As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

Marshall and colleagues (2024) contribute to the literature on autonomy and decision-making capacity by focusing on the case of individuals with opioid use disorder who refuse to remain in the hosp...

Animals are frequently utilized as a teaching-learning tool in multiple educational settings. It is, therefore, important to understand what students think about this topic, in particular medical and veterinary students as “life caregivers” and competent people for a dynamic and responsible social intervention. In this context, this research aims to characterize and disseminate a set of issues related to animal welfare/wellbeing in higher education in the North of Portugal, particularly as regards the teaching of students of the Integrated Master in (...) Medicine (MIM) and Veterinary Medicine (MIMV). After ethical approval, a survey was delivered on paper to 180 undergraduate MIM (n = 100) and MIMV (n = 80) students. After collecting 139 questionnaires partially or fully completed, with varying response rates for each question, it was concluded that most of the students consider that animal experimentation is ethically acceptable when the benefits balance the harms and assuming that refinement of animal procedures is warranted; they also agree to the establishment, maintenance and performance of animal procedures solely for educational purposes as a way of ensuring optimal acquisition of theoretical knowledge, attitudes and behaviors and technical skills. Nevertheless, it is the responsibility of teachers to explore and implement pedagogical methodologies thar are equally effective but more humane and compassionate towards sentient living beings. (shrink)

In their article, Navin, Brummett, and Wasserman (2022) advance the idea that there are qualitatively different types of decision-making capacity (DMC) for treatment refusals. Departing from what t...

Volume 20, Issue 8, August 2020, Page 88-90.

Les langues des signes sont des langues qui n’ont pas un système d’écriture qui leur est propre et qui, par leur nature visuo-gestuelle, ne peuvent pas être écrites phonographiquement. Les conséquences de cette « non‑scriptibilité » sont au centre des travaux menés à partir de 2000 par Elena Antinoro Pizzuto. EAP, décédée en 2011, mettait en évidence les biais que l’utilisation des « gloses », employées comme substituts de la transcription, induisent dans l’analyse linguistique des LS. Ces 10 dernières années, (...) les avancées technologiques et méthodologiques ont rendu plus aisée la saisie automatique des données corporelles, l’annotation multilinéaire de corpus multimodaux et le maintien des liens entre les annotations et les vidéos, ainsi que la diffusion des vidéos sur lesquelles se basent les analyses. Toutefois, ces technologies et bonnes pratiques — bien que fondamentales — ne font pas office de système de transcription : ce sont des solutions qui suppriment une partie des symptômes liés à la non‑scriptibilité des LS, mais ne comblent pas l’absence d’un système de représentation graphique de ces langues. Les questions soulevées par EAP sont donc encore d’actualité. Si différentes tentatives pour transcrire les LS ont vu le jour, leur utilisation pour exploiter de vastes corpus de LS s’est souvent heurtée à leur faible lisibilité et/ou requêtabilité. En comparant les avantages et les inconvénients de ces systèmes, il est possible d’établir une liste des caractéristiques que devrait posséder un système de transcription des LS. Mais développer un système qui réunit toutes ces spécificités est un défi que les linguistes ne peuvent pas relever seuls : c’est dans la pluridisciplinarité, et en particulier dans le travail conjoint avec les spécialistes des aspects graphiques de l’écriture, que semble résider la solution. Cette approche, dite « grapholinguistique », est suivie par l’équipe GestualScript pour développer Typannot, un système de transcription typographique des LS et de la gestualité co-verbale. (shrink)

Two reports have shown that mammalian artificial chromosomes (MAC) can be constructed from cloned human centromere DNA and telomere repeats, proving the principle that chromosomes can form from naked DNA molecules transfected into human cells. The MACs were mitotically stable, low copy number and bound antibodies associated with active centromeres. As a step toward second-generation MACs, yeast and bacterial cloning systems will have to be adapted to achieve large MAC constructs having a centromere, two telomeres, and genomic copies of mammalian (...) genes. Available construction techniques are discussed along with a new P1 artificial chromosome (PAC)-derived telomere vector (pTAT) that can be joined to other PACs in vitro, avoiding a cloning step during which large repetitive arrays often rearrange. The PAC system can be used as a route to further define the optimal DNA elements required for efficient MAC formation, to investigate the expression of genes on MACs, and possibly to develop efficient MAC-delivery protocols. BioEssays 1999;21:76–83. © 1999 John Wiley & Sons, Inc. (shrink)

This paper reflects on quality assessment and performance evaluation in higher education, namely by analysing the insufficient link between those two aspects. We start by reviewing the current state of the art regarding different processes and mechanisms of quality assessment and performance evaluation and discuss some of the major issues regarding the implementation of some of them. In particular, we analyse the current limitations regarding data collected, available and publicised on the performance of HEIs and the problems those limitations bring (...) to a fair evaluation of higher education. Through this analysis we intend to contribute to a better understanding of the mechanisms of evaluation in higher education and the way these may lead to the promotion of better quality assessment practices and institutional management. (shrink)

This book addresses the idea of justice in order to guide society towards a more effective justice system. The authors trace impoverished and accomplished thinking in criminological and justice discourses and show that when justice and love are seen as synonyms, the historic ills that have plagued humanity tend to evaporate.

El presente manuscrito intenta, a través de una sucinta reflexión, dar cuenta de cómo el cuidado de sí rescatado por Foucault podría ser comprendido como una alternativa para superar los mecanismos identitarios de control neoliberal, gracias a la relación activa que el sujeto desarrolla con la verdad. En el entendido de que el abandono del espacio de la norma y el conocimiento por parte de aquella, y su ubicación al servicio de la autoconformación del sujeto favorecería el desarrollo de una (...) relación plena y coherente de cada individuo consigo mismo. (shrink)

Here, Bob Hale and Crispin Wright assemble the key writings that lead to their distinctive neo-Fregean approach to the philosophy of mathematics. In addition to fourteen previously published papers, the volume features a new paper on the Julius Caesar problem; a substantial new introduction mapping out the program and the contributions made to it by the various papers; a section explaining which issues most require further attention; and bibliographies of references and further useful sources. It will be recognized as (...) the most powerful presentation yet of a neo-Fregean program. (shrink)

Resumen:La obra capital de Phillip Mainländer se compone de seis capítulos (Analítica de la facultad cognoscitiva, Física, Estética, Ética, Política, Metafísica) y un Anexo (Crítica de las doctrinas de Kant y Schopenhauer). Seis capítulos y un anexo que hacen gala de la intempestividad de su autor. De esa cualidad presente en pocos pensadores y que condiciona la valoración de su obra al paso del tiempo. De esa cualidad que permite pensar más allá de los límites que impone la época. Curiosamente (...) un pensador del siglo XIX ilumina los tiempos que corren. Unos tiempos signados por prácticas ecocidas y sus derivaciones ecosuicidas (Baquedano: 37-38), y cuyas primeras manifestaciones físicas sobre la naturaleza comenzaron, llamativamente, en dicho momento, a saber, en 1784 cuando James Watt patentó su máquina de vapor. (shrink)

What distinguishes evils from ordinary wrongs? Is hatred a necessarily evil? Are some evils unforgivable? Are there evils we should tolerate? What can make evils hard to recognize? Are evils inevitable? How can we best respond to and live with evils? Claudia Card offers a secular theory of evil that responds to these questions and more. Evils, according to her theory, have two fundamental components. One component is reasonably foreseeable intolerable harm -- harm that makes a life indecent and (...) impossible or that makes a death indecent. The other component is culpable wrongdoing. Atrocities, such as genocides, slavery, war rape, torture, and severe child abuse, are Card's paradigms because in them these key elements are writ large. Atrocities deserve more attention than secular philosophers have so far paid them. They are distinguished from ordinary wrongs not by the psychological states of evildoers but by the seriousness of the harm that is done. Evildoers need not be sadistic:they may simply be negligent or unscrupulous in pursuing their goals. Card's theory represents a compromise between classic utilitarian and stoic alternatives (including Kant's theory of radical evil). Utilitarians tend to reduce evils to their harms; Stoics tend to reduce evils to the wickedness of perpetrators: Card accepts neither reduction. She also responds to Nietzsche's challenges about the worth of the concept of evil, and she uses her theory to argue that evils are more important than merely unjust inequalities. She applies the theory in explorations of war rape and violence against intimates. She also takes up what Primo Levi called "the gray zone", where victims become complicit in perpetrating on others evils that threaten to engulf themselves. While most past accounts of evil have focused on perpetrators, Card begins instead from the position of the victims, but then considers more generally how to respond to -- and live with -- evils, as victims, as perpetrators, and as those who have become both. (shrink)

Slurs are derogatory terms targeting individuals and groups of individuals on the basis of race, nationality, religion, gender or sexual orientation. The aim of my paper is to propose an account of appropriated uses of slurs – i.e. uses by targeted groups of their own slurs for non-derogatory purposes, as in the appropriation of ‘nigger’ by the African-American community, or the appropriation of ‘queer’ by the homosexual community. In my proposal appropriated uses are conceived as echoic, in Relevance Theory terms: (...) in-groups echo derogatory uses in ways and contexts that make manifest the dissociation from the offensive contents. I will show that the echoic strategy has interesting advantages over alternative theories, and especially over Anderson and Lepore’s deflationary strategy. (shrink)

Implementation of formal specifications is very important in formal software development and can be described in terms of simple logical concepts. Formal specifications are presentations of theories in many-sorted first-order logic, and an implementation of a formal specification on another formal specification amounts to an interpretation of the former into a conservative extension of the latter. Here we present and analyse some sort introducing constructs akin to those found in many programming languages. This is of importance because it occurs often (...) in implementing formal specifications, when new sorts are ‘constructed’ from the concrete ones. We specify these constructs and show that these specifications provide extensions with behaviour close to that of the familiar extensions by definitions. (shrink)

La obra capital de Phillip Mainländer se compone de seis capítulos (Analítica de la facultad cognoscitiva, Física, Estética, Ética, Política, Metafísica) y un Anexo (Crítica de las doctrinas de Kant y Schopenhauer). Seis capítulos y un anexo que hacen gala de la intempestividad de su autor. De esa cualidad presente en pocos pensadores y que condiciona la valoración de su obra al paso del tiempo. De esa cualidad que permite pensar más allá de los límites que impone la época. Curiosamente (...) un pensador del siglo XIX ilumina los tiempos que corren. Unos tiempos signados por prácticas ecocidas y sus derivaciones ecosuicidas (Baquedano: 37-38), y cuyas primeras manifestaciones físicas sobre la naturaleza comenzaron, llamativamente, en dicho momento, a saber, en 1784 cuando James Watt patentó su máquina de vapor. (shrink)

This is the first scholarly study of Atlas Shrugged, covering in detail the historical, literary, and philosophical aspects of Ayn Rand's magnum opus. Topics explored in depth include the history behind the novel's creation, publication, and reception; its nature as a romantic novel; and its presentation of a radical new philosophy.

The essays in this collection treat historical, literary, and philosophical topics related to Ayn Rand's Anthem, an anti-utopia fantasy set in the future. The first book-length study on Anthem, this collection covers subjects such as free will, political freedom, and the connection between freedom and individual thought and privacy.

ASD VIII, 1 publishes texts by Erasmus related to the Church Fathers: the Vitae of Jerome, John Chrysostom and Origen, the forgery ‘Cyprian’s _De duplici martyrio_, and the prefaces to the Fathers of the Church.

This paper presents the data gathering of Matthew Fontine Maury at the U.S. Naval Observatory as pushing an epistemic boundary outside traditional laboratory walls. Maury's use and control of civilian navigators explicates the development of an astronomic epistemology deeply embedded in nineteenth century American society. In conclusion, following the movement of epistemic boundaries is offered as a guide to crucial moments in the development of a multifaceted modernity.

The study examined the influence of the Pond Report on the teaching of medical ethics in the London medical schools. A questionnaire was given to both medical students and college officers. All medical colleges reported that ethics was included in the curriculum. However, from students' replies, it seems that attendance of optional courses is low and that not all current final year medical students have had any formal teaching in medical ethics. Stronger guidelines are necessary to ensure appropriate ethical training (...) in London medical schools. (shrink)

The article introduces the problematics of the classical two-valued logic on which Western thought is generally based, outlining that under the conditions of its logical assumptions the subject I is situated in a world that it cannot address. In this context, the article outlines a short history of cybernetics and the shift from first- to second-order cybernetics. The basic principles of Gordon Pask’s 1976 Conversation Theory are introduced. It is argued that this second-order theory grants agency to others through a (...) re-conception of living beings as You logically transcending the I. The key principles of Conversation Theory are set in relation to the poetic forms of discourse that played a key role in art as well as philosophical thinking in China in the past. Second-order thinking, the article argues, is essentially poetic. It foregoes prediction in favour of the potentiality of encountering tomorrow’s delights. (shrink)

The editorial introduces issue 21.1 of Technoetic Arts via a critical reflection on the artificial intelligence hype (AI hype) that emerged in 2022. Tracing the history of the critique of Large Language Models, the editorial underscores that there are substantial ethical challenges related to bias in the training data, copyright issues, as well as ecological challeges which the technology industry has consistently downplayed over the years. -/- The editorial highlights the distinction between the current AI technology’s reliance on extensive pre-existing (...) human-generated data for pattern recognition and the performative process inherent in art practice. Patterns of creative output can be replicated without a thorough understanding of underlying concepts. In contrast, the performative process of art practice, as explored through the conceptual frameworks of creativity by Noam Chomsky, Charles Sanders Peirce, and Roger T. Ames and with reference to an earlier publication of the editorial’s author, creates concepts and continually ‘strives to extend itself towards the unknown.’ -/- Following this introductory section, the editorial provides an overview of the ten articles featured in this issue of Technoetic Arts. The first four texts engage with emerging technologies from various perspectives in art and design. The subsequent six articles, part of a special section titled 'Perspectives from Chandigarh,' reflect a quest for meaningful existence within colonial, patriarchal, and biopolitical structures that frame everyday practices of exclusion and oppression. (shrink)

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

This paper is a reply to George Boolos's three papers (Boolos (1987a, 1987b, 1990a)) concerned with the status of Hume's Principle. Five independent worries of Boolos concerning the status of Hume's Principle as an analytic truth are identified and discussed. Firstly, the ontogical concern about the commitments of Hume's Principle. Secondly, whether Hume's Principle is in fact consistent and whether the commitment to the universal number by adopting Hume's Principle might be problematic. Also the so-called `surplus content' worry is discussed, (...) which points out that the conceptual resources to grasp Hume's Principle vastly outstrip the conceptual resources employed in arithmetical reasoning. And lastly whether Hume's Principle is in bad company with other unsuccessful implicit definitions. In the last section, an account towards our entitlement to Hume&'s Principle is sketched. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...