In this essay, I argue that genuine responsibility and ethical self-understanding are possible without narrative—or, at least, that narrative is not always sufficient. In §2, I introduce and clarify a distinction between our ontological subjectivity and everyday practical identity—one made famous by Heidegger and Sartre. On the basis of this distinction, in §3 I argue that narrative is unable to ground ethical choice and decision. For, although acting in light of practical identities is something we do, it cannot wholly (...) capture what it is to be who we are. Irrespective of whatever worldly projects and identities we press into, something about our subjectivity always remains unchanged. Narrative identity, which trades merely on practical identity, thus obscures this ontological dimension of life wherein human action, decision, choice, and responsibility truly originate. By way of conclusion, in §4, I briefly examine depictions of the narrative life found within the authorships of Dostoevsky, Kierkegaard, and Voltaire, illustrating how self-narrative at times invites self-deception and annuls responsibility. A life of genuine responsibility demands more than what the most candid and best intentioned of self-narratives can supply us. Living the good life, I shall intimate, is thus not something that involves mere narrative. It depends, rather, on inwardness. (shrink)

Delayed-choice experiments in quantum mechanics are often taken to undermine a realistic interpretation of the quantum state. More specifically, Healey has recently argued that the phenomenon of delayed-choice entanglement swapping is incompatible with the view that entanglement is a physical relation between quantum systems. This paper argues against these claims. It first reviews two paradigmatic delayed-choice experiments and analyzes their metaphysical implications. It then applies the results of this analysis to the case of entanglement (...) swapping, showing that such experiments pose no threat to realism about entanglement. (shrink)

There is a fallacy that is often involved in the interpretation of quantum experiments involving a certain type of separation such as the: double-slit experiments, which-way interferometer experiments, polarization analyzer experiments, Stern-Gerlach experiments, and quantum eraser experiments. The fallacy leads not only to flawed textbook accounts of these experiments but to flawed inferences about retrocausality in the context of delayed choice versions of separation experiments.

Delayed-choice experiments in quantum mechanics are often taken to undermine a realistic interpretation of the quantum state. More specifically, Healey has recently argued that the phenomenon of delayed-choice entanglement swapping is incompatible with the view that entanglement is a physical relation between quantum systems. This paper argues against these claims. It first reviews two paradigmatic delayed-choice experiments and analyzes their metaphysical implications. It then applies the results of this analysis to the case of entanglement (...) swapping, showing that such experiments pose no threat to realism about entanglement. (shrink)

This paper explains the delayed choice quantum eraser of Kim et al. in terms of the transactional interpretation of quantum mechanics by Cramer. It is kept deliberately mathematically simple to help explain the transactional technique. The emphasis is on a clear understanding of how the instantaneous “collapse” of the wave function due to a measurement at a specific time and place may be reinterpreted as a relativistically well-defined collapse over the entire path of the photon and over the (...) entire transit time from slit to detector. This is made possible by the use of a retarded offer wave, which is thought to travel from the slits to the detector and an advanced counter wave traveling backward in time from the detector to the slits. The point here is to make clear how simple the transactional picture is and how much more intuitive the collapse of the wave function becomes if viewed in this way. Also, any confusion about possible retro-causal signaling is put to rest. A delayed choice quantum eraser does not require any sort of backward in time communication. This paper makes the point that it is preferable to use the TI over the usual Copenhagen interpretation for a more intuitive understanding of the quantum eraser delayed choice experiment. Both methods give exactly the same end results and can be used interchangeably. (shrink)

It is pointed out that a slight variation on the Wheeler Delayed Choice Experiment presents the same challenge to orthodox quantum mechanics as Maudlin-type contingent absorber experiments present to the Transactional Interpretation. Therefore, the latter cannot be used as a basis for refutation of TI.

It is demonstrated that ‘quantum eraser’ experiments do not erase any information. Nor do they demonstrate ‘temporal nonlocality’ in their ‘delayed choice’ form, beyond standard EPR correlations. It is shown that the erroneous erasure claims arise from assuming that the improper mixed state of the signal photon physically prefers either the ‘which way’ or ‘both ways’ basis, when no such preference is warranted. The latter point is illustrated through comparison of the QE spatial state space with the spin-1/2 (...) space of particles in the EPR-spin experiment. (shrink)

The concept of retroactive apparent occurrence, the main ingredient of Wheeler's delayed-choice thought experiments, is systematically incorporated into the quantum theory of measurement (in the framework of the recent review of Busch, Lahti, and Mittelstaedt). Besides, the (general) notion of individual-system measurement is introduced, and, due to it, premeasurement is defined by a truly minimal condition. Finally, retroactive apparent occurrence is made use of to derive apparent objectification in measurement. The derivation is discussed in the framework of the (...) quantum mechanical approach to the objectification problem. (shrink)

Experiments involving delayed-choice entanglement swapping seem to suggest that particles can become entangled after they’ve already been detected. This astonishing result is taken by some to undermine realism about entanglement. In this paper, I argue that one can offer a fully realist explanation of delayed-choice entanglement swapping by countenancing timelike entanglement relations. I argue that such an explanation—radical though it may be—isn’t incoherent and doesn’t invite paradox. I compare this approach to the antirealist alternative and a (...) more deflationary realist strategy defended by Egg, each of which face certain challenges. The upshot is that we should take seriously the possibility of timelike entanglement and seek to develop a framework for quantum theory which allows for it. (shrink)

Building on Peres’ idea of “Delayed-choice for entanglement swapping” we show that even the degree to which quantum systems were entangled can be defined after they have been registered and may even not exist any more. This does not arise as a paradox if the quantum state is viewed as just a representative of information. Moreover such a view gives a natural quantification of the complementarity between the measure of information about the input state for teleportation and the (...) amount of entanglement of the resulting swapped entangled state. (shrink)

Delayed-choice erasure is investigated in two-photon two-slit experiments that are generalizations of the micromaser experiment of Scully et al. (Nature 351:111–116, 1991). Applying quantum mechanics to the localization detector, it is shown that erasure with delayed choice in the sense of Scully, has an analogous structure as simple erasure. The description goes beyond probabilities. The EPR-type disentanglement, consisting in two mutually incompatible distant measurements, is used as a general framework in both parts of this study. Two (...) simple coherence cases are shown to emerge naturally, and they are precisely the two experiments of Scully et al. The treatment seems to require the relative-reality-of-unitarily-evolving-state (RRUES) approach. Besides insight in the experiments, this study has also the goal of insight in quantum mechanics. The question is if the latter can be more than just a “book-keeping device” for calculating probabilities as Scully et al. modestly and cautiously claim. (shrink)

It was pointed out in the first part of this study (Herbut in Found. Phys. 38:1046–1064, 2008) that EPR-type entanglement is defined by the possibility of performing any of two mutually incompatible distant, i.e., direct-interaction-free, measurements. They go together under the term ‘EPR-type disentanglement’. In this second part, quantum-mechanical insight is gained in the real random delayed-choice erasure experiment of Kim et al. (Phys. Rev. Lett. 84:1–5, 2000) by a relative-reality-of-unitarily-evolving-state (RRUES) approach (explained in the first part). Finally, (...) it is shown that this remarkable experiment, which performs, by random choice, two incompatible measurements at the same time, is actually an EPR-type disentanglement experiment, closely related to the micromaser experiment discussed in the first part. (shrink)

We treat here three apparently uncorrelated topics from the point of view of dense measurement: The EPR paradox, the teleportation process, and Wheeler's delayed-choice experiment (DCE). We begin with the DCE and show, using its unique nature and the histories formalism, that use may ascertain and fix the notion of dense measurement (the Zeno effect). We show here by including the experimenter (observer) as an inherent part of the physical system and using the Aharonov–Vardi notion of dense measurement (...) along a path, that knowledge of certain properties of the incoming system (after a measurement) is equivalent to dense measurement. We reach the same conclusion by discussing the teleportation process, and the EPR paradox from, the same point of view. (shrink)

The prominent characteristic of a delayed-choice effect is to make the choice between complementary types of phenomena after the relevant interaction between the system and measuring instrument has already come to an end. In this paper, we first represent a detailed comparative analysis of some early delayed-choice propositions and also most of the experimentally performed delayed-choice proposals in a coherent and unified quantum mechanical formulation. Taking into the account the represented quantum mechanical descriptions (...) and also the rules of probability theory, we discuss that there are two fundamentally different descriptions concerning the physical mechanism of the delayed-choice between the complementary types of phenomena in these experiments. In this regard, we finally conclude that the delayed-choice experiments can be classified into two main groups where the temporal aspect of each group is characterized differently within their probabilistic descriptions. (shrink)

In the present paper we expand upon ideas published some time ago in connection with which path detectors based on the micromaser. Frequently questions arise concerning the time ordering of detection and eraser events. We here show, by a detailed and careful analysis of a quantum eraser experimental setup, that the experimenter can choose to ascertain particle-like which path information or wavelike interference information even after the atom has hit the screen.

Options are often presented incidentally in a sequence, but does serial position impact choice after delay, and if so, how? We address this question in a consequential real-world choice domain. Using 25 years of citation data, and a unique identification strategy, we examine the relationship between article order and citation count. Results indicate that mere serial position affects the prominence that research achieves: Earlier-listed articles receive more citations. Furthermore, our identification strategy allows us to cast doubt on alternative (...) explanations and instead indicate that the effect is driven by psychological processes of attention and memory. These findings deepen the understanding of how presentation order impacts choice, suggest that subtle presentation factors can bias an important scientific metric, and shed light on how psychological processes shape collective outcomes. (shrink)

Experimental studies suggest that individuals exhibit more risk aversion in choices among prospects when the payment and resolution of uncertainty are immediate relative to when it is delayed. This leads to preference reversals that cannot be attributed to discounting. When data suggest that utility is time-independent, probability weighting functions, such as those used to model prospect theory preferences, can accommodate such reversals. We propose a simple descriptive model with a two-parameter probability weighting function where one of these parameters depends (...) on the time at which a prospect is resolved. The time-dependent parameter is responsible for the curvature of the probability weighting function and is regarded as an index of sensitivity towards changes in probabilities. We provide conditions that characterize increased sensitivity towards more distant probabilities; this can account for the observed relatively less risk aversion towards delayed prospects. In our framework, the discount function is unrestricted, such that the model is compatible with empirical findings of non-constant discounting. In a simple application to bargaining we illustrate when it is advantageous for an individual to advance or delay the bargaining resolution time if an opponent displays increased sensitivity towards probability changes with delay. (shrink)

We have shown that FEF lesion-induced extinction could be compensated for by changing the relative temporal onsets of two targets presented on either side of the midline. Monkeys were trained to make saccades to either of two identical visual stimuli presented with various stimulus onset asynchronies (SOA). In intact animals the targets were chosen with equal probability when they appeared simultaneously. After unilateral FEF lesions an SOA of 67–116 msec had to be introduced, with the contralesional target appearing first, to (...) obtain equal probability choice. With a smaller target separation, averaging saccades occurred with highest frequency at similar SOAs. Our findings suggest that neglect may be attributable to more time being required in the damaged hemisphere for converting sensory information into motor responses. (shrink)

South Africa has an abortion law which codifies the broad themes of reproductive rights set out in the Constitution of South Africa, other laws and national guidelines. Certain wording of the conditions in the Choice Act for abortion after 20 weeks' gestation, are open to interpretation, being ‘severe malformation of the fetus’ and ‘risk of injury to the fetus’. From 24 weeks onwards, abortion is carried out by feticide/induced fetal cardiac asystole (‘IFCA’) and subsequent induction of labour in South (...) Africa. Some maternal‐fetal units have developed guidelines to assist clinicians and patients in decision‐making around eligibility for abortion after 20 weeks' gestation, given the broad terms in the law. We consider the guideline used by an institution in the Western Cape for abortion after 23 weeks and 6 days gestation, in terms of its alignment with the law on reproductive rights and its compliance with fair and transparent procedures. We also note its effect on respect for patients and on staff professionalism. (shrink)

Previous research has shown that subliminally presented stimuli accelerate or delay responses afforded by supraliminally presented stimuli. Our experiments extend these findings by showing that unconscious stimuli even affect free choices between responses. Thus, actions that are phenomenally experienced as freely chosen are influenced without the actor becoming aware of the manipulation. However, the unconscious influence is limited to a response bias, as participants chose the primed response only in up to 60% of the trials. LRP data in free (...) class='Hi'>choice trials indicate that the prime was not ineffective in trials in which participants chose the non-primed response as then it delayed performance of the incongruently primed response. (shrink)

Biotechnological advance is speeding the development of drugs. The approval processes for new drugs will inevitably involve a regulatory agency in making political-economic and scientific choices. Interests of specific patients and the public in general are to be considered, and enormous stakes are involved for companies concerned. A medical regulatory authority must be at once insulated from and responsive to many different mixes of singular and general interests and pressures. Access to new drugs can be spurred by the press of (...) patient advocacy groups, but if there are well organized groups to monitor the testing and approval process for such as AIDS or cancer drugs there is often no similar group to represent patient needs. If there is no organized patient advocacy group, compassionate responsibility by a medical regulatory authority is indeed called for. Delay in the approval of new drugs for fighting severe blood infections raises the question of how to insure the compassionate responsibility of a regulatory authority. (shrink)

We present an experiment in which we add a common delay in a choice between two risky prospects. The results show that delay produces the same change in preferences as in the well-documented common ratio effect in risky lotteries. The added common delay acts as if the probabilities were divided by some common ratio. Moreover, we show that there is a strong magnitude effect, in the sense that the effect of delay depends on the magnitude of the outcome. The (...) results are consistent with the recently introduced probability time trade-off (PTT) model by Baucells and Heukamp. We present a parameterization of the model based on the experimental results, showing that the value function exhibits increasing relative risk aversion, the weighting function is s-shaped, and the intrinsic discount rate is decreasing. (shrink)

When making a decision, humans consider two types of information: information they have acquired through their prior experience of the world, and further information they gather to support the decision in question. Here, we present evidence that data from search engines such as Google can help us model both sources of information. We show that statistics from search engines on the frequency of content on the Internet can help us estimate the statistical structure of prior experience; and, specifically, we outline (...) how such statistics can inform psychological theories concerning the valuation of human lives, or choices involving delayed outcomes. Turning to information gathering, we show that search query data might help measure human information gathering, and it may predict subsequent decisions. Such data enable us to compare information gathered across nations, where analyses suggest, for example, a greater focus on the future in countries with a higher per capita GDP. We conclude that search engine data constitute a valuable new resource for cognitive scientists, offering a fascinating new tool for understanding the human decision-making process. (shrink)

Pickard’s contribution reminds me that conceptualizing choice is no simple matter. Pickard sees choice as entirely voluntary, while I argue that choice is only partially voluntary. Choices are based on appraisals of situations, which fluctuate due to external circumstances and internal states such as emotion and mood. Habit itself competes with volition, and all these parameters vary with development. Psychological factors such as delay discounting and especially one's belief in one's agency are critical for volitional choice (...) as well. (shrink)

The net benefit of vaccinating children is unclear, and vulnerable people worldwide should be prioritised instead, say Dominic Wilkinson, Ilora Finlay, and Andrew J Pollard. But Lisa Forsberg and Anthony Skelton argue that covid-19 vaccines have been approved for some children and that children should not be disadvantaged because of policy choices that impede global vaccination.

Before going further, it will be helpful to consider briefly the notion that novelty per se is a fundamental human need. Experiments with human beings, as well as with animals, indicate that the maintenance of normal, successful behavior depends upon an adequate level of incoming stimulation—or, as some have put it, of novelty.2 But lumping all novelty together is misleading. At least three kinds of novelty need to be distinguished. Some novel patterns arise out of, or represent, changes in the (...) fundamental rules governing the organization of musical processes and structures. By significantly weakening our comprehension of the musical relationships presented—undermining not only our understanding of what is past but our ability to envisage what is to come—such systemic change seriously threatens our sense of psychic security and competent control. Far from being welcome, the insecurity and uncertainty thus engendered is at least as antipathetic, disturbing, and unpleasant as stimulus privation. Novel patterns may also result from the invention of a new strategy that accords with prevalent stylistic rules. Though they may initially seem to threaten existing competencies, the function and significance of novel strategies within the larger set of stylistic constraints can usually be grasped without too much delay or difficulty. For a while the tensions produced by strategic innovation may seem disturbing. But in the end, when our grasp of the principles ordering events is confirmed and our sense of competency is reestablished and control is reinforced, tension is resolved into an elation that is both stimulating and enjoyable. Most novel patterns—original themes, rhythms, harmonic progressions, and so forth—involve the innovative instantiation or realization of an existing strategy or schema .3 Novelties of this kind not only enhance our sense of control—a feeling that we know how things really “work”—but provide both the pleasure of recognition and the joy of skillfully exercising some competency. We enjoy novelty—the stimulation of surprise, the tension of uncertainty—as long as it can be accommodated within a known and understandable set of constraints. When the rules governing the game are abrogated or in doubt—when comprehension and control are threatened—the result is usually anger, anguish, and desperation.These responses to novelty are consequences of fundamental and poignant verities of the human condition: the centrality of choice in human behavior. Because only a minute fraction of human behavior seems to be genetically specified, choice is inescapable.While in lower organisms, behavior is strictly determined by the genetic program, in complex metazoa the genetic program becomes less constraining, more “open” as Ernst Mayr puts it, in the sense that it does not lay down behavioral instructions in great detail but rather permits some choice and allows for a certain freedom of response. Instead of imposing rigid prescriptions, it provides the organism with potentialities and capacities. This openness of the genetic program increases with evolution and culminates in mankind.4The price of freedom is the imperative of choice. Human beings must choose were to sow and when to reap, when to work and where to live, when to play and what to build. Intelligent, successful choices are possible only if alternative courses of action can be imagined and their consequences envisaged with reasonable accuracy. 2. For further discussion, see my Music, the Arts, and Ideas , p. 50.3. Rules are transpersonal but intracultural constraints—for instance, the pitch/time entities established in some style, as well as grammatical and syntactic regularities. Strategies are general means for actualizing some of the possibilities that are potential in the rules of the style. The rules of a style are relatively few, while the number of possible strategies may, depending upon the nature of the rules, be very large indeed. The ways of instantiating a particular strategy are, if not infinite, at least beyond reckoning.4. François Jacob, The Possible and the Actual , p. 61. See also Stephen Jay Gould, Ever Since Darwin , p. 257. (shrink)

In the real world, there are choices between large, delayed, punctate rewards and small, more immediate rewards as well as choices between patterns and acts. A common element in these situations is the choice between long- and short-term interests. Key issues for future research appear to be how acts are restructured into larger patterns of behavior, and whether, as Rachlin implies, pattern perception is the cause of pattern generation.

In many real-world gambles, a non-trivial amount of time passes before the uncertainty is resolved but after a choice is made. An individual may have a preference between gambles with identical probability distributions over final outcomes if they differ in the timing of resolution of uncertainty. In this domain, utility consists not only of the consumption of outcomes, but also the psychological utility induced by an unresolved gamble. We term this utility anxiety. Since a reflective decision maker may want (...) to include anxiety explicitly in analysis of unresolved lotteries, a multiple-outcome model for evaluating lotteries with delayed resolution of uncertainty is developed. The result is a rank-dependent utility representation (e.g., Quiggin, 1982), in which period weighting functions are related iteratively. Substitution rules are proposed for evaluating compound temporal lotteries. The representation is appealing for a number of reasons. First, probability weights can be interpreted as the cognitive attention allocated to certain outcomes. Second, the model disaggregates strength of preference from temporal risk aversion and thus provides some insight into the old debate about the relationship between von Neumann–Morgenstern utility functions and strength of preference value functions. (shrink)

Delay discounting is a common phenomenon in daily life, which refers to the subjective value of a future reward decreasing as a function of time. Previous studies have identified several cortical regions involved in delay discounting, but the neural network constructed by the cortical regions of delay discounting is less clear. In this study, we employed resting-state functional magnetic resonance imaging (RS-fMRI) to measure the spontaneous neural activity in a large sample of healthy young adults and used the Monetary (...) class='Hi'>Choice Questionnaire to directly measure participants’ level of delay discounting. To identify the neural network of delay discounting at rest, we used an individual difference approach to explore brain regions whose spontaneous activities were related to delay discounting across the whole brain. Then, these brain regions served as seeds to identify the neural network of delay discounting. We found that the fractional amplitude of low-frequency fluctuations (fALFF) of the left insula were positively correlated to delay discounting. More importantly, its connectivity to the anterior cingulate cortex was read out for participants’ behavioral performance in the task of delay discounting. In short, our study provides empirical evidence that insula-anterior cingulate cortex connectivity may serve as a part of the neural network for delay discounting. (shrink)

Intertemporal choice is the study of how people make choices about what and how much to do at various points in time, when choices at one time influence the possibilities available at other points in time. These choices are influenced by the relative value people assign to two or more payoffs at different points in time. Most choices require decision-makers to trade off costs and benefits at different points in time. These decisions may be about savings, work effort, education, (...) nutrition, exercise, health care and so forth. Since early in the twentieth century, economists have analyzed intertemporal decisions using the discounted utility model, which assumes that people evaluate the pleasures and pains resulting from a decision in much the same way that financial markets evaluate losses and gains, exponentially 'discounting' the value of outcomes according to how delayed they are in time. Discounted utility has been used to describe how people actually make intertemporal choices and it has been used as a tool for public policy. Policy decisions about how much to spend on research and development, health and education all depend on the discount rate used to analyze the decision. (shrink)

People often feel that a period of time becomes longer when it is described in more detail or cut into more segments, which is known as the time unpacking effect. The current study aims to unveil how time unpacking manipulation impacts intertemporal decision making and whether the gain-loss valence of choices moderates such impacts. We recruited 87 college students and randomly assigned them to the experimental conditions to complete a series of intertemporal choice tasks. The subjective values of the (...) delayed choices were calculated for each participant and then analyzed. The results showed that participants perceived longer time delays and higher subjective values on the delayed gains in the time unpacking conditions than in the time packing conditions. These results suggest that time unpacking manipulation not only impacts time perception but also other factors, which in turn, influence the valuation of delayed outcomes and thereby intertemporal choices. The results are discussed in comparison to previous studies to highlight the complexity of the mechanism underlying the effect of time unpacking on intertemporal decision making. (shrink)

Intertemporal choice involves deciding between smaller, sooner and larger, later rewards. People tend to prefer smaller rewards that are available earlier to larger rewards available later, a phenomenon referred to as temporal or delay discounting. Despite its ubiquity in human and non-human animals, temporal discounting is subject to considerable individual differences. Here, we provide a critical narrative review of this literature and make suggestions for future work. We conclude that temporal discounting is associated with key socio-economic and health-related variables. (...) Regarding personality, large-scale studies have found steeper temporal discounting to be associated with higher levels of self-reported impulsivity and extraversion; however, effect sizes are small. Temporal discounting correlates negatively with future-oriented cognitive styles and inhibitory control, again with small effect sizes. There are consistent associations between steeper temporal discounting and lower intelligence, with effect sizes exceeding those of personality or cognitive variables, although socio-demographic moderator variables may play a role. Neuroimaging evidence of brain structural and functional correlates is not yet consistent, neither with regard to areas nor directions of effects. Finally, following early candidate gene studies, recent Genome Wide Association Study (GWAS) approaches have revealed the molecular genetic architecture of temporal discounting to be more complex than initially thought. Overall, the study of individual differences in temporal discounting is a maturing field that has produced some replicable findings. Effect sizes are small-to-medium, necessitating future hypothesis-driven work that prioritizes large samples with adequate power calculations. More research is also needed regarding the neural origins of individual differences in temporal discounting as well as the mediating neural mechanisms of associations of temporal discounting with personality and cognitive variables. (shrink)

Background Massively parallel sequencing techniques, such as whole exome sequencing (WES) and whole genome sequencing (WGS), may reveal unsolicited findings (UFs) unrelated to the diagnostic aim. Such techniques are frequently used for diagnostic purposes in pediatric cases of developmental delay (DD). Yet policy guidelines for informed consent and return of UFs are not well equipped to address specific moral challenges that may arise in these children’s situations. Discussion In previous empirical studies conducted by our research group, we found that it (...) is sometimes uncertain how children with a DD will develop and whether they could come to possess capacities for autonomous decision-making in the future. Parents sometimes felt this brought them into a Catch-22 like situation when confronted with choices about UFs before undergoing WES in trio-analysis (both the parents’ and child’s DNA are sequenced). An important reason for choosing to consent to WES was to gain more insight into how their child might develop. However, to make responsible choices about receiving or declining knowledge of UFs, some idea of their child’s future development of autonomous capacities is needed. This undesirable Catch-22 situation was created by the specific policy configuration in which parents were required to make choices about UFs before being sequencing (trio-analysis). We argue that this finding is relevant for reconfiguring current policies for return of UFs for WES/WGS and propose guidelines that encompass two features. First, the informed consent process ought to be staged. Second, differing guidelines are required for withholding/disclosing a UF in cases of DD appropriate to the level of confidence there is about the child’s future developmental of autonomous capacities. Conclusion When combined with a dynamic consent procedure, these two features of our guidelines could help overcome significant moral challenges that present themselves in the situations of children undergoing genomic sequencing for clarifying a DD. (shrink)

The model for capacity assessment in the United States and much of the Western world relies upon the demonstration of four skills including the ability to communicate a clear, consistent choice. Yet such assessments often occur at only one moment in time, which may result in the patient expressing a choice to the evaluator that is highly inconsistent with the patient’s underlying values and goals, especially if a short-term factor (such as frustration with the hospital staff) distorts the (...) patient’s preferences momentarily. These challenges are particularly concerning in cases, which arise frequently in hospital settings, in which patients demand immediate self-discharge, often during off-hours, while faced with life-threatening risks. This paper examines the distinctive elements that shape such cases and explores their ethical implications, ultimately offering a model for such situations that can be operationalized. (shrink)

Egg freezing can allow women to preserve their eggs to avoid age-related infertility. The UK's recent extension of elective egg freezing storage has been welcomed as a way of enhancing the reproductive choices of young women who wish to delay having children. In this paper, I explore the issue of enhancing women’s reproductive choices, questioning whether there is a more significant aspect overlooked in egg freezing. While increasing storage limits expands reproductive choices for some women, focus on this extension alone, (...) I argue, misses a fundamental issue with egg preservation that often remains ignored; the importance of effective information on egg freezing and the effect this has on women’s reproductive choices. Ultimately, I highlight the crucial role of balanced information in enhancing women’s choices regarding egg freezing and argue that focusing on extending and increasing provision may obscure this real opportunity to empower women and their authentic reproductive choices. (shrink)