The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)

Abstract:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)

The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human (...) death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 22.1 (2002) 251-254 [Access article in PDF] James Fredericks Interview The 2002 winner of the Frederick J.Streng Book Award is James Fredericks, professor ofTheological Studies at Loyola Marymount University in Los Angeles, California. Professor Fredericks received the award for his book, Faith Among Faiths: Christian Theology and the Non-Christian Religions, published by Paulist Press (New York) in 2001. Buddhist-Christian Studies asked James about his (...) writing of the volume.Buddhist-Christian Studies: Why did you write Faith Among Faiths?James Fredericks: I wanted to help Christians think about the problems that the "pluralist" view of religious diversity poses for inter-religious dialogue.How does the book do that?By making a sustained criticism of the claim that religions are differing interpretations of the same transcendent "Reality." This notion is a problem for a religion of revelation, like Christianity, but also for a religion like Buddhism that has a sophisticated critique of metaphysics. Pluralist thinkers impose a meta-religious grand narrative on all the religions and demand that the religions conform to this grand narrative in the name of "tolerance."This kind of thinking has roots in the European Enlightenment and has affinities with some strands of Hindu thought, especially the "neo-Hindu" thinkers. I do not think that this approach fosters dialogue in depth. If Buddhism and Christianity are varying interpretations of the same ultimate "Reality," then what does Buddhism have to teach Christians that is of genuine theological importance? The obvious differences that distinguish Buddhism from Christianity are of little theological interest to Christians because they are of no soteriological consequence. The pluralist approach is a dead end for dialogue.And the way forward?What I call "comparative theology." I think of this as an alternative to what Christians call the "theology of religions."What's the difference?Theologies of religion interpret the meaning of other religious traditions from within the perspective of Christian tradition. Karl Rahner's theology of the anonymous Christian and Karl Barth's rejection of all religions as "unbelief" are both examples of a theology of religion. John Hick's pluralist model of religions is also a kind of theology of religions. This entire project has reached an impasse within Christianity. As an alternative, I propose that Christians recognize that Buddhism and Christianity [End Page 251] are linked by some significant similarities and distinguished from each other by significant differences.How does that break the impasse?Christians have something of genuine value to learn by entering humbly into dialogue with Buddhists. By taking differences seriously, dialogue becomes a way for Christians to do their own theology collaboratively with Buddhists. In the medieval period, Christians did theology in dialogue with Aristotle and Plato. Today, I want Christians to do theology in dialogue with Nagarjuna and Dogen. Therefore doing theology comparatively is to step beyond the notion of a theology of religions. Comparative theology does not begin with the assumption that Buddhism is a relatively obscured form of the same truth Christians affirm (Rahner) or that Buddhism and Christianity are relatively equal expressions of a truth that transcends them both (Hick). The purpose of dialogue is not to show how we are all really trying to say the same thing. ForChristians, at least, dialogue with Buddhists is a genuinely demanding way of doing theology.Any other reasons for the book?Yes. To promote friendships among Buddhists and Christians. These "inter-religious friendships" are a good way for Christians to practice their faith. My own friendships with Buddhists, both here in the USA and in Asia, are central to my spirituality and my work as a theologian. In a sense, I have never been in dialogue with "Buddhism." All my dialogues have been with actual Buddhists, with all their personal strengths and weaknesses, successes and failures. I am happy to say that, over the years, I have had some skillful teachers who have taught me not only the Dharma, but also taught me new ways to think about Christianity.Was it a difficult book to write?My book was written after years of dialogue with Buddhists and much research and... (shrink)

A combination of emerging life support technologies and entrenched organ donation practices are complicating the physician's task of determining death. On the one hand, technologies that support or replace ventilation and circulation may render the diagnosis of death ambiguous. On the other, transplantation of vital organs requires timely and accurate declaration of death of the donor to keep the organs as healthy as possible. These two factors have led to disagreements among physicians and scholars on the precise moment of death. (...) In this article, I suggest that the debate about exactly when a person dies can benefit from distinguishing the strict biological concept of death from the medical standards for determining human death, and I show how an appreciation of the difference between the permanent and irreversible cessation of circulation is helpful in understanding the reasons for the two approaches to determining when death should be declared. (shrink)

I consider the role of cognitive modeling in cognitive science. Modeling, and the computers that enable it, are central to the field, but the role of modeling is often misunderstood. Models are not intended to capture fully the processes they attempt to elucidate. Rather, they are explorations of ideas about the nature of cognitive processes. In these explorations, simplification is essential—through simplification, the implications of the central ideas become more transparent. This is not to say that simplification has no downsides; (...) it does, and these are discussed. I then consider several contemporary frameworks for cognitive modeling, stressing the idea that each framework is useful in its own particular ways. Increases in computer power (by a factor of about 4 million) since 1958 have enabled new modeling paradigms to emerge, but these also depend on new ways of thinking. Will new paradigms emerge again with the next 1,000‐fold increase? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 35.2 (2002) 138-152 [Access article in PDF] Respecting the Rupture: Not Solving the Problem of Unity in Plato's Phaedrus James L. Kastely Plato's Phaedrus is a particularly instructive example of the double nature and status of rhetoric, for it embodies a tension at the heart of rhetoric. The first half of the dialogue presents three examples of rhetorical practice, while the second develops a theoretical (...) justification of rhetoric as an art. Thus, the dialogue would seem to offer a productive negotiation of the practice/theory tension. What makes the dialogue interesting, however, is the fact that this negotiation does not occur. The dialogue does not bring theory and practice into a harmonious relation, for there is a troubling discontinuity between its two halves, and rhetorical practice feels fractured. The exploration of eros that had occupied the first half of the dialogue is abandoned before the beginning of the second half, and then, following a logic that is at best associational, Socrates and Phaedrus explore the standards that should govern the practice of rhetoric. The infelicity of this transition raises a question: why did Plato structure the Phaedrus in such a way that it emphasized the dissonance between the two halves of the dialogue? To pose the question this way, however, is to go in a direction different from many of the best contemporary interpretations of the dialogue, which either argue that the dialogue is unified (Griswold 164) or suggest that the dissonance between its two halves reflects a shift in Plato's approach to philosophy (Kahn 373; Nehamas 352). In contrast, I will argue that the rupture in the dialogue is thematically purposive, for it points to an inescapable schism within rhetoric that makes rhetoric philosophically interesting.Socrates' second speech, his palinode to Eros, is a rhetorical tour de force that closes the first half of the dialogue. The importance of the palinode, however, is not limited to its role as an exemplary rhetorical performance, [End Page 138] for it also plays a crucial role in resolving the problem of erotic madness that organizes the intellectual drama of the first half. It would seem reasonable to expect that such an important and powerful moment in the dialogue would, at the very least, play a significant role in the philosophical discussion that composes the dialogue's second half. But that doesn't happen. While Socrates does refer to the palinode in his theoretical discussion of rhetoric, he makes little use of it, and, more important, he is silent on the subject of eros. Both the dramatic organization of the second half of the dialogue and its theoretical discussion cooperate to turn the rhetorical triumph of the palinode into a problem. Why has eros been abandoned as a philosophic topic, and what does this abandoning imply about the erotically grounded rhetoric that Socrates practiced and defended?To make matters worse, Socrates himself dismisses the palinode as a serious effort. He characterizes the speech as little more than a pleasant game, one that is not without value only because "these two certain forms (of gathering and dividing) were stated by chance" (265c). Far from viewing the palinode as possessing philosophical significance, Socrates appears to value it principally for its being a so-so example of a work of rhetoric that has been shaped by dialectic. While it is hard not to take Socrates' dismissal of the seriousness of the speech as partially disingenuous (just prior to his dismissal, he refers to the palinode as serious and reverent [265b]), he also does seem to mean what he says. Whether he is being straightforward or ironic does not finally matter because in either case the problem that occupies him and Phaedrus in the first half has disappeared from the dialogue. And that creates a problem: for if the philosophic issues of the first half of the dialogue drop out, then the dialogue is not coherent.This incoherence is especially troubling given Socrates' explicit endorsement of coherence as an important rhetorical value. In fact, when he begins his... (shrink)

Anthropology is a complex, wide-ranging, and ever changing field. Yet, despite its diversity, certain major themes do occur in the understandings of the world that anthropologists have offered. In this clear, coherent, and well-crafted book, James L. Peacock spells out the central concepts, distinctive methodologies, and philosophical as well as practical issues of cultural anthropology. Designed to supplement standard textbooks and monographs, the book focuses on the premises that underlie the facts that the former kinds of works generally present. (...) Free from unnecessarily abstract theoretical language and based on compelling concrete anecdote and engaging illustration, it is written in terms understandable to the anthropological novice, as well as being of value to the professional. The book's three main concerns are the substance, method, and significance of anthropology. In his discussion of substance, method, and significance of anthropology, such as the concept of culture, as well as holism. In writing about method, he explores the distinctive character of ethnographic fieldwork and raises questions of interpretation and comparison. Finally, he considers the relevance of anthropology with respect to both its practical application and what it contributes to understanding of human affairs. Using the photographic metaphors of 'harsh light' and 'soft focus', Peacock characterizes the anthropological worldview as consisting of two elements: on the one hand, a concern with the basic reality of the human condition, free of cultural influence; on the other, a broadly based holism that attempts to grasp all aspects of that condition, including its relation to the anthropologist. His book will appeal widely to readers interested in anthropology, at all levels. (shrink)

In a seminal 1977 article, Rumelhart argued that perception required the simultaneous use of multiple sources of information, allowing perceivers to optimally interpret sensory information at many levels of representation in real time as information arrives. Building on Rumelhart's arguments, we present the Interactive Activation hypothesis—the idea that the mechanism used in perception and comprehension to achieve these feats exploits an interactive activation process implemented through the bidirectional propagation of activation among simple processing units. We then examine the interactive activation (...) model of letter and word perception and the TRACE model of speech perception, as early attempts to explore this hypothesis, and review the experimental evidence relevant to their assumptions and predictions. We consider how well these models address the computational challenge posed by the problem of perception, and we consider how consistent they are with evidence from behavioral experiments. We examine empirical and theoretical controversies surrounding the idea of interactive processing, including a controversy that swirls around the relationship between interactive computation and optimal Bayesian inference. Some of the implementation details of early versions of interactive activation models caused deviation from optimality and from aspects of human performance data. More recent versions of these models, however, overcome these deficiencies. Among these is a model called the multinomial interactive activation model, which explicitly links interactive activation and Bayesian computations. We also review evidence from neurophysiological and neuroimaging studies supporting the view that interactive processing is a characteristic of the perceptual processing machinery in the brain. In sum, we argue that a computational analysis, as well as behavioral and neuroscience evidence, all support the Interactive Activation hypothesis. The evidence suggests that contemporary versions of models based on the idea of interactive activation continue to provide a basis for efforts to achieve a fuller understanding of the process of perception. (shrink)

Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that (...) paralleled advances in intensive care unit treatment. The century‐old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death. (shrink)

In this interview, James L. McClelland responds to questions regarding connectionist models of cognition, a theory inspired by information processing in the brain. McClelland explains the distinction between symbolic and non-symbolic processing for a better understanding of mental processes. He argues that connectionist models can perform the computations which we know the brain can perform. In addition, he responds to several general questions on the perspectives of computational models of cognition.

Conspicuous consumption associated with status reinforcement behavior can be explained in terms of costly signaling, or strategic handicap theory, first articulated by Zahavi and later formalized by Grafen. A theory is introduced which suggests that the evolutionary raison d’être of status reinforcement behavior lies not only in its effects on lifetime reproductive success, but in its positive effects on the probability of survival through infrequent, unpredictable demographic bottlenecks. Under some circumstances, such “wasteful” displays may take the form of displays of (...) altruistic behavior and generosity on the part of high status individuals, in that is signals the ability to bear the short-term costs of being generous or “cooperative,” while at the same time reinforcing the long-term benefits of higher status. (shrink)

It is conjectured that a suitably modified Bondi-type expansion of the gravitational field in the radiation zone is a rapidly convergent series. It is also conjectured that the source behavior in the inner zone is insensitive to the initial conditions imposed on the gravitational field in solving the initial-value problem in this zone. Consequences of these conjectures for the problem of relating source motion to the Bondi news function are discussed.

In this work, a neo-classical relativistic mechanics theory is presented where the spin of an electron is an inherent part of its world space-time path as a point particle. The fourth-order equation of motion corresponds to the same covariant Lagrangian function in proper time as in special relativity except for an additional spin energy term. The theory provides a hidden-variable model of the electron where the dynamic variables give a complete description of its motion, giving a classical mechanics explanation of (...) the electron’s spin, its dipole moments, and Schrödinger’s zitterbewegung, These features are also described mathematically by quantum mechanics theory, of course, but without any physical picture of an underlying reality. The total motion of the electron can be decomposed into a sum of a local spin motion about a point and a global motion of this point, called here the spin center. The global motion is sub-luminal and described by Newton’s Second Law in proper time, the time for a clock fixed at the spin center, while the total motion occurs at the speed of light c, consistent with the eigenvalues of Dirac’s velocity operators having magnitude c. The local spin motion is an inherent perpetual motion, which for a free electron is periodic at the ultra-high zitterbewegung frequency and its path is circular in a spin-center reference frame. In an electro-magnetic field, this spin motion generates magnetic and electric dipole energies through the Lorentz force on the electron’s point charge. The electric dipole energy corresponds to the spin-orbit coupling term involving the electric field that appears in the corrected Pauli non-relativistic Hamiltonian, which has long been used to explain the doublet structure of the spectral lines of the excited hydrogen atom. Pauli’s spin-orbit term is usually derived, however, from his magnetic dipole energy term, including also the effect of Thomas precession, which halves this energy. The magnetic dipole energy from Pauli’s and Dirac’s theory is twice that in the neo-classical theory, a discrepancy that has not been resolved. By defining a spin tensor as the angular momentum of the electron’s total motion about its spin center, the fundamental equations of motion can be re-written in an identical form to those of the Barut–Zanghi electron theory. This allows the equations of motion to be expressed in an equivalent form involving operators applied to a state function of proper time satisfying a neo-classical Dirac–Schrödinger spinor equation. This state function produces the dynamic variables from the same operators as in Dirac’s theory for the electron but without any probability implications. It leads to a neo-classical wave function that satisfies Dirac’s relativistic wave equation for the free electron by applying the Lorentz transformation to express proper time in the state function in terms of an observer’s space-time coordinates, showing that there is a close connection between the neo-classical theory and quantum mechanics theory for the electron’s dynamics. (shrink)

Pre-existing medical conditions and co-infections are common to all human populations, although the natures of the pre-existing conditions and the types of co-infections vary. For these reasons, among others, the arrival of a highly infectious pathogenic agent may differentially affect the disease burden in different sub-populations, as a function of varying combinations of endemic disease, chronic disease, genetic or epigenetic vulnerabilities, compromised immunological status, and socially determined risk exposure. The disease burden may also vary considerably by age cohort and socio-economic (...) status. The social consequences of infection, the medical sequelae, and the paths of recovery from infection may also vary, according to these variables. As a result, different sub-populations may have different experiences of a disease process, including when and how an epidemic comes to an end. This essay suggests that historians' engagement with path-breaking biological and medical anthropological research will allow new approaches to understanding disease processes that will enrich the study of epidemics and their endings. It is organized in three sections. The first discusses some general approaches to and assumptions about epidemics that are used by many historians. The second introduces new perspectives on the study of historical epidemics opened up by the medical anthropological concept of syndemic disease interactions and by an engagement with biological scientific perspectives. It briefly discusses two rural epidemics-one of anemia caused by the syndemic interaction of hookworm and malaria co-infections in early 20th-century British Malaya, and the other of rebound infections caused by the loss of acquired immunity to falciparum malaria in mid-20th-century Liberia-that illustrate, respectively, the utility of the concept of syndemic disease interactions and the centrality of immunological status in understanding epidemic outbreaks in these discrete populations. The third section addresses some of the research considerations involved in moving beyond the single pathogen model of epidemic disease. (shrink)

Despite the popularity, success, and growth of programs of organ donation after the circulatory determination of death (DCDD), a long‐standing controversy persists over whether the organ donor is truly dead at the moment physicians declare death, usually following five minutes of circulatory and respiratory arrest. Advocates of the prevailing death determination standard claim that the donor is dead when declared because of permanent cessation of respiration and circulation. Critics of this standard argue that while the cessation of respiration and circulation (...) may be permanent, it may not be irreversible at the moment death is declared because, if cardiopulmonary resuscitation were performed, it might succeed. And because irreversibility of cessation of respiration and circulation is required by both the statute and the biological concept of death, the donor must be alive. Who is correct?Making two related distinctions clarifies the cause of the disagreement over whether the DCDD donor is dead and points to a possible resolution. First, in a determination of death, there is an important distinction between the permanent and the irreversible cessation of circulation and respiration—two associated phenomena that are often confounded. Second, there is an important distinction between the medical practice standard for death determination, in which physicians certify the permanent cessation of vital functions as sufficient for death declaration, and the underlying biological concept of death that requires the irreversible cessation of vital functions because death, by definition, is an irreversible event. (shrink)

The concept of whole‐brain death is under attack again. Scholars are arguing that the concept of brain death per se—regardless of the focus on “higher,” “stem” or “whole”—is fundamentally flawed. These scholars have identified what they believe are serious discrepancies between the definition and criterion of brain death, and have pointed out that medical professionals and lay persons remain confused about its meaning. Yet whole‐brain death remains the standard for determining death in much of the Western world and its defenders (...) believe this concept best maps onto our everyday conception of death. (shrink)

The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...) other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency. (shrink)

Over the past quarter century, organ donation after the circulatory determination of death (DCD) has grown in acceptance and prevalence throughout the world (Domínguez-Gil et al. 2021). Notwithstan...

This paper compares the preface of Columella’s Res rustica with that of the earliest fully extant Chinese agricultural treatise, the Qimin yaoshu (‘Essential Techniques for the Common People’) of Jia Sixie. I argue that both prefaces have a similar function: to present to the reader the social world in which the author wishes his agricultural work to be understood. By drawing on authoritative literary and historical traditions, each author projects an idealized vision of farming in which the discipline acquires a (...) deep moral significance. Granting these striking similarities, the authors’ views also diverge in certain illuminating respects: these include the moral agency of agriculture, the social location of expertise, and the historical development of agriculture in relation to society. (shrink)