We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

The World Medical Association’s revised Declaration of Helsinki endorses the view that all trial participants in every country are entitled to the worldwide best standard of care. In this paper the authors show that this requirement has been rejected by every national and international committee that has examined this issue. They argue that the consensus view now holds that it is ethically permissible, in some circumstances, to provide research participants less than the worldwide best care. Finally, the authors show that (...) there is also consensus regarding the broad conditions under which this is acceptable. (shrink)

This paper introduces the medical factual matrix as a new and potentially valuable tool in medical ethical analysis. Using this tool it demonstrates the idea that a defined medical intervention can only be meaningfully declared futile in relation to a defined goal of treatment. It argues that a declaration of futility made solely in relation to a defined medical intervention is inchoate. It recasts the definition of goal futility as an intervention that cannot alter the probability of the existence of (...) the important outcome states that might flow from a defined intervention. The idea of value futility and the extent of physician obligations in futile situations are also addressed. It also examines the source of substantive conflicts which commonly arise within the doctor-patient relationship and the ensuing power relations that operate between doctor and patient when questions of futility arise. (shrink)

R K Elliott; Education, Love of One’s Subject, and the Love of Truth, Journal of Philosophy of Education, Volume 8, Issue 1, 30 May 2006, Pages 135–153, https:/.

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is (...) sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research. © 2023 The Author(s). Published by Oxford University Press on behalf of the American Institute of Biological Sciences. (shrink)

R K Elliott; Education, Love of One’s Subject, and the Love of Truth, Journal of Philosophy of Education, Volume 8, Issue 1, 30 May 2006, Pages 135–153, https:/.

R K Elliott; Versions of Creativity, Journal of Philosophy of Education, Volume 5, Issue 2, 30 May 2006, Pages 139–152, https://doi.org/10.1111/j.1467-9752.1971.

For those to whom John Bowring's name means anything, the most likely association with it is the complex and question-begging term ‘Benthamite’. Contemporaries certainly used the term, particularly when they wanted to suggest that his actions were narrowly ideological or theoretical. But to some of Bowring's contemporaries another association served hostile intent almost as well: his Unitarianism.

R K Elliott; The Concept of Development: A Reply to Professor Hamlyn, Journal of Philosophy of Education, Volume 9, Issue 1, 30 May 2006, Pages 40–48, https://d.

R K Elliott; The Concept of Development: A Reply to Professor Hamlyn, Journal of Philosophy of Education, Volume 9, Issue 1, 30 May 2006, Pages 40–48, https://d.

R K Elliott; The Concept of Development: A Reply to Professor Hamlyn, Journal of Philosophy of Education, Volume 9, Issue 1, 30 May 2006, Pages 40–48, https://d.

R K Elliott; Versions of Creativity, Journal of Philosophy of Education, Volume 5, Issue 2, 30 May 2006, Pages 139–152, https://doi.org/10.1111/j.1467-9752.1971.

The theoretical framework adopted in the exact sciences, for constructing and testing deterministic theories on the one hand, and modelling and analysis of observed phenomena on the other, is often implicitly assumed to be that of structural stability. In view of recent developments in nonlinear dynamics, it is argued here that in general it may not be possible to assume strict determinism and structural stability simultaneously; either strict determinism holds, in which case the fragility framework may turn out to be (...) the appropriate framework for the study of certain phenomena in the exact sciences, or ‘structural stability’ is restored at the expense of introducing stochasticity. In this sense a certain degree of indeterminacy may be unavoidable even at the classical level. (shrink)

R K Elliott; The Concept of Creativity, Journal of Philosophy of Education, Volume 5, Issue 1, 30 May 2006, Pages 97–104, https://doi.org/10.1111/j.1467-9752.19.

In this paper, the author argues that the requirement to conduct randomised clinical trials to inform policy in cases where one wants to identify a cheaper alternative to known effective but expensive interventions raises an important ethical issue. This situation will eventually arise whenever there are resource constraints, and a policy decision has been made not to fund an intervention on cost effectiveness grounds. It has been thought that this is an issue only in extremely resource poor settings. This paper (...) gives an example from the United Kingdom illustrating that this is also a problem faced by richer countries. (shrink)

R K Elliott; Aestheticism, Imagination and Schooling: a reply to Ruby Meager, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 33–42.

R K Elliott; Aestheticism, Imagination and Schooling: a reply to Ruby Meager, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 33–42.

R K Elliott; D. W. Hamlyn on Knowledge and the Beginnings of Understanding, Journal of Philosophy of Education, Volume 14, Issue 1, 30 May 2006, Pages 109–116.

R K Elliott; D. W. Hamlyn on Knowledge and the Beginnings of Understanding, Journal of Philosophy of Education, Volume 14, Issue 1, 30 May 2006, Pages 109–116.

R. K. Elliott; VIII—Aesthetic Theory and the Experience of Art, Proceedings of the Aristotelian Society, Volume 67, Issue 1, 1 June 1967, Pages 111–126, https:/.