AI emerged from interviews: (1) trustworthy AI-developing institutions, (2) trustworthy data from which AI is built, and (3) trustworthy decisions made with the assistance of AI. We found that birth parents and mothers trusted public institutions over private companies to develop AI, that they evaluated the trustworthiness of data by how representative it is of all population groups, and that they perceived trustworthy decisions as being mediated by humans even when supported by AI.ConclusionsThe ethical values that underscore birth parents and mothers’ perceptions of trustworthy AI include fairness and reliability, as well as practices like patient-centered care, the promotion of publicly funded healthcare, holistic care, and personalized medicine. Ultimately, these are also the ethical values that people want to protect in the healthcare system. Therefore, trustworthy AI is best understood not as a list of design features but in relation to how it undermines or promotes the ethical values that matter most to its end users. An ethical commitment to these values when creating AI in healthcare contexts opens up new challenges and possibilities for the design and deployment of AI. (shrink)

En 1988, la fouille sous‑marine du port de Thasos permettait l’extraction d’un imposant carreau de marbre, en même temps que d’autres blocs entassés en avant de la jetée antique. En 2017, un nouvel examen de la pierre, qui appartenait originellement à l’élévation d’un édifice de l’agora toute proche, a révélé une inscription rendue très difficilement lisible par un séjour prolongé dans l’eau de mer. Le Peuple des Thasiens y honorait son patron, Caius Octavius, proconsul de Macédoine en 60‑59 av. J.‑C.

The underdevelopment of a pedagogical culture for research methods education and the lack of a body of knowledge with the potential to influence practice have been highlighted by previous studies. This systematic review explores the pedagogic approaches and strategies evident in recent literature (2014–2020) on teaching social science research methods in higher education. It synthesises 55 papers offering a detailed rationale for the approach and strategies employed in doctoral/post-doctoral education. While dispersed across journals, there is a plethora of case studies (...) and reflective accounts about teaching approach, strategy, tactics and tasks in research methods education. Most studies reviewed report on teaching qualitative methods and represent authors’ own teaching practices. Consistent with previous studies, experiential, active learning and student-centred approaches are predominantly discussed, often overlapping or combined with other approaches. This paper illustrates a growing pedagogic culture, represented by an increased volume of papers and theoretical discussion of practices, rationale and reflection on how research methods are taught and learnt. It is concluded that clear intention to engage in dialogue and contribute to evidence-based practice and knowledge in research methods education is evident, and that the ‘how to’ element is richly articulated and justified. (shrink)

BackgroundAs the use of AI becomes more pervasive, and computerised systems are used in clinical decision-making, the role of trust in, and the trustworthiness of, AI tools will need to be addressed. Using the case of computational phenotyping to support the diagnosis of rare disease in dysmorphology, this paper explores under what conditions we could place trust in medical AI tools, which employ machine learning.MethodsSemi-structured qualitative interviews with stakeholders who design and/or work with computational phenotyping systems. The method of constant (...) comparison was used to analyse the interview data.ResultsInterviewees emphasized the importance of establishing trust in the use of CP technology in identifying rare diseases. Trust was formulated in two interrelated ways in these data. First, interviewees talked about the importance of using CP tools within the context of a trust relationship; arguing that patients will need to trust clinicians who use AI tools and that clinicians will need to trust AI developers, if they are to adopt this technology. Second, they described a need to establish trust in the technology itself, or in the knowledge it provides—epistemic trust. Interviewees suggested CP tools used for the diagnosis of rare diseases might be perceived as more trustworthy if the user is able to vouchsafe for the technology’s reliability and accuracy and the person using/developing them is trusted.ConclusionThis study suggests we need to take deliberate and meticulous steps to design reliable or confidence-worthy AI systems for use in healthcare. In addition, we need to devise reliable or confidence-worthy processes that would give rise to reliable systems; these could take the form of RCTs and/or systems of accountability transparency and responsibility that would signify the epistemic trustworthiness of these tools. words 294. (shrink)