Char and colleagues provide a useful conceptual framework for the proactive identification of ethical issues arising throughout the lifecycle of machine learning applications in healthcare. Th...

The literature fails to reflect general agreement over the nature of the services and procedures provided by bioethicists, and the training and core competencies this work requires. If bioethicists are to define their activities in a consistent way, it makes sense to look for common ground in shared communities of practice. We report results of a survey of the services and procedures among bioethicists affiliated with the University of Toronto Joint Centre for Bioethics (JCB). This is the largest group of (...) bioethicists working in healthcare organizations in Canada. The results suggest there are many common services and procedures of JCB bioethicists. This survey can serve as a baseline for further exploration of the work of JCB bioethicists. Common practices exist with respect to the domains of practice, individual reporting relationships, service availability within business hours and the education and training of the bioethicist. (shrink)

The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

Recent developments in science and technology point to the need to unify, and extend, the definition of memory. On the one hand, molecular neurobiology has shown that memory is largely a chemical process, which includes conditioning and any form of stored experience. On the other hand, information technology has led many to claim that cognition is also extended, that is, memory may be stored outside of the brain. In this paper, we review these advances and describe the increasingly accepted extended (...) definition of memory. This definition is largely accepted in neuroscience but not explicitly stated. In the extended definition, memory is the capacity to store and/or retrieve information. Does this new definition of memory mean that everything is now a form of memory? We stress that memory still requires incorporation, that is, a corpore. It is a relationship -- where one biological or chemical process is incorporated into another, and changes both in a permanent way. Looking at natural and biological processes of incorporation can help us think of how incorporation of internal and external memory occurs in cognition. We further argue that, if we accept that there is such a thing as the storage of information outside the brain -- and that this organic, dynamic process can also be called “memory” -- then we open the door to a very different world. The mind is not static. The brain, and the memory it uses, is a work in progress; we are not now who we were then. (shrink)

How has the storage of information shaped human cognition? We bring together current advances in cognitive science, the neurobiology of memory, and archaeology to explore how storage of information affects consciousness. These fields strongly suggest that the increase in storage of information in the environment – which we call exosomatic storage of information – may have led to changes in human consciousness and human neurophysiology over time. To bring these findings together conceptually, we develop what we call a dialectical model (...) of the relationship between storage of information and the development of human consciousness. Using the system of dialectic philosophy, we put forward that (a) environmental changes, consciousness, and neurophysiology develop together, (b) these changes were irreversible, (c) quantitative increases in exosomatic storage of information may have led to qualitative changes in human consciousness and neurophysiology, (d) these changes in turn affected how we see ourselves. Indeed, our capacity to store information exosomatically distinguishes us from other animals, and may be a key attribute of our self-awareness and therefore self-consciousness. Because metaphors are central to human thought and can help structure scientific inquiry, we illustrate our model using a metaphor of drops of silver on the back of a glass, eventually making a mirror—where successive quantitative change leads to an irreversible qualitative development in human consciousness. The dialectic model can offer new insights into the co-evolution of material culture and human beings through its broader philosophical foundations and explanatory power. (shrink)

This book provides the reader with a theoretical and practical understanding of two health care delivery models: the patient/child centred care and family-centred care. Both are fundamental to caring for children in healthcare organizations. The authors address their application in a variety of paediatric healthcare contexts, as well as the ethical and legal issues they raise. Each model is increasingly pursued as a vehicle for guiding the delivery of health care in the best interests of children. Such models of health (...) care delivery shape health care policies, programs, facility design, resource allocation decisions and day-to-day interactions among patients, families, physicians and other health care professionals. To maximize the health and ethical benefits these models offer, there must be shared understanding of what the models entail, as well as the ethical and legal synergies and tensions they can create. This book is a valuable resource for paediatricians, nurses, trainees, graduate students, practitioners of ethics and health policy. (shrink)

This book provides the reader with a theoretical and practical understanding of two health care delivery models: the patient/child centred care and family-centred care. Both are fundamental to caring for children in healthcare organizations. The authors address their application in a variety of paediatric healthcare contexts, as well as the ethical and legal issues they raise. Each model is increasingly pursued as a vehicle for guiding the delivery of health care in the best interests of children. Such models of health (...) care delivery shape health care policies, programs, facility design, resource allocation decisions and day-to-day interactions among patients, families, physicians and other health care professionals. To maximize the health and ethical benefits these models offer, there must be shared understanding of what the models entail, as well as the ethical and legal synergies and tensions they can create. This book is a valuable resource for paediatricians, nurses, trainees, graduate students, practitioners of ethics and health policy. (shrink)

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)

This paper provides a description of the role of the clinical ethicist as it is generally experienced in Canada. It examines the activities of Canadian ethicists working in healthcare institutions and the way in which their work incorporates more than ethics case consultation. The Canadian Bioethics Society established a Taskforce on Working Conditions for Bioethics (hereafter referred to as the Taskforce), to make recommendations on a number of issues affecting ethicists and to develop a model role description. This essay carefully (...) assesses this model role description. (shrink)

This paper provides a description of the role of the clinical ethicist as it is generally experienced in Canada. It examines the activities of Canadian ethicists working in healthcare institutions and the way in which their work incorporates more than ethics case consultation. The Canadian Bioethics Society established a “Taskforce on Working Conditions for Bioethics” (hereafter referred to as the Taskforce), to make recommendations on a number of issues affecting ethicists and to develop a model role description. This essay carefully (...) assesses this model role description. (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 legal risks associated with health research involving human subjects have been highlighted recently by a number of lawsuits launched against those involved in conducting and evaluating the research. Some of these cases have been fully addressed by the legal system, resulting in judgments that provide some guidance. The vast majority of cases have either settled before going to trial, or have not yet been addressed by the courts, leaving us to wonder what might have been and what guidance future (...) cases may bring. What is striking about the lawsuits that have been commenced is the broad range of individuals/institutions that are named as defendants and the broad range of allegations that are made. The research community should take this early experience as a warning and should reflect carefully on practices where research involving human subjects is concerned. (shrink)

In this article, we examine how the U.N. Convention on the Rights of the Child can be useful in pediatric bioethics. Adopted in 1989, the CRC reflects norms that have been deliberated upon for a long period of time and endorsed by most nations. The United States is now the only country that has not ratified the CRC.1 International human rights law shares many key moral concepts with clinical pediatric bioethics, and the CRC provides a considered language common to many (...) jurisdictions that can assist bioethicists in their daily practice and help health-care organizations in their policy development and international interactions. There may, however, be practical challenges with using the CRC in the practice of.. (shrink)

Clinicians such as Sir William Osler reinvented Hippocrates and built the image of a noble, lone, professional man replete with black bag, minister...

Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many (...) were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

Gifts have served as a fundamental aspect of the human experience across time, even as their precise roles and functions have shifted. In the past, bioethicists and others have drawn upon anthropol...

IntroductionThe value of a short life characterized by disability has been hotly debated in the literature on fetal and neonatal outcomes.MethodsWe conducted a scoping review to summarize the available empirical literature on the experiences of families in the context of trisomy 13 and 18 (T13/18) with subsequent thematic analysis of the 17 included articles.FindingsThemes constructed include (1) Pride as Resistance, (2) Negotiating Normalcy and (3) The Significance of Time.InterpretationOur thematic analysis was guided by the moral experience framework conceived by Hunt (...) and Carnevale (2011) in association with the VOICE (Views On Interdisciplinary Childhood Ethics) collaborative research group.RelevanceThis article will be of interest and value to healthcare professionals and bioethicists who support families navigating the medically and ethically complex landscape of T13/18. (shrink)

Physician-researchers are bound by professional obligations stemming from both the role of the physician and the role of the researcher. Currently, the dominant models for understanding the relationship between physician-researchers' clinical duties and research duties fit into three categories: the similarity position, the difference position and the middle ground. The law may be said to offer a fourth.

Clarifying the mission of the American high school / Ernest L. Boyer--Educational goals and curricular decisions in the new Carnegie Report / John Martin Rich--Essential schools : a first look / Theodore R. Sizer--Teaching and learning : the dilemma of the American high school / Chester E. Finn, Jr.--The paideia proposal : rediscovering the essence of education / Mortimer Adler--The paideia proposal : noble amibitions, false leads, and symbolic politics / Willis D. Hawley--Cultural literacy : let's get specific / E.D. (...) Hirsch, Jr.--Cultural literacy : what every educator needs to know / Thomas H. Estes, Carol J. Gutman, and Elise K. Harrison--A blueprint for public education / John E. Chubb--Should market forces control educational decision making / Jack Tweedie--Teachers as transformative intellectuals / Henry A. Giroux--Dilemma language / Colin Lacey--Rich schools, poor schools : the persistence of unequal education / Arthur E. Wise and Tamar Gendler--Partial privatization of publice school finance / Thomas G. Fox and John Riew--Quality and equality in American education : public and Catholic schools / James S. Coleman--Oranges plus apples, Dr. Coleman, give you oranges plus apples / James Rogers--Synthesis of research on school-based management / Jane L. David--Unfulfilled promises / Betty Malen, Rodney T. Ogawa, and Jennifer Kranz--Effective high schools--What are the common characteristics? / Joseph Murphy and Philip Hallinger--Effective schools : a friendly but cautionary note / Larry Cuban--In education, magnets attract controversy / Mary Haywood Metz--Schools of choice : a path to educational quality or 'Tiers of inequity'? / Kathleen Sylvester--Interesting times / Alan H. Jones--Making a difference in educational quality through teacher education / Carolyn M. Evertson, Willis D. Hawley, and Marilyn Zlotnik--Developing a career ladder : getting down to the basics / Thomas Deering--The career ladder and lattice : a new look at the teaching career / Timothy J.L. Chandler, Stacey L. Lane, Janice M. Bibik, and Bernard Oliver--Equity, quality, and effectiveness in bilingual education / George M. Blanco--Bilingual--No! / Muriel Paskin Carrison--Multiethnic education and the quest for equality / James A. Banks--The limits of pluralism / M. Donald Thomas--The case for keeping mentally retarded children in your regular classrooms / Martin Tonn--Mainstreaming : a formative consideration / Harry N. Chandler--Reflections on three decades of eduction of the gifted / A. Harry Passow--Equity vs. excellence : an eductional drama / James J. Gallagher. (shrink)

A revision of George Kennedy's translation of, introdution to, and commentary on Aristotle's On Rhetoric. His translation is most accurate, his general introduction is the most thorough and insightful, and his brief introductions to sections of the work, along with his explanatory footnotes, are the most useful available.

Recent research on algebraic models of _quasi-Nelson logic_ has brought new attention to a number of classes of algebras which result from enriching (subreducts of) Heyting algebras with a special modal operator, known in the literature as a _nucleus_. Among these various algebraic structures, for which we employ the umbrella term _intuitionistic modal algebras_, some have been studied since at least the 1970s, usually within the framework of topology and sheaf theory. Others may seem more exotic, for their primitive operations (...) arise from algebraic terms of the intuitionistic modal language which have not been previously considered. We shall for instance investigate the variety of _weak implicative semilattices_, whose members are (non-necessarily distributive) meet semilattices endowed with a nucleus and an implication operation which is not a relative pseudo-complement but satisfies the postulates of Celani and Jansana’s strict implication. For each of these new classes of algebras we establish a representation and a topological duality which generalize the known ones for Heyting algebras enriched with a nucleus. (shrink)

The paper provides an analysis and interpretation of selected literary texts by Ewa Lipska, with particular focus on poems: 11 września 2001 [September 11th, 2001] and Kopalnia [The Mine]. In these metapoetic poems, Lipska makes use of jewellery imagery in order to emphasise the processuality of an act of creation, its ethical ambivalence, and its complex sources. The offered interpretations refer, among other things, to theses by Carl Gustav Jung and Pierre Marc de Biasi. Analysing the way in which the (...) poet uses motifs of gemstones and metaphors with a jewel – and also demonstrating strategies of the literary refining of poems – the author of this paper challenges the hypothesis of the end of the ‘goldsmith convention’ in contemporary Polish poetry. (shrink)

Transcript of speeches by a Hindu philosopher, chiefly on Hindu philosophy and Hinduism.

Classical text on Nyaya and Vaiśeṣika philosophy; with Āloka Sanskrit commentary.

Classical work on Vedanta; includes Bhāṣyaratnaprabhā of Govindānanda and Śārīrakamīmāṃsābhāṣya of Śaṅkarācārya.

Classical work on Vedanta by Bādarāyaṇa; includes Śārīraka vijñānam bhāṣya of Śrī Madhusūdana Ojhā.

Purpose. The article is aimed to substantiate the view on the phenomenon of laughter as a subject of semiotic analysis, which leads to the following tasks: to reveal the possibilities of semiotics application in the study of laughter nature; to analyze the phenomenon of laughter as a cultural and natural phenomenon, as a sign and as an attribute; to consider the place of laughter in culture, which is understood as a sign system. Theoretical basis. The semiotic approach proceeds from the (...) fact that human lives in the world of signs, all the surrounding reality can be interpreted as a sign system. The basic concept of semiotics is the concept of a sign. The theoretical basis of the article is understanding the culture as a sign-symbolic system. Laughter is considered as a phenomenon ontologically rooted in human culture. At the same time, laughter is on the edge of culture. The research is based on the work of semiotic authors, cultural researchers, and the researchers of laughter. Originality. The originality lies in the application of the semiotic method to the research of laughter phenomenon, consideration of the dialectics of natural and cultural, signedness and non-signedness, manifested in the phenomenon of laughter. Conclusions. Laughter is considered as a psychophysiological phenomenon and as a cultural phenomenon. Laughter acts as an emotional manifestation, a physiological reaction, but socially and culturally mediated. In any case, laughter indicates an emotional or cognitive state of a human. Laughter acts as a process and result of the interpretation of a sign, a reaction to a sign. Laughter is a form and a means of communication. Being a natural phenomenon, in the process of social evolution, laughter acquires signedness, is integrated by culture as a sign system, and, at the same time, maintains a connection with nature. Thus, laughter occupies an ambivalent position between nature and culture. In the phenomenon of laughter, the dual state of human is revealed. In laughter, boundaries are blurred, the unity and opposition of natural and cultural, biological and social, soul and body, thought and feeling, sign and attribute are manifested. (shrink)

Eco-labels emphasize information disclosure as a tool to induce environmentally friendly behaviors by both firms and consumers. The goal of eco-labels is to reduce information asymmetry between producers and consumers over the environmental attributes of a product or service. However, by focusing on this information asymmetry, rather than on how the label meets consumer needs, eco-labels may send irrelevant, confusing, or even detrimental messages to consumers. In this article, the authors investigate how the environmental signal of eco-labels interacts with product (...) characteristics such as brand, quality, and price. In a discrete choice experiment, the authors examine consumer response to two similar eco-labels for wine, one associated with a quality reduction and the other not. The results show that respondents preferred both eco-labeled wines over otherwise identical conventional counterparts when the price was lower and the wine was from a lower quality region. However, they preferred conventional, more expensive wine from a high-quality region. This preference indicates that respondents not only obtain some warm glow value from eco-labeled wine but also possibly interpret eco-labeling as a signal of lower quality. This relationship held across both types of eco-labels, meaning that consumers did not understand the difference between them. This research contributes to the literature on information disclosure policies by highlighting important elements for effective eco-labels. These elements include consumer awareness and understanding of the eco-label, and consumer willingness to pay for an eco-labeled product. The results emphasize the need to create eco-labels that communicate clearly both the environmental attributes and the private benefits associated with them. (shrink)

We are immersed within an odorous sea of chemical currents that we parse into individual odors with complex structures. Odors have been posited as determined by the structural relation between the molecules that compose the chemical compounds and their interactions with the receptor site. But, naturally occurring smells are parsed from gaseous odor plumes. To give a comprehensive account of the nature of odors the chemosciences must account for these large distributed entities as well. We offer a focused review of (...) what is known about the perception of odor plumes for olfactory navigation and tracking, which we then connect to what is known about the role odorants play as properties of the plume in determining odor identity with respect to odor quality. We end by motivating our central claim that more research needs to be conducted on the role that odorants play within the odor plume in determining odor identity. (shrink)

This book completes medical care by adding the comprehensive humanistic perspectives and philosophy of medicine.

Purpose. To consider the uniqueness of Descartes’ way of interpreting poetry as a type of philosophizing that makes it possible to comprehend the metaphysical nature of man. Its implementation involves the consistent solution of the following tasks: a) understanding methodological changes in the philosophy of the 20th century in the process of actualization of anthropological interest; b) argumentation of the importance of poetic thinking for early Descartes in the process of addressing modern historians of philosophy and the thinker’s texts. Theoretical (...) basis. I rely on the conceptual positions of phenomenology, existentialism and hermeneutics. Originality. Finding of the study is that poetic thinking is the most authentic way of meaningful comprehension of the metaphysicity of man. The paper outlines the nature of the expression of this correlation in the philosophizing of the 20th-21th centuries and substantiates the thesis about the importance of the poetic principle for understanding the phenomenon of man in early works by Descartes. Conclusions. The paper examined the methodological shifts in anthropologically oriented philosophizing of the 20th-21th centuries and focused on the manifestations of related moments in the philosophical legacy of Descartes. The latter demonstrates the existence of a still underestimated version of interpreting the metaphysical foundations of human existence, the form of understanding of which is poetic thinking. It is a form of caring for the humane in man. (shrink)