Over the past several decades, medical ethics has gained a solid foothold in medical education and is now a required course in most medical schools. Although the field of medical ethics is by nature eclectic, moral philosophy has played a dominant role in defining both the content of what is taught and the methodology for reasoning about ethical dilemmas. Most educators largely rely on the case‐based method for teaching ethics, grounding the ethical reasoning in an amalgam of theories drawn from (...) moral philosophy, including consequentialism, deontology, and principlism.In this article we hope to make a case for augmenting the focus of education in medical ethics. We propose complementing the traditional approach to medical ethics with a more embedded approach, one that has been described by others as “microethics,” the ethics of everyday clinical practice. (shrink)

Background While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. Methods Survey of 1200 paediatric surgeons, neonatologists and maternal–fetal medicine specialists. Results Of 1176 eligible physicians, 670 responded. In the setting of a lethal condition for which prenatal surgery would likely result in the child (...) surviving with a severe disability, most respondents either disagreed or strongly disagreed that they would recommend the surgery. Male physicians were twice as likely to recommend surgery for the lethal condition, as were physicians who believe that abortion is morally wrong. Older physicians were less likely to recommend surgery. For non-lethal conditions, most respondents agreed that they would recommend prenatal surgery, even if the surgery increases the risk of prematurity or fetal death. Compared with MFMs, surgeons were less likely to recommend such surgery, as were physicians not affiliated with a fetal centre, and physicians who were religious. Conclusion Physician’s attitudes about prenatal surgery relate to physicians’ beliefs about disability as well as demographic, cultural and religious characteristics. Given the variety of views, parents are likely to receive different recommendations from their doctors about the preferable treatment choice. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

Multiple Originals: New Approaches to Hebrew Bible Textual Criticism. By Gary D. Martin. SBL Text-Critical Studies, vol. 7. Atlanta: Society of Biblical Literature, 2010. Pp. xiv + 341. $42.95.

Meeting of the Minds records the proceedings of the S.I.E.P.M. conference held in Boston from June 14-16, 1996. The conference participants centred their attention on the relationships between medieval and classical modern philosophy. These relationships have been painted in dramatically different ways by those who have presented overviews of the two eras. Hans Blumenberg, in The Legitimacy of the Modern Age and his subsequent works, discovers the seeds of modernity in the medieval authors themselves. Leo Strauss and his followers see (...) a radical difference between the classical world views of the ancients and medievals and the successive layers of modern thought. These general portraits demand specifics, and the strength of the conference, whose results are contained in this volume, was that it provided many specific examinations of concrete relations between the philosophical positions of celebrated medieval and modern thinkers. Our hope is that this collection of papers will suggest the direction for further cooperative efforts on the interplay of the philosophical views represented by these two eras, and that the issues commonly debated by the medieval and early modern thinkers represented in this volume will give renewed consideration to important philosophical points that have been ignored in more recent debates. The volume contains contributions from E. Jennifer Ashworth (Waterloo, Ontario), Allan Back (Kutztown, Pennsylvania), Jos Decorte (Leuven), Thomas Dewender (Bochum), Idit Dobbs-Weinstein (Nashville), John P.Doyle (St.Louis), Jeremiah Hackett (Columbia, South Carolina), Simo Knuuttila (Helsinki), James McEvoy (Maynooth), A.Stephen McGrade (Storrs), Edward P.Mahoney (Durham, North Carolina), James D.Maliszewski (Toronto), Emily Michael (New York), Woosuk Park (Taejon, Korea), Horacio Santiago-Otero(+) (Madrid), Alison Simmons (Cambridge, Massachusetts), Jean-Luc Solere (Paris), Jose MariSoto Rabanos (Madrid), and Eileen C. Swe. (shrink)

Background To determine whether fetal care paediatric and maternal–fetal medicine specialists harbour differing attitudes about pregnancy termination for congenital fetal conditions, their perceived responsibilities to pregnant women and fetuses, and the fetus as a patient and whether self-perceived primary responsibilities to fetuses and women and views about the fetus as a patient are associated with attitudes about clinical care.Methods Mail survey of 434 MFM and FCP specialists .Results MFMs were more likely than FCPs to disagree with these statements : ‘the (...) presence of a fetal abnormality is not an appropriate reason for a couple to consider pregnancy termination’ ; ‘the effects that a child born with disabilities might have on marital and family relationships is not an appropriate reason for a couple to consider pregnancy termination’ ; and ‘the cost of healthcare for the future child is not an appropriate reason for a couple to consider pregnancy termination’ . 65% MFMs versus 47% FCPs disagreed that their professional responsibility is to focus primarily on fetal well-being . Specialists did not differ regarding the fetus as a separate patient. Responses about self-perceived responsibility to focus on fetal well-being were associated with clinical practice attitudes.Conclusions Independent of demographic and sociopolitical characteristics, FCPs and MFMs possess divergent ethical sensitivities regarding pregnancy termination, pregnant women and fetuses, which may influence clinical care. (shrink)

Field-Programmable Gate Arrays (FPGAs) have emerged as an attractive means of implementing logic circuits, providing instant manufacturing turnaround and negligible prototype costs. They hold the promise of replacing much of the VLSI market now held by mask-programmed gate arrays. FPGAs offer an affordable solution for customized VLSI, over a wide variety of applications, and have also opened up new possibilities in designing reconfigurable digital systems. Field-Programmable Gate Arrays discusses the most important aspects of FPGAs in a textbook manner. It provides (...) the reader with a focused view of the key issues, using a consistent notation and style of presentation. It provides detailed descriptions of commercially available FPGAs and an in-depth treatment of the FPGA architecture and CAD issues that are the subjects of current research. The material presented is of interest to a variety of readers, including those who are not familiar with FPGA technology, but wish to be introduced to it, as well as those who already have an understanding of FPGAs, but who are interested in learning about the research directions that are of current interest. (shrink)

This article addresses whether cardiopulmonary resuscitation and sustained physiological support should ever be permitted in individuals who are diagnosed as brain dead and who had held previously expressed moral or religious objections to the currently accepted criteria for such a determination. It contrasts how requests for care would normally be treated in cases involving a brain-dead individual with previously expressed wishes to donate and a similarly diagnosed individual with previously expressed beliefs that did not conform to a brain-based conception of (...) death. The paper first focuses narrowly on requests for CPR and then expands its scope to address extended physiological support. It describes how refusing the brain-dead non-donor's requests for either CPR or extended support would represent enduring harm to the antemortem or previously autonomous individual by negating their beliefs and self-identity. The paper subsequently discusses potential implications of policy that would allow greater accommodations to those with conscientious objections to currently accepted brain-based death criteria, such as for cost, insurance, higher brain formulations and bedside communication. The conclusion is that granting wider latitude to personal conceptions around the definition of death, rather than forcing a contested definition on those with valid moral and religious objections, would benefit both individuals and society. (shrink)

Coercion is commonly said to invalidate consent, and that is always true if the source of the coercion is the physician. However, if it is a family member who coerces the patient to consent, the resultant consent may be quite valid and treatment should proceed.

In the outpatient ultrasound suite of a major urban medical center, the mood is somber. A young woman lies tense and anxious. Pregnant for the first time, she has experienced early first-trimester bleeding. The radiologist relates the ultrasound findings: there has been a small hemorrhage, but there is a six-week-size fetus with normal cardiac activity. Translation: the baby is alive! The woman quietly sobs, happy but apprehensive.Across the drive, in the main hospital building, a young boy lies unresponsively comatose in (...) the Pediatric Intensive Care Unit. He was hit by a car while riding his bicycle. He is relying on a ventilator to breath, but his cardiovascular system is supporting itself. After a series... (shrink)

This commentary centres around the system of human visual attention. Although generally supportive of the position advocated in the target article, we suggest that the detailed account overestimates the capacities of active human vision. Limitations of peripheral search and saccadic accuracy are discussed in relation to the division of labour between covert and overt attentional processes.

IntroductionIn this study, we tested a simple, active “ethical consistency” intervention aimed at reducing researchers’ endorsement of questionable research practices (QRPs).MethodsWe developed a simple, active ethical consistency intervention and tested it against a control using an established QRP survey instrument. Before responding to a survey that asked about attitudes towards each of fifteen QRPs, participants were randomly assigned to either a consistency or control 3–5-min writing task. A total of 201 participants completed the survey: 121 participants were recruited from a (...) database of currently funded NSF/nih scientists, and 80 participants were recruited from a pool of active researchers at a large university medical center in the southeastern US. Narrative responses to the writing prompts were coded and analyzed to assist post hoc interpretation of the quantitative data.ResultsWe hypothesized that participants in the consistency condition would find ethically ambiguous QRPs less defensible and would indicate less willingness to engage in them than participants in the control condition. The results showed that the consistency intervention had no significant effect on respondents’ reactions regarding the defensibility of the QRPs or their willingness to engage in them. Exploratory analyses considering the narrative themes of participants’ responses indicated that participants in the control condition expressed lower perceptions of QRP defensibility and willingness.ConclusionThe results did not support the main hypothesis, and the consistency intervention may have had the unwanted effect of inducing increased rationalization. These results may partially explain why RCR courses often seem to have little positive effect. (shrink)

The philosophy of cognitive science has recently become one of the most exciting and fastest growing domains of philosophical inquiry and analysis. Until the early 1980s, nearly all of the models developed treated cognitive processes -- like problem solving, language comprehension, memory, and higher visual processing -- as rule-governed symbol manipulation. However, this situation has changed dramatically over the last half dozen years. In that period there has been an enormous shift of attention toward connectionist models of cognition that are (...) inspired by the network-like architecture of the brain. Because of their unique architecture and style of processing, connectionist systems are generally regarded as radically different from the more traditional symbol manipulation models. This collection was designed to provide philosophers who have been working in the area of cognitive science with a forum for expressing their views on these recent developments. Because the symbol-manipulating paradigm has been so important to the work of contemporary philosophers, many have watched the emergence of connectionism with considerable interest. The contributors take very different stands toward connectionism, but all agree that the potential exists for a radical shift in the way many philosophers think of various aspects of cognition. Exploring this potential and other philosophical dimensions of connectionist research is the aim of this volume. (shrink)

Déjà vu is the striking sense that the present situation feels familiar, alongside the realization that it has to be new. According to the Gestalt familiarity hypothesis, déjà vu results when the configuration of elements within a scene maps onto a configuration previously seen, but the previous scene fails to come to mind. We examined this using virtual reality technology. When a new immersive VR scene resembled a previously-viewed scene in its configuration but people failed to recall the previously-viewed scene, (...) familiarity ratings and reports of déjà vu were indeed higher than for completely novel scenes. People also exhibited the contrasting sense of newness and of familiarity that is characteristic of déjà vu. Familiarity ratings and déjà vu reports among scenes recognized as new increased with increasing feature-match of a scene to one stored in memory, suggesting that feature-matching can produce familiarity and déjà vu when recall fails. (shrink)

Nostalgia, a sentimental longing for one’s past, can serve as a resource for individuals coping with discomforting experiences. The experience of bereavement poses psychological and physical risks....

An elementary theory T in a language L is (strongly) finitely inseparable if the set of logically valid sentences of L and the set of T-finitely refutable sentences are recursively inseparable. In §1 we establish a sufficient condition for the elementary theory of a class of BA's with operators to be finitely inseparable. This is done using the methods developed independently by M. Rabin and D. Scott (see [6]) on the one hand and by Ershov on the other (see [2]).

There are wide individual differences in the ability to detect a stimulus contingency embedded in a complex paradigm. The present study used a cognitive masking paradigm to better understand individual differences related to contingency learning. Participants were assessed on measures of electrodermal arousal and on working memory capacity before engaging in the contingency learning task. Contingency awareness was assessed both by trial-by-trial verbal reports obtained during the task and by a short post-task recognition questionnaire. Participants who became aware had fewer (...) non-specific skin conductance responses and tended to score higher on a digit span assessment. Skin conductance level was not significantly lower in the aware group than in the unaware group. These findings are consistent with studies showing that lower arousal and greater cognitive processing capacity facilitate conscious perception of a greater breadth of information within a scene or a task. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

Depression is ranked as most common type of mental illness by the World Health Organization. Although cognitive behavioural therapy is recommended as the evidence-based psychological treatment of choice, this applies mostly to youthful, attractive, verbal, intelligent and successful persons with medical aid support in high income countries. More holistic counselling that includes holistic, verbal and non-verbal, expressive therapeutic modalities are more suitable for the planetary majority. Consequently, this study describes the process and effectiveness of philophonetics counselling with a sample of (...) ten depressed clients seeking clinical psychological services in Zululand, South Africa, a region and country beset with considerable violence, crime illness and unemployment. Client reports of effectiveness of philophonetics counselling warrants further intervention and evaluative research, with special reference to wider community psychological applications of this expressive therapeutic modality via primary health care facilities, online courses and mobile technology. (shrink)

George Molnar died before finishing his book. He did not write a first chapter, and planned applications of his theory were left in an incomplete state. Nevertheless, what we do have makes this volume one of the important works of metaphysics to appear in recent years. A great debt of gratitude is owed to Stephen Mumford. He has written an excellent substitute for Molnar’s introductory chapter, and given an impressive amount of order to the concluding material.