BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV (PWH) with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life (EOL) to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the (...) United States (PWH, biomedical HIV cure researchers, HIV clinicians, and bioethicists) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable.ResultsAll four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: (1) Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; (2) PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; (3) Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; (4) The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and (5) Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL.ConclusionBecause of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings. (shrink)

The U.S. National Institute of Allergies and Infectious Diseases and the National Institute of Mental Health have a new research priority: inclusion of terminally ill persons living with HIV in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. As end-of-life HIV cure research is relatively new, the scientific community has a timely opportunity to (...) examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

There are many reasons to worry about shame in moral development. Shame can be employed for bad ends, such as manipulation and making others feel powerless. Shame is often associated with denial and hiding behaviors, social phobia, and anxiety. It is also not a motivation suitable for performing virtuous actions. This article argues that, nevertheless, well-ordered shame plays an indispensable and constructive role, as part of a mixed-methods approach in the development of moral character. This article assesses various reasons why (...) shame has fallen out of favor among Western moral educators and demonstrates why each of these reasons falls short of providing a compelling case against employing shame. It defends shame on epistemic and virtue developmental grounds. Moreover, it proposes ways to employ shame in character education, while mitigating potential damages and avoiding the concerns raised by social scientists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Theories of Emotion: Expressing, Feeling, Acting by Pia CAMPEGGIANISabrina B. LittleCAMPEGGIANI, Pia. Theories of Emotion: Expressing, Feeling, Acting. New York: Bloomsbury Publishing, 2023. xiv + 199 pp. Cloth, $80.89; paper, $21.60In Theories of Emotion, Pia Campeggiani provides a philosophical introduction to the emotions. The book is multidisciplinary and empirically informed. It is organized around three “groundbreaking intuitions” of emotion theory—(1) expression, (2) subjectivity, and (3) action. Each section (...) corresponds to a different thinker—Charles Darwin, William James, and John Dewey, respectively—and each section concludes with a discussion of relevant debates. This book is outstanding. It is clearly written, well organized, and impressive in its scope. In what follows, I outline key ideas and raise questions generated by each section, then conclude with general reflections on the text.Campeggiani begins with the “scandal” of emotion research: There is no agreement about what an emotion is. In part, this lack of consensus is due to the imprecise ways we employ concepts like feelings, emotions, affect, and passions in ordinary discourse. In part, it is due to empirical difficulties. For example, Campeggiani describes how implicit assumptions and a forced-choice format compromised an experiment about expression universality.Additionally, Campeggiani points out that the category “emotions” has an internal structure that lacks clear-cut boundaries. There are paradigmatic examples of emotions, such as fear and anger, but there are also ambiguous phenomena, such as respect and modesty, which we may or may not recognize as such. Throughout the text, Campeggiani introduces and evaluates numerous accounts of emotions, drawing our attention to the strengths, limitations, and empirical adequacy of each.Part 1 begins with Charles Darwin’s contributions to emotion theory—an emphasis on the biological origins of emotions and a focus on expression. This section examines emotions in connection to adaptive fitness, exploring phenomena such as blushing when we are ashamed and the biological bases of emotions. A highlight of this section is an exploration of the social or communicative character of the emotions, which Darwin described as “only a secondary effect” of expression. Campeggiani examines emotional contagion and imitation, as well as the [End Page 141] phenomenon of feeling more pain when we express pain on our faces. There is also a rich discussion about constructionism as an alternative to basic emotions theory.Part 2 opens with William James on subjective experience. Campeggiani describes the limitations of James’s position—of understanding emotions to be reducible to feelings. For starters, this position is not empirically well supported. Campeggiani cites Walter Cannon’s observation that “many of the autonomic changes that are symptomatic of a given emotion can also occur in its absence.” Additionally, James fails to “properly flesh out the link between emotions and evaluations.” Campeggiani then describes the cognitive turn in emotion theory that emerged in response to the lack of attention paid to evaluation. Cognitive accounts of emotion deemphasize the bodily dimensions of emotional experiences in favor of the intentional properties, or “aboutness,” of emotions. Emotions see things as things.From my vantage, this was the best part of the book. Campeggiani highlights Damasio’s point that decision-making depends on having a “correct affective perception of the values at stake in a given situation.” For instance, feeling outsized or misdirected fear may undermine our decision-making. Campeggiani also introduces debates about whether emotions are appraisals, and whether emotions entail judgments or make judgments more likely. In the introduction, she mentions that “decision-making processes are always and inevitably underpinned by emotions, for good and for ill.” We see what she means in this section. Emotions participate in reason, impede reason, and have cognitive content themselves.That emotions involve or participate in our judgments raises two kinds of concerns—epistemic and normative. The epistemic worry is that inaccurate appraisals may undermine our understanding of the world. This is especially worrisome for the class of emotions Campeggiani calls “recalcitrant,” or closed off to other mental states, and for the emotions she says are “heavily influenced by our needs and goals.” Emotions are imperfectly truth-tracking, as was made clear earlier, in part 1, regarding their adaptive nature. The normative worry is that certain emotional... (shrink)

Although many studies have found a positive relationship between corporate social performance and employer attractiveness, few have examined how different forms of responsibility might mediate that attraction, particularly when those social practices afford different degrees of employee participation. The current study undertook this line of inquiry by examining prospective employees’ attraction to three common approaches to corporate social performance (CSP) that offer increasing levels of participation: donation, volunteerism, and operational integration. Unexpectedly, findings from an empirical investigation challenged the study's main (...) hypothesis; that is, prospective employees were least attracted to firms that integrated their social and financial goals. Consequently, important implications and questions remain for both employers and business educators. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

There are many reasons to worry about shame in moral development. Shame can be employed for bad ends, such as manipulation and making others feel powerless. Shame is often associated with denial and hiding behaviors, social phobia, and anxiety. It is also not a motivation suitable for performing virtuous actions. This article argues that, nevertheless, well-ordered shame plays an indispensable and constructive role, as part of a mixed-methods approach in the development of moral character. This article assesses various reasons why (...) shame has fallen out of favor among Western moral educators and demonstrates why each of these reasons falls short of providing a compelling case against employing shame. It defends shame on epistemic and virtue developmental grounds. Moreover, it proposes ways to employ shame in character education, while mitigating potential damages and avoiding the concerns raised by social scientists. (shrink)

The virtue development literature often draws on the language of goal-directed automaticity and flow states in discussions of virtue. This article examines the attentional features of various virtues and argues that only some virtuous actions can be adequately described in these terms. It proposes a distinction between three kinds of virtuous actions—flow state actions, deliberative actions, and presence actions—which have varying attentional features, bodily reliance, and conscious reasoning in virtue performance. Then the article motivates these distinctions as important, describing how (...) one might take on-board these classifications in character education, providing a more tailored development of virtues. (shrink)

ABSTRACT Mindfulness is an umbrella term for a set of practices and strategies related to attention and non-critical awareness of our thoughts. Mindfulness is currently having a moment in popular culture and in clinical psychology for its many perceived benefits. However, there are reasons to worry about whether certain commitments and strategies of mindfulness might conflict with long-term progress in character development. This article places mindfulness in conversation with developmental considerations of virtue, asking how mindfulness practices might impact the various (...) stages between natural character and mature moral virtue in different ways. Moreover, it proposes a distinction between two kinds of virtues, presence and absence virtues, that are differently impacted by the continued use of mindfulness practices in the later stages of virtue development. (shrink)

This study describes how a primary school teacher and her students explored multiple means of communication through the use of a project on storytelling and drumming to personalize and translate cultural differences into universal human experiences they could understand. It documents how the teacher and two researchers collaborated with planning and implementing the drumming project so that it integrated social studies with multiple modes of literacy. It discusses how the teacher and researchers examined cultural universals within this project to provide (...) students with a frame of reference to engage in an authentic understanding of diverse cultures within their classrooms. Finally, the study examined the students’ work within the actual drumming project. (shrink)

Recent debate has arisen in the neuroethics literature on the extent to which deep brain stimulation (DBS) may cause changes to core personal traits. This has prompted calls for more empirical data...

The Last Gift is an observational HIV cure-related research study conducted with people with HIV at the end of life (EOL) at the University of California San Diego. Participants agree to voluntarily donate blood and other biospecimens while living and their bodies for a rapid research autopsy postmortem to better understand HIV reservoir dynamics throughout the entire body. The Last Gift study was initiated in 2017. Since then, 30 volunteers were enrolled who are either (1) terminally ill with a concomitant (...) condition and have a prognosis of 6 months or less or (2) chronically ill with multiple comorbidities and nearing the EOL.Multiple ethical and logistical challenges have been revealed during this time; here, we share our lessons learnt and ethical analysis. Issues relevant to healthcare research include surrogate informed consent, personal and professional boundaries, challenges posed conducting research in a pandemic, and clinician burnout and emotional support. Issues more specific to EOL and postmortem research include dual roles of clinical care and research teams, communication between research personnel and clinical teams, legally required versus rapid research autopsy, identification of next of kin/loved ones and issues of inclusion. Issues specific to the Last Gift include logistics of body donation and rapid research autopsy, and disposition of the body as a study benefit.We recommend EOL research teams to have clear provisions around surrogate informed consent, rotate personnel to maintain boundaries, limit direct contact with staff associated with clinical care and have a clear plan for legally required versus research autopsies, among other recommendations. (shrink)

Admiration is often described as having a singular motivational profile – the disposition to imitate. This article provides a developmental assessment of admiration’s action-potential, proposing a series of stages between (1) naïve imitation, a basic mimetic impulse, and (2) non-imitative virtuous actions. The process is marked by an increasing ability to represent the actions and desires of another, becoming the middle term between the learner and the exemplar. This developmental assessment is necessary because the leading accounts of moral development today (...) lean on the idea of imitation as essential to the process of virtue acquisition without providing an explanation of how imitation works, psychologically speaking. Moreover, these accounts treat imitation as a static disposition, rather than one that matures over time. Insight regarding this developmental progression can provide us with a better sense of how to educate using exemplars in order to advance a learner from admiration to moral virtue. This article also fills in gaps in the admiration literature concerning how we regard inimitable excellences and contends that it may not be beneficial to emulate an exemplar’s motivations, in addition to her actions. (shrink)

R.S. Peters coined the term the “paradox of moral education” to describe the I apply the resources of the classical tradition—poetry and gymnastics, the trivium, and the quadrivium—to examine recent strategies for character formation involving aretaic exemplars. I think there is forgotten wisdom here. We have a map of a productive pedagogical sequence of mixed methods in virtue education. For example, stories are paired with physical training. Virtue concept-learning comes next, and strategies involving imitation are adjusted as a student grows. (...) I make the case that we should not think of virtue formation strategies as stand-alone tools, but as part of a broader narrative of training, suitable to age and building on the work of the methods that preceded them. (shrink)

One of the finest private collections of Indian, Himalayan and Southeast Asian art in America is owned by James and Marilynn Alsdorf. This catalogue provides an opportunity for individuals other than scholars and specialists to view the works of art.