This article explores the ethical challenges of providing Medical Assistance in Dying (MAID) in a paediatric setting. More specifically, we focus on the theoretical questions that came to light when we were asked to develop a policy for responding to MAID requests at our tertiary paediatric institution. We illuminate a central point of conceptual confusion about the nature of MAID that emerges at the level of practice, and explore the various entailments for clinicians and patients that would flow from different (...) understandings. Finally, we consider the ethical challenges of building policy on what is still an extremely controversial social practice. While MAID is currently available to capable patients in Canada who are 18 years or older—a small but important subsection of the population our hospital serves—we write our policy with an eye to the near future when capable young people may gain access to MAID. We propose that an opportunity exists for MAID-providing institutions to reduce social stigma surrounding this practice, but not without potentially serious consequences for practitioners and institutions themselves. Thus, this paper is intended as a road map through the still-emerging legal and ethical landscape of paediatric MAID. We offer a view of the roads taken and considered along the way, and our justifications for travelling the paths we chose. By providing a record of our in-progress thinking, we hope to stimulate wider discussion about the issues and questions encountered in this work. (shrink)

In their summary and critique, Gamble, Gamble, and Pruski mischaracterise both the central arguments and the primary objectives of our original paper. Our paper does not provide an ethical justification for paediatric Medical Assistance in Dying by comparing it with other end of life care options. In fact, it does not offer arguments about the permissibility of MAID for capable young people at all. Instead, our paper focuses on the ethical questions that emerged as we worked to develop a policy (...) for responding to MAID requests at our tertiary paediatric institution. Following the Supreme Court of Canada’s recent decriminalisation of MAID, our hospital needed to answer immediate on-the-ground questions such as: ‘What are we going to do if an 18-year-old patient in our care requested MAID today, as is now their legal right? How should we protect their privacy? What is the best way to ensure patients are informed when making these decisions?’ On these important questions, Gamble, Gamble, and Pruskiare silent. (shrink)

The Braess Paradox (BP) is a counterintuitive finding that degrading a network that is susceptible to congestion may decrease the equilibrium travel cost for each of its users. We illustrate this paradox with two networks: a basic network with four alternative routes from a single origin to a single destination, and an augmented network with six alternative routes. We construct the equilibrium solutions to these two networks, which jointly give rise to the paradox, and subject them to experimental testing. Our (...) purpose is to test the generality of the BP when the network is enriched as well as the effects of the information provided to the network users when they conclude their travel. To this end, we compare experimentally two information conditions when each of the two networks is iterated in time. Under public monitoring each user is accurately informed of the route choices and payoffs of all the users, whereas under private monitoring she is only informed of her own payoff. Under both information conditions, over iterations of the basic and augmented games, aggregate route choices converge to equilibrium. (shrink)

The appearance of nuclear weapons suddenly made the extinction of humanity a distinct possibility. In view of this obverse side of scientific progress, attitudes toward science in the general population became ambivalent, at times bordering on hostility. It is argued that to a great extent the scientists themselves are responsible for the tarnished image of science. Accordingly they should restore science to its role of furthering human welfare and, above all, as a source of enlightenment. In our age enlightenment entails (...) emancipating humanity from superstitions generated by the cooptation of science in the service of power. (shrink)

Within the last decade, there has been a dramatic bloom in ridesharing businesses along with the emergence of new enabling technologies. A central issue in ridesharing, which is also important in the general domain of cost-sharing in economics and computer science, is that the sharing of cost implies positive externalities and hence coordination problems for the network users. We investigate these problems experimentally in the present study. In particular, we focus on how sequential observability of transportation mode choices can be (...) a powerful facilitator of coordination in ridesharing. Our study abstracts the essential issues of coordination in ridesharing into a directed network game with experimentally testable predictions. In line with the theoretical analysis, our experimental evidence shows that even a limited extent of sequential choice observability might lead to efficient coordination. However, convergence to efficiency is slower with more limited observability, resulting in a significant increase in travel cost. (shrink)

In relating the problem of comparison to that of conceptualization, Dr. Sjoberg brings into focus a central methodological problem of social science. For to compare is to discover unity in diversity and differences among similarities, that is, to uncover structure. The first act in this process is to name the parts and the relations among them, and naming, of course, both stems from and induces conceptualizations.

Let us begin by proposing a sort of common denominator of the various conceptions of rationality, some feature that underlies practically all its definitions.

Almost anyone seriously interested in decision theory will name John von Neumann's (1928) Minimax Theorem as its foundation, whereas Utility and Rationality are imagined to be the twin towers on which the theory rests. Yet, experimental results and real-life observations seldom support that expectation. Over two centuries ago, Hume (1739–40/1978) put his finger on the discrepancy. “Reason,” he wrote “is, and ought to be the slave of passions, and can never pretend to any other office than to serve and obey (...) them.” In other words, effective means to reach specific goals can be prescribed, but not the goals. A wide range of experimental results and daily life behavior support this dictum. (shrink)

It remains to summarize the contributions which each of the three disciplines discussed here is making toward the development of a science of man. "Significs" makes a study of the effects on human behavior of the linguistic aspects of the evaluative process, the most distinctly human aspect of the behavior of the human organism. "Mathematical Biophysics" seeks to describe the events associated with evaluative processes in physico-mathematical terms. "Cybernetics" is discovering important invariants common to these processes and others, particularly those (...) observed in man-made machines and in situations which lend themselves to description in thermo-dynamic or statistical (order -- chaos) terms. (shrink)

It remains to summarize the contributions which each of the three disciplines discussed here is making toward the development of a science of man. "Significs" makes a study of the effects on human behavior of the linguistic aspects of the evaluative process, the most distinctly human aspect of the behavior of the human organism. "Mathematical Biophysics" seeks to describe the events associated with evaluative processes in physico-mathematical terms. "Cybernetics" is discovering important invariants common to these processes and others, particularly those (...) observed in man-made machines and in situations which lend themselves to description in thermo-dynamic or statistical terms. (shrink)

We study the performance of heuristics relative to the performance of optimal solutions in the rich domain of sequential search, where the decision to stop the search depends only on the applicant’s relative rank. Considering multiple variants of the secretary problem, that vary from one another in their formulation and method of solution, we find that descriptive heuristics perform well only when the optimal solution prescribes a single threshold value. We show that a computational heuristic originally proposed as an approximate (...) solution to a single variant of the secretary problem performs equally well in many other variants where the optimal solution prescribes multiple threshold values that gradually relax the criterion for stopping the search. Finally, we propose a new heuristic with near optimal performance in a competitive or strategic variant of the secretary problem with multiple employers competing with one another to hire job applicants. Both heuristics share a simple computational component: the ratio of the number of interviewed applicants to the number of those remaining to be searched. We present the subgame-perfect Nash equilibrium for this competitive variant and an algorithm for its computation. (shrink)