The interface of health care and insurance requires not just the medical, legal and financial perspectives, but a clear ethical analysis. A varied team of contributors ranging from experts in philosophy, law, medicine and ethics to actuarial science, underwriting and insurance have contributed a series of essays. The ….

A technique for the bilateral activation of neural nets that leads to a functional asymmetry of two simulated ''cerebral hemispheres'' is described. The simulation is designed to perform object recognition, while exhibiting characteristics typical of human consciousness-specifically, the unitary nature of conscious attention, together with a dual awareness corresponding to the ''nucleus'' and ''fringe'' described by William James (1890). Sensory neural nets self-organize on the basis of five sensory features. The system is then taught arbitrary symbolic labels for a small (...) number of similar stimuli. Finally, the trained network is exposed to nonverbal stimuli for object recognition, leading to Gaussian activation of the ''sensory'' maps-with a peak at the location most closely related to the features of the external stimulus. ''Verbal'' maps are activated most strongly at the labeled location that lies closest to the peak on homologous sensory maps. On the verbal maps activation is characterized by both excitatory and inhibitory Gaussians (a Mexican hat), the parameters of which are determined by the relative locations of the verbal labels. Mutual homotopic inhibition across the ''corpus callosum'' then produces functional cerebral asymmetries, i.e., complementary activation of homologous ''association'' and ''frontal'' maps within a common focus of attention-a nucleus in the left hemisphere and a fringe in the right hemisphere. An object is recognized as corresponding to a known label when the total activation of both hemispheres (nucleus plus fringe) is strongest for that label. The functional dualities of the cerebral hemispheres are discussed in light of the nucleus/fringe asymmetry. (shrink)

The right to refuse medical intervention is well established, but it remains unclear how best to respect and exercise this right in life support. Contemporary ethical guidelines for critical care give ambiguous advice, largely because they focus on the moral equivalence of withdrawing and withholding care without confronting the very real differences regarding who is aware and informed of intervention options and how patient values are communicated and enacted. In withholding care, doctors typically withhold information about interventions judged too futile (...) to offer. They thus retain greater decision-making burden and face weaker obligations to secure consent from patients or proxies. In withdrawing care, there is a clearer imperative for the doctor to include patients in decisions, share information and secure consent, even when continued life support is deemed futile. How decisions to withhold and withdraw life support differ ethically in their implications for positive versus negative interpretations of patient autonomy, imperatives for consent, definitions of futility and the subjective evaluation of benefits and burdens of life support in critical care settings are explored. Professional reflection is required to respond to trends favouring a more positive interpretation of patient autonomy in the context of life support decisions in critical care. Both the bioethics and critical care communities should investigate the possibilities and limits of growing pressure for doctors to disclose their reasoning or seek patient consent when decisions to withhold life support are made. (shrink)

Phylogenies are increasingly prominent across all of biology, especially as DNA sequencing makes more and more trees available. However, their utility is compromised by widespread misconceptions about what phylogenies can tell us, and improved tree thinking is crucial. The most-serious problem comes from reading trees as ladders from left to right - many biologists assume that species-poor lineages that appear early branching or basal are ancestral - we call this the primitive lineage fallacy. This mistake causes misleading inferences about changes (...) in individual characteristics and leads to misrepresentation of the evolutionary process. The problem can be rectified by considering that modern phylogenies of present-day species and genes show relationships among evolutionary cousins. Emphasizing that these are extant entities in the 21st century will help correct inferences about ancestral characteristics, and will enable us to leave behind 19th century notions about the ladder of progress driving evolution. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Mentoring Away the Glass Ceiling in Academia: A Cultured Critique describes how women of diverse backgrounds perceive their mentoring experiences or the lack of mentoring experiences in the academy. This book provides a space for envisioning strategies and practices to improve mentoring practices and the collegiate environment.

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

Oxidative damage to DNA appears to be a factor in cancer, yet explanations for why highly elevated levels of such lesions do not always result in cancer remain elusive. Much of the genome is non‐coding and lesions in these regions might be expected to have little biological effect, an inference supported by observations that there is preferential repair of coding sequences. RNA has an important coding function in protein synthesis, and yet the consequences of RNA oxidation are largely unknown. Some (...) non‐coding nucleic acid is functional, e.g. promoters, and damage to these sequences may well have biological consequences. Similarly, oxidative damage to DNA may promote microsatellite instability, inhibit methylation and accelerate telomere shortening. DNA repair appears pivotal to the maintenance of genome integrity, and genetic alterations in repair capacity, due to single nucleotide polymorphisms or mutation, may account for inter‐individual differences in cancer susceptibility. This review will survey these aspects of oxidative damage to nucleic acids and their implication for disease. BioEssays 26:533–542, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Practitioners and advocates of community food security (CFS) envision food systems that are decentralized, environmentally-sound over a long time-frame, supportive of collective rather than only individual needs, effective in assuring equitable food access, and created by democratic decision-making. These themes are loosely connected in literature about CFS, with no logical linkages among them. Clear articulation in a theoretical framework is needed for CFS to be effective as a guide for policy and action. CFS theory should delimit the level of analysis (...) (i.e., what are the boundaries of “community”); show how CFS relates to individual, household, and national food security and explain emergent properties, which are important at the community level of analysis; point to the best indicators of CFS or its lack; clarify the determinants of CFS; and clarify the stages of movement toward CFS. This theoretical base would allow researchers to develop valid and reliable measures, and allow practitioners to weigh alternative options to create strategic plans. A theoretical base also would help establish common ground with potential partners by making the connections to anti-hunger work, sustainable agriculture, and community development clear. (shrink)

Despite widespread interest in the topic of moral repair in the business ethics literature and in the workplace, little is currently known about moral repair with regard to the self—i.e., how and why individuals repair themselves in the aftermath of harming others within workplace contexts and what factors may influence the success of self-repair. We conducted a qualitative study in the context of health care organizations to develop an inductive model of self-repair in the workplace. Our findings reveal a set (...) of factors, including reactions to the harm incident, motivating factors, and methods of self-repair that involve intrapersonal (e.g., self-compassion) and interpersonal (e.g., seeking feedback and support from co-workers and managers) actions. We discovered that self-repair, or what we characterize as “moral self-repair” is a complex process characterized by important ethical, emotional, and social dimensions and that the effectiveness of self-repair actions is moderated by the actions of those within the organization (e.g., co-workers, managers) and outside the organization (e.g., families, friends, counselors). These social actors can promote self-repair by offering encouragement and support, or undermine self-repair by communicating a lack of trust and respect that reinforces self-blame. This model of self-repair is intended to guide future ethics research on the topic of moral self-repair and offers insight to practicing managers. (shrink)

IN an article on Rousseau’s annotations of a popular botany text, Henry Cheyron describes the Genevan philosopher as ‘ce botaniste me´juge´’. 3 The misapprehension of Rousseau’s botanical practice identified by Cheyron has its roots, I believe, in Rousseau’s own depiction of his botanising in the Reˆveries; in the ‘Septie`me promenade’ Rousseau selfconsciously portrays this study as socially isolated, lazy and lacking in direction: ‘La botanique est l’e´tude d’un oisif et paresseux solitaire... Il se prome`ne, il erre librement d’un objet a` (...) l’autre, il fait la revue de chaque fleur avec inte´reˆt et curiosite´.’4 Neither does Rousseau disguise botany’s role for him as a ‘the´rapeutique improvise´e’; the therapeutic purpose has tended to obscure the rigour, application, time and knowledge that Rousseau put into his botanical studies so that no less a scholar than Jean Starobinski asserts: ‘Jean-Jacques herborise en collectionneur, et non pas en naturaliste. C’est pour lui une occupation, un amusement, plutoˆt qu’une ve´ritable action.’5 Finally, Rousseau fuels this misunderstanding.. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

Includes bibliographical references (p. [271]-285) and index.

Many writers in various fields--philosophy, religion, literature, and psychology--believe that the question of the meaning of life is one of the most significant problems that an individual faces. In The Meaning of Life, Second Edition, E.D. Klemke collects some of the best writings on this topic, primarily works by philosophers but also selections from literary figures and religious thinkers. The twenty-seven cogent, readable essays are organized around three different perspectives on the meaning of life. In Part I, the readings assert (...) and defend the theistic view that without the existence of God--or faith in God--life has no significance or purpose. In Part II the selections deny this thesis, defending instead the humanistic alternative--that life has or can have meaning and worth without any theistic beliefs or commitment. In the final group of readings, contributors ask if the question of the meaning of life is in itself legitimate and significant. The volume also includes an introduction by the editor and a selected bibliography. This new edition adds essays by A. J. Ayer, Hazel Barnes, William Lane Craig, Owen Flanagan, Antony Flew, Thomas Nagel, Kai Nielsen, Philip L. Quinn, Arthur Schopenhauer, and Walter T. Stace. The only anthology of its kind, The Meaning of Life, Second Edition, is ideal for courses in introduction to philosophy and human nature. It also provides an accessible and stimulating introduction to the subject for general readers. (shrink)

Empirical evidence is reviewed indicating that the extraordinary aspects of the human mind are due to our species’ ability to go beyond simple “dyadic associations” and to process the relations among three items of information simultaneously. Classic explanations of the “triadic” nature of human skills have been advocated by various scholars in the context of the evolution of human cognition. Here I summarize the core processes as found in (i) the syntax of language, (ii) tool-usage, and (iii) joint attention. I (...) then review the triadic foundations of two perceptual phenomena of great importance in human aesthetics: (iv) harmony perception and (v) pictorial depth perception. In all five subfields of human psychology, most previous work has emphasized the recursive, hierarchical complexity of such “higher cognition”, but a reductionist approach indicates that the core mechanisms are triadic. It is concluded that the cognitive skills traditionally considered to be “uniquely” human require three-way associational processing that most non-Primate animal species find difficult or impossible, but all members of Homo sapiens – regardless of small individual and cultural differences – find easy and inherently intriguing. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Consciousness and Machines:A Commentary Drawing on Japanese PhilosophyS. D. Noam Cook (bio)Viewed from within the great unity of consciousness, thinking is a wave on the surface of a great intuition.Kitarō NishidaIntroductionRecent developments in AI have made the long-standing debate about what computers can and can't do a major public concern. What we understand the properties of such machines to be, and consequently how we design [End Page 305] and (...) deploy them, will increasingly shape how we live and how we understand ourselves. Thus, there is an urgent need for better understanding of these issues.Susan Schneider, in her book Artificial You: AI and the Future of Your Mind, offers an exceptionally careful and insightful examination of key issues entailed in how we understand AI and ourselves. One of her central concerns is how we might test for machine consciousness. Given the variations in design and function among current and projected AIs, Schneider sees no likely one-size-fits-all test. So, she offers a battery of different tests that she believes together will make such testing more reliable. This seems a wise approach, and reflects the conceptual and pragmatic care Schneider takes throughout the book.Similarly, it seems to me that the question of machine consciousness should also include various understandings of consciousness itself. What consciousness is taken to be has varied widely both historically and culturally. No commonly accepted single understanding has emerged, and may never emerge. Just as having a battery of tests might help us better assess possible machine consciousness, having different understandings of consciousness might give us a better understanding of what we are testing for. The two should work in tandem, each gauging and shaping the other.Like the development of computers themselves, the predominant thinking about AI has been shaped, in part, by key presuppositions of a scientific worldview, with its origins in Western thought and culture. Among these presuppositions are materialism, reductionism, and a primary focus on objective behavior. These are reflected in the common concern with observable behavior of physical aspects of the brain in efforts to understand human consciousness, which in turn has become a familiar model for work on machine consciousness. All this is important and valuable work. But, in the spirit of Schneider's cautions, it should not be taken as one-size-fits-all. Accordingly, I offer one view of consciousness from a different perspective.In what follows, I sketch out an understanding of consciousness that draws on Japanese philosophy, particularly that of the highly influential early twentieth-century Japanese philosopher Kitarō Nishida (1870–1945). I then explore how the tests for machine consciousness that Schneider proposes might be viewed from that perspective.Consciousness: A Perspective from Japanese PhilosophyConsciousness was a central concern for Nishida, whose philosophy is deeply informed by Japanese culture and by Zen theory and practice. As one might expect from such a philosopher, Nishida's exploration of consciousness is not concerned with properties of the brain, but with what we might discern through disciplined reflection on the experience of our own consciousness. Ultimately, he views consciousness as an organic whole [End Page 306] of systemically organized interrelationships of activities and sensations within our subjective experience. This may be understood by first considering 'nothingness'.For Nishida, nothingness does not suggest an ultimate and absolute vacuity, as is often understandably assumed. In Nishida's sense, it is a singular "place" that mirrors the multifaceted world of our common experience. In understanding this, I am told by native Japanese speakers that the English word 'nothingness' has an advantage over the Japanese equivalent, 'mu', in that 'nothingness' can usefully be broken down as 'nothing-ness'. This suggests that nothingness is a state of consciousness where what we commonly experience as distinct (self, other, world, blue, ache, joy, etc.) is indistinct, a state of unified experience. This is consciousness without our finding or discriminating in it the myriad "things" of common experience, but rather a "pure experience" of a singular whole. Nishida introduces his concept of "pure experience" as follows:To experience means to know facts just as they are, to know in accordance with facts by completely relinquishing one... (shrink)