The whole of Marx's project confronts the narrow concerns of political philosophy by embedding it in social philosophy and a certain understanding of the aesthetic. From those of aesthetic production to the "poetry of the future" (as Marx writes in the Eighteenth Brumaire), from the radical modernism of bourgeois development to the very idea of association (which defined one of the main lines of tradition in the history of aesthetics), steady references to Dante, Shakespeare and Goethe, and the idea that (...) bourgeois politics is nothing but a theatrical stage: the aesthetic has a prominent place in the constellation of Marx's thought. This book offers an original and challenging study of both Marx in the aesthetic, and the aesthetic in Marx. It differs from previous discussions of Marxist aesthetic theory as it understands the works of Marx themselves as contributions to thinking the aesthetic. This is an engagement with Marx's aesthetic that takes into account Marx's broader sense of the aesthetic, as identified by Eagleton and Buck-Morss - as a question of sense perception and the body. (shrink)

U ovome radu istražujem Polanyijeve glavne argumente za akademsku slobodu. Akademska i politička sloboda međusobno su blisko povezane: ako država preuzme kontrolu nad znanošću, to dovodi do kolapsa same slobode u cijelome društvu. Njegovi argumenti protiv totalitarizma oslanjaju se na njegovu anti-pozitivističku filozofiju znanosti. On definira totalitarizam kao poricanje akademske slobode koje se temelji na pragmatičkom poimanju znanosti i instrumentalističkim interpretacijama moralnih vrijednosti. Polanyijeva ideja znanosti je duhovni, idealistički opis zajednice slobodnih intelektualaca koji su strastveno posvećeni potrazi za istinom i (...) imaju autonomnu zajednicu s vlastitim pravilima i autonomnim upravljanjem. Potraga za istinom radi nje same je bitan cilj znanosti, koji se može postići jedino ako znanost ostane slobodna od političkih, ideoloških i ekonomskih utejcaja. Tvrdim da Polanyijevi uvidi mogu biti relevantni i danas, kada znanost može postati instrument profitno orijentiranih praktičnih potreba umjesto potrage za istinom samom i kada se humanistika često smatra nepotrebnom.In the present essay I investigate Polanyi’s main arguments for academic freedom. Academic and political freedom are closely related to each other: if state takes control over science, it will lead to the collapse of freedom itself in the whole society. His arguments against totalitarianism rely on his anti-positivist philosophy of science. He diagnoses totalitarianism as a denial of academic freedom which is based on a pragmatist view of science and instrumentalist interpretation of moral values. Polanyi’s idea of science is a spiritual, idealistic description of a community of free intellectuals who are passionately committed to seeking the truth and have an autonomous community with its own rules and autonomous direction. Seeking the truth for its own sake is the essential goal of science, which can be accomplished only if it remains free from political, ideological and economical influences. I will argue that Polanyi’s insights can still be relevant today, when science can become an instrument of profit-oriented practical needs instead of seeking the truth itself, and the humanities are often considered unnecessary.Dans cet essai, j’examine les principaux arguments de Polany pour la liberté académique. La liberté académique et politique sont étroitement liées : si l’Etat prend le contrôle de la science, cela conduira à l’effondrement de la liberté elle-même dans toute la société. Ses arguments contre le totalitarisme reposent sur sa philosophie anti-positiviste de la science. Il diagnostique le totalitarisme comme un refus de la liberté académique fondé sur une conception pragmatique de la science et une interprétation instrumentaliste des valeurs morales. L’idée de la science de Polany est une description spirituelle, idéaliste, d’une communauté d’intellectuels libres, passionnément dédiés à la recherche de la vérité, et qui ont une communauté avec ses propres règles et une direction autonome. La recherche de la vérité pour elle-même est l’objectif essentiel de la science, ce qui peut être accompli uniquement si elle demeure libre des influences politiques, idéologiques et économiques. J’affirme que les visions de Polany peuvent toujours être pertinentes aujourd’hui, alors que la science peut devenir un instrument des besoins pratiques orientés vers le profit au lieu de chercher la vérité elle-même, et alors que les sciences humaines sont souvent considérées comme inutiles.Im präsenten Artikel gehe ich Polanyis Hauptargumentation für akademische Freiheit auf den Grund. Die akademische und politische Freiheit sind miteinander nahe verwandt: Unterzieht der Staat die Wissenschaft seiner Kontrolle, endet dies im Kollaps der Freiheit selbst in der gesamten Gesellschaft. Polanyis Begründung gegen den Totalitarismus stützt sich auf dessen antipositivistische Philosophie der Wissenschaft. Er diagnostiziert den Totalitarismus als Versagung der akademischen Freiheit, die auf dem pragmatischen Blickpunkt der Wissenschaft als auch der instrumentalistischen Interpretation der Moralwerte basiert. Polanyis Wissenschaftsvorstellung ist eine spirituelle, idealistische Schilderung einer Gemeinschaft freier Intellektueller, die sich der Suche nach Wahrheit glutvoll gewogen zeigt und über eine autonome Community mit eigenen Regeln sowie autonomer Verwaltung verfügt. Die Erkundung der Wahrheit um ihrer selbst willen repräsentiert das essenzielle Vorhaben der Wissenschaft, welches sich allein unter Bewahrung ihrer Independenz von politischen, ideologischen bzw. wirtschaftlichen Einflüssen zuwege bringen lässt. Ich halte dafür, Polanyis Einblicke hätten auch heutzutage Relevanzpotenzial, zu der Zeit, wenn sich die Wissenschaft auf ein Werkzeug des profitorientierten praktischen Begehrens reduzieren könnte, anstatt nach der Wahrheit selbst zu fahnden, und die Geisteswissenschaften gehäuft als entbehrlich abgestempelt werden. (shrink)

A study found that women participating in mammography screening were content with the programme and the paternalistic invitations that directly encourage participation and include a pre-specified time of appointment. We argue that this merely reflects that the information presented to the invited women is seriously biased in favour of participation. Women are not informed about the major harms of screening, and the decision to attend has already been made for them by a public authority. This short-circuits informed decision-making and (...) the legislation on informed consent, and violates the autonomy of the women. Screening invitations must present both benefits and harms in a balanced fashion, and should offer, not encourage, participation. It should be stated clearly that the choice not to participate is as sensible as the choice to do so. To allow this to happen, the responsibility for the screening programmes must be separated from the responsibility for the information material. (shrink)

In this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical activity (...) in the cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer. (shrink)

ABSTRACT In this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical (...) activity in the cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin (immature) cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude (tentatively) that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer. (shrink)

This volume is dedicated to Mario Bunge in honor of his sixtieth birthday. Mario Bunge is a philosopher of great repute, whose enormous output includes dozens of books in several languages, which will culminate with his Treatise on Basic Philosophy projected in seven volumes, four of which have already appeared [Reidel, I 974ff. ]. He is known for his works on research methods, the foundations of physics, biology, the social sciences, the diverse applications of mathematical methods and of systems (...) analysis, and more. Bunge stands for exact philosophy, classical liberal social philosophy, rationalism and enlightenment. He is brave, even relentless, in his attacks on subjectivism, mentalism, and spiritualism, as well as on positivism, mechanism, and dialectics. He believes in logic and clarity, in science and open-mindedness - not as the philosopher's equivalent to the poli tician's rhetoric of motherhood and apple pie, but as a matter of everyday practice, as qualities to cultivate daily in our pursuit of the life worth living. Bunge's philosophy often has the quality of Columbus's egg, and he is prone to come to swift and decisive conclusions on the basis of argu ments which seem to him valid; he will not be perturbed by the fact that most of the advanced thinkers in the field hold different views. (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive (...) one of three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

This book explores the tradition, impact, and contemporary relevance of two key ideas from Western Marxism: Georg Lukács's concept of reification, in which social aspects of humanity are viewed in objectified terms, and Guy Debord's concept of the spectacle, where the world is packaged and presented to consumers in uniquely mediated ways. Bringing the original, yet now often forgotten, theoretical contexts for these terms back to the fore, Johan Hartle and Samir Gandesha offer a new look at the (...) importance of Western Marxism from its early days to the present moment-and reveal why Marxist cultural critique must continue to play a vital role in any serious sociological analysis of contemporary society. (shrink)

Gruber and Smith (2019) have conducted some interesting virtual reality (VR) experiments, but we think that these experiments fail to illuminate why people think that the present is special. Their experiments attempted to test a suggestion by Hartle (2005) that with VR one might construct scenarios in which people experience the same present twice. If that’s possible, then it could give us a reason to think that when we experience the present as being special, that’s not because it’s (...) objectively so. Instead, our experience of the present being special is a feature of having a psychology like ours. While we are sympathetic to the thought that there is no objective present, we do not think that these experiments give us a reason to think this. That said, VR experiments, such as Gruber and Smith’s, hold much promise for being able to illuminate various aspects of our temporal psychology.According to Hartle’s (2005) IGUS model (which is meant to resemble entities like us) sensory information is routed to two kinds of processes: conscious processes C, which cause behavior, and unconscious processes, U, which construct a schematic representation of the environment. Hartle proposed that we experience the present as being special because of the sensory information at a time entering into C. For Gruber et al. (2020), the succession of sensory information entering into C underpins our experience of time passing. Our experience of time passing is illusory because it fails to be verid... (shrink)

The study aimed to identify the relationship between correcting the deviations in the measurement of performance and achieving the objectives of control and the performance of the job at the Islamic University in the Gaza Strip. To achieve the objectives of the research, the researchers used the descriptive analytical approach to collect information. The questionnaire consisted of (20) statements distributed to three categories of employees of the Islamic University (senior management, faculty members, their assistants and members of the administrative board). (...) A random sample of 314 employees was selected and 276 responses were retrieved with a recovery rate of 88.1%. The Statistical Analysis Program (SPSS) was used to enter, process, and analyze the data. The results of the study showed a positive relationship between correcting deviations in performance measurement and achieving the control objectives represented by the functional performance in the Islamic University from the point of view of the members (senior management, faculty and their assistants, and the administrative board), where the relative weight of all the paragraphs was (74.25%). The study recommended the need to ensure that the actual performance of the planned performance is matched and decisions are taken to correct the serious deviations and take the necessary measures in terms of retraining and change in regulations, wages and bonuses and punishment of the culprit, neglect and negligence by mistake. (shrink)

Internalist approaches to epistemic justification are, though controversial, considered a live option in contemporary epistemology. Accordingly, if ‘active’ externalist approaches in the philosophy of mind—e.g. the extended cognition and extended mind theses—are _in principle_ incompatible with internalist approaches to justification in epistemology, then this will be an epistemological strike against, at least the _prima facie_ appeal of, active externalism. It is shown here however that, contrary to pretheoretical intuitions, neither the extended cognition _nor_ the extended mind theses are in (...) principle incompatible with two prominent versions of epistemic internalism—viz., accessibilism and mentalism. In fact, one possible diagnosis is that pretheoretical intuitions regarding the incompatibility of active externalism with epistemic internalism are symptomatic of a tacit yet incorrect identification of epistemic internalism with epistemic individualism. Thus, active externalism is not in principle incompatible with epistemic internalism per se and does not significantly restrict one’s options in epistemology. (shrink)

Legal scholarship exploring the nature of evidence and the process of juridical proof has had a complex relationship with formal modeling. As evident in so many fields of knowledge, algorithmic approaches to evidence have the theoretical potential to increase the accuracy of fact finding, a tremendously important goal of the legal system. The hope that knowledge could be formalized within the evidentiary realm generated a spate of articles attempting to put probability theory to this purpose. This literature was both (...) insightful and frustrating. Much light was shed on the legal system, but it also quickly became evident that the tools of probability theory were in many ways ill-constructed for the task. Fundamental incompatibilities between the structure of legal decision making and the extant formal tools were identified, and it became evident that many of the purported explanations of legal phenomena were internally inconsistent. As a consequence, interest in this type of formal modeling declined, and attention was directed toward different kinds of explanations of the phenomena. Perhaps under the influence of a recent trend toward various types of formal modeling in legal scholarship, a recent burst of articles, rather than attempting to explain the macro structure of trials, which was the previous object of interest, attempts to quantify the probative value of various items of evidence in ways consistent with the formal features of various probability theories, and then to study decision making from that perspective. For example, the value of evidence is often purported to be its likelihood ratio, that is, the probability of discovering or receiving the evidence given a hypothesis (e.g., the defendant did it) divided by the probability of discovering or receiving the evidence given the negation of the hypothesis (the defendant didn't do it). Alternatively, the value of evidence is purported (more contextually) to be the information gain it provides, defined as the increase in probability it provides for a hypothesis above the probability of the hypothesis based on the other available evidence. Both conceptions then assume that all of the various probability assessments conform or ought to conform to the dictates of Bayes' theorem (that maintains consistency among such assessments); empirical studies are then done testing the extent to which this is so and proposing how the law can increase the probability that it is so. The general criticisms of using Bayes' theorem as a formal model of juridical proof are well known and were integral to the last wave of interest in formal modeling of the evidentiary process. This paper thus for the most part puts aside that more general issue, and focuses specifically on mathematical modeling of the value of particular items of evidence. The paper demonstrates that formal modeling has only limited value in explaining the value of legal evidence, much more limited than those constructing and discussing the models assume, and thus that the conclusions they draw about the value of evidence are unwarranted. This is done through a discussion of four recent examples that attempt to quantify evidence relating to, respectively, carpet fibers, infidelity, DNA random-match evidence, and character evidence used to impeach a witness. This article thus makes two contributions. First, and most importantly, it is another demonstration of the complex relationship between algorithmic tools and legal decision making. Second, at a minimum it points out serious pitfalls for analytical or empirical studies of juridical proof. (shrink)

The theory of mental models and its computer implementations have led to crucial experiments showing that no standard logic—the sentential calculus and all logics that include it—can underlie human reasoning. The theory replaces the logical concept of validity (the conclusion is true in all cases in which the premises are true) with necessity (conclusions describe no more than possibilities to which the premises refer). Many inferences are both necessary and valid. But experiments show that individuals make necessary inferences that (...) are invalid, e.g., Few people ate steak or sole; therefore, few people ate steak. Other crucial experiments show that individuals reject inferences that are not necessary but valid, e.g., He had the anesthetic or felt pain, but not both; therefore, he had the anesthetic or felt pain, or both. Nothing in logic can justify the rejection of a valid inference: a denial of its conclusion is inconsistent with its premises, and inconsistencies yield valid inferences of any conclusions whatsoever including the one denied. So inconsistencies are catastrophic in logic. In contrast, the model theory treats all inferences as defeasible (nonmonotonic), and inconsistencies have the null model, which yields only the null model in conjunction with any other premises. So inconsistences are local. Which allows truth values in natural languages to be much richer than those that occur in the semantics of standard logics; and individuals verify assertions on the basis of both facts and possibilities that did not occur. (shrink)

J.S. Mill argued that Bentham was ‘not a great philosopher’, asserting that one reason for his judgment was ‘the incompleteness of his [i. e. Bentham’s] own mind as a representative of universal human nature’. This paper argues that Mill’s judgment of Bentham on human nature and his assumptions about Bentham’s ‘own mind’ were seriously mistaken. In fact, Bentham understood many of the most natural and strongest feelings of human nature; he recognized spiritual or mental perfection, and recognized many pleasures associated (...) with a desire for self-perfection, or at least self-improvement; he never denied the importance of the faculty of imagination; he was by no means cut off from life’s graver experiences; his conception of arts and sciences was much broader, more metaphysically-based, consistent and sophisticated than Mill appreciated; and he enthusiastically embraced and encouraged arts and sciences. Mill’s mistake was partly caused by his limited reading of Bentham’s works, but mainly because he failed to grasp the ontological basis and fundamental principles of Bentham’s philosophy. (shrink)

Philosophy of mind and cognitive science (e.g., Clark and Chalmers 1998; Clark 2010; Palermos 2014) have recently become increasingly receptive tothe hypothesis of extended cognition, according to which external artifacts such as our laptops and smartphones can—under appropriate circumstances—feature as material realisers of a person’s cognitive processes. We argue that, to the extent that the hypothesis of extended cognition is correct, our legal and ethical theorising and practice must be updated, by broadening our conception of personal assault so as to (...) include intentional harm towards gadgets that have been appropriately integrated. We next situate the theoretical case for extended personal assault within the context of some recent ethical and legal cases and close with some critical discussion. (shrink)

The target article tackles an important and complicated issue of the underlying links between curiosity and creativity. Although thought-provoking, the target article overlooks contemporary theories and research on these constructs. Consequently, the proposed model is inconsistent with prior research in the developmental and educational fields and would benefit from better specification and clarity around key constructs and processes.

Four-month-old infants sometimes can perceive the unity of a partly hidden object. In each of a series of experiments, infants were habituated to one object whose top and bottom were visible but whose center was occluded by a nearer object. They were then tested with a fully visible continuous object and with two fully visible object pieces with a gap where the occluder had been. Pattems of dishabituation suggested that infants perceive the boundaries of a partly hidden (...) object by analyzing the movements of its surfaces: infants perceived a connected object when its ends moved in a common translation behind the occluder. Infants do not appear to perceive a connected object by analyzing the colors and forms of surfaces: they did not perceive a connected object when its visible parts were stationary, its color was homogeneous, its edges were aligned, and its shape was simple and regular. These findings do not support the thesis, from gestalt psychology, that object perception first arises as a consequence of a tendency to perceive the simplest, most regular configuration, or the Piagetian thesis that object perception depends on the prior coordination of action. Perception of objects may depend on an inherent conception of what an object is. (shrink)

In a reflective and richly entertaining piece from 1979, Doug Hofstadter playfully imagined a conversation between ‘Achilles’ and an anthill (the eponymous ‘Aunt Hillary’), in which he famously explored many ideas and themes related to cognition and consciousness. For Hofstadter, the anthill is able to carry on a conversation because the ants that compose it play roughly the same role that neurons play in human languaging; unfortunately, Hofstadter’s work is notably short on detail suggesting how this magic might be achieved1. (...) Conversely in this paper - finally reifying Hofstadter’s imagination - we demonstrate how populations of simple ant-like creatures can be organised to solve complex problems; problems that involve the use of forward planning and strategy. Specifically we will demonstrate that populations of such creatures can be configured to play a strategically strong - though tactically weak - game of HeX (a complex strategic game).We subsequently demonstrate how tactical play can be improved by introducing a form of forward planning instantiated via multiple populations of agents; a technique that can be compared to the dynamics of interacting populations of social insects via the concept of meta-population. In this way although, pace Hofstadter, we do not establish that a meta-population of ants could actually hold a conversation with Achilles, we do successfully introduce Aunt Hillary to the complex, seductive charms of HeX. (shrink)

Purpose This paper aims to explore the ethical and social impact of augmented visual field devices, identifying issues that AVFDs share with existing devices and suggesting new ethical and social issues that arise with the adoption of AVFDs. Design/methodology/approach This essay incorporates both a philosophical and an ethical analysis approach. It is based on Plato’s Allegory of the Cave, philosophical notions of transparency and presence and human values including psychological well-being, physical well-being, privacy, deception, informed consent, ownership and (...) property and trust. Findings The paper concludes that the interactions among developers, users and non-users via AVFDs have implications for autonomy. It also identifies issues of ownership that arise because of the blending of physical and virtual space and important ways that these devices impact, identity and trust. Practical implications Developers ought to take time to design and implement an easy-to-use informed consent system with these devices. There is a strong need for consent protocols among developers, users and non-users of AVFDs. Social implications There is a social benefit to users sharing what is visible on their devices with those who are in close physical proximity, but this introduces tension between notions of personal privacy and the establishment and maintenance of social norms. Originality/value There is new analysis of how AVFDs impact individual identity and the attendant ties to notions of ownership of the space between an object and someone’s eyes and control over perception. (shrink)

Philosophy of mind and cognitive science have recently become increasingly receptive to the hypothesis of extended cognition, according to which external artifacts such as our laptops and smartphones can—under appropriate circumstances—feature as material realizers of a person's cognitive processes. We argue that, to the extent that the hypothesis of extended cognition is correct, our legal and ethical theorizing and practice must be updated by broadening our conception of personal assault so as to include intentional harm toward gadgets that have been (...) appropriately integrated. We next situate the theoretical case for extended personal assault within the context of some recent ethical and legal cases and close with critical discussion. (shrink)

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)

We formulate and analyze the dynamics of an influenza pandemic model with vaccination and treatment using two preventive scenarios: increase and decrease in vaccine uptake. Due to the seasonality of the influenza pandemic, the dynamics is studied in a finite time interval. We focus primarily on controlling the disease with a possible minimal cost and side effects using control theory which is therefore applied via the Pontryagin’s maximum principle, and it is observed that full treatment effort should be (...) given while increasing vaccination at the onset of the outbreak. Next, sensitivity analysis and simulations (using the fourth order Runge-Kutta scheme) are carried out in order to determine the relative importance of different factors responsible for disease transmission and prevalence. The most sensitive parameter of the various reproductive numbers apart from the death rate is the inflow rate, while the proportion of new recruits and the vaccine efficacy are the most sensitive parameters for the endemic equilibrium point. (shrink)

A referral was made to our Cardiac Transplant Program for a patient who was in the New Jersey Prison System. The Medical Director of the New Jersey Department of Corrections called regarding a 39-year-old inmate who was being treated in a New Jersey hospital that has a unit for prisoners from a nearby cor- rectional facility. The referring physician described the patient to our Medical Director of heart transplantation as a “murderer” who had been incarcerated since 1987 and sentenced to (...) prison for 30 years without eligibility for parole before completion of his 30-year sentence. The patient was being treated in the CCU of the facility and according to preliminary studies, was suffering from a possible dilated cardiomyopathy. There was evidence of a prior cerebrovascular accident (etiology unknown) with a dense hemiplegia of the left side. The patient was alert but unable to care for himself. There were a number of specific tests necessary to evaluate the patient's candidacy for heart transplantation before actually placing him-on a waiting list. However, the transplant director was uncertain about having the patient brought to our facility for further testing and called some members of the Transplant Selection Committee team to discuss the case. (shrink)

Scholars of early Chinese philosophy frequently point to the nontranscendent, organismic conception of the cosmos in early China as the source of China's unique perspective and distinctive values. One would expect recent works in Confucian ethics to capitalize on this idea. Reviewing recent works in Confucian ethics by P. J. Ivanhoe, David Nivison, R. P. Peerenboom, Henry Rosemont, and Tu Wei-Ming, the author analyzes these new studies in terms of the extent to which their representation of Confucian ethics reflects and (...) is consistent with the view that in early China the cosmos was conceived to be organismic, nontranscendent, and nondualistic. (shrink)

& Using functional magnetic resonance imaging, we examined whether individual differences in amygdala activation in response to negative relative to neutral information are related to differences in the speed with which such information is evaluated, the extent to which such differences are associated with medial prefrontal cortex function, and their relationship with measures of trait anxiety and psychological well-being (PWB). Results indicated that faster judgments of negative relative to neutral information were associated with increased left and (...) right amygdala activation. In the prefrontal cortex, faster judgment time was associated with relative decreased activation in a cluster in the ventral anterior cingulate cor-. (shrink)

The unprecedented outbreak of Ebola virus disease in West Africa has raised several novel ethical issues for global outbreak preparedness. It has also illustrated that familiar ethical issues in infectious disease management endure despite considerable efforts to understand and mitigate such issues in the wake of past outbreaks. To improve future global outbreak preparedness and response, we must examine these shortcomings and reflect upon the current state of ethical preparedness. To this end, we focus our efforts in this article on (...) the examination of one substantial area: ethical guidance in pandemic plans. We argue that, due in part to their focus on considerations arising specifically in relation to pandemics of influenza origin, pandemic plans and their existing ethical guidance are ill-equipped to anticipate and facilitate the navigation of unique ethical challenges that may arise in other infectious disease pandemics. We proceed by outlining three reasons why this is so, and situate our analysis in the context of the EVD outbreak and the threat posed by drug-resistant tuberculosis: different infectious diseases have distinct characteristics that challenge anticipated or existing modes of pandemic prevention, preparedness, response, and recovery, clear, transparent, context-specific ethical reasoning and justification within current influenza pandemic plans are lacking, and current plans neglect the context of how other significant pandemics may manifest. We conclude the article with several options for reflecting upon and ultimately addressing ethical issues that may emerge with different infectious disease pandemics. (shrink)

Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria, there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, (...) the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. (shrink)

Zuk et al. (2023) explore personality, mood, and behavioral (PMB) changes in DBS and aDBS, though have not invoked what is known about the similarities and differences for other available brain sti...

The relationship between dementia and criminal behavior perplexes legal and health care systems. Dementia is a progressive clinical syndrome defined by impairment in at least two cognitive domains that interferes with one's activities of daily. Dementia symptoms have been associated with behaviors that violate social norms and constitute criminal actions. A failure to address a gap in policies that support appropriate management of individuals with dementia reflects a failure in our social obligation to care for those who (...) are most vulnerable amongst us. Categorical protections, informed by precedent models applied to juveniles and individuals with psychiatric illness, could help meet a social obligation to provide protections to individuals with dementia. We propose an approach that integrates affirmative defenses to mitigate criminal liability and sentencing restrictions to prevent cruel and unusual punishment. (shrink)

Two arguments against the compatibility of epistemic internalism and content externalism are considered. Both arguments are shown to fail, because they equivocate on the concept of justification involved in their premises. To spell out the involved equivocation, a distinction between subjective and objective justification is introduced, which can also be independently motivated on the basis of a wide range of thought experiments to be found in the mainstream literature on epistemology. The subjective/objective justification distinction is also ideally suited for providing (...) new insights with respect to central issues within epistemology, including the internalism/externalism debate and the New Evil Demon intuition. (shrink)

Because of his preoccupation with the formal aspects of music and literature, Theodor W. Adorno is often regarded as the most aesthetically oriented thinker of the Frankfurt School theorists. It is Adorno’s perceived commitment to aestheticism—the study of art for art’s sake and the study of art as a source of sensuous pleasure, rather than as a vehicle for culturally constructed morality or meaning—that many scholars have criticized as hostile to genuine, concrete, substantive political, social, and ethical engagement (...) class='Hi'>with the arts. _Adorno and Ethics_—the first issue of _New German Critique_ to be published by Duke University Press—takes issue with Adorno’s critics. These essays reconsider Adorno’s unique brand of aestheticism, revealing a “politics of aestheticism” and exploring the political and ethical dimensions of his writings. One contributor links the ethical turn taken in Adorno criticism with related developments in American poetry and poetics. Another examines Adorno’s aphorism “Gold Assay” for the ways in which it anticipates one of his seminal works, _The Jargon of Authenticity_. Focusing on Auschwitz and the testimony of its survivors, one contributor explores the impact of the Holocaust on modern philosophy and reason, a relationship that he argues Adorno never specified. Another contributor considers the figure of the animal in the writings of Kant, Adorno, and Lévinas, exploring what it might mean to live, as Adorno suggests, as “a good animal.” _Contributors_. J. M. Bernstein, Detlev Claussen, Samir Gandesha, Alexander García Düttmann, Christina Gerhardt, Martin Jay, Robert Kaufman, Michael Marder, Gerhard Richter. (shrink)

Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived (...) and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)

The literature on affective determinants of physical activity is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Framework, including: affective response to PA; incidental affect; affect processing; and affectively charged motivational states. After defining each category of affective construct, we provide examples of relevant research showing how each construct may (...) relate to PA behavior. We conclude each section with a discussion of future directions for research. (shrink)

State of consciousness and reflective awareness are intrinsically related, in that the different states of consciousness entail "specific forms - including absence - of reflective awareness" (Rapaport, 1951, p. 708). Both phenomena of consciousness would also seem to bear an important relationship with various forms of thought. What has not, hitherto, been explicated is the relationship among time, thought and consciousness, and we have set ourselves the goal of doing just that. While our primary focus is on a theoretical (...) discussion of that intersection, we also incorporate some new empirical data that we have recently gathered, looking at thought (specifically "trance logic") while swimming under water at depths in excess of 30 meters. ©2007 The Institute of Mind and Behavior, Inc. (shrink)

It has been proposed that performance in the think – no think task represents a laboratory analogue of the voluntary form of memory repression. The central prediction of this repression hypothesis is that performance in the TNT task will be influenced by emotional characteristics of the material to be remembered. This prediction was tested in two experiments by asking participants to learn paired associates in which the first item was either emotionally positive or emotionally negative . The second word was (...) always emotionally neutral . Consistent with the repression hypothesis, significant memory suppression was observed in both experiments following ‘no think’ instructions for memories associated with emotionally negative material. No suppression was observed for memories associated with emotionally positive information. Implications of these findings for the relationship between performance in the TNT task and the controversial notion of memory repression are considered. (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)

D.T. a 35-year-old woman, was found to have breast cancer. At the time of mastectomy axillary lymph nodes were positive and the cancer was classified as adenocarcinoma, grade 4. The patient underwent conventional chemotherapy. When it became apparent the disease was metastatic, the patient's oncologist contacted a well-known cancer center regarding the possibility of treating the patient with high dose chemotherapy and autologous bone marrow transplantation. The patient's health insurance provider informed the patient, however, that the treatment—estimated to cost (...) in the range of $150,000–200,000—was “considered experimental or research in nature” and therefore was not included in coverage. D.T. did not pursue this further. Approximately 2 years later, cancer was detected in the patient's spine. This time she applied to another well-known cancer center for HDC/ABMT. The cancer center agreed to accept her on the condition of proof of ability to pay for the treatment. Again her insurer refused coverage on the same grounds as before. D.T. found another source for the money, underwent treatment, then sued the insurance carrier. She sought a declaratory judgment that the treatment was covered under the insurance policy. The court ruled in favor of D.T. finding the contract phrase “considered experimental” ambiguous. (shrink)

This commentary takes up a challenge posed by Franklin Miller in a 2022 essay in Bioethics Forum. Dr. Miller queried whether bioethicists could be useful in public health policy contexts and while he refrained from issuing an ultimate opinion, did identify several challenges to such utility. The current piece responds to the challenges Dr. Miller identifies and argues that with appropriate training, public health ethicists can be of service in virtually any context in which public health policies are deliberated (...) and decided. (shrink)

In his book “Medical Philosophy: Conceptual issues in Medicine”, Mario Bunge provides a unique account of medical philosophy that is deeply rooted in a realist ontology he calls “systemism”. According to systemism, the world consists of systems and their parts, and systems possess emergent properties that their parts lack. Events within systems may form causes and effects that are constantly conjoined via particular mechanisms. Bunge supports the views of the evidence-based medicine movement that randomized controlled trials (RCTs) provide the best (...) evidence to establish the truth of causal hypothesis; in fact, he argues that _only_ RCTs have this ability. Here, we argue that Bunge neglects the important feature of patients being open systems which are in steady interaction with their environment. We show that accepting this feature leads to counter-intuitive consequences for his account of medical hypothesis testing. In particular, we point out that (i) the confirmation of hypotheses is inherently stochastic and affords a probabilistic account of both confirmation and evidence which we provide here; (ii) RCTs are neither necessary nor sufficient to establish the truth of a causal claim; (iii) testing of causal hypotheses requires taking into account background knowledge and the context within which an intervention is applied. We conclude that there is no “best” research methodology in medicine, but that different methodologies should coexist in a complementary fashion. (shrink)

The importance of communities in strengthening the ethics of international collaborative research is increasingly highlighted, but there has been much debate about the meaning of the term ‘community’ and its specific normative contribution. We argue that ‘community’ is a contingent concept that plays an important normative role in research through the existence of morally significant interplay between notions of community and individuality. We draw on experience of community engagement in rural Kenya to illustrate two aspects of this interplay: (i) that (...) taking individual informed consent seriously involves understanding and addressing the influence of communities in which individuals’ lives are embedded; (ii) that individual participation can generate risks and benefits for communities as part of the wider implications of research. We further argue that the contingent nature of a community means that defining boundaries is generally a normative process itself, with ethical implications. Community engagement supports the enactment of normative roles; building mutual understanding and trust between researchers and community members have been important goals in Kilifi, requiring a broad range of approaches. Ethical dilemmas are continuously generated as part of these engagement activities, including the risks of perverse outcomes related to existing social relations in communities and conditions of ‘half knowing’ intrinsic to processes of developing new understandings. (shrink)

: The Centers for Disease Control and Prevention (CDC) has recommended that HIV testing be routinely offered to certain patients in hospitals with a high prevalence of HIV infection and on all pregnant women. The CDC does not, however, offer implementation level guidelines for obtaining informed consent. We provide a moral justification for requiring informed consent for HIV testing and propose guidelines for securing such consent. In particular we argue that genuine informed consent can be secured without elaborate counseling, (...) such as that currently used at Counseling and Testing Sites, provided that sufficient written notice is given to the patients before testing and that they are specifically asked for permission. (shrink)

Despite the increasingly multinational nature of the workplace, there have been few studies of the convergence and divergence in beliefs about ethics-based leadership across cultures. This study examines the meaning of ethical and unethical leadership held by managers in six societies with the goal of identifying areas of convergence and divergence across cultures. More specifically, qualitative research methods were used to identify the attributes and behaviors that managers from the People’s Republic of China (the PRC), Hong Kong, the Republic (...) of China (Taiwan), the United States (the U.S.), Ireland, and Germany attribute to ethical and unethical leaders. Across societies, six ethical leadership themes and six unethical leadership themes emerged from a thematic analysis of the open-ended responses. Dominant themes for ethical and unethical leadership for each society are identified and examined within the context of the core cultural values and practices of that society. Implications for theory, research, and management practice are discussed. (shrink)

Nurse practitioners (NPs) are increasingly called on to provide high‐quality health‐care particularly for people who face significant barriers to accessing services. Although discourses of social justice have become relatively common in nursing and health services literature, critical analyses of how NP roles articulate with social justice issues have received less attention. In this study, we examine the role of NPs from a critical social justice perspective. A critical social justice lens raises morally significant questions, for example, why certain individuals (...) and groups bear a disproportionate burden of illness and suffering; what social conditions contribute to disparities in health and social status; and what social mandate NPs ought to develop in response to these realities. In our analysis, we draw on lessons learned from the initial Canadian experience with the introduction of NPs in the 1970s to consider the renewed and burgeoning interest in NPs in Canada, Australia and elsewhere. As we argue, a critical social justice perspective (in addition to the biomedical foci of NP practice) will be essential to sustaining long‐term, socially responsive NP roles and achieving greater equity in health and health‐care. (shrink)

“Why is there something rather than nothing?” This is perhaps one of the most annoying questions posed in recent times by and to philosophers. It has troubled at least two major thinkers in the last and in this century, namely the romantic idealist Friedrich Schelling and the contemporary existentialist Martin Heidegger, since it was first formulated by Leibniz. We can easily get rid of the question as being simplistic; since although it may be true that nothing is simpler than something, (...) we have no notion of what the simplicity of nothing might consist in. Or we can say that the question is related to the theological answer of a benevolent creator, and hence is not able even to be asked within the ambient of the finite human understanding. Or we may say that the question is supremely hypothetical, in that it would presuppose what is not, in fact, the case; and philosophy can be concerned only with what is. Furthermore, to ask the question in any genuine fashion, the nonexistence of the questioner would seem to be required. The question, therefore, appears Zen-like: “What is the answer to a question posed by a nonexistent questioner?”. (shrink)

Disasters overwhelm resources and threaten the safety and functioning of communities. Mental health and community needs after catastrophic disasters can be substantial, however the effects of traumatic events are not exclusively bad with many people showing individual resilience and some reporting growth. Sustaining the social fabric of the community and facilitating recovery following disaster depends on leadership=s knowledge of a community=s resilience and vulnerabilities as well as an understanding of the distress, disorder, and health risk behavioral responses. A coordinated (...) systems approach across medical care, public health, and emergency response system is necessary to meet the mental health care needs of a disaster region. (shrink)

Few doubt that automation and artificial intelligence will change business and society in the future. Questions arise, however, regarding the motivations associated with such expensive corporation expenditures and the related ethics of the disruption and unemployment that may result from corporation development and installation of sophisticated technology. This study analyzes financial statement data of 100 large public corporations to understand those motivations and their consequences for corporation profitability and employees. The study results indicate that a more automated future may (...) be profitable for corporations and their shareholders, but one of the costs of that future is significant disruption to employees. While some new positions may be created as a result of this technology, many employees will suffer disruption and will need extensive training to maintain employment in an evolving workplace. Many other employees will lose their jobs because the tasks that they once performed will be automated. The related ethics to business and society are profound. (shrink)

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)