Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the classic (...) counterfactual definition of AI as an umbrella term for a range of techniques that can be used to make machines complete tasks in a way that would be considered intelligent were they to be completed by a human. Automation of this nature could offer great opportunities for the improvement of healthcare services and ultimately patients’ health by significantly improving human clinical capabilities in diagnosis, drug discovery, epidemiology, personalised medicine, and operational efficiency. However, if these AI solutions are to be embedded in clinical practice, then at least three issues need to be considered: the technical possibilities and limitations; the ethical, regulatory and legal framework; and the governance framework. In this article, we report on the results of a systematic analysis designed to provide a clear overview of the second of these elements: the ethical, regulatory and legal framework. We find that ethical issues arise at six levels of abstraction (individual, interpersonal, group, institutional, sectoral, and societal) and can be categorised as epistemic, normative, or overarching. We conclude by stressing how important it is that the ethical challenges raised by implementing AI in healthcare settings are tackled proactively rather than reactively and map the key considerations for policymakers to each of the ethical concerns highlighted. (shrink)

Although it is commonly believed that the concept of brain death was developed to benefit organ transplants, it evolved independently. Transplantation owed its development to advances in surgery and immunosuppressive treatment; BD owed its origin to the development of intensive care. The first autotransplant was achieved in the early 1900s, when studies of increased intracranial pressure causing respiratory arrest with preserved heartbeat were reported. Between 1902 and 1950, the BD concept was supported by the discovery of EEG, Crile’s definition of (...) death, the use of EEG to demonstrate abolition of brain potentials after ischaemia, and Crafoord’s statement that death was due to cessation of blood flow. Transplantation saw the first xenotransplant in humans and the first unsuccessful kidney transplant from a cadaver. In the 1950s, circulatory arrest in coma was identified by angiography, and the death of the nervous system and coma dépassé were described. Murray performed the first successful kidney transplant. In the 1960s, the BD concept and organ transplants were instantly linked when the first kidney transplant using a brain-dead donor was performed; Schwab proposed to use EEG in BD; the Harvard Committee report and the Sydney Declaration appeared; the first successful kidney, lung and pancreas transplants using cadaveric donors were achieved; Barnard performed the first human heart transplant. This historical review demonstrates that the BD concept and organ transplantation arose separately and advanced in parallel, and only began to progress together in the late 1960s. Therefore, the BD concept did not evolve to benefit transplantation. (shrink)

On 5 August 1968, publication of the Harvard Committee’s report on the subject of “irreversible coma” established a standard for diagnosing death on neurological grounds. On the same day, the 22nd World Medical Assembly met in Sydney, Australia, and announced the Declaration of Sydney, a pronouncement on death, which is less often quoted because it was overshadowed by the impact of the Harvard Report. To put those events into present-day perspective, the authors reviewed all papers published on this subject and (...) the World Medical Association web page and documents, and corresponded with Dr A G Romualdez, the son of Dr A Z Romualdez. There was vast neurological expertise among some of the Harvard Committee members, leading to a comprehensible and practical clinical description of the brain death syndrome and the way to diagnose it. This landmark account had a global medical and social impact on the issue of human death, which simultaneously lessened reception of the Declaration of Sydney. Nonetheless, the Declaration of Sydney faced the main conceptual and philosophical issues on human death in a bold and forthright manner. This statement differentiated the meaning of death at the cellular and tissue levels from the death of the person. This was a pioneering view on the discussion of human death, published as early as in 1968, that should be recognised by current and future generations. (shrink)

Although it is commonly believed that the concept of brain death was developed to benefit organ transplants, it evolved independently. Transplantation owed its development to advances in surgery and immunosuppressive treatment; BD owed its origin to the development of intensive care. The first autotransplant was achieved in the early 1900s, when studies of increased intracranial pressure causing respiratory arrest with preserved heartbeat were reported. Between 1902 and 1950, the BD concept was supported by the discovery of EEG, Crile’s definition of (...) death, the use of EEG to demonstrate abolition of brain potentials after ischaemia, and Crafoord’s statement that death was due to cessation of blood flow. Transplantation saw the first xenotransplant in humans and the first unsuccessful kidney transplant from a cadaver. In the 1950s, circulatory arrest in coma was identified by angiography, and the death of the nervous system and coma dépassé were described. Murray performed the first successful kidney transplant. In the 1960s, the BD concept and organ transplants were instantly linked when the first kidney transplant using a brain-dead donor was performed; Schwab proposed to use EEG in BD; the Harvard Committee report and the Sydney Declaration appeared; the first successful kidney, lung and pancreas transplants using cadaveric donors were achieved; Barnard performed the first human heart transplant. This historical review demonstrates that the BD concept and organ transplantation arose separately and advanced in parallel, and only began to progress together in the late 1960s. Therefore, the BD concept did not evolve to benefit transplantation. (shrink)

The main goal of Brain Death and Disorders of Consciousness is to provide a suitable scientific platform to discuss all topics related to human death and coma.

Although it is commonly believed that the concept of brain death was developed to benefit organ transplants, it evolved independently. Transplantation owed its development to advances in surgery and immunosuppressive treatment; BD owed its origin to the development of intensive care. The first autotransplant was achieved in the early 1900s, when studies of increased intracranial pressure causing respiratory arrest with preserved heartbeat were reported. Between 1902 and 1950, the BD concept was supported by the discovery of EEG, Crile’s definition of (...) death, the use of EEG to demonstrate abolition of brain potentials after ischaemia, and Crafoord’s statement that death was due to cessation of blood flow. Transplantation saw the first xenotransplant in humans and the first unsuccessful kidney transplant from a cadaver. In the 1950s, circulatory arrest in coma was identified by angiography, and the death of the nervous system and coma dépassé were described. Murray performed the first successful kidney transplant. In the 1960s, the BD concept and organ transplants were instantly linked when the first kidney transplant using a brain-dead donor was performed; Schwab proposed to use EEG in BD; the Harvard Committee report and the Sydney Declaration appeared; the first successful kidney, lung and pancreas transplants using cadaveric donors were achieved; Barnard performed the first human heart transplant. This historical review demonstrates that the BD concept and organ transplantation arose separately and advanced in parallel, and only began to progress together in the late 1960s. Therefore, the BD concept did not evolve to benefit transplantation. (shrink)

In the first edition of the Origin of Species, Charles Darwin apologized for not correctly referencing all the works cited in his magnum opus. More than 150 years later we have catalogued these citations and analyzed the resultant data. Looking for a complete selection of collaborators, a flexible interpretation of the term citation was necessary; we define it as any reference made to a third party, independently of its form or function. Following the same idea, the sixth edition of the (...) Origin, originally published in 1872 and reprinted with minor additions and corrections in 1876, was chosen for the research because it represents the end of a long debate between Darwin and his peers. It naturally is the edition with the greatest number of citations and collaborators. Through a diverse theoretical analysis, we aim to present a new perspective for the study of the Origin of Species: a bibliographic approach that provides the tools needed to understand the history of the book as a physical and cultural object. Bibliometrics provides a theory of citations as well as a quantitative analysis; science studies highlights the profound social aspects of science in the making. The analysis resulted in 639 citations to 298 collaborators and provided a new perspective of the rhetorical structure of the Origin, even though these results are only the tip of the iceberg of the potential of all the data gathered in this study. (shrink)

Esta introdução descreve os mais importantes dados biográficos da vida e da obra do físico teórico austríaco Ludwig Boltzmann (1844-1906). As principais contribuições científicas de Boltzmann situam-se nos domínios da teoria cinética dos gases e mecânica estatística, da qual ele foi um dos fundadores. A tese de que as teorias científicas são representações dos fenômenos naturais é encontrada em todos os artigos de Boltzmann. No verbete "modelo", ela é apresentada de modo mais organizado, o que o torna uma peça fundamental (...) para a compreensão do pensamento filosófico do físico austríaco. O verbete, publicado na famosa enciclopédia Britannica, foi escrito para o público em geral. Ainda assim, Boltzmann não se eximiu de tomar partido em favor do uso de modelos. Estes últimos não apenas seriam inevitáveis, mas necessários, uma vez que tornavam possível o aperfeiçoamento contínuo da ciência. This introduction describes the most important biographical details of the life and work of the Austrian theoretical physicist Ludwig Boltzmann (1844-1906). The main scientific contributions of Boltzmann can be found in areas such as the kinetic theory of gases and statistical mechanics, of which he was one of the co-founders. The thesis that scientific theories are representations of natural phenomena is found in all philosophical articles by Boltzmann. In the entry "model", published in the celebrated Encyclopedia Britannica, the thesis is presented in a more organized way, making it the keystone to understand the philosophical thought of the Austrian physicist. Although the entry was written for the general public, in it Boltzmann did not refrain from taking sides as far as the use of models is concerned. According to him, the latter would not only be inevitable, but in fact necessary, since they would made possible the continuous improvement of science. (shrink)

This essay was a speech pronounced in UNICAMP. It was written for Habermas' brasilian visiting expected at the second semester of the past year. Its unmediate goal was to give some informations about the last Habermas' reflections. Therefore, it tried to insert Habermas' proposal of a "communicative reason" in our days with the generalized irruption of fragmentaries, relativistic and irrationalistic discursive forms . Without claiming to exhaust a so complex subjet, it also tried to put some questions about the critical-cognitive (...) possibilities of the linguistic turn of Habermas' and Apel's philosophy.Este ensaio originalmente foi uma comunicação apresentada na UNICAMP. Foi escrito a propósito da visita de Habermas ao Brasil, esperada para o segundo semestre do ano passado. Seu objetivo imediato era fornecer algumas informações sobre as reflexões habermasianas mais recentes. Para isto, tentou-se inserir historicamente a proposta habermasiana de uma "razão comunicativa" no atual contexto de generalizada irrupção de formas discursivas fragmentárias relativistas e irracionalistas . Sem pretender esgotar um tema tão complexo, tentou-se também levantar algumas questões sobre as possibilidades crítico-cognoscitivas da "guinada linguística" da filosofia de Habermas e de Apel. (shrink)

Wagner lamenta a seu mestre, no início do Fausto de Goethe: “Meu Deus! É longa a arte. E é tão breve nossa vida!”. Decerto a frase não poderia ser aplicada a Ernst Bloch, que nasceu em Ludwigshafen em 1885 e faleceu em Tübingen em 1977, aos 92 anos de idade, deixando uma obra de dimensões monumentais.

O artigo pretende mostrar a articulação apresentada por Hegel entre as noções de práxis material e trabalho na sua obra Fenomenologia do espírito e as noções de ideia prática e a ideia de Bem na sua obra Ciência da lógica. Inicialmente, será traçado um percurso histórico que a ideia de práxis cumpriu desde os pensadores da Antiguidade grega, passando pela Idade Média, quando no Renascimento, relativizam o privilégio da reflexão e da contemplação sobre a práxis material produtiva. Finalmente, chegaremos ao (...) pensamento de Hegel que dará dignidade plena à práxis material, igualando-a as atividades do espírito. (shrink)

Kerridge et al recently published a paper in the journal about organ transplantation and the diagnosis of death.1 Although I appreciate the authors’ efforts to present their arguments about such a controversial issue, I found some inconsistencies in this article that I would like to discussWhen Kerridge and his collaborators discussed the origins of the concept of brain death , they emphasised that after the report of the medical consultants on the diagnosis of death to the US President’s Commission was (...) published in 1981,2 clinicians equated the concept of BD with brainstem death. In fact, the brainstem criterion was first proposed by Mohandas and Chou in Minnesota, in 1971.3 The Minnesota criteria inspired the UK code, which was mainly adopted in UK commonwealth countries.4 This view was afterwards powerfully defended by Christopher Pallis.5 After the US President’s Commission report,2 a lot of countries, and most US states, accepted the whole brain, and not the brainstem, criterion.6Regarding the “dead donor rule”, with the advent of transplant surgery, interest in definitions and diagnosis of death based on brain formulations really acquired a new urgency. None the less, it is important to point out that the concept of BD as death of the individual, did not appear to benefit organ transplantation, but was a consequence of the development of intensive care. As Pallis emphasised, if organ transplant techniques had never been developed, intensive care procedures would have provided the possibility of supplying life support to those cases with destroyed brains and preserved heart function, and physicians would need to face the clinical syndrome called BD.5 When French neurophysiologists and neurologists described the death of the nervous system and coma dépassé, organ transplant techniques were only in the very early stages of development. …. (shrink)

Historicamente, as humanidades têm sido essenciais para a educação, uma vez que são consideradas como disciplinas fundamentais para a formação de cidadãos democráticos. A partir dessa conjectura, esse artigo visa refletir sobre a importância das competências no ensino de humanidades para a formação de cidadãos democráticos. Para isso, realizamos uma pesquisa de cunho bibliográfico, baseada no pensamento de Martha Nussbaum sobre as competências necessárias para o desenvolvimento de uma cidadania democrática (2015). O desenvolvimento de competências no ensino de humanidades promove (...) a autonomia do estudante no âmbito pessoal, profissional, intelectual e político para o enfrentamento dos desafios da sociedade. Essas competências permitem aos estudantes enfrentar a realidade e as necessidades humanas com senso crítico e consciência de sua responsabilidade como pessoa em um meio social, político e cultural. (shrink)

A pandemia de COVID-19 já levou à morte mais de cem mil brasileiros. A doença impõe um debate sobre o papel do Estado na segurança alimentar e na agricultura sustentável, que foram diretamente atingidas pelo isolamento social. O presente artigo, fruto a pesquisa exploratória doutrinária, objetiva fundamentar atuação do Poder Público durante a pandemia, pelo Princípio da Fraternidade, para a realização do Objetivo de Desenvolvimento Sustentável 02 da Organização das Nações Unidas, que prevê metas para erradicação da fome, melhoria da (...) segurança alimentar, da nutrição e da agricultura sustentável. (shrink)

O objetivo da pesquisa é demonstrar a importância da fraternidade na democracia brasileira, caracterizada como representativa, ao menos em tese, visto que a vontade do povo não tem sido considera nas decisões que promovem mudanças legislativas substanciais. Diante disto surge a indagação central do presente estudo: Qual a contribuição da categoria da fraternidade em uma democracia? A metodologia aplicada a pesquisa é qualitativa e bibliográfica ao buscar fontes na doutrina jurídica relacionada com o tema e também quantitativa ao trazer dados (...) como forma de argumentação. Justifica-se o estudo pela relevância da fraternidade na construção da democracia no Brasil. (shrink)