The proposal that the hippocampus is important for the encoding of episodic information, but not familiarity-based recognition, is incompatible with the available data. An alternative way to think about functional specialization within the medial temporal lobe memory system is suggested, based on neuroanatomy.

Being a patient and living a life -- Clinical space and traits of healing -- False starts and frequent failures -- Three journeys : A.'Ibuprofen and love', B. 'Staying tuned up', C. 'We all want the same things' -- Being a patient : the moral field -- Rethinking healthcare ethics : the patient's moral authority.

"This book maps the moral terrain in the grounded reality of human experience without relying on theories or systems of ethics as the primary orienting strategy. Moral awareness needs first to be appreciated for what it is before it is made to conform to theories or systems. And moral consciousness is not a steady or stable set of perceptions; as we change so do the moral challenges that most concern us"--.

The ethicist's role in the clinical context is not presently well defined. Ethicists can be thought of as moralists, technicians, Sophists, or as teachers and learners. Each of these roles is examined in turn. An argument is made for the ethicist as a teacher who must also learn a great deal about the clinical setting in order to encourage an effective critical examination of basic values. Four specific tasks of this teaching role are discussed: describing moral experience, eliciting assumptions, considering (...) multiple alternatives and justifying choices. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

AIDS and the responses and attitudes it evokes surpass the analytic abilities of standard bioethics. These responses and attitudes are explored in terms of literary and anthropological categories, such as dirt, disorder, pollution and ritual cleanliness. Implications for medical education are suggested.

Drew Leder's Clinical Interpretation: The Hermeneutics of Medicine [1] is an essay which understates its case and thereby opens itself to misinterpretation. This response to Leder argues for a more thorough-going hermeneutic for both medicine and science. At the conceptual as well as the practical level, modern medicine and its scientific foundations are hermeneutic enterprises. The purpose of this essay is to argue that we should not back away from this more radical thesis. Embracing it will result in less alienation (...) of physicians from patients, and of physicians from the tasks of medicine. (shrink)

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

The American Journal of Bioethics, Volume 11, Issue 7, Page 15-16, July 2011.

The Covid‐19 pandemic has concentrated bioethics attention on the “lifeboat ethics” of rationing and fair allocation of scarce medical resources, such as testing, intensive care unit beds, and ventilators. This focus drives ethics resources away from persistent and systemic problems—in particular, the structural injustices that give rise to health disparities affecting disadvantaged communities of color. Bioethics, long allied with academic medicine and highly attentive to individual decision‐making, has largely neglected its responsibility to address these difficult “upstream” issues. It is time (...) to broaden our teaching, research, and practice to match the breadth of the field in order to help address these significant societal inequities and unmet health needs. (shrink)

Many international business training programs present a viewpoint of cultural relativism that encourages business people to adapt to the host country's culture. This paper presents an argument that cultural relativism is not always appropriate for business ethics; rather, a code of conduct must be adapted which presents guidelines for core ethical business conduct across cultures. Both moral and economic evidence is provided to support the argument for a universal code of ethics. Also, four steps are presented that will help ensure (...) that company ethical standards are followed internationally. (shrink)

Edmund Pellegrino claims that medical ethics must be derived from a perception of the patient's damaged humanity, rather than from the self-imposed duties of professionals. This essay explores the meaning and examines the challenges to this patient-centered ethic. Social scientific and bioethical interpretations of medicine constitute one kind of challenge. A more pervasive challenge is the ascendancy of managed care, and especially investor-owned, for-profit managed care. A list of questions addressed to patients, physicians and organizations is offered as one means (...) of assessing this threat and moving toward morally trustworthy relationships. (shrink)

Possible measurement and testability weaknesses in Sperry's mind-supervenient emergent interactionism "argument by analogy" model are described. An alternative brain-supervenient interactionism that addresses the weaknesses of Sperry's mind-brain model is presented. The alternative model, Neurological Positivism - a systems-theoretical evolutionary epistemology - proposes that the measurable energy quality of the algorithmic organization of the Darwinian brain supervenes that of cultural mental models and thus downwardly influences the brain circuitry patterns that underlie them. Brain and mind are defined in interrelated energy terms (...) within the context of the self-referential maximum-power principle. The equivalence of maximum-power principle energy hierarchies to chaotic/fractal dynamical designs is described. The production of mental models through reflective thinking is defined as an emergent dimension of energetic self-referencing by the brain operating in accordance with the maximum-power principle. It is concluded that within the context of NP the brain-mind relationship constitutes an "uneven" central state energy identity, with brain supervenient, when brain-mind relative energy qualities are taken into account. (shrink)

ABSTRACT:Aging and death need to be seen as a single reality, aging-and-death. Separating them largely voids the lessons to be learned from aging, and the benefits of seeing life as a whole and learning a new sense of beauty, meaning, hope, and love. All the distinctive experiences central to our sense of ourselves as human beings are tied to recognition of our mortality. Living a full life means accepting and embracing death as not only inevitable, but necessary and desirable.

Images of the future are usually only caricatures of the present. Perhaps this picture of the future of medical care will also prove to be a caricature. Whether it does depends on choices that Americans have still to make. —Paul Starr The Social Transformation of American Medicine.

Book reviewed in this article: Duties to Others. Edited by Courtney S. Campbell and B. Andrew Lustig.

Two decades ago, I wrote an essay expressing my skepticism about the nascent movement to certify bioethics consultants. My concerns were numerous. For example, I worried that the move toward certification would give too much weight to moral theory and neglect the importance of the less formal moral reasoning of patients and their families. I was also concerned that the effort to certify competence, complete with standardized testing, would be largely self-promotional and make unfounded claims about who has the capacity (...) to do this work. My worries were prescient. Notice, for example, the way that the American Society for Bioethics and Humanities was advertising its new Healthcare Ethics... (shrink)

Lauris Kaldjian makes a strong case for respecting the role of conscience in the practice of medicine. His excellent book, Practicing Medicine and Ethics, presents an historically informed and carefully crafted explication of the role of conscience in Western ethics and its relevance for medical practitioners. The essay that initiates the discussion in this issue of Perspectives in Biology and Medicine is an equally well-written and lucid account of this important component of morality. But it is also worrisome in its (...) implications for insulating conscience from the other facets of moral thinking and feeling. The reasons Kaldjian's account is not finally compelling stem from his tethering conscience too... (shrink)

Volume 19, Issue 11, November 2019, Page 63-64.

Our culture is well on its way to reducing medical ethics to legal requirements, general citizen ethics, or personal values. A distinctive ethic for medicine provides critical distance and moral meaning for the profession and an enriched societal ethic.

Weaknesses in Roger Sperry's "Defense of Mentalism" that appeared in the Spring issue of JMB are described. Sperry's clarification of his mentalist position still appears to lack a plausible mechanism of interaction. The wheel rolling down hill analogy is described as "a ghost in the subcircuitry." Neurological Positivism's energetic mechanism of brain-mind interaction is summarized. The relatioship of systems theory to reductionism is described briefly in terms of NP.