An anxious resident paged ethics at 2:00 a.m. His patient, Mr. M, a twenty‐nine‐year‐old man with a history of multiple substance abuse, was in the hospital after cardiac arrest and lack of cerebral perfusion. Sadly, the young man probably met the criteria for brain death, but the final apnea test to confirm the diagnosis could not be done for another forty‐eight to seventy‐two hours because the Klonopin in his system might confound the results. The resident's concern, however, addressed a request (...) made by the patient's mother for a sperm harvest. The patient's mother maintained that her son had said he wanted to give her grandchildren. She wished to harvest sperm from him for a future use with an as‐yet‐to‐be‐determined surrogate mother. (shrink)

European and international regulation of human health research is typified by a morass of interconnecting laws, diverse and divergent ethical frameworks, and national and transnational standards. There is also a tendency for legislators to regulate in silos—that is, in discrete fields of scientific activity without due regard to the need to make new knowledge as generalisable as possible. There are myriad challenges for the stakeholders—researchers and regulators alike—who attempt to navigate these landscapes. This Delphi study was undertaken in order to (...) provide the first interdisciplinary and crosscutting analysis of health research regulation, as it is experienced by such stakeholders in the UK context. As well as reinforcing existing understandings of the regulatory environment, Delphi participants called for greater collaboration, and even co-production, of processes involved in health research regulation. On the basis of this research, we offer insights about how health research regulation can become a matter with which a wider range of stakeholders—including researchers, regulators, publics and research sponsors—can engage. The evidence supports the normative claim that health research regulation should continue to move away from strict, prescriptive rules-based approaches, and towards flexible principle-based regimes that allow researchers, regulators and publics to co-produce regulatory systems serving core principles. By unpacking thorny concepts and practices at the heart of health research regulation—including the public interest and public engagement—our results have the potential to situate and breathe life into them. The results also demonstrate that while proportionality is well-recognised as a crucial element of flexible regulatory systems, more must be done to operationalise this as an ethical assessment of the values and risks at stake at multiple junctures in the research trajectory. This is required if we are to move beyond proportionality as a mere risk-management tool. Compliance culture no longer accurately reflects the needs and expectations of researchers or regulators, nor does it necessarily produce the best research. Embracing uncertainty—both as a human practice and a regulatory objective—may represent the brighter future for health research. (shrink)

Bioethics, Volume 36, Issue 5, Page 605-607, June 2022.

Providing the most thorough coverage available in one volume, this comprehensive, broadly based collection offers a wide variety of selections in four major genres, and also includes a section on film. Each of the five sections contains a detailed critical introduction to each form, brief biographies of the authors, and a clear, concise editorial apparatus. Updated and revised throughout, the new Fourth Edition adds essays by Margaret Mead, Russell Baker, Joan Didion, Annie Dillard, and Alice Walker; fiction by Nathaniel (...) Hawthorne, Ursula K. LeGuin, Anton Chekov, James Joyce, Katherine Mansfield, F. Scott Fitzgerald, William Faulkner, Alice Walker, Louise Erdrich, Donald Barthelme, and James McPherson; poems by John Donne, Robert Browning, Walt Whitman, Edwin Arlington Robinson, e.e. cummings, Langston Hughes, W.H. Auden, Philip Levine, and Louise Gluck; and plays by August Wilson, Marsha Norman, Wendy Wasserstein, and Vaclav Havel. The chapter devoted to film examines the relation of film to literature and gives the complete screenplay for Citizen Kane plus close analysis of a scene from the film. With its innovative structure, comprehensive coverage, and insightful and stimulating presentation of all kinds of literature, this is an anthology readers will turn to again and again. (shrink)

Among philosophers, there are at least two prevalent views about the core concept of intentional action. View I (Adams 1986, 1997; McCann 1986) holds that an agent S intentionally does an action A only if S intends to do A. View II (Bratman 1987; Harman 1976; and Mele 1992) holds that there are cases where S intentionally does A without intending to do A, as long as doing A is foreseen and S is willing to accept A as a consequence (...) of S’s action. Joshua Knobe (2003a) presents intriguing data that may be taken to support the second view.1 Knobe’s data show an asymmetry in folk judgements. People are more inclined to judge that S did A intentionally, even when not intended, if A was perceived as causing a harm (e.g. harming the environment). There is an asymmetry because people are not inclined to see S’s action as intentional, when not intended, if A is perceived as causing a benefit (e.g. helping the environment). In this paper we will discuss Knobe’s results in detail. We will raise the question of whether his ordinary language surveys of folk judgments have accessed core concepts of intentional action. We suspect that instead Knobe’s surveys are tapping into pragmatic aspects of intentional language and its role in moral praise and blame. We will suggest alternative surveys that we plan to conduct to get at this difference, and we will attempt to explain the pragmatic usage of intentional language. (shrink)

Without trust there is no credible human health research (HHR). This article accepts this truism and addresses a crucial question that arises: how can trust continually be promoted in an ever-changing and uncertain HHR environment? The article analyses long-standing mechanisms that are designed to elicit trust—such as consent, anonymization, and transparency—and argues that these are best understood as trust represented by proxies of trustworthiness, i.e., regulatory attempts to convey the trustworthiness of the HHR system and/or its actors. Often, such proxies (...) are assumed to operate as markers that trust exists or, at least, has not been lost. But, since trust can neither be “built” nor “secured,” this is a precarious assumption. Worryingly, there is no existing theoretical account of how to understand and evaluate these proxies of trustworthiness as part of a trusted HHR ecosystem. To remedy this, the paper argues for a radical reimagining of trust and trustworthiness as performative acts that ought to be understood in relation to each other and by reference to the common values at stake. It is shown that proxies of trustworthiness are the operational tools used to perform trustworthiness. It advocates for a values-based approach to understanding the relationship between trust and trustworthiness. This establishes a strong basis for an evaluative framework for proxies of trustworthiness, i.e., to determine how to perform trustworthiness well. Five common proxies in HHR are scrutinized from a values perspective. The contribution is to provide a far-reaching normative and practical framework by which existing and future proxies of trustworthiness can be identified, assessed, maintained, or replaced in rapidly changing HHR regulatory ecosystems where trust itself is crucial to the success of the entire HHR enterprise. (shrink)

We propose that the isomorphism generally observed between the representations composing our momentary phenomenal experience and the structure of the world is the end-product of a progressive organization that emerges thanks to elementary associative processes that take our conscious representations themselves as the stuff on which they operate, a thesis that we summarize in the concept of Self-Organizing Consciousness (SOC). Key Words: Associative learning; automatism; consciousness; development; implicit learning; incubation; language; mental representation; perception; phenomenal experience.

Multinational enterprises are aware of their responsibility to protect human rights now more than ever, but severe human rights violations, including physical integrity abuses, continue unabated. To explore this puzzle, we engage theoretically with the means-ends decoupling literature to examine if and when oil and gas firms’ policies and practices prevent severe human rights abuse. Using an original dataset, we identify two pathways to mitigate means-ends decoupling: while human rights policies alone do not reduce human rights abuses, firms with a (...) high-quality human rights policy over the long-term reduce severe human rights abuses; firms that combine preparedness—which we define as a firm’s capabilities, practices, and engagement—with a long-term human rights policy also reduce the likelihood of human rights abuses. Preparedness, we argue, can lead to reinforcement dynamics between long-term policy efforts and additional capabilities that provide a more holistic understanding of firm behavior. (shrink)

Describing a cognitive system at a mechanistic level requires an engineering task analysis. This involves identifying the task and developing models of possible solutions. Evolutionary psychology and Bayesian modeling make complimentary contributions: Evolutionary psychology suggests the types of tasks that human brains were designed to solve, while Bayesian modeling provides a rigorous description of possible computational solutions to such problems.

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

Chapter 9 describes and evaluates the relatively recent mental health models of the impact of trauma, and discusses the ways that traumatic events affect people, the political and cultural effects of understanding these consequences as ‘disorder’, particularly as Post-traumatic Stress Disorder (PTSD), and concludes by looking at the relevance of the concept of PTSD to forensic populations.

In the coming months and years, the left faces a historic juncture. On the one hand, racist violence is on the rise across the West, and the political class seems intent on mobilising both overt and subtle racism. On the other hand, strategies of anti-racist organising, which have developed on both sides of the Atlantic, have reached a theoretical impasse. I argue that now, more than ever, a serious project of historical and intellectual retrieval is necessary. This article interrogates the (...) theoretical limitations of ‘anti-blackness’ as an analysis of racialised oppression. Through the thought of Frantz Fanon and Steve Biko, among others, I argue that theories of ‘anti-blackness’, specifically those rooted in Afro-pessimism, are predicated on a theoretical shift away from relational social theory to identitarian essentialism which obscures, rather than illuminates, the processes of racialisation which undergird racial oppression. (shrink)

Félix Guattari, a French philosopher and psychotherapist often recognized for his collaboration with Gilles Deleuze, also published important work of his own. The way he conceptualizes subjectivity and schizoanalysis (later developed into institutional analysis) can incite us to interpret our social contexts differently and to help frame an emancipatory path in nursing. At La Borde, a psychiatric clinic, subjectivity was seen as the real power that lies within the institutions; invisible and flowing through all levels of the hierarchal structure—like waves—each (...) of them unique but still part of the same ocean. Even with its elusive character, this concept can be wielded through psychotherapeutic techniques of analysis which aim to reduce hierarchies, encourage collaborations, decentralize levers of power and promote initiatives that arise from the base. These concepts deserve further exploration when it comes to modern institutional issues like the ones present in Quebec's (Canada) healthcare system. Therefore, this article borrows theorizations elaborated through psychotherapy and applies them to the hospital institution which is seen as an organized, stable structure (the molar line), while paying attention to fluid, changing processes and the multiplicity of desires for transformation (the molecular line), to promote nursing movements that escape and abolish these structures, creating new possibilities and new forms of thinking (the line of flight). (shrink)

In this paper, we argue that boredom can be an important experience that contributes to personal autonomous agency by providing authentic motivation, and that strategies of social media providers to bind users’ attention to their platforms undermine this authenticity. As discussed in social epistemology and media ethics for a while now, such strategies can lead to so-called epistemic or filter bubbles. Our analysis of the relation between boredom and social media use focuses on a similarly impairing effect of social media (...) on users’ autonomy, which we call authenticity bubbles. (shrink)

L’écoute d’un couple en crise qui demande à être aidé montre fréquemment que la dégradation de leur communication affective et sexuelle a débuté à la naissance d’un enfant, pas nécessairement le premier. Quelques exemples témoignent à quel point de multiples remaniements psychiques s’opèrent au sein du couple, lorsqu’une femme devient mère : retour de l’enfant en soi, réactivation des conflits œdipiens. Et, comme le souligne Winnicott, n’y aurait-il pas en chaque homme et en chaque femme la représentation d’une femme/mère toute-puissante (...) et dominatrice, source d’angoisses multiples? Cette peur de la femme, qu’il faut donc à tout prix dominer, semble évidente lorsqu’on écoute les représentations que les adolescents se font de l’autre sexe. Les auteurs proposent quelques repères théoriques afin de comprendre ces angoisses et aider les couples à les reconnaître pour mieux les gérer. (shrink)

This article explores the potential applications of feminist pedagogy to the lived experience of weekly preaching from the perspective of a young, white, cis female, heterosexual faith community leader. When privilege is both obvious, but authority is simultaneously presumed and challenged based on historical constructs of theological role and presentation of gender, the act of preaching becomes a site of resistance. This article then discusses the act of homiletics – the art of interpretive storytelling, history teaching, persuasive speech, and spiritual (...) performance – as informed by a feminist perspective. Does the pulpit present a bridge or barrier where gender is concerned? The physical act of preaching can represent an in-moment incarnating of a role, a historical step in a long-flowing river, and a psychological break point of self-erasure. This article posits that a thoughtful application of feminist pedagogy might dismantle these unspoken rules of the trade and create an opportunity for preaching as an act of resistance. (shrink)

L'etude historique du principe de vie dans l'oeuvre de Descartes et dans celle de ses predecesseurs souligne notamment l'enjeu de la scission cartesienne entre l'ame et les phenomenes biologiques. Elle permet de comprendre, dans sa nouveaute radicale, la notion de principe de vie chez Descartes, qui associe la decouverte recente de la circulation du sang par W. Harvey, a une explication mecanique de la chaleur du coeur. Du traite de L'Homme aux Passions de l'ame, Descartes identifie en effet la notion (...) de principe de vie a la chaleur contenue dans le coeur, nourrie par la circulation du sang. Une telle conception s'oppose a la vision aristotelicienne, ou la biologie et la psychologie sont etroitement liees, ainsi qu'aux adeptes du panpsychisme que Descartes a critiques: Campanella et Henry More. (shrink)

BackgroundChildhood adversity is linked to adverse health in adulthood. One posited mechanistic pathway is through physiological responses to acute stress. Childhood adversity has been previously related to both exaggerated and blunted physiological responses to acute stress, however, less is known about the psychological mechanisms which may contribute to patterns of physiological reactivity linked to childhood adversity.ObjectiveIn the current work, we investigated the role of challenge and threat stress appraisals in explaining relationships between childhood adversity and cortisol reactivity in response to (...) an acute stressor.MethodsUndergraduate students completed an online survey that included general demographic information and the Risky Families Questionnaire 24 h before a scheduled lab visit. In the lab, a research assistant collected a baseline salivary cortisol sample. Following the baseline period, participants were read instructions for the Trier Social Stress Test, a validated psychological lab stressor. Next, they completed a challenge vs. threat task appraisal questionnaire and completed the speech and math portion of the TSST. Twenty minutes following the start of the TSST, a second salivary sample was collected to measure changes in salivary cortisol following the TSST.ResultsLinear regression analyses adjusted for age, sex, childhood socioeconomic status, and baseline cortisol levels, showed childhood adversity associated with changes in cortisol levels [B = –0.29 t = –2.35, p = 0.02, R2=0.07]. Linear regression analyses controlling for age, sex, and childhood SES showed childhood adversity associated with both challenge [B = –0.52 t = –5.04, p < 0.001, R2=0.24] and threat [B = 0.55 t = 5.40, p < 0.001, R2=0.27] appraisals. Significant indirect effects of childhood trauma on cortisol reactivity were observed through challenge appraisals [B = –0.01 ], and threat appraisals [B = –0.01 ].ConclusionChildhood adversity may contribute to blunted cortisol reactivity, a pattern of response which is linked to obesity, addiction, and other behavior-related diseases. Our findings suggest that this relationship is in part a product of stress appraisals. (shrink)

This paper investigates the learnability by positive examples in the sense of Gold of Pregroup Grammars. In a first part, Pregroup Grammars are presented and a new parsing strategy is proposed. Then, theoretical learnability and non-learnability results for subclasses of Pregroup Grammars are proved. In the last two parts, we focus on learning Pregroup Grammars from a special kind of input called feature-tagged examples. A learning algorithm based on the parsing strategy presented in the first part is given. Its validity (...) is proved and its properties are examplified. (shrink)

Why does symbolic communication in humans develop primarily in an oral medium, and how do theories of language origin explain this? Non-human primates, despite their ability to learn and use symbolic signs, do not develop symbols as in oral language. This partly owes to the lack of a direct cortico-motoneuron control of vocalizations in these species compared to humans. Yet such modality-related factors that can impinge on the rise of symbolic language are interpreted differently in two types of evolutionary storylines. (...) 1) Some theories posit that symbolic language originated in a gestural modality, as in “sign languages”. However, this overlooks work on emerging sign and spoken language showing that gestures and speech shape signs differently. 2) In modality-dependent theories, some emphasize the role of iconic sounds, though these lack the efficiency of arbitrary symbols. Other theorists suggest that ontogenesis serves to identify human-specific mechanisms underlying an evolutionary shift from pitch varying to orally-modulated vocalizations (babble). This shift creates numerous oral features that can support efficient symbolic associations. We illustrate this principle using a sound-picture association task with 40 learners who hear words in an unfamiliar language (Mandarin) with and without a filtering of oral features. Symbolic associations arise more rapidly and accurately for sounds containing oral features compared to sounds bearing only pitch features, an effect also reported in experiments with infants. The results imply that, beyond a competence to learn and use symbols, the rise of symbolic language rests on the types of signs that a modality of expression affords. (shrink)

À partir d’une situation de couple dans lequel la communication semble bloquée par un trop plein de souffrance, due en partie à des traumatismes dans les liens de filiation de part et d’autre, l’auteure, grâce à un groupe de recherche, expérimente la nécessité d’un nouvel espace pour réguler un transfert massif. Le groupe de recherche prend en quelque sorte le relais de l’appareil psychique du thérapeute et met en scène les émotions et les représentations qui sont à l’œuvre au sein (...) du groupe thérapeutique. Il devient un lieu de dépôt et de mentalisation des émotions qui circulent dans le transfert, et se fait le porte-voix des souffrances traumatiques enfermées dans les incorporats, ces ratés de l’introjection. (shrink)

There is scarce research on the interaction between psychosocial working conditions and being a target of workplace bullying with individual characteristics as a moderator. We therefore examined 3,363 employees from 60 Danish workplaces to test whether sense of coherence moderates the relationship between the job demand-control model and bullying. This work is exploratory in nature, as no previous study to assess this moderation was found. Hierarchical linear regressions showed that demand-control model was significantly associated with bullying. Sense of coherence displayed (...) a significant though practically negligible moderating effect. This suggests that negative psychosocial working conditions are associated with bullying independently of personal characteristics, at least in terms of sense of coherence. (shrink)

The objective of the present study was to show that the use of adversative and conclusive connectives to mark off the prototypical schema of argumentative text begins to set in at approximately the age of 10 or 11. Based on Adam's (1992) proposals, we constituted an argumentative text with two blocks of arguments separated by an adversative instruction (the connective but or an equivalent) and followed by a conclusion introduced by a conclusive instruction (the connective thus or an equivalent). Four (...) revising tasks (insertion or substitution with or without five connectives) have been used to asses children's knowledge of the argumentative schema and the use of connectives that punctuate them. The study of good and erroneous locations (concerning the placement of but and thus) showed that there was some regularity in the choices made by the children. The main result of this study shows that argumentative connectives are used differently by children aged 9 and children aged 10 or 11. The argumentative schema is used more consciously by 11-year-olds to guide revising tasks than by 10-year-olds. (shrink)

Through the concept of self-organizing consciousness (SOC), we posit that the dynamic of the mind stems from the recurrent interplay between the properties of conscious experiences and the properties of the world, hence making it unnecessary to postulate the existence of an unconscious mental level. In contrast, arguments are provided by commentators for the need for a functional level of organization located between the neural and the conscious. Other commentaries challenge us concerning the ability of our model to account for (...) specific phenomena in the domains of language, reasoning, incubation, and creativity. The possibility of unconscious semantic access and other alleged instances of adapted performance in the absence of any conscious counterpart are also put forth as evidence against our view. Our response emphasizes the fact that opponents to our model often present as factual, theory-free evidence which is in fact nothing more than the postulates underlying the classical computational framework. (shrink)

"Cet ouvrage est le fruit d'un seminaire de philosophie des sciences organise au Centre Sevres a Paris pendant l'annee universitaire 1987-1988"--Avant-propos.

Five years ago, remarkable animal experiments on artificial womb technology (AWT) at Children’s Hospital of Philadelphia (CHOP) got us thinking about the ethical for premature babies. We recognized...

Research on the capacity to understand others' minds has tended to focus on representations ofbeliefs,which are widely taken to be among the most central and basic theory of mind representations. Representations ofknowledge, by contrast, have received comparatively little attention and have often been understood as depending on prior representations of belief. After all, how could one represent someone as knowing something if one does not even represent them as believing it? Drawing on a wide range of methods across cognitive science, (...) we ask whether belief or knowledge is the more basic kind of representation. The evidence indicates that nonhuman primates attribute knowledge but not belief, that knowledge representations arise earlier in human development than belief representations, that the capacity to represent knowledge may remain intact in patient populations even when belief representation is disrupted, that knowledge (but not belief) attributions are likely automatic, and that explicit knowledge attributions are made more quickly than equivalent belief attributions. Critically, the theory of mind representations uncovered by these various methods exhibits a set of signature features clearly indicative of knowledge: they are not modality-specific, they are factive, they are not just true belief, and they allow for representations of egocentric ignorance. We argue that these signature features elucidate the primary function of knowledge representation: facilitating learning from others about the external world. This suggests a new way of understanding theory of mind – one that is focused on understanding others' minds in relation to the actual world, rather than independent from it. (shrink)

This paper compares and contrasts the impact and the interface of different sets of values held by social care practitioners in their decision-making process with regard to ethical dilemmas. Specifically, it explores some of the fundamental distinctions between self-directed groupworkers and other qualified social workers practising in both statutory and voluntary sectors. The methodology is qualitative and draws upon a Grounded Theory process. In contrasting the contribution of different sets of values in decision making, we found that participants, regardless of (...) their approach to work, showed an overall fit between their personal and professional values. However, when we explored the influence of participants? agencies on their decision-making processes, participants tended to prioritise organisational values, whereas for participants practising in the self-directed approach, the impact was less marked. Reflections on the role of values in increasing social workers? resistance to organisational constraints, and discussion of some implications for social work education, conclude the article. (shrink)

This photo-essay highlights the ways in which medicine features in the Occupied Palestinian Territories (OPT) and uses it to reflect on the nature of ethical obligation set out by Judith Butler in her work on state-achieved precarity. Although medical infrastructure of even the most basic type is tragically lacking and in some areas shockingly absent in the OPT, it is the particular way in which medicine comes to be needed that we focus on. Leaving aside the rhetoric that has claimed (...) authority over what can or cannot be said of the Occupation, we focus on its geo-technological arrangements. By placing photos and case studies of medical obstruction within an analysis of the Occupation, we forge an encounter between reader and the Occupation to raise questions about the use of medicine in this context and the manner in which conventional ethics can give legitimacy to this use. On the basis of what we show through visual and textual documentary material, we propose ethics be understood as inherent to the geo-technological arrangements that make life possible or, as in this case, undermine, obstruct or deliberately take life. Hence the ethical obligation that Butler calls upon is reiterated in ways that encompass the everyday features of occupation including those active in the emergence of medicine as a tactic of war. (shrink)