Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...) the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting. (shrink)

Social isolation and loneliness are growing concerns around the globe that put people at increased risk of disease and early death. One much‐touted approach to addressing them is deploying artificially intelligent agents to serve as companions for socially isolated and lonely people. Focusing on digital humans, we consider evidence and ethical arguments for and against this approach. We set forth and defend public health policies that respond to concerns about replacing humans, establishing inferior relationships, algorithmic bias, distributive justice, and data (...) privacy. (shrink)

Formalisms such as description logics (DL) are sometimes expected to help terminologies ensure compliance with sound ontological principles. The objective of this paper is to study the degree to which one DL-based biomedical terminology (SNOMED CT) complies with such principles. We defined seven ontological principles (for example: each class must have at least one parent, each class must differ from its parent) and examined the properties of SNOMED CT classes with respect to these principles. Our major results are: 31% of (...) the classes have a single child; 27% have multiple parents; 51% do not exhibit any differentiae between the description of the parent and that of the child. The applications of this study to quality assurance for ontologies are discussed and suggestions are made for dealing with multiple inheritance. (shrink)

Enhancing body awareness has been described as a key element or a mechanism of action for therapeutic approaches often categorized as mind-body approaches, such as yoga, TaiChi, Body-Oriented Psychotherapy, Body Awareness Therapy, mindfulness based therapies/meditation, Feldenkrais, Alexander Method, Breath Therapy and others with reported benefits for a variety of health conditions. To better understand the conceptualization of body awareness in mind-body therapies, leading practitioners and teaching faculty of these approaches were invited as well as their patients to participate in focus (...) groups. The qualitative analysis of these focus groups with representative practitioners of body awareness practices, and the perspectives of their patients, elucidated the common ground of their understanding of body awareness. For them body awareness is an inseparable aspect of embodied self awareness realized in action and interaction with the environment and world. It is the awareness of embodiment as an innate tendency of our organism for emergent self-organization and wholeness. The process that patients undergo in these therapies was seen as a progression towards greater unity between body and self, very similar to the conceptualization of embodiment as dialectic of body and self described by some philosophers as being experienced in distinct developmental levels. (shrink)

We explore the nature of forgetting in a corpus of 125,000 students learning Spanish using the Rosetta Stone® foreign-language instruction software across 48 lessons. Students are tested on a lesson after its initial study and are then retested after a variable time lag. We observe forgetting consistent with power function decay at a rate that varies across lessons but not across students. We find that lessons which are better learned initially are forgotten more slowly, a correlation which likely reflects a (...) latent cause such as the quality or difficulty of the lesson. We obtain improved predictive accuracy of the forgetting model by augmenting it with features that encode characteristics of a student's initial study of the lesson and the activities the student engaged in between the initial and delayed tests. The augmented model can predict 23.9% of the variance in an individual's score on the delayed test. We analyze which features best explain individual performance. (shrink)

Because medicine can preserve and restore health and function, it is widely acknowledged as a basic good that a just society owes its members. Yet there is controversy over the scope of what should be provided, to whom, how, when and why. This comprehensive and authoritative book - by well-known philosophers, doctors, lawyers, political scientists, and economists - lays a theoretical foundation for understanding the debate, assesses how health care is distributed in different countries and to various social groups, and (...) analyzes practical issues in constructing a socially just health care system. (shrink)

Over the past decades, anti-cancer treatments have evolved rapidly from cytotoxic chemotherapies to targeted therapies including oral targeted medications and injectable immunooncology and cell therapies. New anti-cancer medications come to markets at increasingly high prices, and health insurance coverage is crucial for patient access to these therapies. State laws are intended to facilitate insurance coverage of anti-cancer therapies.Using Massachusetts as a case study, we identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of (...) the laws and how well they meet the current needs of cancer care given rapid changes in therapies. Interviewees emphasized that cancer therapies, as compared to many other therapeutic areas, are unique because insurance legislation targets their coverage. They identified the oral chemotherapy parity law as contributing to increasing treatment costs in commercial insurance. For commercial insurers, coverage mandates combined with the realities of new cancer medications — including high prices and often limited evidence of efficacy at approval — compound a difficult situation. Respondents recommended policy approaches to address this challenging coverage environment, including the implementation of closed formularies, the use of cost-effectiveness studies to guide coverage decisions, and the application of value-based pricing concepts. Given the evolution of cancer therapeutics, it may be time to evaluate the benefits and challenges of cancer coverage mandates. (shrink)

The larger part of Yearbook 6 of the Institute Vienna Circle constitutes the proceedings of a symposium on Alfred Tarski and his influence on and interchanges with the Vienna Circle, especially those on and with Rudolf Carnap and Kurt Gödel. It is the first time that this topic has been treated on such a scale and in such depth. Attention is mainly paid to the origins, development and subsequent role of Tarski's definition of truth. Some contributions are primarily historical, others (...) analyze logical aspects of the concept of truth. Contributors include Anita and Saul Feferman, Jan Wolenski, Jan Tarski and Hans Sluga. Several Polish logicians contributed: Gzegorczyk, Wójcicki, Murawski and Rojszczak. The volume presents entirely new biographical material on Tarski, both from his Polish period and on his influential career in the United States: at Harvard, in Princeton, at Hunter, and at the University of California at Berkeley. The high point of the analysis involves Tarski's influence on Carnap's evolution from a narrow syntactical view of language, to the ontologically more sophisticated but more controversial semantical view. Another highlight involves the interchange between Tarski and Gödel on the connection between truth and proof and on the nature of metalanguages. The concluding part of Yearbook 6 includes documentation, book reviews and a summary of current activities of the Institute Vienna Circle. Jan Tarski introduces letters written by his father to Gödel; Paolo Parrini reports on the Vienna Circle's influence in Italy; several reviews cover recent books on logical empiricism, on Gödel, on cosmology, on holistic approaches in Germany, and on Mauthner. (shrink)

La metáfora del teatro no sólo aparece en el título del _Teatro crítico universal_ (1726–1739) de Benito Jerónimo Feijoo, sino también fue aducida por Pierre Bayle en su _Projet et fragmens d’un dictionaire critique _(1692). Es cierto que, a principios de la Edad Moderna, la metáfora del teatro podía emplearse y se empleaba en multitud de contextos y con fines muy diversos. Sin embargo, la combinación de teatro y error, tal y como se da tanto en Bayle como en Feijoo, (...) merece un examen más detenido. Se muestra cómo el _Theatrum vitae humanae_ (1565) de Theodor Zwinger, que es el texto en el que Bayle afirma basar su _Dictionnaire_, introduce una noción de teatro que no se centra en el escenario sino en el auditorio. Esto es significativo tanto para las estrategias de escritura de Bayle como para las de Feijoo, ya que apunta a la gestión de vastos cuerpos de conocimiento y, en última instancia, a la citacionalidad de ambos proyectos. Al mismo tiempo, sitúa al lector frente a la sabiduría tradicional y prepara así un espacio para el modo emergente de la crítica – por algunos caracterizado como escepticismo – que informa los proyectos de ambos autores. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

The prelims comprise: Part I Part II Note.

_The Blackwell Guide to Medical Ethics_ is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and confidentiality (...) Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy. (shrink)

There is a thriving debate over what aspects of our capacity to produce and understand language are special. My concern here is a key part of this wider debate: Is speech special? In particular, my focus is on speech perception, and whether it is special. This isn’t just one but a number of different questions. Too frequently, these very different questions are not clearly distinguished and kept apart. I discuss a framework for distinguishing various versions of the question, Is speech (...) perceptually special? Focusing on a particular class of questions, I make a proposal about the sense in which speech is perceptually special. According to this account, the capacity to perceive speech is an acquired perceptual skill, and involves learning to hear language-specific types of biologically-significant sounds. This account illuminates the significance of interlocution in understanding what makes the perception of speech distinctive. (shrink)

Use of patient clinical photographs requires specific attention to confidentiality and privacy. Although there are policies and procedures for publishing clinical images, there is little systematic evidence about what patients and health professionals actually think about consent for publishing clinical images. We investigated the opinions of three stakeholder groups at 3 academic healthcare institutions and 37 private practices in Croatia. The questionnaire contained patient photographs with different levels of anonymization. All three respondent groups considered that more stringent forms of permission (...) for were needed identifiable photographs than for those with higher levels of anonymization. When the entire face was presented in a photo only 33% of patients considered that written permission was required, compared with 88% of the students and 89% of the doctors. Opinions about publishing patient photographs differed among the three respondent samples: almost half of the patients thought no permission was necessary compared with one-third of students and doctors. These results show poor awareness of Croatian patients regarding the importance of written informed consent as well as unsatisfactory knowledge of health professionals about policies on the publication of patients’ data in general. In conclusion, there is a need for increasing awareness of all stakeholders to achieve better protection of patient privacy rights in research and publication. (shrink)

Three studies were conducted to explore the psychological determinants of COVID-deterrent behaviors. In Study 1, using data collected and analyzed both before and after the release of COVID-19 vaccines, mask-wearing, other preventative behaviors like social distancing, and vaccination intentions were positively related to assessments of the Coronavirus Behavioral Health Mindset ; belief in the credibility of science; progressive political orientation; less use of repressive and more use of sensitization coping; and the attribution of COVID-19 safety to effort rather than ability, (...) powerful forces, fate, or luck. In Study 2, favorable COVID-19 vaccination intentions were related to greater willingness to work, lower emotional distress, and greater customer experience mindset. Study 3 examined the personality and motives of individuals who volunteered to help deliver COVID-19 inoculations to the local community. The vaccine-giving volunteers, especially those with prosocial motives, had high CVBHM scores, belief in the credibility of science, low use of repressive coping, greater attribution of COVID-19 protection to effort, low likelihood of voting conservative, were older, and had more education than others. The majority of public health volunteers expressed prosocial motives to help people or join a cause, but many expressed the personal motives of getting the COVID-19 vaccination for themselves, conveying a public image of compassion, or structuring time. Based on the three research studies, a COVID-19 Mindset Hierarchy model is proposed to integrate the results. (shrink)

Bioethics, Volume 36, Issue 5, Page 500-510, June 2022.

A fundamental tenet of hermeneutic phenomenology is that people seek to create meaning of their experience from the response sited within human consciousness. The focus of this study is on the world of the lived experience as it is interpreted by participants through memory and language as accessed by interviews in order to produce an understanding of the participants’ experience. Three participants were interviewed whose adult children had died as a result of an AIDS-related illness. The interviews were recorded and (...) transcribed, and interwoven analyses sought to illustrate the participants’ lived experience of the phenomenon. An attempt was made to understand how the various phenomena relating to parental bereavement were reflected by participants in the interviews. Common themes included reactions to the knowledge of the illness, the experience of being with their dying child, coping with the pain of the loss, and spiritual and existential concerns. There are references to how others judge their grieving behaviour. Issues of retribution and punishment are prominent and these appear to place a particular burden of sorrow on the grieving parent. The study provided insight into the lived experience of bereavement and the forging of new meaning structures that can accommodate the loss. (shrink)

This paper contributes to the discussion on methodological decolonisation in business ethics research by illustrating how local epistemologies can shape methodology. Historically, business ethics research has been dominated by Western methodologies, which have been argued to be restrictive and limit contextually relevant theorising in non-Western contexts. Over the past decade, scholarship has called for more diversity in research methods and epistemologies. This paper regards arguments founded along neatly divided universalist versus contextualised methodologies as a false dilemma. Instead, we explore how (...) _ubuntu_, a sub-Saharan African epistemology, can contribute as a complementary epistemology and methodology to interpretivism when conducting business ethics research in sub-Saharan Africa. The paper discusses four aspects—research agenda, access, power relations, and context-sensitive methods—that highlight practical ways in which _ubuntu_ epistemology, with its communitarian and relational underpinnings, can enhance business ethics research. We illustrate that methodological decolonisation can be achieved by fusing relevant elements of local epistemologies and methodologies and conventional methodologies to generate context-relevant research approaches. (shrink)

Evidence for one or more loci on the human X chromosome influencing social cognition was recently presented by Skuse et al.(1). The imprinted locus is only expressed from a paternally inherited X chromosome, which means that boys do not express it because their only X chromosome comes from their mother. This raises the possibility of genetic as well as cultural influences on sex differences in behaviour and cognition. It may also offer some explanation for why boys are more vulnerable to (...) developmental disorders that affect social behaviour, such as autism. (shrink)

Tertiary healthcare ethics (HCE) consultation occurs when an HCE consultant at a healthcare facility requests guidance from one or more senior HCE consultants who are not members of that facility’s HCE consultation service. Tertiary HCE consultants provide advanced HCE guidance and/or mentoring to facility (secondary) HCE consultants, mirroring healthcare consultation in clinical practice. In this article, we describe advantages and challenges of providing tertiary HCE consultation through a hub-and-spoke model administered by a national integrated HCE service.

The Buddhist Jātaka tells the tale of a hare lounging under a palm tree who becomes convinced the Earth is coming to an end when a ripe bael fruit falls on its head. Soon all the hares are running; other animals join them, forming a stampede of deer, boar, elk, buffalo, wild oxen, rhinoceros, tigers and elephants, loudly proclaiming the earth is ending.1 In the American retelling, the hare is ‘chicken little,’ and the exaggerated fear is that the sky is (...) falling. The story offers a cautionary tale for considering the trend towards calamity thinking in artificial intelligence (AI). A growing chorus of tech leaders has warned that AI poses existential risk (X-Risk) that could result in the extinction of the human species, the collapse of civilisation, or a colossal decline in human potential and culture. In 2014, Hawking told the Washington Post that AI, ‘could spell the end of the human race’.2 Musk has repeatedly warned about AI’s perils, calling AI, ‘more dangerous than nukes’, recommending colonising Mars to ensure ‘a bolt-hole if AI goes rogue and turns on humanity’,3 and donating 10 million dollars to the Future of Life Institute to jumpstart research on AI’s X-Risk. Gates has stated, ‘I am in the camp…concerned about super intelligence…I agree with … Musk and some others on this and don’t understand why some people are not concerned’.4 Altman, CEO of OpenAI, has fretted that technologies OpenAI was building could endanger humanity—‘even destroying the world as we know it’.5 This paper offers a critical appraisal of the rise of calamity thinking in the scholarly AI ethics literature. It cautions against viewing X-Risk in isolation and highlights ethical considerations sidelined when X-Risk takes centre stage. Section I introduces a working definition of X-Risk, considers its likelihood and …. (shrink)

Out from the Shadows showcases the work of 18 analytical feminists from a variety of traditional areas of philosophy: social and political philosophy, normative ethics, virtue theory, metaethics, philosophy of language, metaphysics, epistemology, and philosophy of science. The collection is unique both in its focus on analytical feminism and in its breadth across the subdisciplines within philosophy. The book highlights successful uses of concepts and approaches from traditional philosophy, and illustrates the contributions that feminist approaches have made and could make (...) to the analysis of issues in key areas of traditional philosophy, while also demonstrating that traditional philosophy ignores feminist insights and feminist critiques of traditional philosophy at its own peril. (shrink)

Meaning lies at the very heart of the development of language. Therefore, it is not surprising that the linguists have long been fascinated by the study of meaning, from the early days of the discipline to the present. Over time, the approach to meaning has evolved, shifting from structuralist analyses of linguistic signs to a focus on the combinatory potential of grammatical structures. Currently, the dominant cognitive-semantics approach examines meaning in relation to concepts and the human brain's abilities. One of (...) the most intriguing questions throughout the history of semantics has been the one that deals with the relationship between an individual and the linguistic community within the framework of the wider sign-meaning relation. This essential, but insufficiently explored relationship was the central topic of the 33rd International Conference of the Croatian Applied Linguistics Society. (shrink)

Les émotions peuvent être pénibles, voire néfastes. Pensons par exemple à la peur, la colère, la haine, la jalousie ou au mépris. De telles émotions sont souvent qualifiées de négatives. Mais que sont les émotions négatives et comment se distinguent-elles des émotions positives ? Plus généralement, qu’impliquent-elles pour notre compréhension des émotions ? Et quels sont concrètement leurs effets sur nos pensées et nos vies ? De plus, comment analyser l’ambivalence affective, comme quand on ressent à la fois de l’amour (...) et de la haine ? Réunissant dix contributions rédigées pour l’occasion, Les ombres de l’âme propose des éléments de réponses originaux à ces questions. Ce faisant, cet ouvrage jette les bases d’une philosophie des émotions négatives. (shrink)

Negative emotions are familiar enough, but they have rarely been a topic of study in their own right. This volume brings together fourteen chapters on negative emotions, written in a highly accessible style for non-specialists and specialists alike. It starts with chapters on general issues raised by negative emotions, such as the nature of valence, the theoretical implications of nasty emotions, the role of negative emotions in fiction, as well as the puzzles raised by ambivalent and mixed emotions. The second (...) part of the volume consists of studies of specific emotional phenomena, ranging from the emotion of being moved and the sense of uncanniness to jealousy, hatred, shame, contempt, anxiety, and grief. (shrink)

The paper presents a comparison of the two most commonly used diagnostic tests for orthorexia – ORTO-15 Questionnaire and BOT (Bratman Orthorexia Test) – that use data-mining methods. Orthorexia nervosa is perceived as a new, unclassified eating disorder, which is characterized with pathological fixation on the consumption of healthy foods. In order to assess the coherence of the aforementioned tests, a method from the data-mining group, i.e. correspondence analysis, was used in addition to traditional statistical methods. On the basis of (...) the obtained results, only average correlation between ORTO-15 Questionnaire and BOT test was found. More cases of orthorexia were diagnosed with the use of ORTO-15 Questionnaire, which may result from its higher sensitivity. It was also noted that the coherence of tests increases with increasing BMI values, despite no relationship between BMI and the presence of orthorexia having been proved. Diagnosis of an orthorexia case with the use of BOT test implies that there is a high probability that it will also be diagnosed with the use of ORTO-15 test, but not necessarily the other way around. The performed correspondence analysis confirmed a not very strong coherence of the results of both tests. (shrink)