Moral pluralism is the norm in contemporary society. Even the best philosophical arguments rarely persuade moral opponents who differ at a foundational level. This has been vividly illustrated in contemporary debates in bioethics surrounding contentious issues such as abortion and euthanasia. It is readily apparent that bioethics discourse lacks an empirical explanation for the broad differences about various topics in bioethics and health policy. In recent years, social and cognitive psychology has generated novel approaches for defining basic differences in moral (...) intuitions generally. We propose that if empirical research using social intuitionist theory explains why people disagree with one another over moral issues, then the results of such research might help people debate their moral differences in a more constructive and civil manner. We illustrate the utility of social intuitionism with data from a national physician survey. (shrink)

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)

In Perceiving God, William Alston briefly suggests the possibility of perceiving God indirectly through the perception of another object. Following recent work by C. Stephen Evans, we argue that Thomas Reid’s notion of “natural signs” helpfully illuminates how people can perceive God indirectly through natural beauty. First, we explain how some natural signs enable what Alston labels “indirect perception.” Second, we explore how certain emotions make it possible to see both beauty and the excellence of the minds behind beauty. Finally, (...) we explain how aesthetic emotions can involve indirect perception of God via the natural sign of natural beauty. (shrink)

Neurological diseases, particularly in the context of aging, have serious impacts on quality of life and can negatively affect bone health. The brain-bone axis is critically important for skeletal metabolism, sensory innervation, and endocrine cross-talk between these organs. This review discusses current evidence for the cellular and molecular mechanisms by which various neurological disease categories, including autoimmune, developmental, dementia-related, movement, neuromuscular, stroke, trauma, and psychological, impart changes in bone homeostasis and mass, as well as fracture risk. Likewise, how bone may (...) affect neurological function is discussed. Gaining a better understanding of brain-bone interactions, particularly in patients with underlying neurological disorders, may lead to development of novel therapies and discovery of shared risk factors, as well as highlight the need for broad, whole-health clinical approaches toward treatment. (shrink)

sirIn a scholarly and thought-provoking paper, Clarke sets out to debunk the concept of “rational suicide” as nonsensical.1 His motivation in this is to undermine any support that the notion of rational suicide might give to a “categorical right to suicide”. If his enterprise were successful, however, it would go far beyond the “rights issue” and would have a profound impact on all arguments raised in support of euthanasia or physician-assisted suicide.Clarke's major thrust might be termed the argument from posthumous (...) ignorance. He begins with a claim that the process of making a rational decision involves the process of “gaining all possible facts and `imagining' all possible consequences”. He goes on to say that making a rational decision “in the consideration of life or death . . . would seem to be impossible”. It is “impossible” …. (shrink)

A crisis continues to brew within the pharmaceutical research and development (R&D) enterprise: productivity continues declining as costs rise, despite ongoing, often dramatic scientific and technical advances. To reverse this trend, we offer various suggestions for both the expansion and broader adoption of modeling and simulation (M&S) methods. We suggest strategies and scenarios intended to enable new M&S use cases that directly engage R&D knowledge generation and build actionable mechanistic insight, thereby opening the door to enhanced productivity. What M&S requirements (...) must be satisfied to access and open the door, and begin reversing the productivity decline? Can current methods and tools fulfill the requirements, or are new methods necessary? We draw on the relevant, recent literature to provide and explore answers. In so doing, we identify essential, key roles for agent-based and other methods. We assemble a list of requirements necessary for M&S to meet the diverse needs distilled from a collection of research, review, and opinion articles. We argue that to realize its full potential, M&S should be actualized within a larger information technology framework—a dynamic knowledge repository—wherein models of various types execute, evolve, and increase in accuracy over time. We offer some details of the issues that must be addressed for such a repository to accrue the capabilities needed to reverse the productivity decline. (shrink)

Ethical leadership research has primarily relied on social learning and social exchange theories. Although these theories have been generative, additional theoretical perspectives hold the potential to broaden scholars’ understanding of ethical leadership’s effects. In this paper, we examine moral typecasting theory and its unique implications for followers’ leader-directed citizenship behavior. Across two studies employing both survey-based and experimental methods, we offer support for three key predictions consistent with this theory. First, the effect of ethical leadership on leader-directed citizenship behavior is (...) curvilinear, with followers helping highly ethical and highly unethical leaders the least. Second, this effect only emerges in morally intense contexts. Third, this effect is mediated by the follower’s belief in the potential for prosocial impact. Our findings suggest that a follower’s belief that his or her leader is ethical has meaningful, often counterintuitive effects that are not predicted by dominant theories of ethical leadership. These results highlight the potential importance of moral typecasting theory to better understand the dynamics of ethical leadership. (shrink)

This paper provides an empirically informed perspective on the notion of responsibility using an ethical framework that has received little attention in the engineering-related literature to date: ethics of care. In this work, we ground conceptual explorations of engineering responsibility in empirical findings from engineering student’s writing on the human health and environmental impacts of “backyard” electronic waste recycling/disposal. Our findings, from a purposefully diverse sample of engineering students in an introductory electrical engineering course, indicate that most of these engineers (...) of tomorrow associated engineers with responsibility for the electronic waste problem in some way. However, a number of responses suggested attempts to deflect responsibility away from engineers towards, for example, the government or the companies for whom engineers work. Still other students associated both engineers and non-engineers with responsibility, demonstrating the distributed/collective nature of responsibility that will be required to achieve a solution to the global problem of excessive e-waste. Building upon one element of a framework for care ethics adopted from the wider literature, these empirical findings are used to facilitate a preliminary, conceptual exploration of care-ethical responsibility within the context of engineering and e-waste recycling/disposal. The objective of this exploration is to provide a first step toward understanding how care-ethical responsibility applies to engineering. We also hope to seed dialogue within the engineering community about its ethical responsibilities on the issue. We conclude the paper with a discussion of its implications for engineering education and engineering ethics that suggests changes for educational policy and the practice of engineering. (shrink)

Cells fine‐tune their DNA repair, selecting some regions of the genome in preference to others. In the paradigm case, excision of UV‐induced pyrimidine dimers in mammalian cells, repair is concentrated in transcribed genes, especially in the transcribed strand. This is due both to chromatin structure being looser in transcribing domains, allowing more rapid repair, and to repair enzymes being coupled to RNA polymerases stalled at damage sites; possibly other factors are also involved. Some repair‐defective diseases may involve repair‐transcription coupling: three (...) candidate genes have been suggested.However, preferential excision of pyrimidine dimers is not uniformly linked to transcription. In mammals it varies with species, and with cell differentiation. In Drosophila embryo cells it is absent, and in yeast, the determining factor is nucleosome stability rather than transcription.Repair of other damage departs further from the paradigm, even in some UV‐mimetic lesions. No selectivity is known for repair of the very frequent minor forms of base damage. And the most interesting consequence of selective repair, selective mutagenesis, normally occurs for UV‐induced, but not for spontaneous mutations. The temptation to extrapolate from mammalian UV repair should be resisted. (shrink)

Imperial Plato presents new translations of three introductions to Plato's thought from the second half of the second century CE: the Introduction to Plato by Albinus of Smyrna, Dissertation 11 of Maximus of Tyre, and On Plato and his Teaching by Apuleius of Madaurus. These three presentations of Plato's ideas--one a Greek dialectic introduction with a suggested reading order for Plato's dialogues, another a Greek speech in the sophistic style of the time, and one a lengthy doxological study in Latin--are (...) examples by three distinct authors using divergent methods of the assorted ways in which Plato and Platonism were understood and discussed during the revival of Hellenism and Greek Philosophy, and the period of the Roman Empire often referred to as the Second Sophistic. (shrink)

Plato in the Third Sophistic examines the influence and impact of Plato and Platonism on later Christian and Byzantine rhetoric. The volume brings together specially commissioned articles from leading scholars of late antique philosophy and literature. Their examinations show that Plato is the single most important and influential literary figure used to frame the literature of this time. Plato in the Third Sophistic will help scholars and students from a wide range of disciplines better understand the development of Christian and (...) Byzantine rhetoric and philosophy during the third through sixth centuries. (shrink)

The author applies the definitions of surrogacy offered by Donum vitae to the question of embryo adoption and shows that embryo adoption does not in fact constitute an act of surrogacy. The author shows that neither Donum vitae nor Dignitas personae condemns heterologous embryo transfer or embryo adoption per se but only when these acts also involve illicit forms of artificial fertilization or surrogacy. The author suggests that the apparent reason for a lack of endorsement of embryo adoption by Donum (...) vitae and Dignitas personae is pastoral caution, concern for scandal, and the connection between embryo adoption and IVF; it is not because embryo adoption is intrinsically illicit. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 249–256. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Limits of Our ObligationsRyan C. MavesDisclaimers. No funding was utilized for this manuscript. Dr. Maves is a retired U.S. Navy officer, and the opinions contained herein are his own. The opinions in this manuscript do not reflect the official opinion of the Department of the Navy, Department of Defense, nor of the U.S. Government.In 2012, I was a commander in the United States Navy, deployed to the NATO (...) Role 3 Multinational Medical Unit in Kandahar Airfield (KAF), Afghanistan. The KAF Role 3 began as a tent hospital under Canadian command, built along the flight line at Ahmad Shah Baba International Airport as [End Page 176] part of an expanding NATO base. By the time of my arrival, it was a small but capable brick-and-mortar building under U.S. Navy command, with four operating rooms, two CT scanners, and a busy intensive care unit (ICU).Not long before my deployment, the KAF Role 3 was described as one of the busiest trauma hospitals in the world. Casualties arrived every day, usually by helicopter. Blast injuries from improvised explosive devices (IEDs) were common, ranging in severity from concussions in passengers in armored vehicles, to multiple amputations from blast injuries with concomitant thoracic, abdominal, and pelvic trauma. KAF had a daytime population of over 30,000 in 2012, and our hospital was effectively the referral center for the region, so patients with non-surgical diagnoses were similarly common: myocardial infarctions, seizures, pulmonary emboli, and endemic infections, to name a few.As an infectious disease (I.D.) specialist, I functioned mainly as a hospitalist, managing patients postoperatively, but I also provided any consultative support when needed. During mass casualty events, the intensivists and I would act as backups in the trauma bay, freeing up the surgeons for the most acutely injured patients. It turned out that an I.D. doctor’s skillset lent itself well to acute trauma evaluations; we are well known for having an eye for fine details, combined with low-grade paranoia. These traits served me well during what I came to describe as “my involuntary trauma fellowship.”Our patients could be divided into five key groups: Afghan National Security Forces (ANSF, including the army and national police), non-Afghan coalition military (mostly U.S. and other NATO members), Afghan civilians, NATO civilian contract staff, and the Taliban. Our approach to each of these groups was different. For all patient groups, we would provide the same emergency care, including acute resuscitation and immediate life-saving surgery. It was after this emergency care period that our management plans diverged.For coalition forces, our next priority after acute resuscitation and stabilization was to assess whether a patient could remain in theater. Stable patients with relatively minor injuries could often undergo rehabilitation at KAF; many personnel could subsequently return to combat duty with their units. More seriously-injured patients would be transported out of Afghanistan within 24-48 hours (if not faster). Usually, this would involve stops at Bagram Airfield near Kabul and then Landstuhl Regional Medical Center in Germany before reaching a military hospital in their home countries. There were few limits on whom could be transported. Dedicated critical care air transport teams (CCATT) included intensivists, respiratory therapists, and critical care nurses, who could manage the most unstable patients on board what was effectively a flying ICU. The “lung team” in Landstuhl could fly to KAF to start patients with severe respiratory failure on extracorporeal membrane oxygenation (ECMO) and then fly them out on maximal support.NATO civilian contractors would receive comparable care, although the exact details of how they would be transported out of theater would depend on their home countries and the nature of their contract. We cared for one civilian contractor with newly-diagnosed HIV infection whom we were able to stabilize on the ventilator, get him extubated, start on initial antiretroviral therapy, and transport him home with a referral to his local HIV care program.Afghan soldiers were part of the coalition, but there was no distant home country where we could transport them. They were home. After their resuscitations and surgeries, we would arrange transfer to the Kandahar Regional... (shrink)

For Levinas dialogue occurs when one is open to and receptive of the Other. He cautions, however, that although dialogue impedes violence, it should not be pursued unilaterally or vigorously, because this can also lead to violence. The abolition of violence, which is the goal at which dialogue aims, can instead turn violent in the face of unrestrained persuasive discourse. Vigilance and caution must be maintained if dialogue is not to lapse into hostility and aggression. It is important to respect (...) differences and acknowledge insoluble problems in order to avoid animosity. Without recognition and respect, dialogue can become adversarial and antagonistic. (shrink)

Ethical issues arising from public administration are quite complex and difficult. Using a monistic normative ethical approach to these issues may not be very helpful. Thus James Svara’s three-pronged approach to public administration ethics is proposed in order to show its plausibility. The case of Dr Stockman in Henrik Ibsen’s play An Enemy of the People is examined as a way of demonstrating the significance of Svara’s model.

Through discourse with international groups of physicians, we conducted a cross-cultural analysis of the types of ethical dilemmas physicians face. Qualitative analysis was used to categorise the dilemmas into seven themes, which we compared among the physicians by country of practice. These themes were a-theoretically-driven and grounded heavily within the text. We then subjected the dilemmas to an analysis of moral intensity, which represents an important theoretical perspective of ethical decision making. These constructs represent salient determinants of ethical behaviour and (...) our cross-cultural sample afforded us the opportunity to consider both the pragmatic aspects of culture, as they are perceived by physicians, as well as the theory-driven concept of moral intensity. By examining both culture and moral intensity, we hope to better elucidate the complexities of ethical decision-making determinants among physicians in their daily practice. Doing so may potentially have practical implications for ethics training of medical students and foreign physicians. (shrink)

This remarkable collection explores the legacy of Wittgenstein's work in contemporary American philosophy. The contributors (including several celebrated philosophers) take a variety of approaches to Wittgenstein; they discuss such topics as rule-following, realism about mathematics, the method of the Tractatus, the relation between style and content in Wittgenstein, and his distinction between sense and nonsense. Wittgenstein also is discussed in relation to subsequent philosophers such as Quine and Kripke.

The radical evolutionary step that divides human decision-making from that of nonhumans is the ability to excite the reward process for its own sake, in imagination. Combined with hyperbolic over-valuation of the present, this ability is a potential threat to both the individual's long term survival and the natural selection of high intelligence. Human belief is intrinsically or under-founded, which may or may not be adaptive.

A large amount of research in cognitive psychology is focused on memory distortions, understood as deviations from various (largely implicit) standards. Many alleged distortions actually suggest a highly functional system that balances the cost of acquiring new information with the benefit of relevant, contextually appropriate decision-making. In this sense many memories may be examples of functionally adaptive misbelief.

Trafficking and persistence of fetal microchimeric cells (fMCs) and circulating extracellular vesicles (EVs) have been observed in animals and humans, but their consequences in the maternal body and their mechanistic contributions to maternal physiology and pathophysiology are not yet fully defined. Fetal cells and EVs may help remodel maternal organs after pregnancy‐associated changes, but the cell types and EV cargos reaching the mother in preterm pregnancies after exposure to various risk factors can be distinct from term pregnancies. As preterm delivery‐associated (...) maternal complications are rising, revisiting this topic and formulating scientific questions for future research to reduce the risk of maternal morbidities are timely. Epidemiological studies report maternal cardiovascular risk as one of the major complications after preterm delivery. This paper suggests a potential link between fMCs and circulating EVs and adverse maternal cardiovascular outcomes post‐pregnancies, the underlying mechanisms, consequences, and methods for and how this link might be assessed. (shrink)

In the midst of recent ethical decision-making failures in business in the past ten or more years, businesses are beginning to prioritize the moral fiber of their new-hire business graduates. In addition to academic performance, intellectual drive, and personality match, perhaps there are other key characteristics that employers seek which speak to the importance of ethical decision makers in practice. The question remains, how can academic institutions help instill such values into their students so that ethical decision making transcends their (...) lives? This article suggests that experiential learning through an institutional-sponsored business forum can help enhance an individual’s self-efficacy and awareness of the school’s value-based education, which ultimately will lead students towards ethical decision making in practice. Five years of survey data collected at business forum events suggests that business forums are making a difference in the students’ self-assessed abilities to show greater self-efficacy, better ethical decision making, and an increased awareness of their institution’s value-based education. Specifically, data collected illustrate a mediating effect of self-efficacy and awareness of a value-based education en route to ethical decision making. Further, support is found for the primary hypothesis that attendance at business forums does result in a higher propensity to make ethical decisions. Because of these positive findings, higher education institutions looking to place a greater emphasis on the ethical leadership of their business students may want to explore adding such experiential learning programs. (shrink)

Heidegger’s two modes of thinking, calculative and meditative, were used as the thematic basis for this qualitative study of physicians from seven countries . Focus groups were conducted in each country with 69 physicians who cared for the elderly. Results suggest that physicians perceived ethical issues primarily through the lens of calculative thinking with emphasis on economic concerns. Meditative responses represented 24% of the statements and were mostly generated by Canadian physicians whose patients typically were not faced with economic barriers (...) to treatment due to Canada’s universal health care system. (shrink)