Honor walks are ceremonies that purportedly honor organ donors as they make their final journey from the ICU to the OR. In this paper, we draw on Ronald Grimes’ work in ritual studies to examine honor walks as ceremonial rituals that display medico-technological power in a symbolic social drama (Grimes, 1982). We argue that while honor walks claim to honor organ donors, ceremonies cannot primarily honor donors, but can only honor donation itself. Honor walks promote the quasi-religious idea of donation (...) as a “good death,” and mask the ambiguity and discomfort inherent in organ donation to promote greater acceptance by the medical community. While some goods may be achieved through honor walks, particularly for donor families, it is still important to examine the negative work done by this practice. (shrink)

In recent years, increasingly advanced artificial intelligence (AI), and in particular machine learning, has shown great promise as a tool in various healthcare contexts. Yet as machine learning in medicine has become more useful and more widely adopted, concerns have arisen about the “black-box” nature of some of these AI models, or the inability to understand—and explain—the inner workings of the technology. Some critics argue that AI algorithms must be explainable to be responsibly used in the clinical encounter, while supporters (...) of AI dismiss the importance of explainability and instead highlight the many benefits the application of this technology could have for medicine. However, this dichotomy fails to consider the particular ways in which machine learning technologies mediate relations in the clinical encounter, and in doing so, makes explainability more of a problem than it actually is. We argue that postphenomenology is a highly useful theoretical lens through which to examine black-box AI, because it helps us better understand the particular mediating effects this type of technology brings to clinical encounters and moves beyond the explainability stalemate. Using a postphenomenological approach, we argue that explainability is more of a concern for physicians than it is for patients, and that a lack of explainability does not introduce a novel concern to the physician–patient encounter. Explainability is just one feature of technological mediation and need not be the central concern on which the use of black-box AI hinges. (shrink)

The COVID-19 outbreak has ravaged all societal domains, including education. Home confinement, school closures, and distance learning impacted students, teachers, and parents’ lives worldwide. In this study, we aimed to examine the impact of COVID-19-related restrictions on Italian and Portuguese students’ academic motivation as well as investigate the possible buffering role of extracurricular activities. Following a retrospective pretest–posttest design, 567 parents reported on their children’s academic motivation and participation in extracurricular activities. We used a multi-group latent change score model to (...) compare Italian and Portuguese students’: pre-COVID mean motivation scores; rate of change in motivation; individual variation in the rate of change in motivation; and dependence of the rate of change on initial motivation scores. Estimates of latent change score models showed a decrease in students’ motivation both in Italy and in Portugal, although more pronounced in Italian students. Results also indicated that the decrease in students’ participation in extracurricular activities was associated with changes in academic motivation. Furthermore, students’ age was significantly associated with changes in motivation. No significant associations were found for students’ gender nor for parents’ education. This study provides an important contribution to the study of students’ academic motivation during home confinement, school closures, and distance learning as restrictive measures adopted to contain a worldwide health emergency. We contend that teachers need to adopt motivation-enhancing practices as means to prevent the decline in academic motivation during exceptional situations. (shrink)

This paper examines heterogeneous impacts of gendered household headship and control of resources on food security in rural Tanzania. Analysis with minimal attention to heterogeneity in gender considerations indicates no differences in household food security between male and female-headed households. But with a more differentiated household headship variable and accounting for gendered differences in resource ownership, the results differ markedly. Using more gender-disaggregated variables, our results show significant differences between female-headed and male-headed households. In these results we find support for (...) the claim that gender norms in the study villages often restrict women’s access to resources, resulting in more vulnerable female-headed households. Female-headed households with no male adults present are particularly vulnerable. The study also points to specific opportunities for enhanced food security with attention to female and joint ownership of livestock. These results represent a hopeful sign that efforts to enhance female livestock ownership could be a useful strategy to address lower levels of food consumption in these Tanzanian villages. (shrink)

Update on donation of bodily material in the UKIn March 2010, the Human Tissue Authority announced that the first pooled kidney transplants, each involving three living donors and three recipients, had been performed in the UK. 1 While the vast majority of living donor transplants take place between people who are genetically related or are otherwise emotionally close, the Human Tissue Act 2004 introduced greater flexibility, permitting, for example, altruistic, paired and pooled donation. The HTA commented that these types of (...) donation represent one in three of all kidney transplants in the UK. Under the system of paired and pooled donation, in which someone needs a donor organ and has a friend or relative willing to donate, but the two are not compatible with each other, they can pair up with one or more other incompatible donor and recipient pairs in an organ exchange. In paired donation, donor A gives an organ to recipient B and donor B gives to recipient A; in pooled donation, more than two donor–recipient pairs take part in an organ exchange, coordinated by the HTA . Under the human tissue legislation, all cases of paired and pooled donation need to be considered by an independent assessor and approved by a panel of at least three members of the HTA, to ensure that all parties fully understand the risks involved and the donors are not under any pressure to donate.The first pooled transplant took place late in 2009, and was followed shortly afterwards by a second. Several paired living kidney transplants, involving two couples, had already taken place, however, with 16 such transplants going ahead between 1 April 2008 and 31 March 2009. Also in March 2010, a …. (shrink)

Recent studies have provided evidence of associations between neurochemistry and reading (dis)ability (Pugh et al., 2014). Based on a long history of studies indicating that fluent reading entails the automatic convergence of the written and spoken forms of language and our recently proposed Neural Noise Hypothesis (Hancock et al., 2017), we hypothesized that individual differences in cross-modal integration would mediate, at least partially, the relationship between neurochemical concentrations and reading. Cross-modal integration was measured in 231 children using a two-alternative forced (...) choice cross-modal matching task with three language conditions (letters, words, and pseudowords) and two levels of difficulty within each language condition. Neurometabolite concentrations of Choline (Cho), Glutamate (Glu), gamma-Aminobutyric (GABA), and N- acetyl-aspartate (NAA) were then measured in a subset of this sample (n = 70) with Magnetic Resonance Spectroscopy (MRS). A structural equation mediation model revealed that the effect of cross-modal word matching mediated the relationship between increased Glu (which has been proposed to be an index of neural noise) and poorer reading ability. In addition, the effect of cross-modal word matching fully mediated a relationship between increased Cho and poorer reading ability. Multilevel mixed effects models confirmed that lower Cho predicted faster cross-modal matching reaction time, specifically in the hard word condition. These Cho... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Fallout from Government-Sponsored Radiation ResearchCarol Mason Spicer (bio)On December 28, 1993, Energy Secretary Hazel R. O'Leary publicly appealed to both the executive and legislative branches of the United States Government to consider compensation for individuals who were harmed by their exposure to ionizing radiation while enrolled in government-sponsored studies conducted between 1940 and the early 1970s.1 The call for compensation was issued three weeks after Secretary O'Leary disclosed (...) that radiation experiments involving humans, sometimes without their consent, had occurred under the auspices of the Atomic Energy Commission (AEC), a forerunner of the Department of Energy (DOE). Secretary O'Leary directed her department to investigate the nature and extent of the experiments, report on their medical and ethical acceptability, and locate the research subjects or their families.Background to the Federal Advisory CommitteeDespite the fact that the existence of many government-sponsored radiation experiments was not a secret—much of the research was reported at the time in scientific journals, and in 1986, Representative Edward J. Markey (D-MA) conducted congressional hearings on such radiation research—Secretary O'Leary's disclosure of the AEC experiments and her call for compensation made the experiments common knowledge and sparked a swift and complex governmental response involving both the executive and legislative branches.It is curious that the "radiation experiments" have garnered so much attention now, since they were virtually ignored in the wake of the 1986 hearings. Secretary O'Leary's disclosure of the radiation studies grew out of a general reassessment of secrecy in government. In April 1993, the Clinton administration set out to review the system of government secrecy that evolved during the Cold War, and in May 1993, DOE began reviewing and declassifying files pertaining to nuclear weapons research. When Dan Reicher, a top aide to Secretary O'Leary, informed her in November of the impending publication of an Albuquerque Tribune investigative report (Welsome 1993) on an experiment conducted between 1945 and 1947 in which 18 subjects were injected with plutonium, [End Page 147] the topic of questionable research involving the exposure of human subjects to radiation was added to the DOE list of information to be disclosed. At the time, it was thought to be but one small part of a massive quantity of DOE information to be made public.As part of its effort to investigate the radiation experiments, DOE established a toll-free telephone hot line for individuals who thought they might have been the subjects of radiation exposure experiments. The hot line, originally staffed by three people to handle the anticipated few dozen calls per day, received more than 2,000 calls in the first week. By early January the hot line was flooded with 6,000 to 10,000 calls daily, and its staff had increased more than ten-fold. Although many of the calls were deemed not to be candidates for further investigation, the extent of the radiation-related experiments, sponsored not only by AEC, but also by the military and other government departments and agencies, took officials by surprise.On December 30, the Department of Defense, the Department of Veterans Affairs, and the National Aeronautics and Space Administration all announced that they were initiating thorough reviews of their files to determine the extent and nature of any radiation experiments conducted under their auspices.2 In January, the CIA and the Department of Health and Human Services, including the National Institutes of Health, followed suit.The White House publicly entered the arena in late December announcing that it would hold a meeting on January 3, 1994, to help coordinate the government's investigative effort. At the same time, Senator Edward M. Kennedy (D-MA) called for a mid-January congressional hearing to investigate experiments conducted between 1946 and 1956 in which mentally retarded boys at the Fernald State School in Massachusetts were fed radioactive iron supplements or milk containing radioactive calcium to enable researchers to trace the absorption of those nutrients. Senator Kennedy's hearing, conducted by the Subcommittee on Health of the Senate Committee on Labor and Human Resources, was the first of a number of congressional hearings held earlier this year to investigate the... (shrink)

I discuss three views of promising: the view is that promising is a social practice, and that our obligation to keep promises is related to the practice in some way; Scanlon’s non-practice view, and Wallace and Kolodny’s “hybrid view”. I shall argue that none of these accounts is satisfactory, and propose a fourth view: deflationism. Deflationism is the view that saying “I promise” merely adds emphasis and does not incur any extra obligation.

This paper traces the development of parental rights to accept or to refuse treatment for a defective newborn infant in the United Kingdom and in the United States of America; its main purpose is to explore the common trends from which an acceptable policy may be derived. It is probable that the British law on parental decision-making in respect of infants suffering from Down's syndrome is to be found in the civil case of In Re B rather than in the (...) criminal case of R v Arthur. United States court decisions are strongly influenced by constitutional law and reflect the right to personal privacy. The position on each side of the Atlantic seems very similar but this similarity includes a sense of uncertainty as to legal responsibility. There is a case for agreed guidelines and a suggested format is offered for consideration. (shrink)