This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

ABSTRACTAdopting a temporally distant perspective on stressors reduces distress in adults. Here we investigate whether the extent to which individuals project themselves into the future influences distancing efficacy. We also examined modulating effects of age across adolescence and reactive aggression: factors associated with reduced future-thinking and poor emotion regulation. Participants read scenarios and rated negative affect when adopting a distant-future perspective, near-future perspective, or when reacting naturally. Self-report data revealed significant downregulation of negative affect during the distant-future condition, with a (...) similar though non-significant skin conductance pattern. Importantly, participants who projected further ahead showed the greatest distress reductions. While temporal distancing efficacy did not vary with age, participants reporting greater reactive aggression showed reduced distancing efficacy, and projected themselves less far into the future. Fi... (shrink)

Health Wearable Devices enhance the quality of life, promote positive lifestyle changes and save time and money in medical appointments. However, Wearable Devices store large amounts of personal information that is accessed by third parties without user consent. This creates ethical issues regarding privacy, security and informed consent. This paper aims to demonstrate users’ ethical perceptions of the use of Wearable Devices in the health sector. The impact of ethics is determined by an online survey which was conducted from patients (...) and users with random female and male division. Results from this survey demonstrate that Wearable Device users are highly concerned regarding privacy issues and consider informed consent as “very important” when sharing information with third parties. However, users do not appear to relate privacy issues with informed consent. Additionally, users expressed the need for having shorter privacy policies that are easier to read, a more understandable informed consent form that involves regulatory authorities and there should be legal consequences the violation or misuse of health information provided to Wearable Devices. The survey results present an ethical framework that will enhance the ethical development of Wearable Technology. (shrink)

The principal contemporary moral views are treated under three headings: 1) Intuitionism, represented by G. E. Moore, H. A. Prichard, and W. D. Ross; 2) Emotivism, as expounded by C. L. Stevenson; and 3) Prescriptivism, R. M. Hare's view. Warnock carefully distinguishes the questions these views were designed to answer from the questions which he feels they do in fact answer. Warnock emphasizes throughout the problem of the relation between moral discourse and conduct, as well as the question of the (...) possibility of moral "argument" in the sense of giving "reasons" for a moral viewpoint. In the latter half of the volume Warnock sketches what he takes to be some of the necessary requirements for a more adequate moral theory. He discusses "Naturalism" and rejects the blanket term as misleading unless the precise view one labels "naturalistic" is spelled out. Warnock distinguishes two "anti-naturalist" views: 1) that description and evaluation are different, i.e., that evaluation is not "reducible" to description and 2) that they are logically independent. He considers 1) a platitude. He accepts 2), but rejects what might be considered a further implication of this view—that absolutely anything might be regarded as a criterion of evaluation. In conclusion Warnock suggests that it might be profitable to look for the distinctive features of moral discourse in the content rather than the form. A good introduction to critical thinking, Warnock's account raises more questions than it answers.—C. L. H. (shrink)

Mrs. Warnock opens her discussion with a warning against the attempt to define existentialism, or to treat it as a single, unified position. With this warning in mind, she then proceeds to trace some of the general features of existentialist "ethics" through the philosophies of Kierkegaard, Heidegger, and Sartre. Mrs. Warnock sees the common aim of these thinkers as the attempt to "free people from illusion." She particularly stresses 1) the breakdown of the distinction between thinking and feeling, and the (...) resultant blurring of the line between an ethics and the rest of each thinker's philosophy; and 2) the breakdown of the distinction between feeling and acting—in Sartre's words "we try to change the world." Throughout the volume the import of the role of freedom, choice, and anguish are emphasized.—C. L. H. (shrink)

Hudson's contribution is a general critical introduction to eighteenth century ethical intuitionism. Hudson divides intuitionism into two basic views: 1) "sentimentalism" or the "moral sense" view propounded by Shaftesbury and Hutcheson, and 2) "intellectualism," or the view that intuition is a form of reason or understanding, held in one form or another by Cudworth, Clarke, Balguy, and Price. Mention is also made of Butler, whom Hudson sees in the bridge position between the other extremes. After expounding these views, Hudson discusses (...) three outstanding questions raised, but not satisfactorily answered, by the eighteenth century intuitionists: i) How does one decide between conflicting obligations?; ii) Do all men intuit the "heads" of virtue?; iii) Is it our duty to do what is right or what we think right? Finally, in a brief critique, Hudson presents objections to intuitionism based primarily on his own view of the conditions that must be fulfilled in order to legitimately say "I know X." He also raises the problem of a criterion of "intuition."—C. L. H. (shrink)

This brief volume is the first in a series of monographs designed to introduce the main types of ethical theory from ancient Greece to the present. The series provides an historical purview for the beginner, brief but accurate, interspersed with critical evaluation from a modern analytic point of view. Huby's volume on Greek Ethics is more expository than evaluative in nature, with most attention directed toward Plato and Aristotle. Some of the virtues of the volume, in spite of the lack (...) of critical comment, are: 1) The attempt to show the historical continuity of problems. ; 2) A careful treatment of Greek terms, notably physis, nomos, arete, dikaios, sophrosyne, philia, eros, emphasizing multiple meanings and connotations and, where necessary, indicating any differences between Greek and present day usage which might tend to confuse the reader.—C. L. H. (shrink)

Hudson's contribution is a general critical introduction to eighteenth century ethical intuitionism. Hudson divides intuitionism into two basic views: 1) "sentimentalism" or the "moral sense" view propounded by Shaftesbury and Hutcheson, and 2) "intellectualism," or the view that intuition is a form of reason or understanding, held in one form or another by Cudworth, Clarke, Balguy, and Price. Mention is also made of Butler, whom Hudson sees in the bridge position between the other extremes. After expounding these views, Hudson discusses (...) three outstanding questions raised, but not satisfactorily answered, by the eighteenth century intuitionists: i) How does one decide between conflicting obligations?; ii) Do all men intuit the "heads" of virtue?; iii) Is it our duty to do what is right or what we think right? Finally, in a brief critique, Hudson presents objections to intuitionism based primarily on his own view of the conditions that must be fulfilled in order to legitimately say "I know X." He also raises the problem of a criterion of "intuition."—C. L. H. (shrink)

The practice of respecting patients’ autonomy is rooted in the healthcare professionals’ empathy for patients’ situations, without which appropriate supports to the patients during the informed consent process may be remarkably moderated. The purpose of this study was to explore elective surgery patients’ experiences during their decision-making process. This research was conducted using a phenomenological approach, and the data analysis was guided by Colaizzi’s method. A total of 17 participants were recruited from a hospital in southern Taiwan. Two major themes (...) emerged from the analyses: (a) a voluntary yet necessary alternative—to undergo a surgery and (b) alternatives compelled by the unalterable decision—the surgery. It was concluded that unless healthcare professionals can empathize with the distressed situation of their patients who are facing elective surgery, the practice of informed consent may become merely a routine. Nurses can be the best advocates for patients and facilitators to enhance communication between patients and healthcare personnel. (shrink)

Given a set of objects characterized by a number of attributes, hidden patterns can be discovered in them for the grouping of similar objects into clusters. If each of these clusters can be considered as exemplifying a certain concept, then the problem concerned can be referred to as a concept discovery problem. This concept discovery problem can be solved to some extent by existing data clustering techniques. However, they may not be applicable when the concept involved is vague in nature (...) or when the attributes characterizing the objects can be qualitative, quantitative, and fuzzy at the same time. To discover such concepts from objects with such characteristics, we propose a Genetic-Algorithm-based technique. By encoding a specific object grouping in a chromosome and a fitness measure to evaluate the cluster quality, the proposed technique is able to discover meaningful fuzzy clusters and assign membership degrees to objects that do not fully exemplify a certain concept. For evaluation, we tested the proposed technique with simulated and real data and the results are found to be very promising. (shrink)

Given a set of objects characterized by a number of attributes, hidden patterns can be discovered in them for the grouping of similar objects into clusters. If each of these clusters can be considered as exemplifying a certain concept, then the problem concerned can be referred to as a concept discovery problem. This concept discovery problem can be solved to some extent by existing data clustering techniques. However, they may not be applicable when the concept involved is vague in nature (...) or when the attributes characterizing the objects can be qualitative, quantitative, and fuzzy at the same time. To discover such concepts from objects with such characteristics, we propose a Genetic-Algorithm-based technique. By encoding a specific object grouping in a chromosome and a fitness measure to evaluate the cluster quality, the proposed technique is able to discover meaningful fuzzy clusters and assign membership degrees to objects that do not fully exemplify a certain concept. For evaluation, we tested the proposed technique with simulated and real data and the results are found to be very promising. (shrink)

In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and potential benefits. They conclude with a discussion of responsible behavior in the context of SBG research. (...) SBG research that compares individuals within a group according to a “sensitive” phenotype requires extra attention to responsible conduct and to responsible communication about the research and its findings. SBG research (1) on sensitive phenotypes that (2) compares two or more groups defined by (a) race, (b) ethnicity, or (c) genetic ancestry (where genetic ancestry could easily be misunderstood as race or ethnicity) requires a compelling justification to be conducted, funded, or published. All authors agree that this justification at least requires a convincing argument that a study's design could yield scientifically valid results; some authors would additionally require the study to have a socially favorable risk‐benefit profile. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2017 Heft: 216 Seiten: 363-381.

Objectives: To analyse legislation and medical professional positions concerning the doctor’s role in assisted dying in western Europe, and to discuss their implications for doctors.Method: This paper is based on country-specific reports by experts from European countries where assisted dying is legalised , or openly practiced , or where it is illegal .Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide is not illegal in either Germany or Switzerland, but a doctor’s (...) participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not.Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This “neutral” stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a “medical end-of-life decision” since the 1970s.Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions. (shrink)

Mole's (2008 [this issue]) argument that consciousness is a necessary concomitant of attention rests on the question of what is being attended in spatial attention. His answer is space. Some authors, including ourselves, claim that the fact that the processing of unseen objects can be modulated by spatial attention (e.g. Kentridge et al., 1999; 2004; 2008; Marzouki et al., 2007; Sumner et al., 2006) demonstrates that visual attention is not a sufficient precondition for visual awareness. Mole, however, contends that as (...) space, rather than any object that might occupy that space, is what is being attended, these experiments do not constitute evidence for a dissociation between attention and consciousness. We disagree. To understand the source of this disagreement we need to understand the various processes encompassed by the term 'attention' and to consider experimental evidence illustrating how these processes operate. We review evidence that spatial attention can be deployed with the specific goal of determining the properties of objects occupying the attended region of space. One might, for example, attend to a location with the goal of determining the colour of objects occupying that space as efficiently as possible. Mole's assumption that all that is attended in spatial attention is space is not consistent with this evidence. We conclude that attention can be directed at objects by mechanisms of so- called 'spatial attention' without those objects necessarily eliciting conscious visual experience and hence that attention is not a sufficient precondition for visual awareness. (shrink)

BackgroundCurrent policies regulating the use of animals for scientific purposes are based on balancing between potential gain of knowledge and suffering of animals used in experimentation. The balancing process is complicated, on the one hand by plurality of views on our duties towards animals, and on the other hand by more recent discussions on uncertainty in the probability of reaching the final aim of the research and problems of translational failure.MethodsThe study combines ethical analysis based on a literature review with (...) neuropsychiatry-related preclinical research as a case study.ResultsBased on the analysis and the case study we show that neuropsychiatry-related preclinical research is an especially interesting case from an ethical perspective. The 3R principles are used to minimize the negative consequences for the animals used in research. However, neuropsychiatric research is characterized by specific challenges in assessing the probability of success of reaching the final aim, due to our limited mechanistic knowledge of human neuropsychiatric illness. Consequently, the translational value of the currently used animal models may be difficult to prove, which undermines the validity of these models and complicated the ethical assessment.ConclusionsWe conclude that a combined approach that deals with both science and the ethical dimensions is necessary to address the problems of validity and translation in neuropsychiatry-related preclinical research. We suggest this approach to comprise first, improved experimental methods, e.g. by using systematic reviews, second, a more patients-based approach that leads to models that reflect interindividual variation better, and third, more interdisciplinary cooperation. (shrink)