Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

Response to Emily A. Largent, Franklin G. Miller and Steven Joffe, A Prescription for Ethical Learning, Hastings Center Report, 43, s1, (S28-S29), (2013).

L'A. propose ici une lecture de la Bible, philosophique et en recherche de la sagesse. Il illustre cela en recherchant dans l'étude de la Bible ce qu'il appelle le rêve humaniste qui revient sans cesse de la société rationnelle. Parce que la Bible enseigne, la plupart du temps, non par argumentation, mais par récits, il propose de s'arrêter sur la première histoire concernant ce thème, celle de la ville et de la tour de Babel, racontée dans le livre de la (...) Genèse. (shrink)

Philosophers of experiment have acknowledged that experiments are often more than mere hypothesis-tests, once thought to be an experiment's exclusive calling. Drawing on examples from contemporary biology, I make an additional amendment to our understanding of experiment by examining the way that `wide' instrumentation can, for reasons of efficiency, lead scientists away from traditional hypothesis-directed methods of experimentation and towards exploratory methods.

L R Perry; Training and Education, Journal of Philosophy of Education, Volume 6, Issue 1, 30 May 2006, Pages 7–29, https://doi.org/10.1111/j.1467-9752.1972.tb00.

In transplant medicine, the use of normothermic regional perfusion (NRP) in donation after circulatory determination of death raises ethical difficulties. NRP is objectionable because it restores the donor's circulation, thus invalidating a death declaration based on the permanent cessation of circulation. NRP's defenders respond with arguments that are tortuous and factually inaccurate and depend on introducing extraneous concepts into the law. However, results comparable to NRP's—more and higher‐quality organs and more efficient allocation—can be achieved by removing organs from deceased donors (...) and using normothermic machine perfusion (NMP) to support the organs outside the body, without jeopardizing confidence in transplantation's legal and ethical foundations. Given the controversy that NRP generates and the convoluted justifications made for it, we recommend a prudential approach we call “ethical parsimony,” which holds that, in the choice between competing means of achieving a result, the ethically simpler one is to be preferred. This approach makes clear that policy‐makers should favor NMP over NRP. (shrink)

Philosophical discussions of species have focused on multicellular, sexual animals and have often neglected to consider unicellular organisms like bacteria. This article begins to fill this gap by considering what species concepts, if any, apply neatly to the bacterial world. First, I argue that the biological species concept cannot be applied to bacteria because of the variable rates of genetic transfer between populations, depending in part on which gene type is prioritized. Second, I present a critique of phylogenetic bacterial species, (...) arguing that phylogenetic bacterial classification requires a questionable metaphysical commitment to the existence of essential genes. I conclude by considering how microbiologists have dealt with these biological complexities by using more pragmatic and not exclusively evolutionary accounts of species. I argue that this pragmatism is not borne of laziness but rather of the substantial conceptual problems in classifying bacteria based on any evolutionary standard. (shrink)

In order to study early human development while avoiding the burdens associated with human embryo research, scientists are redirecting their efforts towards so-called human embryo-like structures (hELS). hELS are created from clusters of human pluripotent stem cells and seem capable of mimicking early human development with increasing accuracy. Notwithstanding, hELS research finds itself at the intersection of historically controversial fields, and the expectation that it might be received as similarly sensitive is prompting proactive law reform in many jurisdictions, including the (...) Netherlands. However, studies on the public perception of hELS research remain scarce. To help guide policymakers and fill this gap in the literature, we conducted an explorative qualitative study aimed at mapping the range of perspectives in the Netherlands on the creation and research use of hELS. This article reports on a subset of our findings, namely those pertaining to (the degrees of and requirements for) confidence in research with hELS and its regulation. Despite commonly found disparities in confidence on emerging biotechnologies, we also found wide consensus regarding the requirements for having (more) confidence in hELS research. We conclude by reflecting on how these findings could be relevant to researchers and (Dutch) policymakers when interpreted within the context of their limitations. (shrink)

The third edition gives particular attention to neuroimaging, which has emerged in the past decade as one of the most active areas of research in the field.

In computer science, an algorithm is an unambiguous specification of how to solve a class of problems. Algorithms can perform calculation, data processing and automated reasoning tasks. As an effective method, an algorithm can be expressed within a finite amount of space and time and in a well-defined formal language for calculating a function. Starting from an initial state and initial input (perhaps empty), the instructions describe a computation that, when executed, proceeds through a finite number of well-defined successive states, (...) eventually producing "output" and terminating at a final ending state. The transition from one state to the next is not necessarily deterministic; some algorithms, known as randomized algorithms, incorporate random input. This book introduces a set of concepts in solving problems computationally such as Growth of Functions; Backtracking; Divide and Conquer; Greedy Algorithms; Dynamic Programming; Elementary Graph Algorithms; Minimal Spanning Tree; Single-Source Shortest Paths; All Pairs Shortest Paths; Flow Networks; Polynomial Multiplication, to ways of solving NP-Complete Problems, supported with comprehensive, and detailed problems and solutions, making it an ideal resource to those studying computer science, computer engineering and information technology. (shrink)

L. R. Reinhardt; III—Dualism and Categories, Proceedings of the Aristotelian Society, Volume 66, Issue 1, 1 June 1966, Pages 71–92, https://doi.org/10.1093/aris.

In the course of writing this book, answers to the following questions and many others were given in both narrative and visual form. Most of them were presented rather forcefully, and not when I was expecting them. I understood that I was to share what I learned. What is in store for the geology of North America? How do we create matter every day? What is the nature of nature? How did people live more than a half million years ago? (...) What was space travel like a half million years ago? Where is God? What are our responsibilities as humans? Is Hitler in heaven? How can we go to heaven? (shrink)

George Christopher Stead's aim, throughout his scholarly work, was to lay bare and explain. He was very good at it, as this first piece in 1961 shows. It is a fine example of Stead's mature thinking. All the features that distinguish his work and made it fresh at the time are apparent here: clarity and directness, thoroughness of research, a gift for illustration of a technical point of logic from plain examples; and the, perhaps most noticeable, sign of an essay (...) on some patristic theme's being his very own–the presence in it of critical appraisal. Though Stead was, sometimes and in other contexts, to voice sharply destructive criticism, his appraisals are usually conducted, as in this first essay, so that sympathy with the ancient writer is preserved. (shrink)

The old ritual word macte was only vaguely understood even in Republican times. As is well known, the ancient critics connected the word with magis, magnus, and explained it as magis auctus. A glance at Walde's Wörterbuch reveals that many attempts have been made in modern times to solve the mystery; but the formidable equipment of the modern philologist has yielded little better results than the popular etymology of the ancients, the most favoured view to-day seeing in mactus the PPP (...) of a verb mago with macto as the frequentative which replaces it. The supposed semantic development of this verb, originally meaning ‘to increase’, has been set forth by Warde Fowler in a well-known passage, to which recent authorities have accorded their assent and praise: ‘the vitality of the deity … was really increased by placing on the altar the organs of life of the victim’. But this is a solution which ignores half the problem: macte and mactare are used not only of the deities but also of the victim. One can perhaps understand lovem mactare as ‘to magnify J.’, but not even by the most superficial analogy can we find a transition from here to the meaning typified in mactare vinum. Yet this is one of the most frequent usages of the word. So deep a gulf lies between the two semantic spheres of the verb that some scholars have sought to find in it two different verbs. But this is a counsel of despair which the editor of the Thesaurus dismisses with a non recte. We must agree, then, with Hey that the modern explanation is ‘sicher eine unrichtige’ and with Meillet-Ernout that there exists ‘aucune étymologie claire’. It is, therefore, surprising that so ill-founded a preconception should lead investigators to ignore or even dismiss important evidence which the ancient authorities offer for the solution of this problem. (shrink)

Electrophysiology deals with apparatus applied in a stimulus response situation. This technique is partly concerned with physical problems, partly with biological ones. The failure to appreciate differences in these problems leads to assumptions which require critical examination. Assumptions stating the constancy of objective stimuli, the meaning of inter and intra-individual variation, and the stability of the so-called “resting level” are examined.Some experiments are cited which reveal complications by the apperception of the patient and which have a significant influence on electrophysiological (...) data. The evocation of stress reactions by routine laboratory procedures is discussed and a suggestion is made of the way in which the validity of electro-physiological measurements may be improved.Dans la science de l'électro-physiologie on se sert des instruments pour mesurer des processus de réaction d'une objet stimulée.La méthodique dans cette science est dérivée partiellement de la science biologique et partiellement de la science physicale.Une des difficultées est d'apprécier justement des differences dans les problèmes de mesure dans les deux terraines scientifiques, ce que mène à des assumptions douteuses, qui a besoin d'une examination scrupuleuze.Des assumptions concernant la constance de stimulations objectives, la significance des variations inter- et intra-individuelles et la stabilité du niveau, dit „resting level”, sont examinés.Quelques experiments, révelant des complexités dans l'apperception des patients ayant une influence importante sur les données électro-physiologiques, sont cités.L'évocation des réactions de tension, par des procedures routinières en laboratoire sont discutés et une suggestion afin d'améliorer la validité des données de mesure électrophysiologique est donnée.In der Elektrophysiologie ist man beschäftigt mit Instrumentarium, waraus die Zusammenhang zwischen Reiz und Reaktion untersucht wird. In diesen Untersuchungen werden Methoden angewandt, welche teils aus der biologischen, teils aus der physikalischen Wissenschaft stammen. Es kommt vor, dass Unterschiede in Messungsprobleme innerhalb jedem Fachgebiet nicht richtig gewertet werden, was zu Annahmen führt, welche eine kritische Analyse bedürfen.Annahmen was betrifft, die Konstanz von objective Reize, die Bedeutung von inter- und intra-individuellen Variationen und die Konstanz des sogenannten „resting level”, wurden einer Analyse unterzogen.Einige Experimenten sind zitiert, die eine erhebliche Komplexität in der Wahrnehmungsempfindung des Patienten nachweisen und die eine bedeutungsvolle Einfluss haben auf den elektro-physiologischen Angaben. Das Hervorrufen Spannungsreaktionen durch Routine-vorgänge im Laboratorium wurde diskutiert und eine Weise um mit möglicherweise zuverlassigem Erfolg elektro-physiologischen Messungen aus zu führen wurde vorgeschlagen. (shrink)

Open peer commentary on the target article “Who Conceives of Society?” by Ernst von Glasersfeld. Excerpt: In the light of the almost brilliant equilibrium of the author, who manages to compose a resourceful explanation, switching between the notional conditionality and the expected contextual understanding, I intend to focus on the interdisciplinary potential of some suggestions that offer new perspectives on conceiving society, which are driven by a non-analytical and holistic vision.

Keeping the diagnosis of a client confidential is one of the cornerstones of professional practice. In the case of a diagnosis such as HIV/AIDS, however, the ethics of this action may be challenged. Such a decision has a range of negative effects, for example, the blaming of others, supporting the denial of the client, and complicating the health education and care of the patient. It is suggested that the four ethical principles should be used to explore the ethics of such (...) decisions, and that professional regulatory bodies and organizations should support professionals in situations where the client’s sexual partner is informed against the wishes of the client. (shrink)