Here we describe how more important findings were obtained in a delirium study by using an informal assessment of mental capacity, and, in those who lacked capacity, obtaining consent later when or if capacity returned or a proxy was found. From a total of 233 patients 23 patients lacked capacity as judged by our informal capacity judgment and 210 did not. Of those who lacked capacity, 13 agreed to enter in the study. Six of them regained capacity later. When these (...) 13 participants were excluded from analysis, significant findings were no longer evident. These results show that by the inclusion of subjects who lacked capacity the results of analyses of the condition from whish they suffer are altered. We suggest that this approach to the study of delirium is more ethical than the usual system of strict exclusion of people who lack capacity to give consent and for whom assent is not available. (shrink)

Nanotechnology presents significant challenges in terms of developing a regulatory framework. This is due to a lack of scientific knowledge about the behaviour of the technology in its interactions with biological and ecological processes, the environment and other technologies. Crucially, there is a great deal of uncertainty surrounding the potential environmental and human health and safety impacts of NT. Consequently, the development of NT is a potential test case for framing new models of ‘soft law’ voluntary governance as a substitute (...) for traditional command and control type regulation. Driven by ‘new science governance,’ an approach based on a combination of ideas in anticipatory ethics, future-oriented responsibility, upstream public engagement and deliberation and theories of justice may offer a solution. The uniqueness of the approach can be found in the incorporation of anticipatory approaches via public participation and deliberation as the input into procedural justice approaches with distributional justice as the output. The overarching objective of this work is to contribute to the discussion in relation to the internalisation of responsibility and the building of intellectual and societal capacity to anticipate negative consequences before they arise in the hope that such an approach could be the antithesis of the retrospective imposition of responsibility and liability after the harm is done, which is the outcome of traditional regulatory and ethical approaches. Ultimately, the purpose is to contribute to the long-term sustainability of NT. (shrink)

Public policy issues around access to networked information are explored and examined. Long viewed as the quintessential public good, information has evolved into a critically important market commodity in little more than a generation. New technologies and a political climate in which the meaning of universal access to information is no longer commonly understood and in which its importance is no longer taken for granted pose significant challenges for American society. Libraries, as information commons, offer the means of meeting those (...) challenges. Historical, economical, and professional factors that shape the conflict are described and discussed. (shrink)

A role of perirhinal cortex (PrC) in recognition memory for objects has been well established. Contributions of parahippocampal cortex (PhC) to this function, while documented, remain less well understood. Here, we used fMRI to examine whether the organization of item-based recognition memory signals across these two structures is shaped by object category, independent of any difference in representing episodic context. Guided by research suggesting that PhC plays a critical role in processing landmarks, we focused on three categories of objects that (...) differ from each other in their landmark suitability as confirmed with behavioral ratings (buildings > trees > aircraft). Participants made item-based recognition-memory decisions for novel and previously studied objects from these categories, which were matched in accuracy. Multi-voxel pattern classification revealed category-specific item-recognition memory signals along the long axis of PrC and PhC, with no sharp functional boundaries between these structures. Memory signals for buildings were observed in the mid to posterior extent of PhC, signals for trees in anterior to posterior segments of PhC, and signals for aircraft in mid to posterior aspects of PrC and the anterior extent of PhC. Notably, item-based memory signals for the category with highest landmark suitability ratings were observed only in those posterior segments of PhC that also allowed for classification of landmark suitability of objects when memory status was held constant. These findings provide new evidence in support of the notion that item-based memory signals for objects are not limited to PrC, and that the organization of these signals along the longitudinal axis that crosses PrC and PhC can be captured with reference to landmark suitability. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

We investigate the notion of conditional probability and the quantum mechanical concept of state reduction in the context of GL spaces satisfying the Alfsen-Shultz condition.

Inequities in access to oncology care among Indigenous peoples in Canada are well documented. Access to oncology care is mediated by a range of factors; however, emerging evidence suggests that healthcare providers, including nurses, play a significant role in shaping healthcare access. The purpose of this study was to critically examine access to oncology care among Indigenous peoples in Canada from the perspective of oncology nurses. Guided by postcolonial theoretical perspectives, interpretive descriptive and critical discourse analysis methodologies informed study design (...) and data analysis. Oncology nurses were recruited from across Canada to complete an online survey (n = 78). Nurses identified a range of barriers experienced by Indigenous peoples when accessing oncology care, yet located these barriers primarily at the individual and systems levels. Nurses perceived themselves as mediators of access to oncology care; however, their efforts to facilitate access to care were constrained by the dominance of biomedicine within healthcare. Nurses' constructions of access to oncology care highlight the embedded narrative of individualism within nursing practice and the relative invisibility of racism as a determinant of equitable access to care among Indigenous peoples. This suggests a need for oncology nurses to better understand and incorporate structural determinants of health perspectives. (shrink)

Introducing Philosophy: A Text with Integrated Readings, Tenth Edition is a thorough introduction to the core problems of philosophy, including explanations and background by the authors along with generous excerpts from the philosophers under discussion. Organized topically, the chapters present alternative perspectives-including analytic, continental, feminist, and non-Western viewpoints-alongside the historical works of major philosophers. The text provides the course materials that allow instructors and students to focus on a variety of philosophical problems and perspectives. Spanning 2,500 years, the selections range (...) from the oldest known fragments to cutting-edge contemporary essays. (shrink)

The financial crisis of 2007–2008 had its origins in the manner by which complex financial instruments allowed qualitative phenomena to become a tradable commodity. This process is part of a profound tendency in modern economic life to convert the qualitative, specific and non-commensurable into quantitative data. Simmel, in his Philosophy of Money, identified this transformative quality as an inherent characteristic of money. This paper argues that Simmel’s work continues to provide important insights. Modern financial instruments, in particular collateralised debt obligations, (...) possess this same transformative power thus showing the enduring relevance of Simmel’s work. (shrink)

Our social relations are changing, we are now not just talking to each other, but we are now also talking to artificial intelligence (AI) assistants. We claim AI assistants present a new form of digital connectivity risk and a key aspect of this risk phenomenon is related to user risk awareness (or lack of) regarding AI assistant functionality. AI assistants present a significant societal risk phenomenon amplified by the global scale of the products and the increasing use in healthcare, education, (...) business, and service industry. However, there appears to be little research concerning the need to not only understand the changing risks of AI assistant technologies but also how to frame and communicate the risks to users. How can users assess the risks without fully understanding the complexity of the technology? This is a challenging and unwelcome scenario. AI assistant technologies consist of a complex ecosystem and demand explicit and precise communication in terms of communicating and contextualising the new digital risk phenomenon. The paper then argues for the need to examine how to best to explain and support both domestic and commercial user risk awareness regarding AI assistants. To this end, we propose the method of creating a risk narrative which is focused on temporal points of changing societal connectivity and contextualised in terms of risk. We claim the connectivity risk narrative provides an effective medium in capturing, communicating, and contextualising the risks of AI assistants in a medium that can support explainability as a risk mitigation mechanism. (shrink)

Heidegger’s two modes of thinking, calculative and meditative, were used as the thematic basis for this qualitative study of physicians from seven countries . Focus groups were conducted in each country with 69 physicians who cared for the elderly. Results suggest that physicians perceived ethical issues primarily through the lens of calculative thinking with emphasis on economic concerns. Meditative responses represented 24% of the statements and were mostly generated by Canadian physicians whose patients typically were not faced with economic barriers (...) to treatment due to Canada’s universal health care system. (shrink)

This work is an exceptionally rich account both of the connections and divergences between Levinas and Derrida as ethical thinkers. Against the backdrop of nineteenth and twentieth century philosophy and phenomenology, Srajek draws on Hermann Cohen's ethics of correlation so as to demonstrate how far it is possible to read Levinas and Derrida as constructing similar approaches to ethics.

The Institute of Medicine's report, the American Medical Association's project, the Open Society Institute's and the initiative sponsored by the Robert Wood Johnson Foundation have focused attention on improving the care of dying patients. These efforts include advance care planning and the use of written advance directives. Although previous studies have provided quantitative descriptions of patient preferences for life-sustaining treatment, including those documented in written ADs, to our knowledge open-ended written preferences have not been studied. Studies of these open-ended preferences (...) could highlight issues with respect to quality end-of-life care. The purpose of this study was to explore the open-ended proxy, health, and personal care preferences of people with HIV as expressed in a written AD form. (shrink)

We point out that current belief revision operations can be used to revise non-monotonic theories and we propose a new operation, called permissive belief revision. The underlying idea of permissive belief revision consists of instead of abandoning some beliefs during a revision, transforming those beliefs into weaker ones, while still keeping the resulting belief set consistent. This framework allows us to keep more beliefs than what is usual using existing belief base-based revision theories.

In light of the potential long-term societal and economic benefits of novel nano-enabled products, there is an evident need for research and development to focus on closing the gap in nano-materials safety. Concurrent reflection on the impact of decision-making tools, which may lack the capability to assist sophisticated judgements around the risks and benefits of the introduction of novel products, is essential. This paper addresses the potential for extant decision support tools to default to a precautionary principle position in the (...) face of uncertainty. A more utilitarian-based approach could be facilitated by adding simple methods to formulate realistic hypotheses, which would assist non-specialists to make more nuanced decisions in terms of managing the risks of introducing new NMs. A decision support analytical framework is applied to identify the potential risks and benefits of novel nano-enabled products such as textiles with in-built enhanced antimicrobial activity for the prevention of nosocomial infections produced by spray or sonochemical coating possesses. While the results demonstrate valuable societal and environmental benefits compared to conventional products, due to uncertainty regarding the possible hazard to humans, sizable risks were identified in some cases due to the precautionary principle. (shrink)

Originally published in 1988, M. C. Dillon's classic study of Merleau-Ponty is now available in a revised second edition containing a new preface and a new ...

Empathy is an important human ability associated with successful social interaction. It is currently unclear how to optimally measure individual differences in empathic processing. Although the Big Five model of personality is an effective model to explain individual differences in human experience and behavior, its relation to measures of empathy is currently not well understood. Therefore, the present study was designed to investigate the relationship between the Big Five personality concept and two commonly used measures for empathy (Empathy Quotient (EQ), (...) Interpersonal Reactivity Index (IRI)) in four samples from China, Germany, Spain and the United States of America. This approach was designed to advance the way the Big Five personality model can be used to measure empathy. We found evidence of medium effect sizes for associations between personality and empathy, with agreeableness and conscientiousness as the most important predictors of affective and cognitive empathy (measured by the respective IRI subscales) as well as a for a one-dimensional empathy score (measured by the EQ). Empathy in a fictional context was most closely related to openness to experience while personal distress was first of all related to neuroticism. In terms of culture, we did not observe any distinct pattern concerning cultural differences. These results support the cross-cultural applicability of the Empathy Quotient and the Interpersonal Reactivity Index and indicate structurally similar associations between personality and empathy across cultures. (shrink)

What are the most fundamental features of the world? Do minds stand outside the natural order? Is a unified picture of mental and physical reality possible? The Mind in Nature provides a staunchly realist account of the world as a unified system incorporating both the mental and the physical.