BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with (...) sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness. (shrink)

What if human joy went on endlessly? Suppose, for example, that each human generation were followed by another, or that the Western religions are right when they teach that each human being lives eternally after death. If any such possibility is true in the actual world, then an agent might sometimes be so situated that more than one course of action would produce an infinite amount of utility. Deciding whether to have a child born this year rather than next is (...) a situation wherein an agent may face several alternatives whose effects could well ramify endlessly on such suppositions, for the child born this year would be a different person—one who preferred different things, performed different actions, and had different descendants—from a child born next year. It has recently been suggested that traditional utilitarianism stumbles on such cases of infinite utility. Specifically, utilitarianism seems to require, for its application, that all experience of pleasure and pain cease at some time in the future or asymptotically approach zero.2 If neither of these conditions holds, then the utility produced by each of two alternative actions may turn out to be infinite, and utilitarianism thus loses its ability to discriminate morally between them. (shrink)

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

In a reflective and richly entertaining piece from 1979, Doug Hofstadter playfully imagined a conversation between ‘Achilles’ and an anthill (the eponymous ‘Aunt Hillary’), in which he famously explored many ideas and themes related to cognition and consciousness. For Hofstadter, the anthill is able to carry on a conversation because the ants that compose it play roughly the same role that neurons play in human languaging; unfortunately, Hofstadter’s work is notably short on detail suggesting how this magic might be achieved1. (...) Conversely in this paper - finally reifying Hofstadter’s imagination - we demonstrate how populations of simple ant-like creatures can be organised to solve complex problems; problems that involve the use of forward planning and strategy. Specifically we will demonstrate that populations of such creatures can be configured to play a strategically strong - though tactically weak - game of HeX (a complex strategic game).We subsequently demonstrate how tactical play can be improved by introducing a form of forward planning instantiated via multiple populations of agents; a technique that can be compared to the dynamics of interacting populations of social insects via the concept of meta-population. In this way although, pace Hofstadter, we do not establish that a meta-population of ants could actually hold a conversation with Achilles, we do successfully introduce Aunt Hillary to the complex, seductive charms of HeX. (shrink)

This study investigated the differences between past and future temporal discounting in terms of neural activity in relation to temporal distance. Results show that brain regions are engaged differently in past and future temporal discounting. This is likely because past temporal discounting requires memory reconstruction, whereas future temporal discounting requires the processing of uncertainty about the future. In past temporal discounting, neural activity differed only when preferences were made between rewards received one hour prior and rewards received further in the (...) past. The peak amplitudes of P2 and P3 varied as the temporal distance increased from 2 weeks to 50 years. In future temporal discounting, neural activity differed only when preferences were evaluated between two delayed rewards. The delay conditions and had a significant influence on P2 and N2. Findings indicate the existence of different decision-making systems operating in past and future temporal discounting. (shrink)

Prospective follow-up studies have shown that even though some children outgrow the disorder, a childhood diagnosis of attention deficit hyperactivity disorder is clearly a risk factor for a broad range of adverse outcomes, with extremes including drug abuse and juvenile delinquency. This article considers the use of several spectrum concepts and some neuroethical issues. It provides a list of criterion symptoms with a threshold set for the number of symptoms required for categorical diagnoses of disorders. It gives a brief review (...) of some brain imaging and pharmacological treatment studies of ADHD to set the stage for a consideration of brain-specific issues related to neuroethics. Studies using reaction time tasks of cognitive control, response inhibition, and conflict have identified interindividual variance in task performance as one of the most prominent aspects of cognitive deficits related to ADHD. (shrink)

One method for investigating the neurobiology of consciousness is to experimentally manipulate consciousness as a variable and then visualize the resultant functional brain changes with advanced imaging techniques. To begin investigation into this area, healthy volunteers underwent positron emission tomography scanning while listening to randomized word lists in both conscious and unconscious conditions. Following anaesthesia, subjects had no explicit memories. Nonetheless, subjects demonstrated implicit memory on a forced-choice test . These subsequent memory scores were correlated with regional brain metabolism measured (...) during encoding. Conscious recall and unconscious recognition memory demonstrated considerable anatomic overlap in correlating significantly with relative glucose metabolism in auditory verbal memory areas. However, only conscious recall correlated with mediodorsal thalamic nucleus activity; unconscious recognition memory did not. These findings suggest that conscious versus unconscious memory distinctions may depend on the presence or absence of correlated thalamic activity, and directly implicate the thalamus in the neurobiology of consciousness. (shrink)

Physical pain has always been part of human experience, and throughout history it is recorded that doctors and wise men and women have sought to ease pain. The attitudes of those suffering pain, however, have varied from stoical acceptance to sullen endurance. Today, most people consciously seek to avoid pain or to have their pain eased, although they do not always expect what in fact appears to be possible. This study of 13 patients with protracted pain was carried out at (...) The London Hospital by a professional group to see how patients regarded their own pain and the efforts of doctors and nurses to relieve it. The attitudes of the doctors and nurses were also studied, and the results, despite the limitations of the survey, suggest that: [List: see text]. (shrink)

This paper takes the case of the proposed building of the Traveston dam on the Mary River in Australia to examine the ways postcolonial power relations are played out in city/regional relationships to further the interests of the city. Postcolonialism is concerned with unravelling multiple histories of colonialism, and identifying the reproduction, contestation, ambivalence and transformation of modes of domination and subordination in colonial relations. Political contingencies and contestations by residents, farmers, traditional Indigenous owners and environmentalists seeking to protect endangered (...) species are examined to highlight the dominance of Western anthropocentric, technocentric, and eurocentric epistemologies in political, ecological, environmental, biotheical debates. (shrink)

This paper is an introduction to a virtual special issue of AI and Law exploring the legacy of the influential HYPO system of Rissland and Ashley. The papers included are: Arguments and cases: An inevitable intertwining, BankXX: Supporting legal arguments through heuristic retrieval, Modelling reasoning with precedents in a formal dialogue Game, A note on dimensions and factors, An empirical investigation of reasoning with legal cases through theory construction and application, Automatically classifying case texts and predicting outcomes, A factor-based definition (...) of precedential constraint and An improved factor based approach to precedential constraint. After describing HYPO, in this introduction to the special issue I look at various aspects of its influence on AI and Law: the developments led by Rissland at Amherst; the developments led by Ashley in Pittsburgh; the expression of these ideas in terms of rule based systems, and their subsequent formalisation; value based theories, which were inspired by a critique of HYPO; and contemporary approaches which revive the idea of dimensions. (shrink)

This paper discusses some engineering considerations that should be taken into account when building a knowledge based system, and recommends isomorphism, the well defined correspondence of the knowledge base to the source texts, as a basic principle of system construction in the legal domain. Isomorphism, as it has been used in the field of legal knowledge based systems, is characterised and the benefits which stem from its use are described. Some objections to and limitations of the approach are discussed. The (...) paper concludes with a case study giving a detailed example of the use of the isomorphic approach in a particular application. (shrink)

Modelling reasoning with legal cases has been a central concern of AI and Law since the 1980s. The approach which represents cases as factors and dimensions has been a central part of that work. In this paper I consider how several varieties of the approach can be applied to the interesting case of Popov v Hayashi. After briefly reviewing some of the key landmarks of the approach, the case is represented in terms of factors and dimensions, and further explored using (...) theory construction and argumentation schemes approaches. (shrink)

In this paper we describe a method for the specification of computationalmodels of argument using dialogue games. The method, which consists ofsupplying a set of semantic definitions for the performatives making upthe game, together with a state transition diagram, is described in full.Its use is illustrated by some examples of varying complexity, includingtwo complete specifications of particular dialogue games, Mackenzie's DC,and the authors' own TDG. The latter is also illustrated by a fully workedexample illustrating all the features of the game.

This book deserves the attention of philosophers of religion. Tracy presents a monumental synthesis of philosophy and history within the context of a "revisionist" theological model. Part I attempts adequately to articulate a method of inquiry by outlining the sets of evaluative criteria, the uses of evidence, and the place of the various philosophical and historical methods within this model. Not only must the method be responsive to the historical tradition, but it also must heed the non-Christian scrutiny of what (...) Van A. Harvey calls the "morality of scientific knowledge," which demands a critical posture toward beliefs and tradition. Tracy’s model involves three steps: 1) phenomenology of the "religious dimension" of our "common experience and language," 2) an "historical and hermeneutical investigation" of the Christian tradition, and 3) "transcendental or metaphysical reflection" in order both to determine the "truth-status" of the previous steps and to effect a critical correlation of philosophy and hermeneutics. (shrink)

In this introduction I give an overview of Carole Hafner’s work and discuss the papers in this volume. The final section offers some more personal reminiscences of Carole and her contribution to the AI and Law community, from myself and other colleagues.

In this text, the reader will find a well focused, clearly written, and concise review of major themes in the philosophy of Edmund Husserl. This work could well serve the beginning student to focus on the major problems in Husserlian thought. Fuchs argues that Husserl’s phenomenology is in conformity with and an outgrowth of the traditional orientation of Western philosophy called the metaphysics of presence. In separate discussions of evidence, temporality, and intersubjectivity, the author attempts to demonstrate both that Husserl (...) is tied to this traditional metaphysical doctrine which grants primacy to presence over absence, and that he nonetheless laid the foundation for the overcoming of this metaphysic. Throughout, Husserl is portrayed as wrestling with the juxtaposition of presence and absence; and yet on each point, presence is said to remain of primary constitutive status: evidence is seen as "absolute presence," the presence of impression plays a stronger constitutive role than the absences of past and future, and knowledge of other human beings is secured on the ground of presence. In short, the author claims that Husserl provided the foundation for the overcoming of the prejudice of the metaphysics of presence, and yet did not succeed in fully extricating himself from the confusions of this tradition. (shrink)