It is often assumed that engaging in a one‐on‐one dialogue with a tutor is more effective than listening to a lecture or reading a text. Although earlier experiments have not always supported this hypothesis, this may be due in part to allowing the tutors to cover different content than the noninteractive instruction. In 7 experiments, we tested the interaction hypothesis under the constraint that (a) all students covered the same content during instruction, (b) the task domain was qualitative physics, (c) (...) the instruction was in natural language as opposed to mathematical or other formal languages, and (d) the instruction conformed with a widely observed pattern in human tutoring: Graesser, Person, and Magliano's 5‐step frame. In the experiments, we compared 2 kinds of human tutoring (spoken and computer mediated) with 2 kinds of natural‐language‐based computer tutoring (Why2‐Atlas and Why2‐AutoTutor) and 3 control conditions that involved studying texts. The results depended on whether the students' preparation matched the content of the instruction. When novices (students who had not taken college physics) studied content that was written for intermediates (students who had taken college physics), then tutorial dialogue was reliably more beneficial than less interactive instruction, with large effect sizes. When novices studied material written for novices or intermediates studied material written for intermediates, then tutorial dialogue was not reliably more effective than the text‐based control conditions. (shrink)

It is often assumed that engaging in a one‐on‐one dialogue with a tutor is more effective than listening to a lecture or reading a text. Although earlier experiments have not always supported this hypothesis, this may be due in part to allowing the tutors to cover different content than the noninteractive instruction. In 7 experiments, we tested the interaction hypothesis under the constraint that (a) all students covered the same content during instruction, (b) the task domain was qualitative physics, (c) (...) the instruction was in natural language as opposed to mathematical or other formal languages, and (d) the instruction conformed with a widely observed pattern in human tutoring: Graesser, Person, and Magliano's 5‐step frame. In the experiments, we compared 2 kinds of human tutoring (spoken and computer mediated) with 2 kinds of natural‐language‐based computer tutoring (Why2‐Atlas and Why2‐AutoTutor) and 3 control conditions that involved studying texts. The results depended on whether the students' preparation matched the content of the instruction. When novices (students who had not taken college physics) studied content that was written for intermediates (students who had taken college physics), then tutorial dialogue was reliably more beneficial than less interactive instruction, with large effect sizes. When novices studied material written for novices or intermediates studied material written for intermediates, then tutorial dialogue was not reliably more effective than the text‐based control conditions. (shrink)

New techniques for the genetic modification of organisms are creating new strategies for addressing persistent public health challenges. For example, the company Oxitec has conducted field trials internationally—and has attempted to conduct field trials in the United States—of a genetically modified mosquito that can be used to control dengue, Zika, and some other mosquito-borne diseases. In 2016, a report commissioned by the National Academies of Sciences, Engineering, and Medicine discussed the potential benefits and risks of another strategy, using gene drives. (...) Driving a desired genotype through a population of wild animals or insects could lead to irreversible genetic modification of an entire species. The NASEM report recommends community, stakeholder, and public engagement about potential uses of the technology, and it argues that the engagement should occur as research advances, well before gene drives are deployed. Yet what “engagement” means in practice is unclear. This article seeks clarity on this problem by offering a justification for community engagement and drawing out implications of this argument for the implementation and desired outcomes of community engagement. Community engagement is essential when it comes to research that would release genetically modified insects or animals into the environment. By contrast, obtaining informed consent from people who live near such a proposed field trial is neither necessary nor sufficient. Drawing on the epistemic and moral arguments for deliberative democracy, I propose two discrete mechanisms of community engagement: community advisory boards and deliberative forums, neither of which has been systematically incorporated into research governance. The proposed mechanisms would engender respect for persons who live near field trials, even when the results of deliberation override some individuals’ preferences. Community engagement foregrounds the community in our thinking about humans’ relationship to nature, and it implies that deciding to release genetically modified insects or animals into the wild ought to be a collective decision, not one made by product developers, policy-makers, private companies, research funders, or scientists alone. (shrink)

In this paper, I interrogate an ethical obligation to participate in genomics research on the basis of solidarity. I explore two different ways in which solidarity is used to motivate participation in genomics research: as an appeal to participate in genomic research because it cultivates solidarity and as an appeal to participate in genomic research because it expresses solidarity. I critique those appeals and draw lessons from them for how we ought to understand solidarity. The working definition of solidarity that (...) I defend is that solidarity involves recognizing another creature, person, or persons as, like ourselves, vulnerable to injustice and entails acting in ways that contribute to creating, reforming, and participating in institutions that are aimed at enhancing their flourishing. I argue that participating in genomics research is not an expression of solidarity. Participation in research may be praiseworthy, a “good thing to do,” but actually cultivating and expressing solidarity requires much more of us. (shrink)

Recent reports and papers on chimeric research highlight the promise of chimeric models of human neuropsychiatric disorders to ameliorate human suffering due to autism spectrum disorders, depression, and schizophrenia. These calls, however, typically do not acknowledge, much less address, criticisms of model creation and validation, or concerns about scientific conduct more generally. The ethical justification for the use of nonhuman animals in research depends on the production of benefits to humans based on such research. But the assessment and production of (...) benefits are highly uncertain and rife with both practical and conceptual challenges. This essay provides a general framework for classifying the benefits of biomedical research and then focuses on two factors that directly impact—and threaten—the production of knowledge in research that models neuropsychiatric disorders. (shrink)

Non-human animal models of human diseases advance our knowledge of the genetic underpinnings of disease and lead to the development of novel therapies for humans. While mice are the most common model organisms, their usefulness is limited. Larger animals may provide more accurate and valuable disease models, but it has, until recently, been challenging to create large animal disease models. Genome editors, such as Clustered Randomised Interspersed Palindromic Repeat, meet some of these challenges and bring routine genome engineering of larger (...) animals and non-human primates well within reach. There is growing interest in creating NHP models of brain disorders such as autism, depression and Alzheimer’s, which are very difficult to model or study in other organisms, including humans. New treatments are desperately needed for this set of disorders. This paper is novel in asking: Insofar as NHPs are being considered for use as model organisms for brain disorders, can this be done ethically? The paper concludes that it cannot. Notwithstanding ongoing debate about NHPs’ moral status, animal welfare concerns, the availability of alternative methods of studying brain disorders and unmet expectations of benefit justify a stop on the creation of NHP model organisms to study brain disorders. The lure of using new genetic technologies combined with the promise of novel therapeutics presents a formidable challenge to those who call for slow, careful, and only necessary research involving NHPs. But researchers should not create macaques with social deficits or capuchin monkeys with memory deficits just because they can. (shrink)

Founded on a commitment to social justice and health equity, community health centers in the United States provide high‐quality primary care to underserved populations and address social drivers of health disparities. Through an examination of two books on the history of community health centers, Peace & Health: How a Group of Small‐Town Activists and College Students Set Out to Change Healthcare, by Charles Barber, and Community Health Centers: A Movement and the People Who Made It Happen, by Bonnie Lefkowitz, this (...) essay provides insight into what it takes to center social justice in community‐based health care organizations. As bioethics reorganizes itself around an emphasis on justice, scholars in bioethics have much to learn from colleagues in community health. (shrink)

What kind of world do we want to live in? It’s rare that we ask this question of ourselves, and even rarer that we get to do so with others. In Altered Inheritance: CRISPR and the Ethics of Human Genome Editing, Francoise Baylis encourages us to keep this question in the forefront of our minds as we think about whether, when, or how to edit the human genome. She is neither an “enthusiastic proponent nor a staunch opponent” of heritable human (...) genome editing. She is, however, very clear that the ethics of human genome editing is not the domain of scientists, ethicists, or elites. Her thesis is that all of us must think together about what our collective future should look like, and then consider whether and how... (shrink)

This August, I participated in the conference “Genome Editing: Biomedical and Ethical Perspectives,” hosted by the Center for the Study of Bioethics at the University of Belgrade and cosponsored by the Division of Medical Ethics of NYU Langone Health and The Hastings Center. The prime minister of Serbia, Ana Brnabić, spoke of the significance of bringing together an international community of bioethicists, acknowledging that ethical, social, and legal issues surrounding gene editing technologies transcend national boundaries. Europe's Oviedo Convention prohibits human (...) germline gene editing, and UNESCO's Universal Declaration on the Human Genome and Human Rights says that germline editing “could be contrary to human dignity,” an assault on humanity itself. Whether one agrees or not, engaging with the idea forces us to think about what it means to be part of the global human community and about the moral significance of the human genome to creating that community. The conference highlighted for me how challenging having international, much less global, conversations about bioethics can be. (shrink)

When President Obama laid out his vision for the U.S. Precision Medicine Initiative in a 2016 Boston Globe op‐ed, he cautioned, “[I]t only works if we collect enough information first.” “Collecting information” is an apt way to describe the subject of both books reviewed here. Jenny Reardon's The Postgenomic Condition: Ethics, Justice, and Knowledge after the Genome traces the history of the Human Genome Project and efforts around the globe to obtain blood samples to extract not only genetic data but (...) also meaning from them. Barbara Prainsack's Personalized Medicine: Empowered Patients in the 21st Century? concerns the capture of digital, quantifiable, and computable information about nearly all aspects of people's lives in the pursuit of personalized medicine. Reardon and Prainsack critique scientists’ and corporations’ appeals to liberal democracy, justice, and empowerment to collect more and more information about people. They reveal the limitations and frequent superficiality of those appeals and remind us that person‐centric ethics rather than data‐centric research is needed to realize a more democratic, just, and empowered society. (shrink)

In “Obligations of the Gift,” Lee argues that ethical thinking regarding return of genetic research results has been too narrowly focused on individual consent and participants’ “right to kn...

Among the results of this paper are the following: 1. Every Boolean (ultra) power is the union of an updirected elementary family of direct ultrapowers. 2. Under certain conditions, a finitely iterated Boolean ultrapower is isomorphic to a single Boolean ultrapower. 3. A ω-bounded filtral power is an elementary substructure of a filtral power. 4. Let K be an elementary class closed under updirected unions (e.g., if K is an amalgamation class); then K is closed under finite products if and (...) only if K is closed under reduced products if and only if K is a Horn class. (shrink)

Among the results of this paper are the following: 1. Every Boolean power is the union of an updirected elementary family of direct ultrapowers. 2. Under certain conditions, a finitely iterated Boolean ultrapower is isomorphic to a single Boolean ultrapower. 3. A $\omega$-bounded filtral power is an elementary substructure of a filtral power. 4. Let $\mathscr{K}$ be an elementary class closed under updirected unions ; then $\mathscr{K}$ is closed under finite products if and only if $\mathscr{K}$ is closed under reduced (...) products if and only if $\mathscr{K}$ is a Horn class. (shrink)

Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to (...) explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to (...) explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed. (shrink)

This article provides current Schwartz Values Survey (SVS) data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societal-level analyses. At the individual-level, we report on the ten circumplex values sub-dimensions and two sets of values dimensions (collectivism and individualism; openness to change, conservation, self-enhancement, and self-transcendence). At the societal-level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective (...) autonomy, intellectual autonomy, egalitarianism, and harmony. For each society, we report the Cronbach’s α statistics for each values dimension scale to assess their internal consistency (reliability) as well as report interrater agreement (IRA) analyses to assess the acceptability of using aggregated individual level values scores to represent country values. We also examined whether societal development level is related to systematic variation in the measurement and importance of values. Thus, the contributions of our evaluation of the SVS values dimensions are two-fold. First, we identify the SVS dimensions that have cross-culturally internally reliable structures and within-society agreement for business professionals. Second, we report the society cultural values scores developed from the twenty-first century data that can be used as macro-level predictors in multilevel and single-level international business research. (shrink)

The view that phenomenally conscious robots are on the horizon often rests on a certain philosophical view about consciousness, one we call “nomological behaviorism.” The view entails that, as a matter of nomological necessity, if a robot had exactly the same patterns of dispositions to peripheral behavior as a phenomenally conscious being, then the robot would be phenomenally conscious; indeed it would have all and only the states of phenomenal consciousness that the phenomenally conscious being in question has. We experimentally (...) investigate whether the folk think that certain (hypothetical) robots made of silicon and steel would have the same conscious states as certain familiar biological beings with the same patterns of dispositions to peripheral behavior as the robots. Our findings provide evidence that the folk largely reject the view that silicon-based robots would have the sensations that they, the folk, attribute to the biological beings in question. (shrink)

:In a recent paper in Cambridge Quarterly of Healthcare Ethics on the necessary conditions for morally responsible animal research David DeGrazia and Jeff Sebo claim that the key requirements for morally responsible animal research are an assertion of sufficient net benefit, a worthwhile-life condition, and a no-unnecessary-harm condition. With regards to the assertion of sufficient net benefit, the authors claim that morally responsible research offers unique benefits to humans that outweigh the costs and harms to humans and animals. In this (...) commentary we will raise epistemic, practical, and ethical challenges to DeGrazia and Sebo’s emphasis on benefits in the prospective assessment of research studies involving animals. We do not disagree with DeGrazia and Sebo that, at the theoretical level, the benefits of research justify our using animals. Our contribution intends to clarify, at the practical level, how we should understand benefits in the prospective assessment and moral justification of animal research. We argue that ASNB should be understood as an assessment of Expectation of Knowledge Production in the prospective assessment and justification of animal research. EKP breaks down into two further claims: that morally responsible research generates knowledge worth having and that morally responsible research is designed and executed to produce generalizable knowledge. We understand the condition called knowledge worth having as scientists’ testing a hypothesis that, whether verified or falsified, advances an important interest, and production of generalizable knowledge in terms of scientific integrity. Generalizable knowledge refers to experimental results that generalize to a larger population beyond the animals studied. Generalizable scientific knowledge is reliable, replicable, and accurately descriptive. In sum, morally responsible research will be designed and carefully executed to successfully test a hypothesis that, whether verified or falsified, advances important interests. Our formulation of EKP, crucially, does not require further showing that an experiment involving animals will produce societal benefits. (shrink)

The Rudin-Keisler ordering of ultrafilters is extended to complete Boolean algebras and characterised in terms of elementary embeddings of Boolean ultrapowers. The result is applied to show that the Rudin-Keisler poset of some atomless complete Boolean algebras is nontrivial.

This article provides current Schwartz Values Survey data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societallevel analyses. At the individual- level, we report on the ten circumplex values sub- dimensions and two sets of values dimensions. At the societal- level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective autonomy, intellectual autonomy, egalitarianism, and harmony. For each (...) society, we report the Cronbach' s? statistics for each values dimension scale to assess their internal consistency as well as report interrater agreement analyses to assess the acceptability of using aggregated individual level values scores to represent country span sp. (shrink)

The release of genetically engineered organisms into the shared environment raises scientific, ethical, and societal issues. Using some form of democratic deliberation to provide the public with a voice on the policies that govern these technologies is important, but there has not been enough attention to how we should connect public deliberation to the existing regulatory process. Drawing on lessons from previous public deliberative efforts by U.S. federal agencies, we identify several practical issues that will need to be addressed if (...) relevant federal agencies are to undertake public deliberative activities to inform decision‐making about gene editing in the wild. We argue that, while agencies may have institutional capacity to undertake public deliberative activities, there may not be sufficient political support for them to do so. Advocates of public deliberation need to make a stronger case to Congress about why federal agencies should be encouraged and supported to conduct public deliberations. (shrink)

This article is the lead piece in a special report that presents the results of a bioethical investigation into chimeric research, which involves the insertion of human cells into nonhuman animals and nonhuman animal embryos, including into their brains. Rapid scientific developments in this field may advance knowledge and could lead to new therapies for humans. They also reveal the conceptual, ethical, and procedural limitations of existing ethics guidance for human‐nonhuman chimeric research. Led by bioethics researchers working closely with an (...) interdisciplinary work group, the investigation focused on generating conceptual clarity and identifying improvements to governance approaches, with the goal of helping scholars, funders, scientists, institutional leaders, and oversight bodies (embryonic stem cell research oversight [ESCRO] committees and institutional animal care and use committees [IACUCs]) deliver principled and trustworthy oversight of this area of science. The article, which focuses on human‐nonhuman animal chimeric research that is stem cell based, identifies key ethical issues in and offers ten recommendations regarding the ethics and oversight of this research. Turning from bioethics’ previous focus on human‐centered questions about the ethics of “humanization” and this research's potential impact on concepts like human dignity, this article emphasizes the importance of nonhuman animal welfare concerns in chimeric research and argues for less‐siloed governance and oversight and more‐comprehensive public communication. (shrink)

This essay introduces a special report from The Hastings Center entitled Democracy in Crisis: Civic Learning and the Reconstruction of Common Purpose, which grew out of a project supported by the John S. and James L. Knight Foundation. This multiauthored report offers wide‐ranging assessments of increasing polarization and partisanship in American government and politics, and it proposes constructive responses to this in the provision of objective information, institutional reforms in government and the electoral system, and a reexamination of cultural and (...) political values needed if democracy is to function well in a pluralistic and diverse society. The essays in the special report explore the norms of civic learning and institutions, social movements, and communal innovations that can revitalize civic learning in practice. This introductory essay defines and explains the notion of civic learning, which is a lynchpin connecting many of the essays in the report. Civic learning pertains to the ways in which citizens learn about collective social problems and make decisions about them that reflect the duties and responsibilities of citizenship. Such learning can occur in many social settings in everyday life, and it can also be facilitated through participation in the processes of democratic governance on many levels. Civic learning is not doctrinaire and is compatible with a range of public goals and policies. It is an activity that increases what might be called the democratic capability of a people. (shrink)

Harms and risks to groups and third-parties can be significant in the context of research, particularly in data-centric studies involving genomic, artificial intelligence, and/or machine learning technologies. This article explores whether and how United States federal regulations should be adapted to better align with current ethical thinking and protect group interests. Three aspects of the Common Rule deserve attention and reconsideration with respect to group interests: institutional review board (IRB) assessment of the risks/benefits of research; disclosure requirements in the informed (...) consent process; and criteria for waivers of informed consent. In accordance with respect for persons and communities, investigators and IRBs should systematically consider potential group harm when designing and reviewing protocols, respectively. Research participants should be informed about any potential group harm in the consent process. We call for additional public discussion, empirical research, and normative analysis on these issues to determine the right regulatory and policy path forward. (shrink)

It is often assumed that engaging in a one‐on‐one dialogue with a tutor is more effective than listening to a lecture or reading a text. Although earlier experiments have not always supported this hypothesis, this may be due in part to allowing the tutors to cover different content than the noninteractive instruction. In 7 experiments, we tested the interaction hypothesis under the constraint that (a) all students covered the same content during instruction, (b) the task domain was qualitative physics, (c) (...) the instruction was in natural language as opposed to mathematical or other formal languages, and (d) the instruction conformed with a widely observed pattern in human tutoring: Graesser, Person, and Magliano's 5‐step frame. In the experiments, we compared 2 kinds of human tutoring (spoken and computer mediated) with 2 kinds of natural‐language‐based computer tutoring (Why2‐Atlas and Why2‐AutoTutor) and 3 control conditions that involved studying texts. The results depended on whether the students' preparation matched the content of the instruction. When novices (students who had not taken college physics) studied content that was written for intermediates (students who had taken college physics), then tutorial dialogue was reliably more beneficial than less interactive instruction, with large effect sizes. When novices studied material written for novices or intermediates studied material written for intermediates, then tutorial dialogue was not reliably more effective than the text‐based control conditions. (shrink)

Recent research indicates that compensation structure can be used by firms to discourage their employees from whistleblowing. We extend the ethics literature by examining how compensation structures and financial rewards work together to influence managers’ decisions to blow the whistle. Results from an experiment indicate that compensation with restricted stock, relative to stock payments that lack restrictions, can enhance the likelihood that managers will blow the whistle when large rewards are available. However, restricted stock can also threaten the effectiveness of (...) whistleblowing systems without the presence of large financial rewards for whistleblowing. Thus, the large potential rewards for whistleblowing enacted by the Dodd–Frank Act appear timely as firms are moving toward compensation agreements that include greater proportions of restricted stock. (shrink)

This paper employs theory of normal organizational wrongdoing and investigates the joint effects of management tone and the slippery slope on financial reporting misbehavior. In Study 1, we investigate assumptions about the effects of sliding down the slippery slope and tone at the top on financial executives’ decisions to misreport earnings. Results of Study 1 indicate that executives are willing to engage in misreporting behavior when there is a positive tone set by the Chief Financial Officer, regardless of the presence (...) or absence of a slippery slope. A negative tone set by the CFO does not facilitate the transition from minor indiscretions to financial misreporting. In Study 2, we find that auditors evaluating executives’ decisions under the same conditions as those in Study 1 do not react to the slippery slope condition, but auditors assess higher risks of fraud when the CFO sets a negative tone. Overall, our results indicate that many assumptions about the slippery slope and tone at the top should be questioned. We provide evidence that pro-organizational behaviors and incrementalism yield new insights into the causes of ethical failures, financial misreporting behavior, and failures of corporate governance mechanisms. (shrink)

In this paper I demonstrate that theories which postulate a strict tree structure of discourse on either the intentional or attentional level are not totally adequate for handling spontaneous dialogues. I use as..

La autoetnografía es un enfoque de investigación y escritura que busca describir y analizar sistemáticamente la experiencia personal con el fin de comprender la experiencia cultural. Esta aproximación desafía las formas canónicas de hacer investigación y de representar a los otros, a la vez que considera a la investigación como un acto político, socialmente justo y socialmente consciente. Para hacer y escribir autoetnografía, el investigador aplica los principios de la autobiografía y de la etnografía. Así, como método, la autoetnografía es, (...) a la vez, proceso y producto. (shrink)

The term "false memories" has been used to refer to suggestibility experiments in which whole events are apparently confabulated and in media accounts of contested memories of childhood abuse. Since 1992 psychologists have increasingly used the term "false memory" when discussing memory errors for details, such as specific words within word lists. Use of the term to refer to errors in details is a shift in language away from other terms used historically (e.g., "memory intrusions"). We empirically examine this shift (...) in language and discuss implications of the new use of the term "false memories." Use of the term presents serious ethical challenges to the data-interpretation process by encouraging over-generalization and misapplication of research findings on word memory to social issues. (shrink)

Lukas J. Meier et al. offer the promise of a pathway for resolving clinical bioethical problems using an artificial intelligence interface. The ultimate goal, we assume, is...

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called (...) early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

Before there was the digital divide there was the analog divide– and universal service was the attempt to close that analogdivide. Universal service is becoming ever more complex in terms ofregulatory design as it becomes the digital divide. In order to evaluatethe promise of the next generation Internet with respect to the digitaldivide this work looks backwards as well as forwards in time. Byevaluating why previous universal service mechanisms failed andsucceeded this work identifies specific characteristics ofcommunications systems – in particular (...) in billing and managinguncertainty – and argues that these characteristics underliesuccess or failure in terms of technological ubiquity. Developing a setof characteristics of services rather than a set of services is afundamental break with the tradition of universal service. In fact, theimplications of our proposal is that basic characteristics in theoffering of the service rather than the absolute price are critical toclose the digital divide: certainty of total charge, ability to avoiddeposits or disconnection via best effort service, and payer-basedcontrol of all charges. While all of these principles sound obvious infact none of these hold in the telephony network. Universal service hasevolved from common carriage (serve all with no discrimination) to aright to basic services (100% penetration). Universal service isnow discussed as the digital divide, as the access to information asopposed to services becomes increasingly critical. However, we arediscussing in this paper access to the bits and the network rather thanaccess to the information (or intellectual property) once connected. Theprovision of universal service is seen as a technical problem only in thatthe technology costs money – universal service debates have longbeen the domain of economists. Yet the design of protocols has been thedomain of engineers, the building of systems the corporate domain, andthe discussion of equity the interest of ethicists. The design ofprotocols can define the parameters of the corporate decision-makers,the variables of the economist, and the questions for the ethicist. Thedesign decisions made at the fundamental levels can make communicationsequity more or less likely. In this work I focus on the design ofprotocols for the next generation Internet, protocols which willfundamentally change the best-effort nature of Internet services.Building on the economic and ethnographic work of others I argue thatthe effects of protocols adoption on universal service can be predictedto some degree. By examination of past and current technologies Iexamine a set of technical mechanisms to determine how such mechanismsmight harm or enhance universal service. I define each mechanism (e.g.denial of entry) and offer observations about each particularmechanism''s implicit pricing assumptions. I close with a discussion ofinterest to ethicists and regulators on evaluating communicationsprotocols with respect to universal access. Protocols for developingmultiple qualities of service for packet-switched networks have focusedon economic efficiency (e.g. Mackie-Mason, 1995; Choi, Stahl &Winston, 1997; Shapiro & Varian, 1998), billing to encouragewidespread adoption of network innovations (e.g. Xie & Sirbu, 1985)and billing in a manner consistent with the underlying network (e.g.Clark, 1996). Here we examine a set of protocols which include varyingquality of service mechanisms with respect to the compatibility of theprotocols with universal access. (shrink)

laudationem ferculum est insecutum plane non pro expectatione magnum: novitas tamen omnium convertit oculos. rotundum enim repositoriurr duodecim habebat signa in orbe disposita, super quae proprium convenien. temque materiae structor imposuerat cibum: super arietem cicer arietinum, super taurum bubulae frustum, super geminos testiculos ac rienes, supei cancrum coronam, super leonem ficum Africanam, super virginem steriliculam super libram stateram in cuius altera parte scriblita erat, in altera placenta super scorpionem † pisciculum marinum, super sagittarium oclopetam, supei capricornum locustam marinam,† super pisces (...) duos mullos. in medio autem caespes cum herbis excisus favum sustinebat. (shrink)