Organ donation after the circulatory determination of death requires the permanent cessation of circulation while organ donation after the brain determination of death requires the irreversible cessation of brain functions. The unified brain-based determination of death connects the brain and circulatory death criteria for circulatory death determination in organ donation as follows: permanent cessation of systemic circulation causes permanent cessation of brain circulation which causes permanent cessation of brain perfusion which causes permanent cessation of brain function. The relevant circulation that (...) must cease in circulatory death determination is that to the brain. Eliminating brain circulation from the donor ECMO organ perfusion circuit in thoracoabdominal NRP protocols satisfies the unified brain-based determination of death but only if the complete cessation of brain circulation can be proved. Despite its medical and physiologic rationale, the unified brain-based determination of death remains inconsistent with the Uniform Determination of Death Act. (shrink)

ABSTRACT Recently, the hypothesis that purely evaluative disputes are metalinguistic negotiations has gained traction. I resist a strong version of that hypothesis, and argue that some of those disputes are not metalinguistic negotiations. To defend that claim, I argue that metalinguistic negotiations have three linguistic properties that some purely evaluative disputes lack. First, in a metalinguistic negotiation it is felicitous to embed the dispute-initial statement under the subjective attitude verb consider; second, a speaker can reply to that initial statement by (...) using a metalinguistic comparative; and, third, such negotiations address metalinguistic questions under discussion. Some purely evaluative disputes lack these properties, which suggests that they are not metalinguistic negotiations. (shrink)

Nair-Collins and Joffe (2023) highlighted the noncongruence between the language of the Uniform Determination of Death Act (UDDA) and the accepted brain death bedside testing standard by showing th...

En este artículo se revisan los avances, los desafíos y las particularidades de la ciencia abierta en la investigación cualitativa. En particular se analiza la apertura de datos porque tiene menor avance en comparación con la publicación en repositorios y revistas de acceso libre. Se revisan los criterios de validez en la investigación cualitativa en ciencias sociales, para identificar algunos elementos que fomenten la apertura de datos, ya que, mientras se plantee como una vía para replicar resultados de investigación, tendrá (...) poco eco en la comunidad que practica la investigación cualitativa. Sin embargo, el artículo muestra que el compartir datos puede fortalecer las estrategias de verificación cualitativa y preservar el conocimiento, las experiencias, las historias y los contextos cotidianos de las personas participantes. (shrink)

This paper argues that there is a class of terms, or uses of terms, that are best accounted for by an expressivist account. We put forward two sets of criteria to distinguish between expressive and factual terms. The first set relies on the action-guiding nature of expressive language. The second set relies on the difference between one's evidence for making an expressive vs. factual statement. We then put those criteria to work to show, first, that the basic evaluative adjectives such (...) as ‘good’ have expressive as well as factual uses and, second, that many adjectives whose primary meanings are factual, such as ‘powerful’, also have expressive uses. (shrink)

I argue against the view that metalinguistic usage is a form of conversational implicature. That view, suggested by Thomasson (Anal Philos 57(4):1-28, 2016) and Belleri (Philos Stud 174(9):2211–2226, 2017), has been most recently fleshed out by Mankowitz (Synthese 199:5603–5622, 2021). I provide two types of criticism to the implicature view. From an empirical point of view, metalinguistic usage differs in key respects from standard cases of conversational implicature. From a conceptual standpoint, I argue that the calculation algorithm provided by the (...) implicature view makes undesirable predictions. Although my main objective is negative, I end the paper by sketching an alternative neo-Stalnakerian view of metalinguistic usage, that can be gathered from work by Barker (Linguist Philos 25(1):1–36, 2002; Inquiry 56(2–3):240–257, 2013) and others. (shrink)

Abstract:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)

I defend a metalinguistic account of Mates's puzzle: sentences where synonymous expressions cannot be substituted salva veritate. If Andrea thinks that attorneys are different from lawyers, and she thinks that Fiona is the former but not the latter, we may hesitate to substitute ‘lawyer’ for ‘attorney’ in ‘Andrea believes that Fiona is an attorney’, even though ‘lawyer’ and ‘attorney’ are synonymous. I argue that these sentences report de re beliefs about linguistic expressions, thereby blocking such substitutions, and I offer a (...) compositional derivation of their meaning. (shrink)

Lewis emphasizes the role of theta oscillations in emergent coupling among neural subsystems during emotionally relevant tasks or situations. Here I present some recent data on the relationship of rhythmic neuronal discharge in the supramammillary nucleus and the large-scale theta oscillations in the limbic system which provide support to many of his ideas regarding vertical integration in dynamic systems.

The aim of this study was to assess the predictive capacity of some of the most relevant cognitive skills pertaining to the academic field as measured by the Spanish Primary School Aptitude Test Battery. This psychometric tool was applied to all students who were enrolled in the final year of Early Childhood Education in the public schools of the province of Alicante and a follow-up of their academic progress was carried out when they completed Primary Education. The results obtained show (...) that medium-high and high scores in Verbal Aptitude and Numerical Aptitude tests in Early Childhood Education, can predict academic success at the end of Primary Education in instrumental subjects such as: Language and Mathematics. We have determined the importance of developing pedagogical programs that stimulate the development of these skills during Early Childhood Education, while implementing support strategies during Primary Education, for those students who present underdeveloped aptitudes in these areas. In this way, school difficulties would be prevented in the instrumental subjects that provide access to other academic areas. (shrink)

The concept of whole‐brain death is under attack again. Scholars are arguing that the concept of brain death per se—regardless of the focus on “higher,” “stem” or “whole”—is fundamentally flawed. These scholars have identified what they believe are serious discrepancies between the definition and criterion of brain death, and have pointed out that medical professionals and lay persons remain confused about its meaning. Yet whole‐brain death remains the standard for determining death in much of the Western world and its defenders (...) believe this concept best maps onto our everyday conception of death. (shrink)

Attention-deficit hyperactivity disorder is one of the most common neurodevelopmental disorders in children and adolescents. People who have this disorder are characterized by presenting difficulties in the processes of sustained attention, being very active, and having poor control of their impulses. Despite the high prevalence of this disorder and the existence of various tests used for its diagnosis, few data are available regarding the usefulness and diagnostic validity of these tools. Given the difficulties that these subjects present in executive functions, (...) the aim of this study was to evaluate whether the Neuropsychological Assessment of Executive Functions battery for Children allows to establish specific profiles of executive performance for people with attention-deficit hyperactivity disorder. The sample was made up of 197 participants of both sexes, aged between 6 and 12 years age. A nonexperimental design was followed, using a comparative descriptive study method. The results indicated that the scales of phonological fluency, color path, rings, and interference are the most associated with the diagnosis of ADHD, providing data on inhibition, mental flexibility, sustained and selective attention, planning, verbal fluency, and working memory, among others. The practical implication of these results is in line with providing support in the clinical diagnosis that is carried out in children’s mental health units. In addition, the ENFEN tool can be valued as a suitable psychometric instrument in the psychoeducational field, helping professionals in a school environment to be more aware of the areas of cognitive development in which a student diagnosed with ADHD will have more difficulties and, in doing so, providing more adjusted and effective psychopedagogical measures when it comes to supporting students in their adaptation to the school environment. (shrink)

The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)

Mediante el recurso que Rorty emplea para argumentar que Heidegger no ha dejado el canon Platón-Kant, vamos a mostrar que el mismo Rorty no puede salir del planteamiento platónico. Para ello nuestro artículo se divide en dos partes principales. En primer lugar, sistematizaremos la inversión de Heidegger que Rorty dejó meramente apuntada en «Overcoming the Tradition: Heidegger and Dewey», rastreando los supuestos ontológicos y epistemológicos en los que el pragmatista se basó para llevar a cabo su peculiar lectura de Heidegger. (...) Después, evidenciaremos que la técnica de inversión y recontextualización que emplea Rorty con Heidegger pueden volverse contra él y no permitirle salir de la matriz platónica. (shrink)

The locked-in syndrome is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple (...) medical decisions but not for consequential medical decisions such as whether to refuse further life-sustaining therapy. Emerging technologies including computer-tracking assistance of retained partial motor function and brain-computer interfaces promise to improve the communication ability of LIS patients and, when better developed, will allow them to fully exercise their right to actively participate in consequential medical decisions about their own medical care. Although so-called “covert cognition” patients clinically diagnosed as vegetative state that are shown to be aware by functional neuroimaging maybe metaphorically considered locked-in, it is nosologically more coherent not to categorize them formally as LIS. (shrink)

“Brain death,” the determination of human death by showing the irreversible loss of all clinical functions of the brain, has become a worldwide practice. A biophilosophical account of brain death requires four sequential tasks: agreeing on the paradigm of death, a set of preconditions that frame the discussion; determining the definition of death by making explicit the consensual concept of death; determining the criterion of death that proves the definition has been fulfilled by being both necessary and sufficient for death; (...) and determining the tests of death for physicians to employ at the patient's bedside to demonstrate that the criterion of death has been fulfilled. The best definition of death is “the cessation of functioning of the organism as a whole.” The whole-brain criterion is the only criterion that is both necessary and sufficient for death. Brain death tests are used only in the unusual case in which a patient's ventilation is being supported. Brain death critics have identified weaknesses in its formulation. But despite its shortcomings, the whole-brain death formulation comprises a concept and public policy that make intuitive and practical sense and that has been well accepted by many societies. (shrink)

Despite the popularity, success, and growth of programs of organ donation after the circulatory determination of death (DCDD), a long‐standing controversy persists over whether the organ donor is truly dead at the moment physicians declare death, usually following five minutes of circulatory and respiratory arrest. Advocates of the prevailing death determination standard claim that the donor is dead when declared because of permanent cessation of respiration and circulation. Critics of this standard argue that while the cessation of respiration and circulation (...) may be permanent, it may not be irreversible at the moment death is declared because, if cardiopulmonary resuscitation were performed, it might succeed. And because irreversibility of cessation of respiration and circulation is required by both the statute and the biological concept of death, the donor must be alive. Who is correct?Making two related distinctions clarifies the cause of the disagreement over whether the DCDD donor is dead and points to a possible resolution. First, in a determination of death, there is an important distinction between the permanent and the irreversible cessation of circulation and respiration—two associated phenomena that are often confounded. Second, there is an important distinction between the medical practice standard for death determination, in which physicians certify the permanent cessation of vital functions as sufficient for death declaration, and the underlying biological concept of death that requires the irreversible cessation of vital functions because death, by definition, is an irreversible event. (shrink)

A combination of emerging life support technologies and entrenched organ donation practices are complicating the physician's task of determining death. On the one hand, technologies that support or replace ventilation and circulation may render the diagnosis of death ambiguous. On the other, transplantation of vital organs requires timely and accurate declaration of death of the donor to keep the organs as healthy as possible. These two factors have led to disagreements among physicians and scholars on the precise moment of death. (...) In this article, I suggest that the debate about exactly when a person dies can benefit from distinguishing the strict biological concept of death from the medical standards for determining human death, and I show how an appreciation of the difference between the permanent and irreversible cessation of circulation is helpful in understanding the reasons for the two approaches to determining when death should be declared. (shrink)

The definition of death is one of the oldest and most enduring problems in biophilosophy and bioethics. Serious controversies over formally defining death began with the invention of the positive-pressure mechanical ventilator in the 1950s. For the first time, physicians could maintain ventilation and, hence, circulation on patients who had sustained what had been previously lethal brain damage. Prior to the development of mechanical ventilators, brain injuries severe enough to induce apnea quickly progressed to cardiac arrest from hypoxemia. Before the (...) 1950s, the loss of spontaneous breathing and heartbeat were perfect predictors of death because the functioning of the brain and of all other organs ceased rapidly and nearly simultaneously thereafter, producing a unitary death phenomenon. In the pretechnological era, physicians and philosophers did not have to consider whether a human being who had lost certain “vital functions” but had retained others was alive, because such cases were technically impossible. (shrink)

Sta se zabv modelovnm demokracie jakoto popisu politickho systmu; David Held je jednm z autor, kter nabz obecn modely demokracie, je nle pslunm spolenostem a jejich tradicm. Jeliko m esk republika specifick demokratick systm, pokou se tato sta za pomoci syntetizace Heldovch model co nejvstinji popsat souasnou eskou demokracii. Model kombinuje znaky stavnosti v jejich formln podob a reln politick chovn. Nsledn se sna nalzt pozici demokracie ve spoleenskm du za pomoci Hayekova pohledu na tuto tematiku.

Resumen En el presente artículo repasaremos someramente algunos de los hitos más reseñables de la historia militar del Imperio Romano Tardío, haciendo hincapié en el papel de los bárbaros que luchaban junto a los romanos, puesto que la barbarización del ejercito romano ha sido uno de los puntos de referencia en las investigaciones acerca de la decadencia y caída del Imperio Romano. En este sentido, haremos referencia al papel integrador que tuvo el ejército romano durante buena parte de la historia (...) del Imperio Romano, y señalaremos los principales hechos que condujeron al final de dicho papel; esbozando también las desastrosas consecuencias que tuvo este hecho para el futuro del Imperio, especialmente del Occidental. Palabras clave: Bárbaros, ejército, integración, migración, godos, reclutamiento.In this article we will briefly review some of the most important milestones in the military history of the Late Roman Empire. In it we will emphasize the role of the barbarians who fought with the Romans, since the barbarización of the Roman army is one of the points of reference in the investigations about the decay and fall of the Roman Empire. In this sense, we will refer to the role played by the Roman army in the integration of foreigners during a large part of the history of the Roman Empire. In addition, we will point out the main events that led to the end of this integrating role; we will also indicate the disastrous consequences this fact had for the future of the Empire, especially for the Western part. Key words: Barbarians, army, integration, migration, goths, recruitment. (shrink)

This article reviews the development, challenges, and specificities of open data in qualitative research. Particularly, open data is analyzed because it is relatively less developed as compared to publication in repositories and open access journals. Validity criteria of qualitative research in the social sciences are reviewed in order to identify some of the elements that encourage data openness. As long as data openness is viewed as a way to replicate research results, it’s resonance in the community of qualitative research practitioners (...) will be limited. Nevertheless, the article shows that sharing data might strengthen qualitative verification strategies, as well as preserve the knowledge, experiences, stories, and everyday contexts of the participants. (shrink)

Eric Voegelin's Political Readings fills a critical void by providing a original approach to studying the work of Eric Voegelin, one of the major political philosophers of the twenty first century. Across six chapters a group of experts guide the reader from classical to modern times presenting six political philosophers who have had an impact on the life and philosophical production of Eric Voegelin. Philosophers examined include Plato, Aristotle, Saint Augustine, Hobbes, Weber and Kelsen. Through this innovative structure the chapters (...) collectively illustrate how Voegelin was an exceptional thinker through his engagement with political philosophers both modern and antique. The plurality of unique, academic perspectives and voices enriches our understanding of Voegelin's own thought while also encouraging a re-think of ancient and modern thinkers, and the transformation and continuity between these. Designed for students and scholars alike, Eric Voegelin's Political Readings will appeal to all those with an interest in Voegelin as well as readers familiar with classical and modern political philosophers. (shrink)

Notwithstanding these wise pronouncements, my project here is to characterize the biological phenomenon of death of the higher animal species, such as vertebrates. My claim is that the formulation of “whole- brain death ” provides the most congruent map for our correct understanding of the concept of death. This essay builds upon the foundation my colleagues and I have laid since 1981 to characterize the concept of death and refine when this event occurs. Although our society's well-accepted program of multiple (...) organ procurement for transplantation requires the organ donor first to be dead, the concept of brain death is not merely a social contrivance to permit us to obtain the benefits of organ procurement. Rather, the concept of whole- brain death stands independently as the most accurate biological representation of the demise of the human organism. (shrink)

The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...) other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency. (shrink)

The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human (...) death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public. (shrink)

La sexualité préoccupe le Moyen Âge occidental : miroir de la nature peccamineuse de l’homme, elle en révèle le meilleur (tempérance, renoncement) et le pire (appétit, violence). Envisagée dans le seul mariage chrétien, elle est hors de ce cadre adultère, condamnée (juridiquement, judiciairement) et expose les individus à la vindicte populaire. Les lettres de rémission (grâce royale des crimes) des xiv e et xv e siècles témoignent de façon originale de l’impact que le type de conjugalité vécu peut avoir sur (...) les violences sexuelles faites aux femmes. Si les sources sont muettes et absentes sur les violences matrimoniales, isolement, célibat laïc, séparation et adultère exposent les femmes médiévales au viol. Mariée, la femme est appropriée, son corps territorialisé, gardé ; seule ou concubine, elle est mal famée et son corps à prendre. C’est dans ce paradigme que la question du couple et des violences sexuelles se pose alors. (shrink)

It has been argued that moral assertions involve the possession, on the part of the speaker, of appropriate non-cognitive attitudes. Thus, uttering ‘murder is wrong’ invites an inference that the speaker disapproves of murder. In this paper, we present the result of 4 empirical studies concerning this phenomenon. We assess the acceptability of constructions in which that inference is explicitly canceled, such as ‘murder is wrong but I don’t disapprove of it’; and we compare them to similar constructions involving ‘think’ (...) instead of ‘disapprove’—that is, Moore paradoxes (‘murder is wrong but I don’t think that it is wrong’). Our results indicate that the former type of constructions are largely infelicitous, although not as infelicitous as their Moorean counterparts. (shrink)

Ariane Lewis provided an insightful review of several controversial cases of death by neurologic criteria (“brain death”) in the UK, focusing on Archie Battersbee, a boy whose tragic illness provok...

Over the past quarter century, organ donation after the circulatory determination of death (DCD) has grown in acceptance and prevalence throughout the world (Domínguez-Gil et al. 2021). Notwithstan...

This essay examines the relationship between Eric Voegelin and Leo Strauss in order to show the central themes necessary to elucidate their philosophical positions. The essay reveals the centrality of the figure of Plato as a point of departure to understand the agreement and the disagreement concerning fundamental questions (such as the way of reading ancient texts, the importance of the historical perspective or the importance of the study of the past in order to orient the modern science) which revolves (...) around the issue of the relation between revelation and philosophy. The work concludes with an identification of the common core of both thinkers that allows us to understand their differences (homogeneity or heterogeneity of reality and the human) and, moreover, identifies both perspectives with a «foundational» (Voegelin) or «negative» (Strauss) interpretation of Plato’s thought. (shrink)

Although death statutes permitting physicians to declare brain death are relatively uniform throughout the United States, academic debate persists over the equivalency of human death and brain death. Alan Shewmon showed that the formerly accepted integration rationale was conceptually incomplete by showing that brain-dead patients demonstrated a degree of integration. We provide a more complete rationale for the equivalency of human death and brain death by defending a deeper understanding of the organism as a whole and by using a novel (...) strategy with shared objectives to justify death determination criteria. Our OaaW account describes different types of OaaW, defining human death as the loss of status as a human OaaW. We defend human death as similar to nonhuman death in terms of wakefulness, but also distinct in terms of the sui generis properties, particularly conscious awareness. We thereby defend the equivalency of brain death and human death using a resulting neurocentric rationale. (shrink)

Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that (...) paralleled advances in intensive care unit treatment. The century‐old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death. (shrink)

El artículo examina el origen del proyecto rortiano de acabar con la imagen única de Platón. En su escrito autobiográfico, Trotsky las orquídeas silvestres, Rorty describe su trayectoria filosófica y presenta su alternativa a Platón como pensada desde su más pronta juventud. Sin embargo, como vamos a mostrar, el proyecto central de acabar con la imagen única de Platón no es algo que esté pensado ni se dé desde un principio en sus obras. Defendemos que, pese a lo que el (...) propio Rorty indicó en sus escritos, encontramos indicios de que no es hasta la década de los noventa que Rorty piensa en elaborar una nueva relación alternativa al léxico último de Platón. (shrink)

This paper studies how Europe conceived America, not only as a place inhabited by monsters, but also as a monstrous space in itself, as soon as its mere appearance meant an alteration of the previous ontological order. By way of illustration we analyze how the Europeans imagined projected on America each of the different theratologic currents that dominated during the 16TH and 17TH centuries.