Background Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input.Methods We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood (...) vaccination.Results 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children.Conclusions We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination. (shrink)

The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence that they will be (...) of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. (shrink)

The extended Church-Turing thesis posits that any computable function can be calculated efficiently by a probabilistic Turing machine. If this thesis held true, the global effort to build quantum computers might ultimately be unnecessary. The thesis would however be strongly contradicted by a physical device that efficiently performs a task believed to be intractable for classical computers. BosonSampling - the sampling from a distribution of n photons undergoing some linear-optical process - is a recently developed, and experimentally accessible example of (...) such a task [1]. (shrink)

In this paper the authors argue that the exploration of the nature of needs and rights should begin with the actually existing organization of care and of justice in society. The authors raise two key concerns with this organization: 1) the invisibility of care to some, and 2) the inaccessibility of rights to others. Recent work by care scholars has called attention to the ways the current organization of care work perpetuates the myth of self-sufficiency for some, while reducing others (...) to mere dependents. Law and Society scholars have demonstrated the problems of uneven access to legal remedies within the current organization of the legal system. Addressing these concerns simultaneously reveals both the problems of the current organization of needs and rights as well as illuminating alternative possibilities. The authors argue, first, that a justice perspective, based on rights is inadequate because its presumed universality is belied by the reality of the inaccessibility of rights to many. Second, the authors argue that a care perspective, currently formulated upon the assumption that only some people have needs, is also flawed because its presumed particularity distorts the human experience and subsequent policies. Instead, the authors need to conceive of care in a public way that permits both rights and needs to be understood as applicable to all. The authors propose some initial thoughts about how to create such a public concept of care. (shrink)

This workshop complemented a Professional Development Workshop offered at the 2012 Academy of Management meeting on “Effective online teaching for social and environmental topics.” This workshop provided new perspectives on how to adapt and enhance Business & Society/Business Ethics undergraduate courses with the adult learner in mind. This workshop was led by conference participants who have experience teaching B&S/BE courses for adult learners.

Health care is provided in many contexts—not just hospitals, clinics, and community health settings. Different institutional settings may significantly influence the design and delivery of health care and the ethical obligations and practices of health care practitioners working within them. This is particularly true in institutions that are established to constrain freedom, ensure security and authority, and restrict movement and choice. We describe the results of a qualitative study of the experiences of doctors and nurses working within two women’s prisons (...) in the state of New South Wales (NSW), Australia. Their accounts make clear how the provision and ethics of health care may be compromised by the physical design of the prison, the institutional policies and practices restricting movement of prisoners and practitioners, the focus on maintaining control and security, and the very purpose of the prison and prison system itself. The results of this study make clear the impact that context has on professional practice and illustrate the importance of sociology and anthropology to bioethics and to the development of a more nuanced account of professional ethics. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Youths with disruptive behavior disorders and psychopathic traits showed reduced amygdala responses to fearful expressions under low attentional load but no indications of increased recruitment of regions implicated in top- down attentional control. These findings suggest that the emotional deficit observed in youths with disruptive behavior disorders and psychopathic traits is primary and not secondary to increased top- down attention to nonemotional stimulus features.

The authors present a case study involving truth telling responsibilities in the setting of nonepileptic seizures. Specifically, over the course of several suspected nonepileptic seizures, a patient’s seizures stopped after he received a saline flush meant to precede the administration of anti-seizure medication. The patient and his surrogate believed he had received the medication each time, and the team wondered whether they should disclose the truth. Some worried that disclosure would reinforce the suspected psychogenic behavior, exacerbating the patient’s condition. In (...) this way, the case study presents a twist on the traditional truth telling archetype. While most truth telling cases center on navigating cultural differences or worries about emotional harm, this case presented concerns about medical harm in the form of exacerbating the patient’s condition. The authors describe the complex patient-family-team dynamic that preceded this ethical dilemma, describe the case, analyze the ethical issue, and describe the outcome. (shrink)

This workshop complemented a Professional Development Workshop offered at the 2012 Academy of Management meeting on “Effective online teaching for social and environmental topics.” This workshop provided new perspectives on how to adapt and enhance Business & Society/Business Ethics undergraduate courses with the adult learner in mind. This workshop was led by conference participants who have experience teaching B&S/BE courses for adult learners.

The nonvisual self-touch rubber hand paradigm elicits the compelling illusion that one is touching one’s own hand even though the two hands are not in contact. In four experiments, we investigated spatial limits of distance and alignment on the nonvisual self-touch illusion and the well-known visual rubber hand illusion. Common procedures and common assessment methods were used. Subjective experience of the illusion was assessed by agreement ratings for statements on a questionnaire and time of illusion onset. The nonvisual self-touch illusion (...) was diminished though never abolished by distance and alignment manipulations, whereas the visual rubber hand illusion was more robust against these manipulations. We assessed proprioceptive drift, and implications of a double dissociation between subjective experience of the illusion and proprioceptive drift are discussed. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

This essay results from a common interest in the history of emotions shared by an academic with appointments in philosophy and psychiatry (Charland) and a literary historian (White). Where our interests converge is in the early modern concept of 'the passions,' as explanatory of what we now call mental illness. The task we have set ourselves is to see how this might: (a) be exemplified in a 'case study' of the dramatic revelation of Leontes's jealousy in the first half of (...) William Shakespeare's The Winter's Tale, and his 'cure' which takes sixteen years. Both events have troubled literary critics as implausible, lacking in realistic motivation, and clumsy as narrative devices, but can be explained in terms of theories of the passions ; and (b) open up a greater, modern understanding of irrational, pathological states, their onset and termination, by using as an explanatory model the early modern understanding of passions as revived and refined in the nineteenth century by Théodule Ribot. Janus-like, this chapter faces into the past and the future (our present) via a play written in 1610 that is still performed to receptive audiences today. We hope to show that the theory can illuminate a playtext, and that the play can revivify the theory, and to contend that historical analysis can shed light on modern clinical problems. The particular historical distinction which lies at the heart of our approach derives from early modern terminology offered by Thomas Wright in his book, The Passions of the Minde in Generall (first published in 1601; corrected, enlarged and augmented in 1604), and presented in more modern fashion in the nineteenth century by Théodule Ribot, in his La Psycholgie des sentiments * We dedicate this essay to Philippa Maddern, whose inspiration has generated so much inter-disciplinary research in the history of emotions and has brought so many like-minded scholars into fertile contact—in our cases, linking Western Ontario and Western Australia. (shrink)

A reply to Stuart Brown on how to understand the concept of learning.

The rubber hand paradigm is used to create the illusion of self-touch, by having the participant administer stimulation to a prosthetic hand while the Examiner, with an identical stimulus , administers stimulation to the participant’s hand. With synchronous stimulation, participants experience the compelling illusion that they are touching their own hand. In the current study, the robustness of this illusion was assessed using incongruent stimuli. The participant used the index finger of the right hand to administer stimulation to a prosthetic (...) hand while the Examiner used a paintbrush to administer stimulation to the participant’s left hand. The results indicate that this violation of tactile expectations does not diminish the illusion of self-touch. Participants experienced the illusion despite the use of incongruent stimuli, both when vision was precluded and when visual feedback provided clear evidence of the tactile mismatch. (shrink)

This book is a philosophical commentary on Schopenhauer's "Fourfold Root of the Principle of Sufficient Reason," dealing with each of Schopenhauer's principal ...

A simple experimental paradigm creates the powerful illusion that one is touching one’s own hand even when the two hands are separated by 15 cm. The participant uses her right hand to administer stimulation to a prosthetic hand while the Examiner provides identical stimulation to the participant’s receptive left hand. Change in felt position of the receptive hand toward the prosthetic hand has previously led to the interpretation that the participant experiences self-touch at the location of the prosthetic hand, and (...) experiences a sense of ownership of the prosthetic hand. Our results argue against this interpretation. We assessed change in felt position of the participant’s receptive hand but we also assessed change in felt position of the participant’s administering hand. Change in felt position of the administering hand was significantly greater than change in felt position of the receptive hand. Implications for theories of ownership are discussed. (shrink)

In Philosophy for April 1961 Mr J. R. Lucas argues that Gödel's theorem proves that Mechanism is false. I wish to dispute this view, not because I maintain that Mechanism is true, but because I do not believe that this issue is to be settled by what looks rather like a kind of logical conjuring-trick. In my discussion I take for granted Lucas's account of Gödel's procedure, which I am not competent to criticise.

Towards the close of Book V of theRepublicPlato tells us that the true philosopher has knowledge and that the objects of knowledge are the Forms. By contrast, the ‘lovers of sights and sounds’, he tells us, have no more than belief, the objects of which are physical particulars. He then goes on to present us with some very radical-sounding assertions about the nature of these physical particulars. They are bearers of opposite properties, he says, in so thorough-going a manner that (...) we cannot say of them that they are nor that they are not: they lie somewhere between being and utter non-being.This passage of theRepublic still awaits an agreed interpretation and I want to suggest as a reason for this that it is usually interpreted in isolation. I will argue that it becomes easier to understand when seen against the background of Plato's developing thought. To be more precise, it makes sense when taken as a rejection by Plato of one of his earlier beliefs: namely, a doctrine of essentialism to be found in thePhaedo.The greater part of this paper then will be an attempt to show thatRepublicV is a rejection of thePhaedo'sdoctrine of essences. Its concluding part will try to explain why that doctrine was rejected. (shrink)

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

This chapter contains sections titled: The Nature of Schopenhauer's Platonic Ideas and Their Relation to Individuals The Exclusion of Mathematical Ideas The Exclusion of Value Ideas Schopenhauer's Justification of His Restriction of Ideas to Ideas in Nature Schopenhauer's Theory of Art Considered in Itself Irresoluble Conflicts between Plato and Schopenhauer Notes References Further Reading.

ABSTRACTThis research investigated whether precues engage proactive control to reduce emotional interference during speech production. A picture-word interference task required participants to name target pictures accompanied by taboo, negative, or neutral distractors. Proactive control was manipulated by presenting precues that signalled the type of distractor that would appear on the next trial. Experiment 1 included one block of trials with precues and one without, whereas Experiment 2 mixed precued and uncued trials. Consistent with previous research, picture naming was slowed in (...) both experiments when distractors were taboo or negative compared to neutral, with the greatest slowing effect when distractors were taboo. Evidence that precues engaged proactive control to reduce interference from taboo distractors was found in Experiment 1. In contrast, mixing precued trials in Experiment 2 resulted in no taboo cueing benefit. These results suggest that item-level proactive control can b... (shrink)