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

The practice of paying research subjects for participating inclinical trials has yet to receive an adequate moral analysis.Dickert and Grady argue for a wage payment model in whichresearch subjects are paid an hourly wage based on that ofunskilled laborers. If we accept this approach, what follows?Norms for just working conditions emerge from workplacelegislation and political theory. All workers, includingpaid research subjects under Dickert and Grady''s analysis,have a right to at least minimum wage, a standard work week,extra pay for overtime hours, (...) a safe workplace, no faultcompensation for work-related injury, and union organization.If we accept that paid research subjects are wage earners likeany other, then the implications for changes to current practiceare substantial. (shrink)

Notwithstanding requirements for scientific/social value and risk/benefit proportionality in major research ethics policies, there are no widely accepted standards for these judgments in Phase 1 trials. This paper examines whether the principle of clinical equipoise can be used as a standard for assessing the ratio of risk to direct-benefit presented by drugs administered in one category of Phase 1 study—first-in-human trials involving patients. On the basis of the supporting evidence for, and architecture of, Phase 1 studies, the articles offers two (...) provisional conclusions: (1) the risks of drug administration in such trials cannot generally be justified on therapeutic grounds but by appeal to the social value of the research; and (2) a framework for adjudicating the ratio of risk/social-value must be developed. (shrink)

The effort to revise the Declaration of Helsinki and the CIOMS Guidelines has sparked a sometimes vitriolic debate centering on the use of placebo controls.

Since its introduction in 1987, Benjamin Freedman’s principle of clinical equipoise has enjoyed widespread uptake in bioethics discourse. Recent years, however, have witnessed a growing consensus that the principle is fundamentally flawed. One of the most vocal critics has undoubtedly been Franklin Miller. In a 2008 paper, Steven Joffe and Miller build on this critical work, offering a new conception of clinical research ethics based on science, taking what they call a “scientific orientation” toward the ethics of clinical research. Though (...) there is much to recommend Joffe and Miller’s scientifically oriented conception of clinical research ethics, I believe that both the critical and constructive projects suffer from the same basic mistake: inattention to context. The internal norms of science cannot be fully specified, let alone satisfied, independently of contextual (external) factors that only come into view when we are attentive to the particular context of that form of inquiry. (shrink)

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

As scientists target communities for research into the etiology, especially the genetic determinants of common diseases, there have been calls for the protection of communities. This paper identifies the distinct characteristics of aboriginal communities and their implications for research in these communities. It also contends that the framework in the Belmont Report is inadequate in this context and suggests a fourth principle of respect for communities. To explore how such a principle might be specified and operationalized, it reviews existing guidelines (...) for protecting aboriginal communities and points out problems with these guidelines and areas for further work. (shrink)

Despite their crucial role in the translation of pre-clinical research into new clinical applications, phase 1 trials involving patients continue to prompt ethical debate. At the heart of the controversy is the question of whether risks of administering experimental drugs are therapeutically justified. We suggest that prior attempts to address this question have been muddled, in part because it cannot be answered adequately without first attending to the way labor is divided in managing risk in clinical trials. In what follows, (...) we approach the question of therapeutic justification for phase 1 trials from the viewpoint of five different stakeholders: the drug regulatory authority, the IRB, the clinical investigator, the referring physician, and the patient. Our analysis shows that the question of therapeutic justification actually raises multiple questions corresponding to the roles and responsibilities of the different stakeholders involved. By attending to these contextual differences, we provide more coherent guidance for the ethical negotiation of risk in phase 1 trials involving patients. We close by discussing the implications of our argument for various perennial controversies in phase 1 trial practice. (shrink)

Written from a post-modern perspective, this article makes use of the concepts of obligation, subject position, line of action, discursive form, sentient agent, exchange, mediating technology, intentionality, improvisational performance, and communicative routines to produce an overarching theory of communication and its processes. The work of the article is to develop the linkages among these concepts and founds this analysis in ethnographic research. It concludes that the process of communication occurs inside a nexus of obligation from relational subject positions within some (...) line of action regularly involving a discursive form. It is enacted by two or more sentient agents performing an exchange often utilizing a mediating technology under the intentionality of an improvisationalperformance of a pre-existing communicative routine. (shrink)

This article discusses the properties of a controllable, flexible, hybrid parallel computing architecture that potentially merges pattern recognition and arithmetic. Humans perform integer arithmetic in a fundamentally different way than logic-based computers. Even though the human approach to arithmetic is both slow and inaccurate it can have substantial advantages when useful approximations are more valuable than high precision. Such a computational strategy may be particularly useful when computers based on nanocomponents become feasible because it offers a way to make use (...) of the potential power of these massively parallel systems. Because the system architecture is inspired by neuroscience and is applied to cognitive problems, occasional mention is made of experimental data from both fields when appropriate. (shrink)

This book combines approaches from science, literary theory, and philosophy to examine the canon of Stephen King’s fiction from a Darwinist hermeneutic perspective in one critical study.

The authors offer their sincere thanks to all of the commentators for taking the time to comment on our work ; one of the advantages of the AJOB format is immediate feedback,...

Sir Isaac Newton, writing in Latin, defined his celebrated laws of motion verbally. When the laws of motion are read as relating to his arithmetic and his calculus, division by zero is undefined so his physics fails at mathematical singularities. The situation is unchanged in modern real arithmetic and real calculus: division by zero is undefined so both Newtonian Physics and its modern developments fail at mathematical singularities. However, when Newton’s text is read as relating to transreal arithmetic and transreal (...) calculus, division by zero is defined and we show that the resulting Transreal Newtonian Physics does operate at mathematical singularities. We hold out the hope that the whole of modern physics may be similarly extended. We use the new physics to predict a convection current at the singularity in a black hole and suggest experiments in astronomy and high energy physics that might confirm or rebut our predictions. Thus our exegesis of Newton’s text extends mathematical physics and may, in future, extend experimental physics. (shrink)

This article discusses the properties of a controllable, flexible, hybrid parallel computing architecture that potentially merges pattern recognition and arithmetic. Humans perform integer arithmetic in a fundamentally different way than logic-based computers. Even though the human approach to arithmetic is both slow and inaccurate it can have substantial advantages when useful approximations ( intuition ) are more valuable than high precision. Such a computational strategy may be particularly useful when computers based on nanocomponents become feasible because it offers a way (...) to make use of the potential power of these massively parallel systems. Because the system architecture is inspired by neuroscience and is applied to cognitive problems, occasional mention is made of experimental data from both fields when appropriate. (shrink)