Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

Background:Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leave the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for suspected victims of child maltreatment. Data on pediatric nurses’ moral distress are limited, as most research in this field has been done in adult inpatient and intensive care units.Aim:The purpose of this study was to describe pediatric nurses’ moral distress and evaluate the impact of caring for suspected victims (...) of child maltreatment on nurses’ moral distress, burnout, and intention to leave. Design and method: This descriptive cross-sectional correlational study was conducted in a mid-Atlantic, urban area Magnet pediatric level I trauma center that cares for over 1800 cases of suspected child maltreatment annually. An anonymous electronic survey was sent to all the nurses working at the hospital.Ethical considerations:Institutional Review Board approval was received from the first author’s university and the hospital where the study was conducted.Findings:Overall, nurses ( N = 146) reported low levels of moral distress with a mean score of 59.54 (SD = 49.22) and a range of 0–300 on the Moral Distress Scale Neonatal–Pediatric version. Although the frequency of caring for suspected child maltreatment victims did not affect nurses’ moral distress, caring for victims with fatal maltreatment contributed to nurses’ intention to leave, χ2(1) = 5.35, p = 0.02.Conclusion:The results of this study add to the understanding of moral distress in pediatric nursing. Caring for victims with fatal maltreatment impacts pediatric nurses’ intention to leave. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

Responding to a major pandemic and planning for allocation of scarce resources under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland’s response to COVID-19 and the role of the Maryland (...) Healthcare Ethics Committee Network in bridging gaps in the state’s response to prepare health care facilities for potential implementation of ASR plans. Identified “lessons learned” include: Deliberative Democracy Provided a Strong Foundation for Maryland’s ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:IntroductionSpatial, Environmental, and Ecocritical Approaches to Holocaust MemoryEmily-Rose Baker (bio), Michael Holden (bio), Diane Otosaka (bio), Sue Vice (bio), and Dominic Williams (bio)The successful implementation of genocide during the Holocaust depended on the spatial organisation of mass murder. From the concentrated ghettos and camps delimited by walls and barbed wire to the open fields and camouflaged forests where victims were shot en masse, Anne Kelly Knowles et al. (...) argue, specific locations, patterns of migration, deportation and evacuation, and other spatial elements such as scale, were all central to the Nazi regime's creation of a "comprehensive geography of oppression."1 This is hardly surprising given the biopolitical logics and colonial fantasies underpinning Lebensraum ('living space'), the territorial concept guiding the genocidal aims of the Third Reich, which designated zones of life as well as the inverse on the European continent. The Holocaust was also experienced spatially by its victims, who were forced to navigate new (and at times familiar) sites and landscapes as those of genocide, and whose testimonies in the aftermath of the event conjured these very places in detail.In recent years, the spaces of the Holocaust have been variously revisited, reconstructed, and reimagined within Holocaust studies scholarship. As a broader part of the 'spatial turn' in the humanities, Holocaust scholars have increasingly employed spatial perspectives of the event to deepen our understanding of the environments in which the Holocaust took place and the transformation of these spaces over time—particularly in the fields of history and social science.2 While drawing on diverse modes of spatialisation from interdisciplinary perspectives, contributions from these fields have tended to privilege methods we might describe as variously 'forensic,' including mapping, model-making, and investigations of material traces of the past.3 This work has resulted in many significant insights, not only into the [End Page 1] contexts and structures of Nazi genocide and the perpetrator imaginings of space, but also the experiences of victims and survivors.4Another significant body of work has attended to space and culture within Holocaust contexts. From early on in the postwar period, particular locations and buildings became identified with the Holocaust, such as the notorious entrance guard house at Auschwitz-Birkenau, which appears on countless book covers as well as within films and artworks. Engaging with spatial insights and methodologies from the perspective of cultural and memory studies, scholars have attested to the production and mnemonic significance of these and less well-known sites, as well as the symbolic spatial worlds and experiences to which they give rise. These include Paul Jaskot and Gavriel Rosenfeld, who have turned respectively to Holocaust and post-Holocaust architectures as commonly overlooked sites of history and memory. Drawing attention to the construction of Holocaust space, Jaskot shows how reading architecture 'as process' rather than static structures laden with symbolic meaning reveals unique histories of forced labor in which "the goals of the SS intersected with victims' experience."5 Rosenfeld demonstrates the ways in which spaces built in response to Nazi genocide after 1945 have been variously "imbued with Jewish significance" by their users and creators, resulting in the rise to prominence of Jewish-identified architects.6 Along similar lines, Michael Meng's work has explored the ways in which Jews and gentiles interact with ruined synagogues, cemeteries and Jewish districts as important remnants of pre-war Jewish life in the post-war period in German and Polish cities.7Studies such as those noted above have tended to focus on cities and public buildings, as well as state and civic policy. But as the spatial histories and geographies of the Holocaust have helped to show, extermination often took place in rural settings (mostly located in Central and Eastern Europe), such as the killing fields where Jews were shot en masse; the forests where victims hid and were hunted by Germans and local collaborators; or the open spaces of the dissolving Reich through which former concentration camp inmates were forced to march during the final year of the war—sites in which, owing to less contained spatial dynamics, violence played out differently.8These kinds of sites, which are sparsely documented and often simply thought of... (shrink)

This study is unique in that it presents the first empirically developed framework for use as a tool for measuring historical empathy. The Historical Empathy Measurement Tool (HEMT) was developed using a design-based research method with three iterative macrocycles of design, experiment, and retrospective analysis. The study involved question responses from 276 students in grade 8 studying WWI trench warfare. The research resulted in a framework of seven levels. (0) Non-response, (1) Facts, (2) Assumptions and Deficits, (3) General Comparison of (...) the Past and Present, (4) Emotional Comparison of the Past and Present, (5) Understanding Motives, Behaviors, Thoughts, & Emotions in the Past, and (6) Acknowledgement of Differences from those in the Past. The inter-rater reliability at the end of macrocycle three was 95%. (shrink)

In this study, we conducted a pseudosign repetition task with 22 children acquiring American Sign Language as a first language from deaf parents. Thirty-nine pseudosigns with varying complexity were developed and organized into eight categories depending on number of hands, number of simultaneous movement types, and number of movement sequences. Pseudosigns also varied in handshape complexity. The children’s performance on the ASL pseudosign task improved with age, displaying relatively accurate production of location and orientation, but much less accurate handshape and (...) movement, a finding in line with real sign productions for both L1 and L2 signers. Handshapes with higher complexity were correlated with lower accuracy in the handshape parameter. We found main effects of sequential and simultaneous movement combinations on overall performance. Items with no movement sequence were produced with higher overall accuracy than those with a movement sequence. Items with two simultaneous movement types or a single movement type were produced with higher overall accuracy than those with three simultaneous movement types. Finally, number of hands did not affect the overall accuracy. Remarkably, movement sequences impose processing constraints on signing children whereas complex hands and two simultaneous movement types do not significantly lower accuracy, indicating a capacity for processing multiple simultaneous components in signs. Spoken languages, in contrast, manifest greater complexity in temporal length. Hearing children’s pseudoword repetition still displays high levels of accuracy on disyllabic words, with complexity effects affecting only longer multisyllabic words. We conclude that the pseudosign repetition task is an informative tool for studies of signing children’s phonological development and that sheds light on potential modality effects for phonological development. (shrink)

The success of fecal microbiota transplantation as a treatment for Clostrioides difficile infection has stirred excitement about the potential for microbiota transplantation as a therapy for a wide range of diseases and conditions. In this article, we discuss vaginal microbiota transplantation as “the next frontier” in microbiota transplantation and identify the medical, regulatory, and ethical challenges related to this nascent field. We further discuss what we anticipate will be the first context for testing VMT in clinical trials, prevention of the (...) recurrence of a condition referred to as bacterial vaginosis. We also compare clinical aspects of VMT with FMT and comment on how VMT may be similar to or different from FMT in ways that may affect research design and regulatory decisions. (shrink)

v. 1. Religion and the powers of the common life -- v. 2. The spirit and the modern authorities -- v. 3. Christ and the dominions of civilization -- v. 4. Globalization and grace.

ObjectiveTo assess distracted attention and performance on a computer task following completion of a sustained attention and acute media multitasking task among adolescents with varying self-reported usual media multitasking.MethodsNinety-six 13- to 17-year-olds played the video game Tetris following completion of a Go/No-go paradigm to measure sustained attention in the presence of distractors, an acute media multitasking, or a passive viewing condition. Adolescents completed the conditions on separate visits in randomized order. Sustained attention was measured within the Go/No-go task by measuring (...) errors of omission. Distracted attention while playing the Tetris task was measured by computing eye tracking measures of attention to irrelevant distractor images that bordered the Tetris game. Participants also self-reported their daily media multitasking.ResultsThe Go/No-go task revealed important qualitative differences in sustained attention among low and high usual media multitaskers. There was a uniform improvement in sustained attention among low usual media multitaskers, demonstrated by a consistent linear decrease in omission errors. Among high usual media multitaskers, there was initially a decrease in sustained attention followed by an increase. Completing the Go/No-go task also statistically significantly reduced distractibility and increased performance while playing Tetris compared to the passive viewing condition, but only among those with low usual media multitasking. There was a non-statistically significant trend that completing the acute media multitask increased subsequent distractibility and performance while playing Tetris among high media multitaskers.ConclusionIn this sample of adolescents, practicing a sustained attention task reduces distractibility and improves task performance among those who have low levels of usual media multitasking. (shrink)

Although considerable research indicates that mental energy is an important factor in many domains, including athletic performance (Cook & Davis, 2006), athletic mental energy (AME) has never been conceptualized and measured. Therefore, the aim of this study was to conceptualize and develop a reliable and valid instrument to assess athletic mental energy. In Study 1, a focus group interview established the initial framework of athletic mental energy. Study 2 used a survey to collect athletes’ experiences of athletic mental energy and (...) develop a scale draft titled “Athletic Mental Energy Scale (AMES).” In Study 3, we examined the psychometric properties and the underlying structure of AMES via item analysis, internal consistency, and exploratory factor analysis (EFA). In Study 4, we used confirmatory factor analysis (CFA) to examine AMES’s factorial validity; and examined concurrent and discriminant validity by examining correlations with athletes’ life stress, positive state of mind, and burnout. In study 5, we examined the measurement invariance of the 6-factor, 18-item AMES with Taiwanese and Malaysian samples. Study 6 examined the predictive validity by comparing AMES scores of successful and unsuccessful martial artists. Across these phases, results showed a 6-factor, 18-item AMES had adequate content validity, factorial structure, nomological validity, discriminant validity, predictive validity, measurement invariance, and reliability. We suggest future studies may use AMES to examine its relationships with athletes’ cognition, affect, and performance. The application of AMES in sport psychology was also discussed. (shrink)

The current work investigated whether differences in phonological overlap between the past- and present-tense forms of regular and irregular verbs can account for the graded neurophysiological effects of verb regularity observed in past-tense priming designs. Event-related potentials were recorded from 16 healthy participants who performed a lexical-decision task in which past-tense primes immediately preceded present-tense targets. To minimize intra-modal phonological priming effects, cross-modal presentation between auditory primes and visual targets was employed, and results were compared to a companion intra-modal auditory (...) study (Justus, T., Larsen, J., de Mornay Davies, P., Swick, D. (2008). Interpreting dissociations between regular and irregular past-tense morphology: evidence from event-related potentials. Cognitive, Affective, Behavioral Neuroscience, 8, 178–194.). For both regular and irregular verbs, faster response times and reduced N400 components were observed for present-tense forms when primed by the corresponding past-tense forms. Although behavioral facilitation was observed with a pseudopast phonological control condition, neither this condition nor an orthographic-phonological control produced significant N400 priming effects. Instead, these two types of priming were associated with a post-lexical anterior negativity (PLAN). Results are discussed with regard to dual- and single-system theories of inflectional morphology, as well as intra- and cross-modal prelexical priming. (shrink)

It has been suggested that damage to anterior regions of the left hemisphere results in a dissociation in the perception and lexical activation of past-tense forms. Specifically, in a lexical-decision task in which past-tense primes immediately precede present-tense targets, such patients demonstrate significant priming for irregular verbs (spoke–speak), but, unlike control participants, fail to do so for regular verbs (looked–look). Here, this behavioral dissociation was first confirmed in a group of eleven patients with damage to the pars opercularis (BA 44) (...) and pars triangularis (BA 45) of the left inferior frontal gyrus (i.e., Broca's area). Two conditions containing word-onset orthographic–phonological overlap (bead–bee, barge–bar) demonstrated that the disrupted regular-verb priming was accompanied by, and covaried with, disrupted ortho-phonological priming, regardless of whether prime stimuli contained the regular inflectional rhyme pattern. Further, the dissociation between impaired regular-verb and preserved irregular-verb priming was shown to be continuous rather than categorical; priming for weak-irregular verbs (spent–spend) was intermediate in size between that of regular verbs and strong verbs. Such continuous dissociations grounded in ortho-phonological relationships between present- and past-tense forms are predicted by single-system, connectionist approaches to inflectional morphology and not predicted by current dual-system, rule-based models. Event-related potential data demonstrated that N400 priming effects were intact for both regular and irregular verbs, suggesting that the absence of significant regular-verb priming in the response time data did not result from a disruption of lexical access, and may have stemmed instead from post-lexical events such as covert articulation, segmentation strategies, and/or cognitive control. (shrink)

Neural markers, such as the mismatch negativity, have been used to examine the phonological underspecification of English feature contrasts using the Featurally Underspecified Lexicon model. However, neural indices have not been examined within the approximant phoneme class, even though there is evidence suggesting processing asymmetries between liquid and glide phonemes. The goal of this study was to determine whether glide phonemes elicit electrophysiological asymmetries related to [consonantal] underspecification when contrasted with liquid phonemes in adult English speakers. Specifically, /ɹɑ/ is categorized (...) as [+consonantal] while /wɑ/ is not specified [i.e., ]. Following the FUL framework, if /w/ is less specified than /ɹ/, the former phoneme should elicit a larger MMN response than the latter phoneme. Fifteen English-speaking adults were presented with two syllables, /ɹɑ/ and /wɑ/, in an event-related potential oddball paradigm in which both syllables served as the standard and deviant stimulus in opposite stimulus sets. Three types of analyses were used: traditional mean amplitude measurements; cluster-based permutation analyses; and event-related spectral perturbation analyses. The less specified /wɑ/ elicited a large MMN, while a much smaller MMN was elicited by the more specified /ɹɑ/. In the standard and deviant ERP waveforms, /wɑ/ elicited a significantly larger negative response than did /ɹɑ/. Theta activity elicited by /ɹɑ/ was significantly greater than that elicited by /wɑ/ in the 100–300 ms time window. Also, low gamma activation was significantly lower for /ɹɑ/ vs. /wɑ/ deviants over the left hemisphere, as compared to the right, in the 100–150 ms window. These outcomes suggest that the [consonantal] feature follows the underspecification predictions of FUL previously tested with the place of articulation and voicing features. Thus, this study provides new evidence for phonological underspecification. Moreover, as neural oscillation patterns have not previously been discussed in the underspecification literature, the ERSP analyses identified potential new indices of phonological underspecification. (shrink)

This book from the Center for Bioethics and Human Dignity provides a faith-based evaluation of recent technologies and trends in bioethics--including the current debate surrounding stem cell research. Fifteen noted scholars and medical practitioners discuss some of today's new and controversial work in biomedicine--xenotransplantation, artificial intelligence, cybernetics, and more--and evaluate from a Christian perspective both the science and the ethical questions it raises. Designed to orient general readers to the current state of biomedical research, Cutting-Edge Bioethics is must reading for (...) anyone wishing to confront and wrestle with the challenging moral issues posed by this ever-advancing field. (shrink)

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services. Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic review (...) was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. (shrink)

Diane Blakemore; XI*—Performatives and Parentheticals, Proceedings of the Aristotelian Society, Volume 91, Issue 1, 1 June 1991, Pages 197–214, https://doi.org/.

This book provides answers to both normative and metaethical questions in a way that shows the interconnection of both types of questions, and also shows how a complete theory of reasons can be developed by moving back and forth between the two types of questions. It offers an account of the nature of intimate relationships and of the nature of the reasons that intimacy provides, and then uses that account to defend a traditional intuitionist metaethics. The book thus combines attention (...) to the details of the lived moral life – the context in which many of our most pressing moral questions arise, how we deliberate and make moral decisions, the complexities that plague our attempts to know what we ought to do – with theoretical rigor in offering an account of the nature of reasons, how we come to have moral knowledge, and how we can adjudicate between competing positions. (shrink)

In the 70 years since Alan Turing’s ‘Computing Machinery and Intelligence’ appeared in Mind, there have been two widely-accepted interpretations of the Turing test: the canonical behaviourist interpretation and the rival inductive or epistemic interpretation. These readings are based on Turing’s Mind paper; few seem aware that Turing described two other versions of the imitation game. I have argued that both readings are inconsistent with Turing’s 1948 and 1952 statements about intelligence, and fail to explain the design of his game. (...) I argue instead for a response-dependence interpretation. This interpretation has implications for Turing’s view of free will: I argue that Turing’s writings suggest a new form of free will compatibilism, which I call response-dependence compatibilism. The philosophical implications of rethinking Turing’s test go yet further. It is assumed by numerous theorists that Turing anticipated the computational theory of mind. On the contrary, I argue, his remarks on intelligence and free will lead to a new objection to computationalism. (shrink)