Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action (...) to address variation in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)

The recently published Guidelines on Disorders of Consciousness by the European Academy of Neurology and by the American Academy of Neurology in collaboration with the American Congress of Rehabilitation Medicine and the National Institute on Disability, Independent Living, and Rehabilitation Research stand as the most ambitious international attempts to provide clear and standardized recommendations to clinicians working with patients with DoCs. They offer an updated, timely, and wide-ranging list of recommendations for the diagnosis, prognosis, (...) and clinical care of affected patients. However, while commendable, the guidelines pose a number of questions including some related to the practical implementation of their recommendations. The paper introduces the Distributed Responsibility Model as a tool for maximizing the impact of recommendations in clinical practice. (shrink)

In this essay, I focus on the initial reaction of the then leadership of the Academy of Management to President Trump’s travel ban issued in January 2017. By viewing the travel ban in purely administrative terms, AOM leadership framed it as an example of “political speech”, on which they were organizationally barred to take a public stand. I subject this view to critical assessment, arguing that the travel ban had a distinct moral character, which was antithetical to scholarly values. (...) Τhe travel ban, I suggest, should be viewed as a non-prototypical case of political speech, which required AOM leadership to flexibly adapt existing rules in situ: to imaginatively frame the travel ban in order to undertake responsible action. Accordingly, the early 2017 AOM rules about political speech should be seen not as recipes-for-action but as reminders-for-action, thus allowing an imaginative reframing. Finally, exploring the notion of moral imagination, I distinguish between “disclosive” and “incremental” moral imagination and responsibility, and suggest that AOM leadership engaged mainly in the latter. (shrink)

This notice serves to identify and correct the following inaccuracies in article Tsoukas Leadership, the Academy of Management, and President Trump’s Travel Ban: A Case Study in Moral Imagination published online on 26 July 2018.

We critically evaluate arguments in a recent Journal of Law, Medicine & Ethics article by Svoboda, Adler, and Van Howe disputing the 2012 affirmative infant male circumcision policy recommendations of the American Academy of Pediatrics. We provide detailed evidence in explaining why the extensive claims by these opponents are not supported by the current strong scientific evidence. We furthermore show why their legal and ethical arguments are contradicted by a reasonable interpretation of current U.S. and international law and (...) ethics. After all considerations are taken into account it would be logical to conclude that failure to recommend male circumcision early in infancy may be viewed as akin to failure to recommend childhood vaccination to parents. In each case, parental consent is required and the intervention is not compulsory. Our evaluation leads us to dismiss the arguments by Svoboda et al. Instead, based on the evidence, infant male circumcision is both ethical and lawful. (shrink)

(1994). Annex: The survey questionnaires. World Futures: Vol. 39, The Evolution of European Identity: Surveys of the Growing Edge A Report by the European Culture Impact Research Consortium (EUROCIRCON), pp. 161-164.

With a few exceptions all the essays in this issue of Daedalus are biographies of world intellectual and political leaders. Erik Erikson's "psycho-historical" examination of Gandhi is followed by sketches of Nkrumah, Ataturk, de Gaulle, Bismarck, Andrew Johnson, Newton, James Mill, and William James. There are three exceptions to the biographical motif: 1) an essay on charisma which, although it does not go much beyond Weber, does offer a concise anatomy of the various dimensions of this slippery category which is (...) an underlying theme throughout many of the biographies; 2) a short essay proposing that obstacles to change in underdeveloped countries are connected with obstacles to the perception of change; and 3) an essay which examines the relation of the American intellectual-academic community to government during the first half of this century. Dankwart Rustow's introductory essay consists of "scattered remarks" on various methodologies for the exploration of the anatomy of leadership. His organizing themes are leadership as communication, leadership as learning process, and leadership as sense of timing.--S. O. H. (shrink)

With a few exceptions all the essays in this issue of Daedalus are biographies of world intellectual and political leaders. Erik Erikson's "psycho-historical" examination of Gandhi is followed by sketches of Nkrumah, Ataturk, de Gaulle, Bismarck, Andrew Johnson, Newton, James Mill, and William James. There are three exceptions to the biographical motif: 1) an essay on charisma which, although it does not go much beyond Weber, does offer a concise anatomy of the various dimensions of this slippery category which is (...) an underlying theme throughout many of the biographies; 2) a short essay proposing that obstacles to change in underdeveloped countries are connected with obstacles to the perception of change; and 3) an essay which examines the relation of the American intellectual-academic community to government during the first half of this century. Dankwart Rustow's introductory essay consists of "scattered remarks" on various methodologies for the exploration of the anatomy of leadership. His organizing themes are leadership as communication, leadership as learning process, and leadership as sense of timing.--S. O. H. (shrink)

At its January 2017 meeting, the Executive Committee of the Peirce Society decided to plan a panel on "Charles S. Peirce and the Study of Religion" for the American Academy of Religion Annual Meeting in November, 2017, in Boston. The AAR accepted our proposal as a special meeting and I had the privilege of organizing and chairing it. We are pleased that the panel of papers will be published as a group in The Transactions of the Charles S. (...) Peirce Society.Michael L. Raposa's paper, "On Reading God's Great Poem: A Delayed Response to Christopher Hookway," picks up a long debate about the extent to which Peirce's late "Neglected Argument for the Reality of God" is continuous or discontinuous with his early work.Brandon... (shrink)

With a view to addressing the moral concerns about the use of donor siblings, the Policy Statement of the American Academy of Pediatrics - Children as Hematopoietic Stem Cell Donors (the Policy) has laid out the criteria upon which tissue harvest from a minor would be permissible.

This chapter reviews fundamental ethical controversy surrounding the ongoing effort to revise the Uniform Determination of Death Act in the United States. Instead of focusing on the process of the revision itself, the chapter explores the underlying ethical debate over brain death that has been ongoing for many decades and finally culminated in this revision. Three issues are focused: the requirement for consent and personal exemptions before applying brain death for the diagnosis of death; redefining the areas of the brain (...) that have ceased to function in the definition of brain death; and codifying the American Academy of Neurology as the authority to issue the standards of the diagnosis of brain death. The chapter concludes that allowing the personal choice of death determination gives a pragmatic compromise to the disputed definition and practice of diagnosing brain death. So long as all risks and imperfections of the diagnosis are accepted through the consenting process, there is nothing ethically objectionable to continuing the current practice of diagnosing brain death as a successful tool to facilitate heart-beating organ donation without violating the dead-donor rule. By contrast, precluding personal choice and imposing legal restrictions to consent and exemptions would further erode public trust. (shrink)

On January 5, 2019, the Associated Press reported that a woman thought to have been in the vegetative state for over a decade gave birth at a Hacienda HealthCare facility. Until she delivered, the staff at the Phoenix center had not noticed that their patient was pregnant. The patient was also misdiagnosed.Misdiagnosis of patients with disorders of consciousness in institutional settings is more the norm than the exception. Misdiagnosis is also connected to a broad and extremely significant change in the (...) understanding of the vegetative state—a change that the field of bioethics has not yet fully taken into account. In September 2018, the American Academy of Neurology, the American College of Rehabilitation Medicine, and the National Institute on Disability, Independent Living, and Rehabilitation Research issued a comprehensive evidence‐based review on disorders of consciousness and an associated practice guideline on the care of these patients. These landmark publications update the 1994 Multi‐Society Task Force Report on the Vegetative State, which subcategorized the persistent vegetative state as either persistent (once the vegetative state lasted one month) or permanent (once the vegetative state lasted three months after anoxic injury or twelve months after traumatic injury). Noting that 20 percent of patients thought to be permanently unconscious might regain some level of consciousness, the new guideline has eliminated the permanent vegetative state as a diagnostic category, replacing it with the chronic vegetative state. (shrink)

Abstract:This paper, presented as the 2019 Cambridge Quarterly Neuroethics NetworkCharcot Lecture, traces the nosology of disorders of consciousness in light of 2018 practice guidelines promulgated by the American Academy of Neurology, the American College of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research. By exploring the ancient origins of Jennett and Plum’s persistent vegetative state and subsequent refinements in the classification of disorders of consciousness—epitomized by the minimally conscious state, cognitive motor (...) dissociation, and the recently described chronic vegetative state—the author argues that there is a counter-narrative to the one linking these conditions to the right to die. Instead, there is a more nuanced schema distinguishing futility from utility, informed by technical advances now able to identify covert consciousness contemplated by Jennett and Plum. Their prescience foreshadows recent developments in the disorders of consciousness literature yielding a layered legacy with implications for society’s normative and legal obligations to these patients. (shrink)

As the first President of the Royal Academy of Arts, Joshua Reynolds played a pivotal role in shaping the course of British art in the 18th century. In these discourses, Reynolds reflects on the nature of art, the role of the artist, and the importance of aesthetic education. With insightful commentary on the works of the Old Masters and a wealth of practical advice for aspiring artists, this volume is a must-read for anyone interested in the history of art (...) or art theory. This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This text addresses the problems of complex systems in understanding natural phenomena and the behaviour of systems related to human activity, from a science and humanities perspective. It discusses molecular behaviour and structures, and offers examples of ecological and environmental modelling.

In lieu of an abstract, here is a brief excerpt of the content:Demystifying the Mystery of Alzheimer's as Late, No Longer Mild Cognitive ImpairmentPeter J. Whitehouse (bio)Keywordsaging, Alzheimer’s disease, deconstruction, mild cognitive impairmentProfessor Tom Kirkwood and Michael Bavidge's comments are welcome additions to our discourse as both emphasize the importance of considering mild cognitive impairment (MCI) and Alzheimer's disease (AD) in relationship to the normal biological and cultural processes of aging. Whereas I agree with my colleague and co-author, Atwood Gaines' (...) response, I wish to add my own commentary to update the reader concerning the dynamic political processes at work in the social construction and deconstruction of MCI and AD. I have referred to MCI as autodeconstructing AD because whatever we come to think of the MCI label on the spectrum of cognitive aging should alter our beliefs about the ultimate utility of the concept of AD. Tensions in the field of study of MCI have increased since the project reported in this journal began. The social science and philosophical contributions toward understanding MCI need to inform our debate now; otherwise, we will be less effective at influencing a critical debate for society about its relationships to medicine, science, and modern capitalism.This past year, Ron Petersen, the major proponent of the concept of MCI was awarded the prestigious Potamkin Prize for research in Alzheimer's disease by the American Academy of Neurology. The National Institute on Aging (NIA) placed the discovery of MCI as first on the list of contributions during twenty years of research funded through hundreds of millions of dollars poured into the NIA Alzheimer's Research Centers. Some have even suggested that we relabel MCI of the amnestic type, Petersen syndrome. Yet, John Morris, who was co-awarded the Potamkin Prize, has continued to write that MCI is early AD and most recently has suggested (Morris 2006) that we should revise our diagnostic criteria. He joins me and a growing list of other so-called thought leaders who believe (but do not always state publicly) that the term MCI is not useful clinically. Lon Schneider (2005) has recently joined the camp of critics publicly by suggesting that MCI is [End Page 87] not only confusing clinically but is now possibly retarding research.The proliferation of different kinds of MCI indicates that we are studying heterogeneous processes of brain aging. Whereas, John Morris suggests that we relabel MCI as early AD, I have suggested the converse. For example, in a grand rounds lecture at Johns Hopkins in March 2004, I used the lecture title "LNLMCI (late no longer MCI)" as a synonym for AD.Kirkwood is right to compare the quest for biological therapy for AD to the search to treat aging processes in other organs. He has been an outspoken critic of anti-aging medicine quackery that claims that aging itself is a disease that can be reversed today. But, if AD is brain aging, are we not in fact creating a "disease" category that raises false hopes and expectations?Kirkwood also points out that aging is a lifespan process. To prevent dementia in older individuals, we should prevent damage to neurons in younger individuals. Recently, it has been claimed, for example, that exposure to lead in young animals makes these animals more at risk for amyloid deposition in later life (Basha et al. 2005). Whether or not lead directly affects the pathogenesis of AD, it seems eminently reasonable to try to prevent damage to neurons in young children so that they may have maximum cognitive capacity throughout their lifespan.Almost ten years ago, when I stepped down as the editor of the Alzheimer's Disease and Associated Disorders Journal and as John Morris took over this responsibility, I wrote an editorial calling for the end of AD (Whitehouse 2001). In other words, I argued that thinking through the invention of the term mild cognitive impairment reveals that we are attempting to assign medical categories to what are a heterogeneous set of processes that affect our brains as we age. At the hundredth anniversary of the first case of what we have come to call Alzheimer's disease, perhaps it is time to reflect on the individual and social... (shrink)