The question of how to handle incidental findings has sparked a heated debate among neuroimaging researchers and medical ethicists, a debate whose urgency stems largely from the recent explosion in the number of imaging studies being conducted and in the sheer volume of scans being acquired. Perhaps the point of greatest controversy within this debate is whether the magnetic resonance imaging scans of all research participants should be reviewed in an active search for pathology and, moreover, whether this search should (...) be performed by a radiologist. Resistance to routine readings performed by radiologists, as opposed to selective review of those scans on which investigators have spotted a possible IF, has been fueled in part by the obvious and enormous cost — financial and logistical — of engaging radiologists to read massive numbers of scans. This cost would be especially burdensome, even prohibitive, to investigators who are not affiliated with a medical center, because of their limited access to radiologists and other medical expertise. (shrink)

ABSTRACT:Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative experiences involve either the acquisition of (...) knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes. (shrink)

Ecologists are challenged by the need to bridge and synthesize different approaches and theories to obtain a coherent understanding of ecosystems in a changing world. Both food web theory and regime shift theory shine light on mechanisms that confer stability to ecosystems, but from different angles. Empirical food web models are developed to analyze how equilibria in real multi-trophic ecosystems are shaped by species interactions, and often include linear functional response terms for simple estimation of interaction strengths from observations. Models (...) of regime shifts focus on qualitative changes of equilibrium points in a slowly changing environment, and typically include non-linear functional response terms. Currently, it is unclear how the stability of an empirical food web model, expressed as the rate of system recovery after a small perturbation, relates to the vulnerability of the ecosystem to collapse. Here, we conduct structural sensitivity analyses of classical consumer-resource models in equilibrium along an environmental gradient. Specifically, we change non-proportional interaction terms into proportional ones, while maintaining the equilibrium biomass densities and material flux rates, to analyze how alternative model formulations shape the stability properties of the equilibria. The results reveal no consistent relationship between the stability of the original models and the proportionalized versions, even though they describe the same biomass values and material flows. We use these findings to critically discuss whether stability analysis of observed equilibria by empirical food web models can provide insight into regime shift dynamics, and highlight the challenge of bridging alternative modelling approaches in ecology and beyond. (shrink)

Hoerl & McCormack's dual systems framework provides a new avenue toward the scientific investigation of temporal cognition. However, some shortcomings of the model should be considered. These issues include their reliance on a somewhat vague consideration of “systems” rather than specific computational processes. Moreover, the model does not consider the subjective nature of temporal experience or the role of consciousness in temporal cognition.

Coastal ecosystems are increasingly dominated by humans. Consequently, the human dimensions of sustainability science have become an integral part of emerging coastal governance and management practices. But if we are to avoid the harsh lessons of land management, coastal decision makers must recognize that humans are one of the more coastally dependent species in the biosphere. Management responses must therefore confront both the temporal urgency and the very real compromises and sacrifices that will be necessary to achieve a sustainable coastal (...) ecosystem, one that is economically feasible, socially just, and ecologically sound. (shrink)

Cross-national studies of business-related ethicality frequently have concluded that Americans possess higher ethical standards than non-Americans. These conclusions have generally been based on survey responses of relatively small convenience samples of individuals in a very limited number of countries. This article reports a study of the relationship between nationality and business-related ethicality based on survey responses from more than 6300 business students attending 120 colleges and universities in 36 countries. Two well-documented determinants of business ethics (gender and religiosity) were investigated (...) as moderators of the nationality–business ethicality relationship. The major research finding is that, while statistically significant differences were found between the business-related ethicality of American survey participants and the business-related ethicality of the non-American survey participants, the magnitudes of the differences were not substantial. The results of the study suggest that (i) more empirical cross-cultural/national research is required on business-related ethicality and (ii) previous explanations for cross-cultural/national differences in ethics need to be reconsidered before further generalizations are warranted. (shrink)

Is it really necessary to add something like the Health Impact Fund to the existing global patent system? We can divide this question into two parts. First, is there something seriously wrong with the status quo and, if so, what exactly is it? Second, how do we best go about solving the problem; that is, how does the design of the reform proposal address the flaws in the status quo? Jorn Sonderholm, in his critique of the Health Impact Fund, or (...) HIF, raises both of these issues. These criticisms afford us the opportunity to reaffirm our commitment to ameliorating glaring problems with the current system for incentivizing R&D for essential medicines, and to clarify why we believe the HIF is exactly what the world needs. (shrink)

Two interpretations of the precautionary principle are considered. According to the normative interpretation, the precautionary principle should be characterised in terms of what it urges doctors and other decision makers to do. According to the epistemic interpretation, the precautionary principle should be characterised in terms of what it urges us to believe. This paper recommends against the use of the precautionary principle as a decision rule in medical decision making, based on an impossibility theorem presented in Peterson . However, (...) the main point of the paper is an argument to the effect that decision theoretical problems associated with the precautionary principle can be overcome by paying greater attention to its epistemic dimension. Three epistemic principles inherent in a precautionary approach to medical risk analysis are characterised and defended. (shrink)

SummarySon preference has been considered as a determinant of women's risk of intimate partner violence experience in India, although quantitative evidence from large nationally representative studies testing this relationship is limited. This study examines the association between husband's son preference, sex composition of children and risk of physical and sexual IPV victimization among wives. Information was collected for 26,284 couples in the nationally representative 2005–2006 National Family Health Survey of India. The exposures were husband's son preference measured as husband's desire (...) for one or more sons greater than the number of daughters and sex composition of the household: only sons, only daughters and mixed. Outcome included past year physical and/or sexual IPV. The results showed that husband's reported son preference and sex composition of children were not associated with risk for IPV victimization in the models adjusted for socio-demographic factors. The findings from this first population-based study of socio-cultural norms around son preference and married Indian women's risk for IPV victimization indicate that cultural preference for sons does not influence women's risk for IPV victimization. (shrink)

Here we present and develop the hypothesis that the derepression of endogenous retrotransposable elements (RTEs) – “genomic parasites” – is an important and hitherto under‐unexplored molecular aging process that can potentially occur in most tissues. We further envision that the activation and continued presence of retrotransposition contribute to age‐associated tissue degeneration and pathology. Chromatin is a complex and dynamic structure that needs to be maintained in a functional state throughout our lifetime. Studies of diverse species have revealed that chromatin undergoes (...) extensive rearrangements during aging. Cellular senescence, an important component of mammalian aging, has recently been associated with decreased heterochromatinization of normally silenced regions of the genome. These changes lead to the expression of RTEs, culminating in their transposition. RTEs are common in all kingdoms of life, and comprise close to 50% of mammalian genomes. They are tightly controlled, as their activity is highly destabilizing and mutagenic to their resident genomes. (shrink)

Both unipolar and bipolar depression have been linked with impairments in executive functioning. In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as (...) blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions using structural equation modeling in adolescents and young adults with varying severity of mood symptoms. A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal. (shrink)

We employ a frequency-dependent asymmetric and causality analysis to investigate the connectedness between gold and cryptocurrencies during the COVID-19 pandemic. Hence, the variational mode decomposition-based quantile regression is utilised. Findings from the study divulge that the variational mode functions at the lower quantiles are mostly significant and negative indicating that gold acts as a safe haven, a diversifier at most market conditions with insignificant coefficients, and a hedge at normal market conditions for most cryptocurrencies at various investment horizons. Particularly, hedging (...) benefits mostly occur in the short- and medium-term for Bitcoin and Ripple, as well as Bitcoin and Dogecoin in the long-term with gold. This implies that there is high persistence in the hedging properties of gold with Bitcoin, followed by Ripple. We notice more significant relationship between gold and some cryptocurrencies in the long-term of the COVID-19 pandemic relative to the medium-term emphasising the delayed responses of prices to information. Investors are recommended to be observant and mindful of investing in these markets due to the different dynamics. (shrink)

Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

This paper critically examines whether patients with severe brain injury, who can only communicate through assistive neuroimaging technologies, may permissibly participate in medical decisions. We examine this issue in the context of a unique case study from the Brain and Mind Institute at the University of Western Ontario. First, we describe how the standard approach to medical decision making might problematically exclude patients with communication impairments secondary to severe brain injury. Second, we present a modified approach to medical decision making. (...) We argue that this approach might warrant the inclusion of some patients with severe brain injury in low-stakes decisions, or to express preferences. Third, we present a model of supported decision making to address recalcitrant uncertainty. We conclude by suggesting that the modified approach to decision making and supported decision making might allow a patient with severe brain injury to participate in some medical decisions. Our analysis is provisional and has not yet been implemented in practice. Our discussion is intended to generate further debate on approaches to enhancing autonomy in patients with profound motor and cognitive impairments. (shrink)

This paper sets out to give sufficient detail to the notion of mental simulation to allow an appraisal of its contribution to ‘mindreading’ in the context of the ‘false-belief tasks’ used in developmental psychology. We first describe the reasoning strategy of ‘modified derivation’, which supports counterfactual reasoning. We then give an analysis of the logical structure of the standard false-belief tasks. We then show how modified derivation can be used in a hybrid strategy for mindreading in these tasks. We then (...) formulate the hypothesis that children become able (around the age of 4 years) to pass these tasks when they acquire the counterfactual reasoning ability required in this strategy. We find this to be consistent with various empirical findings. We then discuss the implications for the theory/simulation debate, meta-representation and pretence. (shrink)

This volume, derived from the Royal Institute of Philosophy 1992 conference, brings together some of the leading figures in the burgeoning field of cognitive science to explore current and potential advances in the philosophical understanding of mind and cognition. Drawing on work in psychology, computer science and artificial intelligence, linguistics and philosophy, the papers tackle such issues as concept acquisition, blindsight, rationality and related questions as well as contributing to the lively debates about connectionism and neural networks. The collection as (...) a whole reflects the theoretical and methodological dynamism of this interdisciplinary field. (shrink)

Li Zehou and Vera Schwarcz argue that key political events in twentieth century Chinese intellectual history, like the May Fourth Movement, separate one generation of intellectuals from the next.1 I have also frequently heard contemporary Mainland intellectuals speak of generational differences among themselves. In lectures, Liu Binyan often contrasts the idealism and suffering of his generation with the disillusionment of the younger group of intellectuals and writers that grew up during the Cultural Revolution. This notion of generation seems to distinguish (...) between an older group and a younger and unproven one. The relationship between these successive generations has taken a variety of forms, but one can also argue that it has two paradigms. On the one hand, there is a relationship based on the idea of continuity, on the idea that a pupil from the younger generation obediently carries on a tradition or school of thought his older master inherited or created. The best example of this master-disciple relationship is Confucius's relationship to his followers. This idea also has strong familial overtones, and can be seen in the stress Confucian texts give to the bond between father and son, and to the values that underlie this bond: the notions of xiao, or filial piety, and zhong, or loyalty. This idea of chuan or transmission from one generation to the next is a strong element in sinicized religions like Chan Buddhism. Transmission of an idea, or even a family name, is a value informing many aspects of life in late imperial society. Mary Rankin and Hilary Beattie's work on family lineages shows how local elites used all the financial, cultural, and political means available to them to preserve the elite status of their extended families over several hundred years.2 Education, provided by teachers in local village and lineage schools, was the key to transmitting and inculcating these ethical values of loyalty, obedience, filial piety, and ethical behavior. The values informing this intergenerational relationship obligated the teacher to act in a morally conscious way, but also gave him power over his pupils, who were taught to obediently follow him. (shrink)

This issue of Chinese Studies in Philosophy contains two translations of the contemporary Chinese thinker Liu Xiaobo: "A Dialog with Li Zehou—The Sensate, The Individual, My Choice" and "Unavoidable Reflection—Contemplating Stories on Intellectuals." The first originally appeared in Zhongguo, No. 10 . Since then it has been modified by Liu and republished as a book under the title A Critique of Choice Taipei: Troubled Times Publishers , 1989. I have used the original magazine version of the text for my translation. (...) The second article was originally published in Zhongguo, No. 4. (shrink)

Comer and Schwartz argue that the business ethics course should aim to cultivate moral courage within our students. Essential to their argument is the use of fictional exemplars of moral courage to motivate our students. I argue that the classroom, even when supplemented by good fiction, is not the right context by which to practice moral courage—the habituation of moral courage requires a context of risk. I suggest a virtue that can be practiced in the classroom—intellectual courage. By aiming at (...) this virtue, we will also get the virtue of moral courage. (shrink)

In this essay, Liu Xiaobo has chosen to wrestle with some of the more famous pieces of "scar literature." This body of texts from the post-Mao period attempted to comprehend the horrendous experiences that intellectuals endured during the Cultural Revolution. To Liu, however, these works, rather than coming to terms with that chaotic event, have simply replicated the "traditional feudal ideology" that he sees as its cause. One of the central features of this "feudal tradition" that can be found in (...) Classical literary and philosophical texts is an idealized image of intellectuals, an image that, he believes, continues to this day to stifle both literature and the intelligensia. The traditional intellectual, or more accurately the scholar-official, aspired to be a sage, but by attempting to make himself into a moral and social exemplar, and conform to this model, he repressed his own individuality and critical facilities. The intellectuals presented in the texts Liu discusses conform to this precedent. They are, in his terms, "human deities" : the epitome of selflessness and diligence, idealized stereotypes rather than feeling, thinking human beings. This aspect of the "feudal tradition," Liu believes, has also stifled Classical and contemporary literature. It has meant that characters, rather than being strong individuals, conform to models and stereotypes, and that Chinese literature approaches subjects like the Cultural Revolution uncritically. (shrink)

The roots of much of Western medicine lie in the Christian monastic tradition and its commitment to nonstigmatizing compassionate care throughout the life cycle and to the ideal of empathic personal connection between physicians, patients, and the communities and relationships in which both of these are embedded. In the modern West, these Christianly informed aspects of medicine are increasingly being undercut as medical care becomes ever more specialized, technologized, and depersonalized. At the same time, there exist a variety of efforts (...) to counter these tendencies and to foster a practice of medicine that is more sensitive to the personal, relational, familial, and narrative dimensions of health, illness, and medical care. There are, in particular, considerable numbers of physicians, psychologists, and psychotherapists working at the intersections of biomedical and psychosocial care, of care for individuals and care for families, and of the body and the mind. Given the natural affinity that Christian bioethicists might be expected to have to communitarian, narrative, and family-oriented approaches to health care, it is thus remarkable that there appears to be no work of Christian bioethics that interacts in any discernible way with this psychotherapeutic literature concerning health, illness, families, and the mind-body interface. Instead, Christian bioethicists appear to endorse a narrowly reductionistic biomedical view of health and illness while either ignoring the psychosocial, integrative, and collaborative literature, or actively blaming and shaming those pastors or lay Christians who might have anything to do with psychotherapy or psychosocial care. This is unbecoming and unhelpful. In the fragmented, complex, and potentially dehumanizing world that is modern medical care, those who would think Christianly about the care of the sick cannot afford to despise psychology and psychosocial care. On the contrary, the church needs psychotherapy. In this article, I will thus consider, first, what the state of the conversation is where Christian bioethics and psychosocial and psychotherapeutic care are concerned. I will then turn to some of the principal landmarks in the professional literature concerning psychotherapeutic work with the sick, the disabled, the dying, and the bereaved, particularly as these are considered in contexts that include families and lay and professional caregivers. I will then identify a few opportunities for practical and theological reflection that present themselves in this literature, and will conclude with a few comments on the substance and relationship of salvation and health. (shrink)

Willem II van Haecht?s panel of the Cabinet of Cornelis van der Geest (1628), introduces the viewer to the theme of the Five Senses by including five prominently displayed paintings, each corresponding to one of the senses, in the foreground. The paper offers a new reading of the panel, suggesting that this image may be read as an allegory of the Five Senses, proposing this theme as a key to the rhetorical performance the collector, van der Geest, is shown undertaking, (...) and connecting the senses to the picture?s punning motto: Vive l?Esprit. (shrink)

The contributors to The Moral of the Story, all preeminent political theorists, are unified by their concern with the instructive power of great literature. This thought-provoking combination of essays explores the polyvalent moral and political impact of classic world literatures on public ethics through the study of some of its major figures-including Shakespeare, Dante, Cervantes, Jane Austen, Henry James, Joseph Conrad, Robert Penn Warren, and Dostoevsky. Positing the uniqueness of literature's ability to promote dialogue on salient moral and intellectual virtues, (...) editor Henry T. Edmonson III has culled together a wide-ranging exploration of such fundamental concerns as the abuse of authority, the nature of good leadership, the significance of "middle class virtues" and the needs of adolescents. This collection reinvigorates the study of classic literature as an endeavor that is not only personally intellectually satisfying, but also an inimitable and unique way to enrich public discourse. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Physically frail, badly educated girls, brought up to lead useless lives as idle gentlewomen, married to dominant husbands, and relegated to "separate spheres" of life—these phrases have often been used to describe Victorian upper-middle-class women. M. Jeanne Peterson rejects such formulations and the received wisdom they embody in favor of a careful examination of Victorian ladies and their lives. Focusing on a network of urban professional families over three generations, this book examines the scope and quality of gentlewomen's education, (...) their physical lives, their relationship to money, their experience of family illness and death, and their relationships to men (brothers and friends as well as fathers and husbands). Peterson also examines the prominent place of work in the lives of these "leisured" Victorian ladies, both single and married. Far from idle, the mothers, wives, and daughters of Victorian clergymen, doctors, lawyers, university dons, and others were accomplished and productive members of society who made substantial public and private contributions to virtually every sphere of Victorian life. (shrink)

Patriarchal institutions govern all aspects of women's lives: their minds, their bodies, and their souls. Additionally, they govern the ways in which women are perceived by others and the ways in which women perceive themselves. (Re) Interpretations: The Shapes of Justice in Women's Experience, is a collection of essays on language, religion, war, sex trafficking, and medicine-the patriarchal structures that form the basis of western society and, thus, are in many ways inherently unjust. The essays illustrate the multitude of ways (...) that women have found to work within and without these structures to create justice. Traditional theories of justice cast it as a cardinal virtue, unbiased and impartial. The essays in this book, however, remove justice from the abstract and return it to the specific: most of the essays use personal narratives to highlight the connections all people share. The women discussed here are challenging the authority of existing patriarchal narratives by telling their versions, and, thus, calling attention to and challenging their own political and social realities. Reflecting a focus on global connectedness and interdisciplinarity, the writers of these essays aim not only to raise questions, but also to show ways in which women are creating new pathways for themselves. Only by exploring solutions will women reclaim justice. From L.A. to Zimbwabe, women have stories to tell about their experiences of justice in the inherently patriarchal institutions of Language, Religion, War, Sex Trafficking, and Medicine. This relevant and thought-provoking collection captures the trials that women across the world face and the hope they create through their courageous actions. Through both personal narrative and factual overview, these essays emphasize that as people committed to justice, women must not simply raise the questions, but they must also explore solutions in order to reclaim justice for themselves, their daughters, their sisters, and their mothers. Contributors: Yifat Bitton, Stephany Ryan Cate, Jo Scott-Coe, Susan Dewey, Carmela Epright, Carmen Faymonville, Adam Gaynor, Pauline Greenhill, Denise Handlarski, Alison Jobe, Marc J.W. de Jong, Jodie M. Lawston, Jody Lisberger, Kristy Maher, Susan Maloney, Mickias Musiyiwa, Ruben Murillo, Annemarie Profanter, Natalie Wilson, and J. Carter Wood. (shrink)