Since the Harvard Committees bold and highly successful attempt to redefine death in 1968 (Harvard Ad Hoc committee, 1968), multiple controversies have arisen. Stimulated by several factors, including the inherent conceptual weakness of the Harvard Committees proposal, accumulated clinical experience, and the incessant push to expand the pool of potential organ donors, the lively debate about the definition of death has, for the most part, been confined to a relatively small group of academics who have created a large body of (...) literature of which this issue of the Journal of Medicine and Philosophy is an example. Law and public policy, however, have remained essentially unaffected. This paper will briefly review the multiple controversies about defining death in an attempt to explain why they have and will remain unresolved in the academic community and have even less chance of being understood and resolved by politicians, legislators, and the general public. Considering this, we will end by suggesting the probable course of public policy and clinical practice in the decades ahead. (shrink)

One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.

One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.

The dead donor rule—that persons must be dead before their organs are taken—is a central part of the moral framework underlying organ procurement. Efforts to increase the pool of transplantable organs have been forced either to redefine death (e.g., anencephaly) or take advantage of ambiguities in the current definition of death (e.g., the Pittsburgh protocol). Society's growing acceptance of circumstances in which health care professionals can hasten a patient's death also may weaken the symbolic importance of the dead donor rule. (...) We consider the implications of these efforts to continually revise the line between life and death and ask whether it would be preferable to abandon the dead donor rule and rely entirely on informed consent as a safeguard against abuse. (shrink)

Public health agencies regularly survey randomly selected anonymous students to track drug use, sexual activities, and other risk behaviors. Students are unidentifiable, but a recent project that i...

In On What We Mean, Arnold Chien discusses the meaning of a speaker, a notion we use in everyday conversation. Speaker's meaning is a fundamental notion of pragmatics, i.e. the study of the relation between words and speakers. Yet everyday speaker's meaning has not been systematically studied in philosophy or linguistics. Chien's approach to these issues is to take a speaker's meaning as an answer to "what do you (s/he) mean" (WDYM) questions. He then analyzes WDYM-questions in terms of (...) Bas van Fraassen's analysis of why-questions, according to which, a question consists of a set of parameters whose values vary according to the context. The constraints on speaker's meanings are analyzed in terms of certain constraints on answers to WDYM-questions. The account is extended to metaphor, understood to be a kind of conceptual indeterminacy. (shrink)

Institutional ethics committees (IECs) are part of a growing phenomenon in the American health care system. Although a major force driving hospitals to establish IECs is the desire to resolve difficult clinical dilemmas in a quick and systematic way, in this paper we argue that such a goal is naive and, to some extent, misguided. We assess the growing trend of these committees, analyse the theoretical assumptions underlying their establishment, and evaluate their strengths and shortcomings. We show how the 'medical (...) consultation' model is often inappropriately applied to IECs and suggest that IECs must operate under a different framework. Finally, we argue that IECs should be valued for the process they facilitate, and not for the product that they are, often unreasonably, expected to deliver. (shrink)

Peter J Arnold; Sport, Moral Education and the Development of Character, Journal of Philosophy of Education, Volume 18, Issue 2, 30 May 2006, Pages 275–281, htt.

Whereas previous research has focused on the link between workload and task performance, less is known about the intervening mechanisms influencing this relationship. In the present study, we test the moderating roles of daily recovery and total sleep time in the relationship between work pressure and daily task performance. Using performance and recovery theories, we hypothesized that work pressure relates positively to daily task performance, and that both daily recovery in the form of psychological detachment and relaxation, and total sleep (...) time independently enhance this relationship. Our hypotheses were tested in a 30-day diary study with 110 officer cadets on a cross-Atlantic voyage on a Naval sail ship. The results of multilevel modeling lend support to all three hypotheses. Taken together, our findings suggest that recovery and sleep duration between shifts play a key role in the relationship between daily work pressure and task performance. We discuss the implications of these findings for the stressor-detachment model. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Somaesthetics, Education, and the Art of DancePeter J. Arnold (bio)This essay has two related purposes. The first is to explicate what dance as an art form should minimally comprise if it is to be taught as a distinctive aspect of education in the school curriculum. The second and main purpose is to argue that dance, if taught in accordance with what is outlined, is not only an efficacious (...) means in the development, understanding and promotion of somaesthetics, a new term in aesthetic theory, but an example of itsvery embodiment. Put differently it will be upheld that the practice of danceis not only an excellent vehicle in the promotion of somaesthetics but a paradigm case of what it is.But what is somaesthetics? Briefly put, in common with the thinking of some noted philosophers in the past, it can be said that somaesthetics is as much concerned with the idea of being a person and living well as with the development of rational thought and the development of the intellect. It emphasizes, in particular, that the soma in the form of its physical skills, senses and pleasures plays no less a part in the living of a full life than conceptual understanding and the imaginative use of language.1 Richard Shusterman, upholding these sentiments, refers to somaesthetics asthe critical and meliorating study of the experience and use of one's body as a locus of sensory aesthetic appreciation and creative self-fashioning. It is....devoted to the knowledge, discourses, practices, and bodily disciplines that structure such somatic care or can improve it.2Although such values and concerns are known to many educationists, they are rarely acted upon or taught in a deliberate or systematic way. Even within the realms of dance and sport more could be done than is done somaesthetically to educate in the interests of what it is to be a whole person. [End Page 48]Before embarking on the task of exemplifying dance as a form of somaesthetics, it will be helpful first to say a little about education and the idea of dance as a valued human practice; and second, to say something about the aesthetic in relation to art.Education and the Art of Dance as a Valued Human PracticeWhat is clear about the idea of dance as an art form is that it is more than the human body making rhythmical and patterned movements in space. It can be more accurately described as a coherent and complex range of actions in which intentions are physically expressed in terms of a meaningful performance that is artistic in nature and not merely aesthetic in appeal.It is my view that these elements of what constitutes dance best come together and are most readily grasped when it is seen as a valued form of human practice. Following Alistair MacIntyre, I take the term "practice" to meanany coherent and complex form of socially established co-operative human activity through which goods internal to that activity are realized in the course of trying to achieve those standards of excellence which are appropriate to, and partially definitive of, that form of activity, with the result that human powers to achieve excellence and human conceptions of the ends and goods involved are systematically extended.3The idea of the arts as forms of practice is helpful in at least two important ways. First, it draws attention to the fact that an art, like medicine, the law, or sport, is a distinctive form of life with its own standards, values, and procedures. Second, it recognizes, in keeping with the idea of education, thatthe internal goods of an activity, like the art of dance, will enlighten and enlarge the powers of the participant. MacIntyre undoubtedly recognizes the connection between the idea of a practice and the concept of education when he observes the proper end of education isto help to discover activities whose ends are not outside themselves — The critical ability which ought to be the fruit of education serves nothing directly except itself, no one except those who exercise it — above all the task of education is to teach the value of activity for its own... (shrink)

ABSTRACT It is argued that sport, like science or medicine, is a valued human practice and is characterised as much by the moral manner in which its participants conduct themselves as by the pursuit of its own skills, standards and excellences. Virtues, such as justice, honesty and courage, are not only necessary to pursue its goals but to protect it from being corrupted by external interests. After explicating the practice view of sport in contrast to the sociological view, the nature (...) of competition in sport is discussed before examining two related issues: winning at all costs and the taking of performance-enhancing drugs. The importance of practices to education and the good life is also outlined. (shrink)

The very high genome copy number in cytoplasmic organelles is a puzzling fact in cell biology. It is proposed here that high copy number reflects an increased need for organellar ribosomes that can only be satisfied by the increased ribosomal RNA gene number that results from genome multiplication.

The very high genome copy number in cytoplasmic organelles is a puzzling fact in cell biology. It is proposed here that high copy number reflects an increased need for organellar ribosomes that can only be satisfied by the increased ribosomal RNA gene number that results from genome multiplication.

From cytological examination, the size and form of the chromosomes in the eukaryotic nucleus are invariant across generations, leading to the expectation that constancy of inheritance likely depends on constancy of the chromosomal DNA molecule conveying the constant phenotype. Indeed, except for rare mutations, major phenotypic traits appear largely without change from generation to generation. Thus, when it was discovered that the inheritance of traits for bacteria, mitochondria and chloroplasts was also constant, it was assumed that chromosomes in those locations (...) were also constant. Such has not turned out to be the case, however; those chromosomes are highly variable in structure. I propose, therefore, that only for the nucleus is there a requirement that a chromosome be “finished” (contain only fully replicated genomes) before it may segregate to daughter cells. This requirement does not apply to the variable chromosomes among chloroplasts, mitochondria and bacteria. BioEssays 29:474–483, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

The recent publication by Wylie et al. is reviewed, demonstrating that the p53 protein regulates the movement of transposons. While this work presents genetic evidence for a piRNA‐mediated p53 interaction with transposons in Drosophila and zebrafish, it is herein placed in the context of a decade or so of additional work that demonstrated a role for p53 in regulating transposons and other repetitive elements. The line of thought in those studies began with the observation that transposons damage DNA and p53 (...) regulates DNA damage. The presence of transposon movement can increase the rate of evolution in the germ line and alter genes involved in signal transduction pathways. Transposition can also play an important role in cancers where the p53 gene function is often mutated. This is particularly interesting as recent work has shown that de‐repression of repetitive elements in cancer has important consequences for the immune system and tumor microenvironment. (shrink)

Few residency training programmes explicitly require substantive exposure to issues in medical ethics and fewer still have a formal curriculum in this area. Traditional undergraduate medical ethics courses teach preclinical students to identify ethical issues and analyse them at a theoretical level. Residency training, however, is the ideal time to establish the critical behavioural link which makes ethics truly useful in clinical medicine. The General Internal Medicine Residency Training Program at Rhode Island Hospital has developed an integrated, three-year curriculum with (...) the goals of helping residents to perceive ethical issues in clinical practice, to utilise basic philosophical principles in resolving ethical dilemmas and to communicate these issues clearly and sensitively to patients. The curriculum has been well received by residents and has had a hospital-wide impact. We believe that training residents in medical ethics and communication skills is an effective approach to developing physicians' humane qualities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Back to the Future:Obtaining Organs from Non-Heart-Beating CadaversRobert M. Arnold (bio) and Stuart J. Youngner (bio)Organ Transplantation requires viable donor organs. This simple fact has become the Achilles' heel of transplantation programs. Progress in immunology and transplant surgery has outstripped the supply of available organs. Between 1988 and 1991, for example, the number of transplant candidates on waiting lists increased by about 55 percent, while the number of (...) donors increased only about 16 percent.1 By the end of March 1993, more than 30,000 potential recipients awaited transplantation (United Network for Organ Sharing Database (UNOS) 1993). Every day six of these patients die prior to receiving a heart or liver transplant, while patients needing kidney transplants must tolerate a lower quality of life on dialysis (Grenvik 1992; Evans, Orians, and Ascher 1992).This scarcity is likely to get worse. As transplantation becomes more successful, it is being offered to sicker and older patients. Attempts to transplant other solid organs, such as small bowel and pancreas, will only fuel the demand for donors. However, the current source of organs is unlikely to grow. Most organs come from patients who have been declared dead by neurologic criteria (commonly referred to as "brain dead" or heart-beating cadaver donors (HBCDs) because their hearts are beating at the time of procurement). Estimates of the potential pool of HBCDs have been revised downward from 20,000-27,000 to roughly 10,000-12,000 (Nathan et al. 1991). Improvements in automobile safety and handgun legislation will likely lead to further reductions. Moreover, the rate of procurement from HBCDs has remained relatively flat despite extensive public awareness campaigns and legislation requiring hospitals to routinely request donation from families of dead patients (Caplan et al. 1992).If organ transplantation is going to continue to flourish, alternative [End Page 103] sources of organs must be found. Recently the University of Pittsburgh Medical Center (UPMC) proposed procuring organs from patients who have been declared dead by traditional cardiopulmonary rather than brain-oriented criteria after they or their families have decided to forgo life-sustaining treatment—hereafter referred to as the Pittsburgh protocol (UPMC Policy 1993). These patients are typically referred to as non-heart-beating cadaver donors (NHBCDs) because their hearts are no longer beating at the time of organ procurement.Although NHBCDs were a major source of transplantable kidneys prior to the institution of death by neurologic criteria, their usefulness was limited by "warm ischemia time." This term refers to the injury to tissues that occurs when the blood supply is interrupted and before the organs are cooled and reperfused. Under the Pittsburgh protocol, therapy is withdrawn in the operating room where a waiting surgical team removes organs immediately after death is declared. By controlling the place and time of death, it has been possible to minimize warm ischemia time and thus solve the technical problems previously associated with procurement from NHBCDs.The potential contribution of NHBCD organs is significant. Nathan (1992), using data from Delaware Valley Transplant Program, concludes that the use of severely brain injured, but not "brain dead" patients, would increase the donor pool by 20-25 percent. Moreover, unpublished data from the Pittsburgh organ procurement organization, the Center for Organ Recovery and Education (CORE), suggests that these organs, particularly kidneys, function as well as those procured from HBCDs (Broznick 1993).This volume is devoted to the ethical, psychosocial, and public policy implications of procuring organs from non-heart-beating cadaver donors after a discussion to forgo life-sustaining treatment. The genesis of this volume was a project in which we invited leading experts in transplantation, ethics, and public policy to use the Pittsburgh protocol as a starting point for exploring a broad range of issues associated with attempts to procure organs from NHBCDs. The issues raised by NHBCDs turned out to have important implications about the fundamental conceptual and moral assumptions underlying organ procurement.Although each of the papers in this volume can be read separately, we intend the volume to be read as a whole. Many of the latter pieces on the ethical implications of the policy are best understood in light of the earlier background papers... (shrink)

Fodor argued that in contrast to input systems which are informationally encapsulated, general intelligence is unencapsulated and hence non-modular; for this reason, he suggested, prospects for understanding it are not bright. It is argued that an additional property, primitive functionality, is required for non-modularity. A functionally primitive computational model for quantifier scoping, limited to some scoping influences, is then motivated, and an implementation described. It is argued that only such a model can be faithful to intuitive scope preferences. But it (...) is also argued that an extended model which includes all scoping influences is a hopeless prospect from a developmental perspective. Fodor's views are concluded to have some independent support: quantifier scoping is a mental ability parasitic on general intelligence that is non-modular though in a revised sense, warranting pessimism about our ability of model it. (shrink)

Studies have failed to yield definitive evidence for the existence and/or role of well-defined chaotic attractors in real brain systems. Tsuda's transients stabilized on unstable manifolds of unstable fixed points using mechanisms similar to Ott's algorithmic “control of chaos” are demonstrable. Grebogi's order in preserving “strange nonchaotic” attractor with fractal dimension but Lyapounov is suggested for neural network tasks dependent on sequence.