BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Predictable somatosensory feedback leads to a reduction in tactile sensitivity. This phenomenon, called tactile suppression, relies on a mechanism that uses an efference copy of motor commands to help select relevant aspects of incoming sensory signals. We investigated whether tactile suppression is modulated by the task-relevancy of the predicted consequences of movement and the intensity of related somatosensory feedback signals. Participants reached to a target region in the air in front of a screen; visual or tactile feedback indicated the reach (...) was successful. Furthermore, tactile feedback intensity varied across two groups of participants. We measured tactile suppression by comparing detection thresholds for a probing vibration applied to the finger either early or late during reach and at rest. As expected, we found an overall decrease in late-reach suppression, as no touch was involved at the end of the reach. We observed an increase in the degree of tactile suppression when strong tactile feedback was given at the end of the reach, compared to when weak tactile feedback or visual feedback was given. Our results suggest that the extent of tactile suppression can be adapted to different demands of somatosensory processing. Downregulation of this mechanism is invoked only when the consequences of missing a weak movement sequence are severe for the task. The decisive factor for the presence of tactile suppression seems not to be the predicted action effect as such, but the need to detect and process anticipated feedback signals occurring during movement. (shrink)

There is the world of ideas and the world of practice; the French are often for sup pressing the one and the English the other; but neither is to be suppressed. -Matthew Arnold The Function of Criticism at the Present Time From its inception, bioethics has confronted the need to reconcile theory and practice. At first the confrontation was purely intellectual, as writers on ethical theory (within phi losophy, theology, or other humanistic disciplines) turned their attention to topics from the (...) world of medical practice. Recently the confrontation has grown more intense. The ap pointment of clinical ethicists in hospitals and other health care settings is an accelerating trend in North America. Concomitantly, those institutions involved in training peo ple in clinical ethics have added organized exposure to the world of practice, in the form of placement requirements, to the normal academic course load. In common with other dis ciplines, bioethics has begun to see clinical training as a con dition of didactic theory and apprenticeship. (shrink)

Research ethics committees—animal ethics committees for animal-based research and institutional research boards for human subjects—have a key role in research governance, but there has been little study of the factors influencing their effectiveness. The objectives of this study were to examine how the effectiveness of a research ethics committee is influenced by committee composition and dynamics, recruitment of members, workload, participation level and member turnover. As a model, 28 members of AECs at four universities in western Canada were interviewed. Committees (...) were selected to represent variation in the number and type of protocols reviewed, and participants were selected to include different types of committee members. We found that a bias towards institutional or scientific interests may result from a preponderance of institutional and scientist members, an intimidating atmosphere for community members and other minority members, recruitment of community members who are affiliated with the institution and members joining for reasons other than to fulfil the committee mandate. Thoroughness of protocol review may be influenced by heavy workloads, type of review process and lack of full committee participation. These results, together with results from the literature on research ethics committees, suggested potential ways to improve the effectiveness of research ethics committees. (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)

An animal confronts numerous challenges when constructing an optimal navigational route. Spatial representations used for path optimization are likely constrained by critical environmental factors that dictate which neural systems control navigation. Multiple coding schemes depend upon their ecological relevance for a particular species, particularly when dealing with the third, or vertical, dimension of space.

There is little question that neuroethics can be enriched by closer engagement with Buddhism. One key concern is how to minimize risks of moral imperialism and appropriation while doing so. This co...

Blumenthal-Barby et al. (2022) list several areas of philosophy that may contribute to bioethics. Missing from their list and explicit discussion is the philosophy of disability. Whereas mainstream...

People crossing the border into the United States or Canada may find their electronic devices subject to search. Border agents can require travelers to unlock their devices, and then browse through...

Anglo-American approaches to Aristotelian metaphysics have been deeply influenced by the reconstructions of the “Oxford analysts,” most notably of the late G. E. L. Owen. In Owen’s seminal articles, Aristotle emerges—like the later Plato of G. Ryle and J. L.Ackrill—as a primitive exponent of analytical methodologies. The principles of Aristotelian metaphysics—being, unity, identity, essence, accident—are reconstructed by Owen as foundational concepts implicit in ordinary linguistic practices. Metaphysics is, in effect, reduced to a form of logic, focused on the clarification of (...) the conceptual apparatus of ordinary language. (shrink)

The First Conference of the International Society for the Study of Time was held at the Mathematisches Forschungsinstitut at Oberwolfach in the Black Forest, Federal Republic of Germany from Sunday, 31 August to Saturday, 6 September, 1969. The origin of this conference and the formation of the Society goes back to a proposal due to J. T. Fraser that was discussed at a conference on "Interdisciplinary Perspectives of Time" held by the New York Academy of Sciences in January, 1966. (...) It was unanimously agreed than that an international society should be formed on an interdisciplinary basis with the object of stimulating interest in all problems concerning 'time and that this object could best be attained by means of conferences held at regular intervals. J. T. Fraser was elected Secretary, S. Watanabe Treasurer, and I was elected President. It was agreed, at my suggestion, that the organization of the first conference of the newly formed Society be left to a committee of these three officers, on the understanding that they would invite authorities on the role of time in the various special sciences and humanities to form an Advisory Board to assist them. One of the main difficulties in seeking support for an interdisciplinary conference is that most foundations confine their interest exclusively either to the sciences or to the humanities. (shrink)

Within the field of causal inference, it is desirable to learn the structure of causal relationships holding between a system of variables from the correlations that these variables exhibit; a sub-problem of which is to certify whether or not a given causal hypothesis is compatible with the observed correlations. A particularly challenging setting for assessing causal compatibility is in the presence of partial information; i.e. when some of the variables are hidden/latent. This paper introduces the possible worlds framework as a (...) method for deciding causal compatibility in this difficult setting. We define a graphical object called a possible worlds diagram, which compactly depicts the set of all possible observations. From this construction, we demonstrate explicitly, using several examples, how to prove causal incompatibility. In fact, we use these constructions to prove causal incompatibility where no other techniques have been able to. Moreover, we prove that the possible worlds framework can be adapted to provide a complete solution to the possibilistic causal compatibility problem. Even more, we also discuss how to exploit graphical symmetries and cross-world consistency constraints in order to implement a hierarchy of necessary compatibility tests that we prove converges to sufficiency. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

Analysis of sites of newly integrated DNA in cellular genomes is important to several fields, but methods for analyzing and visualizing these datasets are still under development. Here, we describe tools for data analysis and visualization that take as input integration site data from our INSPIIRED pipeline. Paired-end sequencing allows inference of the numbers of transduced cells as well as the distributions of integration sites in target genomes. We present interactive heatmaps that allow comparison of distributions of integration sites to (...) genomic features and that support numerous user-defined statistical tests. To summarize integration site data from human gene therapy samples, we developed a reproducible report format that catalogs sample population structure, longitudinal dynamics, and integration frequency near cancer-associated genes. We also introduce a novel summary statistic, the UC50, which provides a single number summarizing possible clonal expansion. Using these tools, we characterize ongoing longitudinal characterization of a patient from the first trial to treat severe combined immunodeficiency-X1, showing successful reconstitution for 15 years accompanied by persistence of a cell clone with an integration site near the cancer-associated gene CCND2. Software is available at https://github.com/BushmanLab/INSPIIRED. (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

Each world faith tradition has its own distinctive relationship with science, and the science-religion dialogue benefits from a greater awareness of what this relationship is. In this book, members of the International Society for Science and Religion (ISSR) offer international and multi-faith perspectives on how new discoveries in science are met with insights regarding spiritual realities.The essays reflect the conviction that “religion and science each proceed best when they’re pursued in dialogue with each other, and also that our fragmented and (...) divided world would benefit more from a stronger dialogue between science and religion.” In Part One, George F. R. Ellis, John C. Polkinghorne, and Holmes Rolston III, each a Templeton Prize winner, discuss their views on why the science and religion dialogue matters. They are joined in Part Two by distinguished theologians Fraser Watts and Philip Clayton, who place the dialogue in an international context; John Polkinghorne’s inaugural address to the ISSR in 2002 is also included. In Part Three, five members of the ISSR look at the distinctive relationships of their faiths to science: •Carl Feit on Judaism •Munawar Anees on Islam •B.V. Subbarayappa on Hinduism •Trinh Xuan Thuan on Buddhism •Heup Young Kim on Asian Christianity George Ellis, the recently elected second president of ISSR, summarizes the contributions of his colleagues. Ronald Cole-Turner then concludes the book with a discussion of the future of the science and religion dialogue. (shrink)

Background. The events of 9/11 and the October 2002 National Intelligence Estimate on Iraq's Continuing Programs for Weapons of Mass Destruction precipitated fundamental changes within the US Intelligence Community. As part of the reform, analytic tradecraft standards were revised and codified into a policy document – Intelligence Community Directive (ICD) 203 – and an analytic ombudsman was appointed in the newly created Office for the Director of National Intelligence to ensure compliance across the intelligence community. In this paper we investigate (...) the untested assumption that the ICD203 criteria can facilitate reliable evaluations of analytic products. Method. Fifteen independent raters used a rubric based on the ICD203 criteria to assess the quality of reasoning of 64 analytical reports generated in response to hypothetical intelligence problems. We calculated the intra-class correlation coefficients for single and group-aggregated assessments. Results. Despite general training and rater calibration, the reliability of individual assessments was poor. However, aggregate ratings showed good to excellent reliability. Conclusions. Given that real problems will be more difficult and complex than our hypothetical case studies, we advise that groups of at least three raters are required to obtain reliable quality control procedures for intelligence products. Our study sets limits on assessment reliability and provides a basis for further evaluation of the predictive validity of intelligence reports generated in compliance with the tradecraft standards. (shrink)