Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

Although established in the law and current practice, the determination of death according to neurological criteria continues to be controversial. Some scholars have advocated return to the traditional circulatory and respiratory criteria for determining death because individuals diagnosed as ‘brain dead’ display an extensive range of integrated biological functioning with the aid of mechanical ventilation. Others have attempted to refute this stance by appealing to the analogy between decapitation and brain death. Since a decapitated animal is obviously dead, and ‘brain (...) death’ represents physiological decapitation, brain dead individuals must be dead. In this article we refute this ‘decapitation gambit.’ We argue that decapitated animals are not necessarily dead, and that, moreover, the analogy between decapitation and the clinical syndrome of brain death is flawed. (shrink)

Data monitoring committees often are employed to review interim findings of randomised controlled trials. Interim findings are kept confidential until the data monitoring committee finds that they provide sufficiently compelling evidence regarding efficacy, typically because they have crossed the pre-defined statistical boundaries, or they raise serious concerns about safety. While this practice is vital to maintaining the scientific integrity of controlled trials and thereby ensuring their social value, it has been criticised as unethical. Commentators argue that withholding interim findings from (...) research participants is deceptive, inconsistent with valid informed consent, and a violation of respect for participants’ autonomy. The present article examines these arguments, focusing specifically on confidential data monitoring for efficacy. This practice need not be deceptive provided its use is disclosed to prospective research participants. In addition, confidential data monitoring does not make research participants worse off than they would be in the clinical setting and represents an acceptable limitation on the options available to prospective research participants. Taken together, these considerations suggest confidential data monitoring, subject to adequate safeguards, is ethically acceptable. (shrink)

Dual-track assessment directs research ethics committees to assess the risks of research interventions based on the unclear distinction between therapeutic and non-therapeutic interventions. The net risks test, in contrast, relies on the clinically familiar method of assessing the risks and benefits of interventions in comparison to the available alternatives and also focuses attention of the RECs on the central challenge of protecting research participants.Research guidelines around the world recognise that clinical research is ethical only when the risks to participants are (...) reasonable.1 Appropriate implementation of this requirement is vital to protecting research participants and allowing research to proceed when it poses acceptable risks. Unfortunately, as the US National Bioethics Advisory Commission notes: “current regulations do not further elaborate how risks and potential benefits are to be assessed, and little additional guidance is available to IRBs.”1The NBAC, as well as numerous commentators, recommend that research ethics committees , ethics review committees and institutional review boards should adopt what may be called dual-track risk assessment.2–5 Yet, dual-track assessment unnecessarily divides research interventions into two different categories before assessing their risks and relies on the unclear distinction between therapeutic and non-therapeutic interventions. As a result, dual-track assessment provides RECs with confusing guidance and has the potential to block valuable research that poses acceptable risks. This paper describes one alternative, the net risks test, and argues that this approach offers a better method for assessing research risks, one that puts RECs in a position to protect participants without blocking appropriate research studies.BACKGROUNDClinical research exposes participants to interventions and procedures to gather systematic data that may be used to improve overall health and well-being. To ensure that research is ethical, RECs must ensure that the risks and burdens to participants are not excessive and that …. (shrink)

Ethical guidelines for conducting clinical trials have historically been based on a perceived therapeutic obligation to treat and benefit the patient-participants. The origins of this ethical framework can be traced to the Hippocratic oath originally written to guide doctors in caring for their patients, where the overriding moral obligation of doctors is strictly to do what is best for the individual patient, irrespective of other social considerations. In contrast, although medicine focuses on the health of the person, public health is (...) concerned with the health of the entire population, and thus, public health ethics is founded on the societal responsibility to protect and promote the health of the population as a whole. From a public health perspective, research ethics should be guided by giving due consideration to the risks and benefits to society in addition to the individual research participants. On the basis of a duty to protect the population as a whole, a fiduciary obligation to realise the social value of the research and the moral responsibility to distribute the benefits and burdens of research fairly across society, how a public health perspective on research ethics results in fundamental re-assessments of the proper course of action for two salient topical issues in research ethics is shown: stopping trials early for reasons of efficacy and the conduct of research on less expensive yet less effective interventions. (shrink)

This paper explains how to use a new software tool for argument diagramming available free on the Internet, showing especially how it can be used in the classroom to enhance critical thinking in philosophy. The user loads a text file containing an argument into a box on the computer interface, and then creates an argument diagram by dragging lines from one node to another. A key feature is the support for argumentation schemes, common patterns of defeasible reasoning historically know as (...) topics . Several examples are presented, as well as the results of an experiment in using the system with students in a university classroom. (shrink)

As contribution to a recent debate (James, 1998; Murphy etal., 1997, 1998) the proportion of twins following ovulation induction (OI) or assisted conception (AC) in 1994 in Oxfordshire and West Berkshire was estimated, and by extrapolation the natural twinning rate in England and Wales was judged to have maintained a plateau phase since the 1970s. Similar figures for 1995 and 1996 from the same study, and hence a more stable local estimate, are now provided. The proportions, as before, were estimated (...) from women's responses to a questionnaire within a case[hyphen]control study, with ascertainment from general practitioners' records or hospital case[hyphen]notes for non[hyphen]responders or for those excluded from the study originally. In 1994, 1995 and 1996 the proportion of twins following OI/AC was overall 27% (24%, 30% and 27% respectively). Restriction to the 87% locally resident made no difference. The national crude twinning rate for those years was overall 13·3 per 1000 maternities (12·8, 13·6 and 13·4 respectively). (shrink)

Current guidelines on investigators' responsibilities to communicate research results to study participants may differ on whether investigators should proactively re-contact participants, the type of results to be offered, the need for clinical relevance before disclosure, and the stage of research at which results should be offered. Lack of consistency on these issues, however, does not undermine investigators' obligation to offer to disclose research results: an obligation rooted firmly in the principle of respect for research participants.

A novel and versatile polarization-entanglement scheme is adopted to investigate the violation of the EPR local realism for a non-maximally entangled two-photon system according to the recent nonlocality proof by Lucien Hardy. In this context the adoption of a sophisticated detection method allows direct determination of any element of physical reality (viz., determined with probability equal to unity in the words of Einstein, Podolsky and Rosen) for the pair system within complete measurements that are largely insensitive to the detector quantum-efficiencies (...) and noise. (shrink)

Der Beschreibung der zeitlichen Entwicklung lebender Systeme kann eine reine Differentialanalyse nicht genügen. In solchen Fällen muss man sich an Stelle der gewöhnlichen Differentialgleichungen der integraldifferentiellen, bezw. der Integralgleichungen bedienen. Zur leichteren Veranschaulichung der mathematischen Darstellung betrachtet Verfasser zuerst diejenigen Systeme, deren innerer Zustand sich durch ein einziges Parameterc bestimmen lässt. Die zeitliche Entwicklung eines leblosen Systems dieser Klasse werde durch die Differentialgleichung $$\frac{{dc}}{{dt}} = kf...$$ dargestellt, wot=Zeit, undk eine Funktion der äusseren Parameterα, Β, γ. ist. Im Falle eines jeden (...) Systems sind die äusseren Parameterα, Β, γ. charakteristische individuelle Funktionen der Zeit. Misst manc am. Zeitpunktt, so lässt sich die Zukunft des Systems vermittelst der Gleichung berechnen, wenn die zukünftigen Werte der äusseren Parameter gegeben sind. Solche Systeme nennt Verfasser nicht-historische Systeme. Im Falle der lebenden Systeme werde die zeitliche Entwicklung durch die Integral-differentialgleichung $$\frac{{dc}}{{dt}} = k_1 f_1 + \mathop \smallint \limits_{t - \lambda }^t k_2 f_2 dt........$$ dargestellt, wof 1 undf 2 Funktionen des Zustandsparametersc, undk 1 undk 2 Funktionen der äusseren Parameter sind. Das Zeitintegral erstreckt sich auf das vergangene Zeitintervalt-λ →t, woλ einen positiven endlichen konstanten Wert besitzt. Diese Systeme nennt Verfasser historische Systeme. Setzt manH für das darin enthaltene Integralglied, so verwandelt sich die Gleichung in: $$\frac{{dc}}{{dt}} = k_1 f_1 + H..........$$ Misst man nunc am Zeitpunktt, so kann man in diesem Fall die Zukunft des Systems ohne Kenntnis des historischen GliedsH nicht berechnen. Das Vorkommen des historischen IntegralgliedsH nennt Verfasser Chronoholismus. Man kann deshalb die historischen Systeme auch chronoholistische Systeme nennen. Die biologische Interpretation dieser Betrachtungsweise wird vom Verfasser diskutiert, und die Gleichung auf Systeme mit erblichen Eigenschaften ausgedehnt. Es werden zuletzt Systeme mit vielen Zustandsparametern in gewissen einfachen Fällen kurz behandelt. L'analyse différentielle ne suffit pas, selon l'avis de de l'auteur, pour la description de l'évolution des systèmes vivants au cours des temps. Il faut utiliser dans ces cas les équations intégro-différentielles ou intégrales. Pour faciliter le traÎtement mathématique, on peut considérer d'abord les systèmes dont l'état intérieur est défini par un seul paramètrec. L'évolution d'un système inanimé de cette classe se laisse décrire par l'équation différentielle $$\frac{{dc}}{{dt}} = k f,...........$$ oùt=temps, etk est une fonction déterminée des paramètres extérieurs α,Β, γ. Si l'on connaÎtc à un temps donnét, l'état du système à un temps futurt′ se laisse prévoir au moyen de l'équation, quand les valeurs des paramètres extérieurs dans l'intervallet → t∼' sont fixées. L'auteur appelle les systèmes de cette classe des systèmes non-historiques. Pour les systèmes vivants, il faut se servir, selon l'avis de l'auteur, des équations intégro-différentielles. Pour les systèmes définis par un seul paramètrec, on peut se servir, par exemple, de l'équation $$\frac{{dc}}{{dt}} = k_1 f_1 + \mathop \smallint \limits_{t - \lambda }^t k_2 f_2 dt........$$ où k1 et k2 sont des fonctions déterminées des paramètres extérieurs. L'intégrale s'étend sur l'intervallet-λ→ t où λ est positif et constant. En indiquant le terme intégral par le symboleH, on peut écrire $$\frac{{dc}}{{dt}} = k_1 f_1 + H..........$$ La connaissance de c à un temps donnét ne laisse pas prévoir l'état du système à un temps futurt′ sans connaissance du terme historiqueH, quand mÊme les paramètres α, Β, γ,..., seraient des fonctions déterminées du temps dans l'intervallet→t′. L'auteur appelle l'existence du terme intégral historiqueH le chronoholisme. On peut appeler les systèmes de cette classe des systèmes historiques ou chronoholistiques. L'interprétation biologique de cette faÇon de traÎter les systèmes vivants est discutée par l'auteur, qui étend l'équation pour le faire représenter aussi les propriétés héréditaires des Êtres vivants. Quelques cas de systèmes dont l'état intérieur est défini par plusieurs paramètres et plusieurs phases sont traités brièvement. (shrink)

Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from (...) the established biological conception of death. We argue that the current approach to determining death consists of two different types of unacknowledged legal fictions. These legal fictions were developed for practices that are largely ethically legitimate but need to be reconciled with the law. The considerable debate over the determination of death in the medical and scientific literature has not informed the public that vital organs are being procured from still-living donors and it seems unlikely that this information can remain hidden for long. Given the instability of the status quo and the difficulty of making the substantial legal changes required by complete transparency, we argue for a second-best policy solution: acknowledging the legal fictions involved in determining death to move in the direction of greater transparency. This may someday result in more substantial legal change to directly confront the challenges raised by life-sustaining and life-preserving technologies without the need for fictions. (shrink)

IPCC SPECIAL REPORT ON CLIMATE CHANGE AND LAND (SRCCL) -/- Chapter 3: Climate Change and Land: An IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems.

In diesem Aufsatz gibt der Verfasser eine präcisere und vollständigere Darstellung des Inhalts seiner früheren Veröffentlichung über dasselbe Thema. Im Falle eines biologischen Systems, dessen innerer Zustand sich durch ein einziges Parameterc bestimmen lässt, werde seine zeitliche Entwicklung durch die Gleichung dctdt=f1+∫t−λtf2dτ......dargestellt. Es wird gezeigt, dass Differentiation dieser Gleichung nacht nicht zu einer gewöhnlichen Differentialgleichung zweiter Ordnung führt. Im Gegensatz zur Theorie gewöhnlicher Differentialgleichungen, werden die Eigenschaften von Gleichung und ihren Derivaten nach der Zeit diskutiert. Es lässt sich Gleichung auf (...) eine gewöhnliche Differentialgleichung höherer Ordnung reduzieren. nur im ausgeschlossenen Fall, dasst-λ ein bestimmter Zeitpunkt wäre.Wolle man einwenden, dass Gleichung und ihre Derivaten nach der Zeit die zeitliche Entwicklung von Systemen darstellen, die zu jedem Moment nur ein „Punktgedächtnis” besitzen, dann lässt sich das Integralglied leicht derart transformieren, dass keine weitere Differentiation nach der Zeit auf eine Gleichung ohne Integralglied führen kann. Beispiele solcher Transformationen werden gegeben. Die neuen Gleichungen beschreiben die Entwicklung von Systemen die sicher ein „lineäres” Gedächtnis besitzen, d.h. ein Gedächtnis das sich zu jedem Moment auf ein endliches Kontinuum von Zeitpunkten und Zuständen erstreckt.Es ergibt sich aus der vollständigeren Betrachtung, dass Gleichung der früheren Abhandlung einer Revision bedarf.L'auteur fait un examen plus exact et plus approfondi du sujet traité dans sa première publication. Pour le cas d'un système biologique dont l'état intérieur est défini par un seul paramètrec, l'évolution au cours du temps se laisse decrire par l'équation dctdt=f1+∫t−λtf2dτ......Une différentiation d'après le tempst ne peut pas réduire l'équation à une équation différentielle ordinaire. Cela est possible seulement dans le cas exclu quet-λ soit un moment fixé. Au contraste des équations différentielles ordinaires, l'auteur explique comment se différent les propriétés de l'équation et de ses dérivés d'après le temps.Pour éviter la critique que l'équation et ses dérivés d'après le temps décrivent l'évolution de systèmes qui à tout moment donné ne possèdent qu'une „mémoire à une seule valeur”, l'auteur expose comment l'intégrale peut se transformer afin qu'aucune nouvelle différentiation d'après le temps ne conduise à une équation sans intégrale. Plusieurs exemples d'une telle transformation sont donnés. Les équations transformées décrivent sans aucun doute l'évolution de systèmes qui à tout moment possèdent une mémoire qui s'étend sur une intervalle continue du temps passé. L'examen plus approfondi démontre que l'équation de la première publication doit être corrigée. (shrink)

A letter to the editor from Howard Brody, David Buchanan, and Franklin G. Miller in response to the recent article by Erik Malmqvist Understanding Exploitation," March-April 2011).

A novel and versatile polarization-entanglement scheme is adopted to investigate the violation of the EPR local realism for a non-maximally entangled two-photon system according to the recent “nonlocality proof” by Lucien Hardy. In this context the adoption of a sophisticated detection method allows direct determination of any “element of physical reality” (viz., determined “with probability equal to unity” in the words of Einstein, Podolsky and Rosen) for the pair system within complete measurements that are largely insensitive to the detector quantum-efficiencies (...) and noise. (shrink)

Disfluencies include editing terms such as uh and um as well as repeats and revisions. Little is known about how disfluencies are processed, and there has been next to no research focused on the way that disfluencies affect structure-building operations during comprehension. We review major findings from both computational linguistics and psycholinguistics, and then we summarize the results of our own work which centers on how the parser behaves when it encounters a disfluency. We describe some new research showing that (...) information associated with misarticulated verbs lingers, and which adds to the large body of data on the critical influence of verb argument structures on sentence comprehension. The paper also presents a model of disfluency processing. The parser uses a Tree Adjoining Grammar to build phrase structure. In this approach, filled and unfilled pauses affect the timing of Substitution operations. Repairs and corrections are handled by a mechanism we term “Overlay,” which allows the parser to overwrite an undesired tree with the appropriate, correct tree. This model of disfluency processing highlights the need for the parser to sometimes coordinate the mechanisms that perform garden-path reanalysis with those that do disfluency repair. The research program as a whole demonstrates that it is possible to study disfluencies systematically and to learn how the parser handles filler material and mistakes. It also showcases the power of Tree Adjoining Grammars, a formalism developed by Aravind Joshi which has yielded results in many different areas of linguistics and cognitive science. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

The focus of this study was to analyze the content, distribution, and comparative genome relationships of 996 chromosome bin-mapped expressed sequence tags accounting for 2266 restriction fragments on the homoeologous group 3 chromosomes of hexaploid wheat. Of these loci, 634, 884, and 748 were mapped on chromosomes 3A, 3B, and 3D, respectively. The individual chromosome bin maps revealed bins with a high density of mapped ESTs in the distal region and bins of low density in the proximal region of the (...) chromosome arms, with the exception of 3DS and 3DL. These distributions were more localized on the higher-resolution group 3 consensus map with intermediate regions of high-mapped-EST density on both chromosome arms. Gene ontology classification of mapped ESTs was not significantly different for homoeologous group 3 chromosomes compared to the other groups. A combined analysis of the individual bin maps using 537 of the mapped ESTs revealed rearrangements between the group 3 chromosomes. Approximately 232 of the consensus mapped ESTs matched sequences on rice chromosome 1 and revealed large- and small-scale differences in gene order. Of the group 3 mapped EST unigenes ∼21 and 32% matched the Arabidopsis coding regions and proteins, respectively, but no chromosome-level gene order conservation was detected. (shrink)

An outline of Dostoevsky's moral and metaphysical orientations. Characters from most of Dostoevsky's works are discussed; many are juxtaposed in an attempt to establish a rough systematization of Dostoevsky's moral hierarchy. Dostoevsky's metaphysical beliefs are shown to be coordinate with this hierarchy. Neither beliefs nor hierarchy are subjected to a philosophical critique. Inconsistencies and problematic notions are offered without apology. The possibilities of comparison with other thinkers, e.g., Kierkegaard, are left untouched. The more circumscribed project of merely sketching Dostoevsky's ideas (...) is, however, gracefully executed.--G. D. D. (shrink)