Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised (...) exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of “surgery schools” and detail practical recommendations that can be embedded in existing or emerging clinical settings. (shrink)

Photo by Jonathan Ford on Unsplash ABSTRACT Since 2008, an average of twenty million people per year have been displaced by weather events. Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. This paper analyzes the idea of expanding a duty to rescue to climate migration. We address who should have (...) the duty and to whom the duty should extend. The paper discusses ways to define and apply the duty to rescue as well as its limitations, arguing that it may take the form of an ethical duty to prepare. INTRODUCTION Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. Examples of circumstances range from person-to-person intimate rescue to saving those in poverty, even in distant parts of the world.[1] Since 2008, an average of twenty million people per year have been displaced by weather events.[2] Circumstances like being thrust from homes under the threat of fire, mudslide, and flooding vary greatly from long-term changes like land becoming too arid for crops or temperatures increasing annually gradually pushing up the number of heat-related deaths, with the area slowly becoming uninhabitable. Imminence in fleeing affects resettling and need for rescue with important implications for how the duty to rescue might apply. This paper reevaluates the ethical framing of the duty to rescue and, while it is arguably a stretch, applies it to climate migration. Climate migration has become common and is expected to increase due to rises in sea level, increases in weather events that make areas uninhabitable, and changes to land that preclude farming or other necessary land uses. We argue that a duty to rescue may help highlight who has moral obligations to whom. Because the problem is so large in scope, we suggest a change in the ethical limits to humans' duty to rescue other humans who are in distress. We imagine an expansion or extension of the duty to rescue to meet some of the basic needs created by climate migration. Yet how it should expand, and how much depend on ethical framing and practical limitations. l. Expanding the Geographical Boundaries Two commonly recognized emergencies, Hurricane Katrina in the case of weather events and the current COVID-19 pandemic, provide a historical and current backdrop to evaluate ethical obligations as more disasters displace people. A significant reassessment of the ethical scope of an obligation to rescue in the case of weather events will be limited by the ability to render aid to those in distress in the case of a planet-wide weather catastrophe. The problems may overwhelm the ability to rescue or the reasonableness of attempting rescue. The extent of the moral obligation borne by humans to other humans in the case of a weather event has been largely defined by its locality and limited geographic influence. Whether we are imagining the scope of ethical obligation in the case of hurricane, flood, tornado, drought, or wildfire events, the perceived ethical obligation is significantly defined by the limited impact of these weather events on people outside the zone of the weather event's direct impact, yet close to that zone. A hurricane affecting New Orleans will not have immediate impact on the residents of California or even those on the northeast coast of the United States until a later time. Wildfires in the Pacific Northwest do not impair the ability of those in the rest of the country to come forward with assistance. But as climate migration crosses international borders, and climate events occur simultaneously in many regions, a more expansive duty to rescue may provide the ethical impulse to help those who live afar or migrate long distances. In this respect, the need for help in the event of widespread climate migration due to global warming is more like a pandemic than a weather event. Its broad impact area diminishes the capability of nearly the entire balance of the human population to help due to those populations' awareness that they will, in short order, have the same need for the same resources, from the same cause. Those living near current flood zones may find their historically safe havens are also a flood zone. Those previously best positioned to rescue may find themselves also needing to relocate. Thus, we may observe the need for new rescuers. ll. The Rule of Rescue The Rule of Rescue as defined by Al Jonsen describes the moral impetus or knee jerk reaction to save identifiable people facing death.[3] A duty to rescue has since been expanded beyond imminent death and beyond the near and identifiable. But there are limitations. For example, by most accounts, the ethical duty tends not to require extreme bodily risk or financial depletion. In comparing Good Samaritans to humanitarians, Scott M. James argues the duty to rescue arises from unique dependence, but the ethical obligation to help strangers through humanitarian aid is of a different nature.[4] The wrongness of failing to help is arguably more egregious when one is in a unique position to help. Like in the tragedy of the commons, where there is no unique positioning, when the global community is called upon to help, each individual in it may feel less obliged to do so. Climate migration falls in between—it requires helping strangers, yet it may move forward without anyone seeing themselves as uniquely positioned to help until those strangers become part of communities, at which time, there may be more moral justification to help a community member in need. Generally, arguments about Good Samaritans hinge on extraordinary acts, praiseworthy because they are acts of compassion, not obligation. Now all US states have Good Samaritan laws[5] which protect helpers from liability for help gone wrong or for a failure to succeed once engaged in an act of rescue. Extraordinary help as a moral good is thus somewhat encouraged through legal protection, but not imposed. Conversely, jobs like firefighting, search and rescue, and emergency medical care tend to oblige employees to take on risks that would be extraordinary if undertaken by the average bystander, yet they are rendered ordinary rescue as part of the job. Three states, Minnesota, Rhode Island, and Vermont have a broad duty to rescue, adding legal considerations to an otherwise moral conundrum. The laws do not require bystanders to take on risk for the sake of rescuing strangers.[6] The moral duty will require looking beyond law, but it is unclear how the moral duty to rescue should be distributed in the case of climate migration. A bare minimum would prevent taking advantage of newcomers, paying sub-minimum wage, and discriminating against them. Yet such a minimum is hardly rescue. lll. An Ethical Rather than Legal Duty The difficulty in defining the duty to rescue as a legal obligation is that it is difficult to determine the extent of risk a rescuer ought to be required to take. The nature of this ethical duty is also arguably tied to the experiences of both the rescuer and the rescued. There are subjective aspects like what someone perceives as a danger that make it difficult to write enforceable laws requiring rescue. It is one thing to expect a rescuer to step into several inches of relatively warm water to lift a person lying face down in a pond and enable them to breathe. It is something altogether different to expect that rescuer to dive into frigid water and attempt to extricate someone trapped in a submerged automobile. As the legal philosopher H.L.A. Hart observed, it is always easier to define application of the core intention of any rule, whether law or ethical norm. It is more difficult to create legal certainty about how the law applies to what he described as “penumbra circumstances”. In the case of a hurricane, it is easier to define what surplus resources are available in areas geographically remote from the impact of the storm and demand, as a moral obligation, that those nearby but outside the area provide assistance. It is more difficult to obligate people, organizations, or governments to supply a quantity of medication or some number of ventilators to an adjacent community when they expect to imminently need them for their own community. In the early stages of climate migration, the ethics of extreme weather event assistance, a common application of the duty to rescue, will be useful and appropriate. The rising sea levels first experienced by island nations in the South Pacific[7] will not render those living in other coastal communities, those with greater available “high ground”, unable to supply resources to those in need. But when sea level rise and climate change affect more communities simultaneously, albeit in varying degree, the task of defining what response is ethically obligatory becomes increasingly complicated. Pinpointing the obligations of those communities which are resource rich to those communities which are resource deprived, and of those partly affected to those more severely affected may become necessary. The limitations of the traditional duty to rescue could expand to meet the needs. lV. Contribution to the Problem Many argue that the duty to rescue may depend on any appropriate claim of those needing rescue. One issue is whether preferential claims among those who can identify the source of the harm should call for a greater duty or whether everyone in need should be approached as like candidates for rescue, shaping the duty as equal across those on the receiving end. As climate change does have human-made causes, there are strong arguments to impose a greater ethical duty on any entity that caused the climate-related problems leading to the mass exodus. While the global north is often implicated in pollution that causes migration, industries like energy, transportation, and agriculture are tied to climate change and associated with significant greenhouse gas emissions.[8] Practices like directing agriculture to less sustainable single crop growth generally made land less farmable. Yet it is difficult to place blame and identify specific causal relationships as most migration is due to many factors. A movement toward greater accountability can be reframed as a greater duty to rescue, a duty to engage in the extraordinary. The fossil fuel industry, for example, should have a larger obligation than the average person. Similarly, some may argue anyone unjustly enriching themselves while contributing to climate change or people who over-consume have an elevated duty to rescue.[9] Climate change lawsuits demonstrate an eagerness to hold governments and corporations accountable, despite difficulty proving causation. V. The Most Vulnerable One ethical dimension of climate migration that remains unexplored is how a duty to rescue applies to vulnerable populations who stand to be left behind or unable to migrate without assistance. Researchers from the Global North working across the Global South are increasingly observing the phenomenon of ethics dumping, where the research ethics of some countries are imposed on research subjects in other countries.[10] In that vein, rescuers should be careful not to impose unwelcome cultural standards or exploit people who are in the process of migrating. There is a gap in discussions reflecting voices that have been left out. The duty to rescue is incomplete without an attempt to understand the ethical experiences of those being rescued. The actual people affected by climate migration who are the least likely to have the means to migrate, or to do so without extreme hardship, should have a voice informing the global community including those in a position to carry out rescue. People who have the means and are young and healthy may easily make decisions to avoid the catastrophic consequences that climate migration brings. However, what about those who are left behind? For example, especially recognizing cultural differences, the homeless community, disabled community, refugees, the elderly community, and women[11] and children may suffer differently and call for more attention. In some parts of the world, human rights are severely constrained. An ethical duty to rescue, with many considerations and variables, may be more justified in the case of those most in need. As climate migration continues and increases significantly, it may be reasonable to ask the local and global community to focus on those least well positioned to migrate successfully. In this context, the use of phenomenology to understand the lived experiences of those migrating, sometimes termed “ethical experiences”, may help flesh out how a duty to rescue takes shape. The discussion of duty and obligation requires an articulation of the ethical experiences (how the local community in need of rescue views the proposed rescue). Then, the obligation to interpret the duty as ‘one shall not’ or ‘one must’ can be focused on the migrants’ needs rather than the rescuers’ feelings of obligation.[12] A revised theory of the duty to rescue taking into account the asymmetrical experiences of communities involved could ensure that the needs of people whose living situations, gender, ethnicity, age, or race impact their ability to even begin the migration process are considered. In this discussion, the rescuing is directed toward communities /collectives of persons migrating, whether at once or across a period of time. Often, the climate migrant may not be in a state to articulate the nature of this event when it happens, given its subjective proximity. Yet, when communities are given the space and opportunity to articulate their shared values, the ethical action of rescue derives its meaningfulness from the community rather than the rescuers. In other words, allowing climate migrants to explain their feelings can add complexity to what some see as a binary receiver-giver (of rescue) dynamic. This is necessary because the concept of vulnerable populations is fraught with problematic assumptions. There have been various definitions and criteria to determine what would constitute vulnerable populations.[13] For example, the United Nations Framework Convention on Climate Change[14] identifies and assesses vulnerable populations. These criteria may be helpful. However, they do not provide the full picture. Rather than identifying categorical criteria of vulnerable populations, engaging with people who are experiencing climate migration and listening to their current experiences and concerns helps determine need. Knowing what people need may prevent the kneejerk reaction to label people who are quite resilient yet have appropriate needs “vulnerable”. Proceeding with caution is important because the duty to rescue has hierarchical underpinnings of "us" and "them." Often when people swoop in to save, there are good and bad consequences of the intervention. We should proceed with caution because often the helper misses the actual needs of those in need. The only way to combat this would be to make sure that people are empowered to inform those agencies that are able to help. In addition to more practical approaches, large scale oral histories could allow those who have migrated already to share their experiences. It would be important to capture the lived experiences of people who are already experiencing the consequences of climate migration or of other migration like that due to political or economic extreme events. These experiences could shape our analysis of whether people in fact wish for rescue. If so, further conversations can determine best actions as well as give important insight into what resources might be necessary to empower people now and in the future. Vl. A Duty to Rescue as a Duty to Prepare If we view Good Samaritans as going above and beyond, then a duty to rescue, something ethically compelled, must bring rescue out of the framework of charity and place it in the context of humanity and obligations. Such a view would also support expanding the geographical reach of the otherwise more proximate duty. The duty may be stronger and take shape in a more workable way if it applies to preparing places expecting to see an influx of people due to climate migration and to helping those most in need. The duty may arise out of expectations of what type of community the place welcoming those migrating due to climate should be—does it want to offer good housing, schooling, and medical care as well as economic opportunity to new people? And if so, at what cost, or with which risks? If the newcomers are viewed as community members rather than strangers, a model of acceptance may lead to better preparation. Some considerations like whether the actions will reasonably help the persons in need of rescue[15] will shape the application of a duty to rescue in the context of climate migration. Similarly, ensuring that people have the chance to articulate their values may help communities support the newcomers. New relationships should not be defined as migrant and rescuer. Voluntariness in participation and not forcing any action deemed rescue would help ensure the human rights of those migrating. In the United States, President Biden issued an executive order addressing impending climate migration steeped in a duty to prepare by making plans for resettlement and to address the impact of climate migration.[16] Vll. At What Risk? As we investigate the ethical obligations to meet even basic needs, we must also ask what level of risk is ethically compelled. There is an extraordinary need to integrate newcomers successfully, but it is difficult to stretch an ethical duty to rescue to require all the prerequisites for successful climate migration. Even defining success would create deep ethical arguments. As observed in almost all migrations, extraordinary charitable acts may be the key to success, while an ethical duty to rescue must try to require the important government and community-based basics and ensuring respect for human rights. That is, the migrating people should be rescued from circumstances that contradict basic human rights. Rather than comparing communities to bystanders, mere places where people will arrive and need to hash out how to find housing, jobs, education, and opportunity, a duty of preparation may be the key to rescue those disenfranchised by migration. There are cultural, personal, physical, psycho-social, and geopolitical issues surrounding how to best help those needing to permanently relocate. Ethics arguments will certainly range from “do nothing”, which may fail people, to “do everything”, which could waste taxpayer money in futile over-preparation while failing to actually help. Communities must avoid planning exclusively for one scenario only to have it not take place. Striking the balance, a duty to rescue as it could apply to climate migration should set goals of societal integration, and providing the basics like education, housing, food, health care, and job opportunity, the precursors to flourishing. Recommending the extraordinary, morally preferred but perhaps not compulsory, when charitable actors are participating, or when wrongdoers are compensating, may be more workable than seeing the duty to rescue as compelling people or local governments to take on significant financial and personal risk for newcomers. While humanitarian ethics supports helping everyone, it is likely that people who resettle in advance of a need to flee will find themselves with more choices and opportunities. Help is warranted for those with more dire needs. Preparing for them may do just that. Vlll. Rescue Prior to Migration and Rescue in the Process of Resettlement The duty to enable the migration in the first-place hints to the inadequacy of a duty to prepare. The traditional duty to rescue perhaps steps in if rescue looks like those geographically just out of harm's way rescuing those in danger. That resembles the traditional moral requirement, or duty to rescue according to the Rule of Rescue. Humanitarian aid typically provided by many institutions makes sense and is in place, although financial support for additional humanitarian aid is always needed. Despite having moved to purportedly more capable communities, migrant communities may be able to develop more egalitarian orders of living. Rather than continually being identified as having been rescued, it is important to make sure people keep or make social ties during and after migration. Immigrants often face social isolation.[17] Small shifts in gestural language also have the potential to welcome people and show they are valued. For instance, some migrants may not like questions like “Where are you from?” and “What brings you here?” as they emphasize differences over fitting in. CONCLUSION The ethical duty to rescue should be expanded to better match those in need of relocation with a welcome environment and the resources needed to achieve success and fully integrate socially and culturally. Expanding a dialogue that includes the voices of people who have recently migrated whether due to violence, poverty, or climate, could properly frame the extent of the duty. If we are to apply the duty of rescue to climate migration, rescuers should avoid labeling people vulnerable, dependent, or needy, although there is reason to focus on those whose needs are the most dire. A soft duty to rescue people during the course of climate migration can come in the form of preparation. People will need help finding housing, education, access to food, and employment. Ultimately, to help them help themselves may be the best goal. While the obligations should be borne differently by people, whether due to a special responsibility, or a special relationship that creates a clearer duty, the global community must prepare for its role in rescuing those displaced by climate events. By helping those displaced at the start of the climate migration process according to a more commonly held notion of the duty to rescue, and by preparing to incorporate newcomers successfully according to an expanded duty to rescue, effectively a duty to prepare, countries that take on climate refugees may find themselves rewarded by the cultural diversity and workplace talents that people bring. A duty to those at a distance is a reasonable expansion of the duty to rescue. But what one ought to do in the global community varies somewhat from the traditional Rule of Rescue. - [1] Singer, P. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(3): 229-43. [2] Irfan, U. (2022, March 16). Why We Still Don’t Yet Know How Bad Climate Migration Will Get. Vox. https://www.vox.com/2022/3/16/22960468/ipcc-climate-change-migration-migrant-refugee, citing the International Panel on Climate Change (IPCC) (2022). Sixth Assessment Report, Climate Change 2022, Impacts, Adaptation, and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ [3] McKie, J., Richardson, J. (2003) The Rule of Rescue. Social Science & Medicine, 56(12): 2407-2419. https://doi.org/10.1016/S0277-9536(02)00244-7. [4] James, S.M. (2007). Good Samaritans, Good Humanitarians. Journal of Applied Philosophy, 24(3):238-254. [5] Overview of Good Samaritan laws. https://worldpopulationreview.com/state-rankings/good-samaritan-law-states [6] Fifield, J. (2017, Sept. 19). Why It’s Hard to Punish ‘Bad Samaritans’. Stateline Blog, Pew Charitable Trusts, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/09/19/why-its-hard-to-punish -bad-samaritans [7] Cassella, C. (2019). There’s a Climate Threat Facing Pacific Islands That’s More Dire Than Losing Land, Science Alert, https://www.sciencealert.com/pacific-islanders-are-in-a-climate-crisis-as-rising-sea-levels-threaten -water; Hassan, H. R., and Cliff, V. (2019). For Small Island Nations, Climate Change is not a Threat. It’s Already Here, World Economic Forum, https://www.weforum.org/agenda/2019/09/island-nations-maldives-climate-change/ [8] For example, Lyons, K. (2019). Australia Coal use is Existential threat to Pacific Islanders, The Guardian. https://www.theguardian.com/world/2019/aug/12/australia-coal-use-is-existential-threat-to-pacific-is lands-says-fiji-pm [9] Cripps, E. (2013). Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. [10] Schroeder, D., Chatfield, K., Singh, M., Chennells, R., and Herissone-Kelly, P.. Ethics Dumping and the Need for a Global Code of Conduct. In Cham. (Ed.)(2019). Equitable Research Partnerships. SpringerBriefs in Research and Innovation Governance. Springer. 2019. https://doi.org/10.1007/978-3-030-15745-6_1 [11] Giudice L.C., Llamas-Clark E.F., DeNicola N., Pandipati, S., Zlatnik, M.G., Decena, D.C.D., Woodruff, T.J., Conry, J.A. (2021). Climate Change, Women’s Health, and the Role of Obstetricians and Gynecologists in Leadership, International J Gynecol Obstet, 155(3), 345-356. 10.1002/ijgo.13958 [12] See Ferrarello, S. and Zapien, N. (2020). Ethical Experience: A Phenomenology, Bloomsbury. (for understanding phenomenological determinants of ethical action). [13] McLeman, R.A., Hunter, L.M., (2010). Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change, 1(3): 450-461. [14] Least Developed Countries Expert Group. (2018). Considerations Regarding Vulnerable Groups, Communities and Ecosystems in the Context of the National Adaptation Plans: United Nations Framework Convention on Climate Change. [15] Jecker, N.S. 2013. "The Problem with Rescue Medicine." J Med Philos, 38(1):64-81. [16] White House Report. (February 9, 2021), Executive Order (E.O.) 14013, “Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration.” (calls on the National Security Advisor to prepare a report on climate change and its impact on migration. “This report marks the first time the U.S. Government is officially reporting on the link between climate change and migration.” https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/executive-order-on-tackling -the-climate-crisis-at-home-and-abroad/ [17] Torres, J.M., Casey, J.A. (2017) The centrality of social ties to climate migration and mental health. BMC Public Health, 17: 600. https://doi.org/10.1186/s12889-017-4508-0. (shrink)

According to two critics, Georgia Warnke and John Caputo, Gadamer's hermeneutics is inherently "conservative" insofar as he appeals to tradition as a constituent in understanding. They insist that he simply preserves the ideals, norms and values of the Western metaphysical tradition without critically examining them. I do not agree and will argue that views like this depend upon several false assumptions -- for example, that Gadamer reifies the text as a "thing-in-itself" and remains trapped in subjectivism. I will begin by (...) examining some of the ways in which these charges might be warranted before proceeding to defend him. (shrink)

The following scenario seems possible: a community uses concepts that play the same role in guiding actions and shaping social life as our normative concepts, and yet refer to something else. As Eklund argues, this apparent possibility poses a problem for any normative realist who aspires to vindicate the thought that reality itself favors our ways of valuing and acting. How can realists make good on this idea, given that anything they might say in support of the privileged status of (...) our normative concepts can be mirrored by the imagined community? E.g., the realist might claim that using our concepts is what we ought to do if we are to describe normative facts correctly, but members of the other community can claim the same about their concepts, using their own concept of ought. A promising approach to this challenge is to try to rule out the possibility of alternative normative concepts, by arguing that any concepts that have the same normative role must share a reference as well. In this paper I argue that normative quasi-naturalism, a view that combines expressivism about normative discourse with a naturalist metaphysics of normativity, supports referential normativity and solves the problem of alternative normative concepts. (shrink)

BackgroundOver the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care.MethodsIn this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a (...) dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data.ResultsWe first explore the gap between the ideal of personalized healthcare and the reality of today’s personalized medicine. We show that the nearly exclusive focus of personalized medicine on the objective part of personhood leads to a flawed ethical debate that needs to be reframed. Second, we seek to contribute to this reframing by drawing on the phenomenological-hermeneutical movement in philosophy. Third, we show that these admittedly theoretical analyses open up new conceptual possibilities to tackle the very practical ethical challenges that personalized medicine faces.ConclusionFinally, we propose a reversal: if personalization is a continuous process by which the person reappropriates all manner of objective data, giving them meaning and thereby shaping his or her own way of being human, then personalized medicine, rather than being personalized itself, can facilitate personalization of those it serves through the data it provides. (shrink)

While often presented as promising assistive technologies for motor-impaired users, electroencephalography (EEG)-based Brain-Computer Interfaces (BCIs) remain barely used outside laboratories due to low reliability in real-life conditions. There is thus a need to design long-term reliable BCIs that can be used outside-of-the-lab by end-users, e.g., severely motor-impaired ones. Therefore, we propose and evaluate the design of a multi-class Mental Task (MT)-based BCI for longitudinal training (20 sessions over 3 months) of a tetraplegic user for the CYBATHLON BCI series 2019. In (...) this BCI championship, tetraplegic pilots are mentally driving a virtual car in a racing video game. We aimed at combining a progressive user MT-BCI training with a newly designed machine learning pipeline based on adaptive Riemannian classifiers shown to be promising for real-life applications. We followed a two step training process: the first 11 sessions served to train the user to control a 2-class MT-BCI by performing either two cognitive tasks (REST and MENTAL SUBTRACTION) or two motor-imagery tasks (LEFT-HAND and RIGHT-HAND). The second training step (9 remaining sessions) applied an adaptive, session-independent Riemannian classifier that combined all 4 MT classes used before. Moreover, as our Riemannian classifier was incrementally updated in an unsupervised way it would capture both within and between-session non-stationarity. Experimental evidences confirm the effectiveness of this approach. Namely, the classification accuracy improved by about 30% at the end of the training compared to initial sessions. We also studied the neural correlates of this performance improvement. Using a newly proposed BCI user learning metric, we could show our user learned to improve his BCI control by producing EEG signals matching increasingly more the BCI classifier training data distribution, rather than by improving his EEG class discrimination. However, the resulting improvement was effective only on synchronous (cue-based) BCI and it did not translate into improved CYBATHLON BCI game performances. For the sake of overcoming this in the future, we unveil possible reasons for these limited gaming performances and identify a number of promising future research directions. Importantly, we also report on the evolution of the user's neurophysiological patterns and user experience throughout the BCI training and competition. (shrink)

A la fin du XIXe siècle, alors que l'Europe assiste au retour triomphal de la métaphysique dont Henri Bergson est une figure de proue, sur le positivisme, l'Espagne de la Restauration bourbonienne fait figure de résistante. La répartition bipolaire de l'intellectualité espagnole, entre les conservateurs néo-thomistes et les réformateurs de plus en plus attirés par la psychologie scientifique notamment, rend le dialogue primordialement impossible avec le bergsonisme. Seul Leopoldo Alas, dit Clarin, tente alors de faire entendre la "philosophie nouvelle", dans (...) son pays. Après que le bergsonisme a été boudé durant ces premières décennies d'existence par l'Espagne, la crise théologique moderniste de 1907 précipite son entrée dans la péninsule. Les premiers acteurs "philosophiques" du bergsonisme sont anti-bergsoniens et catholiques. Cet anti-bergsonisme religieux se double d'un rejet politique, pendant la Grande Guerre, principalement lors de la visite diplomatique de Bergson à Madrid, en mai 1916. Parallèlement, les réformateurs, férus de pédagogie, qui ont créé en 1876 la Institucion Libre de Ensenanza, découvrent la conceptualité bergsonienne qu'ils intègrent progressivement, entre 1900 et 1930, dans leur nouvelle science psychopédagogique. Toutefois, les grands acteurs espagnols de la régénération métaphysique sont les littéraires, les poètes symbolistes, appelés "modernistes" dans ce pays, puis les avant-gardes esthétiques. Ce sont eux qui métabolisent le bergsonisme en une (méta-)physique intime et organique. Ce n'est que dans un second temps, dans les années 1910, et non sans obstacles, que les spécialistes espagnols de philosophie intègrent et diffusent le bergsonisme. (shrink)

Simone Weil's ideas proved fundamental for Iris Murdoch, opening up a difficult path of thought for one rooted in the British philosophical tradition in the 1950s (Sim 1985, Bok 2005, Lovibond 2011a, Panizza 2022a, Mac Cumhaill and Wiseman 2022). Grasping the Weilian-inspired moral theory of attention sketched by Iris Murdoch is a prerequisite for comprehending the development of her moral ideas (Panizza 2015, Broackes 2012) and the form they may take in her literary writings (Griffin 1993, Morgan 2006). This paper (...) argues that we can read an expression of Simone Weil in Iris Murdoch's novels which articulate her notions of grace and gravity, but also convey the Weilian insights that shape Murdoch's moral perfectionism. It investigates three of Murdoch's well-known male protagonists, i.e., Bradley Pearson, Charles Arrowby and Hilary Burde, so as to comprehend how their moral failures relate to a defective implementation of the concepts of love and attention as theorised by Simone Weil as leading to goodness. Hence, it offers a new examination of the way in which the Murdochian literary staging of inattention as a cause of moral deficiency reveals its Weilian-based ethics of attention. (shrink)

Training in the responsible conduct of research (RCR) is mandated for select trainees supported by federal funds. RCR Instructors typically address standards and accepted practices for the planning, conduct and reporting of academic research. While this focus may be relevant to future academic scientists, the majority of science graduate students pursue careers in non-academic employment sectors (e.g., government, non-profit, industry). The ethical and regulatory conventions, norms and expectations of the academic setting may not always transfer to other work environments. As (...) such, educators should focus less on answering specific questions about standards and practices in academia, and instead design ethics education to actively engage students in a learning process that prepares them with the skills to identify and navigate ethical dimensions in a wide range of possible science professions. This paper introduces the principles of andragogy and provides recommendations for educators to consider when designing research ethics education for graduate students seeking cross-sector science careers. By applying principles that resonate with adult learning and integrating strategies that promote self-directed and life-long learning (e.g., reflective practice and collaborative projects), professional and research ethics instructional effectiveness may be enhanced. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male (...) participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

Are human beings essentially good or evil? Immanuel Kant responds, “[H]e [man] is as much the one as the other, partly good, partly bad.” Given this, I’d like to explore the following: What does Kant mean by human nature and how is it possible to be both good and evil? What is “original sin” and does it place limits on free will? In what respect might Kant’s views be significant for non-believers? More specifically, is Kant saying that human beings need (...) God in order to be good or is morality possible without faith? (shrink)

Niedenthal et al. discuss the importance of eye gaze in embodied simulation and, more globally, in the processing of emotional visual stimulation (such as facial expression). In this commentary, we illustrate the relationship between oriented eye movements, consciousness, and emotion by using the case of severely brain-injured patients recovering from coma (i.e., vegetative and minimally conscious patients).

Selon Félix Guattari les systèmes de coercition matériels sont progressivement remplacés au XX e siècle par des techniques de « modelage des systèmes perceptifs », à la fois plus douces et plus prenantes. Pour rendre compte de cette théorie de la socialisation de la perception et des ses enjeux socio-politiques nous nous focalisons sur la perception du visage d’autrui en soulignant l’ensemble des biais perceptifs (notamment racistes) identifiés par Guattari. Une étude approfondie des modalités d’apprentissage perceptif permet d’actualiser une dimension (...) souvent inaperçue de la pensée de Guattari. (shrink)

Quoi que nous nous efforcions de penser, nous continuons d'appartenir à notre siècle par Les croyances les plus communes et, quand cela a lieu, par le fait tout aussi commun de ne plus croire - ou de ne pas donner notre confiance au monde. Nos pères se sont tant méfiés, ou ils ont été à ce point cyniques, que cette foi, entendue dans son sens large, semble nous être aujourd'hui interdite. À nous qui avons hérité de cette perte sans l'avoir (...) consommée, ne restent que les débris d'une tradition devenue muette. Or la foi est vitale, et pas seulement la croyance religieuse. Mais dans une époque désorientée, nous ne pourrons peut-être sauver que le désir de croire : rien ne nous dit que nous retrouverons la croyance. Le paradoxe veut que cette impuissance annonce un temps de dangereuse crédulité. Il nous faut donc tout réapprendre. C'est à cette tâche que la philosophie doit s'atteler en prenant le contrepied de son éternelle tendance : en se mettant en quête de croire aussi résolument qu'elle avait cherché à savoir. La traversée du nihilisme est à ce prix."--Page 4 of cover. (shrink)

Resumo: O texto aqui apresentado analisa aspectos relevantes da complexa relação que Bergson estabelece com Kant. Defende-se a hipótese de que Bergson não pode ser considerado mero adversário do filósofo alemão, mas seu projeto filosófico tem como objetivo retomar a metafísica, levando em consideração os limites que a crítica kantiana lhe impôs. Nesse sentido, a Crítica da Razão Pura, à qual Bergson dedicou sua atenção, serve de guia e apoio para a colocação das questões propriamente metafísicas, as quais a filosofia (...) da duração busca responder. Procuramos mostrar também que, se Bergson criticou Kant em vários momentos da sua obra, foi apenas na medida em que a Crítica o impedia e impedia os outros de avançar. A relação entre as interdições kantianas para a razão especulativa e as ilusões da inteligência dissolvidas em A Evolução Criadora revela como Kant condensa ilusões que existiam antes dele e que, nesse sentido, Bergson não é nem pré-crítico, nem pós-kantiano. Em suma, defendemos que Bergson desloca as análises críticas e rompe com Kant do interior de sua filosofia, que ele divide em duas tendências - uma que ele rejeita, como antiga, outra da qual ele se apropria.: This paper examines important aspects of Bergson's complex relationship with Kant. Our hypothesis defends that Bergson can not be considered a mere opponent of Kant, but that instead his philosophical project aims to renew metaphysics, taking into account the limits that the Kantian critique has imposed. In this sense, the Critique of Pure Reason, to which Bergson devoted his attention, serves as a guide and support for reworking metaphysical questions that the philosophy of duration seeks to answer. We have also shown that if Bergson criticized Kant at various points in his work, it was only to the extent that the Critique was an impediment to moving forward. The relation between Kantian interdictions to speculative reason and the illusions of intelligence dissolved by the analysis of Creative Evolution shows how Kant condenses illusions that existed before him. In in this sense, Bergson is neither pre-critical nor post-Kantian. To sum up, we argue that Bergson displaces critical analysis and breaks with Kant from the inside of Kant's philosophy, which Bergson divides into two tendencies, one that he rejects as old, another that he accepts. (shrink)

Background COVID-19 has greatly impacted the health of incarcerated individuals in the US. The goal of this study was to examine perspectives of recently incarcerated individuals on greater restrictions on liberty to mitigate COVID-19 transmission.Methods We conducted semi-structured phone interviews from August through October 2021 with 21 people who had been incarcerated in Bureau of Prisons (BOP) facilities during the pandemic. Transcripts were coded and analyzed, using a thematic analysis approach.Results Many facilities implemented universal “lockdowns,” with time out of the (...) cell often limited to one hour per day, with participants reporting not being able to meet all essential needs such as showers and calling loved ones. Several study participants reported that repurposed spaces and tents created for quarantine and isolation provided “unlivable conditions.” Participants reported receiving no medical attention while in isolation, and staff using spaces designated for disciplinary purposes (e.g., solitary housing units) for public health isolation purposes. This resulted in the conflation of isolation and discipline, which discouraged symptom reporting. Some participants felt guilty over potentially causing another lockdown by not reporting their symptoms. Programming was frequently stopped or curtailed and communication with the outside was limited. Some participants relayed that staff threatened to punish noncompliance with masking and testing. Liberty restrictions were purportedly rationalized by staff with the idea that incarcerated people should not expect freedoms, while those incarcerated blamed staff for bringing COVID-19 into the facility.Conclusions Our results highlighted how actions by staff and administrators decreased the legitimacy of the facilities’ COVID-19 response and were sometimes counterproductive. Legitimacy is key in building trust and obtaining cooperation with otherwise unpleasant but necessary restrictive measures. To prepare for future outbreaks facilities must consider the impact of liberty-restricting decisions on residents and build legitimacy for these decisions by communicating justifications to the extent possible. (shrink)

We present an empirical case study that connects psycholinguistics with the field of cultural evolution, in order to test for the existence of cultural attractors in the evolution of quotations. Such attractors have been proposed as a useful concept for understanding cultural evolution in relation with individual cognition, but their existence has been hard to test. We focus on the transformation of quotations when they are copied from blog to blog or media website: by coding words with a number of (...) well-studied lexical features, we show that the way words are substituted in quotations is consistent with the hypothesis of cultural attractors and with known effects of the word features. In particular, words known to be harder to recall in lists have a higher tendency to be substituted, and words easier to recall are produced instead. Our results support the hypothesis that cultural attractors can result from the combination of individual cognitive biases in the interpretation and reproduction of representations. (shrink)

BackgroundEthics review is the process of assessing the ethics of research involving humans. The Ethics Review Committee (ERC) is the key oversight mechanism designated to ensure ethics review. Whether or not this governance mechanism is still fit for purpose in the data-driven research context remains a debated issue among research ethics experts.Main textIn this article, we seek to address this issue in a twofold manner. First, we review the strengths and weaknesses of ERCs in ensuring ethical oversight. Second, we map (...) these strengths and weaknesses onto specific challenges raised by big data research. We distinguish two categories of potential weakness. The first category concerns persistent weaknesses, i.e., those which are not specific to big data research, but may be exacerbated by it. The second category concerns novel weaknesses, i.e., those which are created by and inherent to big data projects. Within this second category, we further distinguish between purview weaknesses related to the ERC’s scope (e.g., how big data projects may evade ERC review) and functional weaknesses, related to the ERC’s way of operating. Based on this analysis, we propose reforms aimed at improving the oversight capacity of ERCs in the era of big data science.ConclusionsWe believe the oversight mechanism could benefit from these reforms because they will help to overcome data-intensive research challenges and consequently benefit research at large. (shrink)

Empiricism in philosophy is either a method or a theory. The two are separable: one might hold that all knowledge is empirical but that philosophy does something other than add to our knowledge, e.g., that it clarifies concepts; or one might hold that philosophy’s method is empirical and that one of the things known in that way is that not all knowledge is empirical, e.g., mathematics. And what is the empirical? If it is knowledge based on observation, then what is (...) it that can be observed? If philosophy is in method empirical, the range of the observable must be broad, perhaps including mental processes, human history, social institutions such as language, and even the difference between good and evil.In Peirce’s... (shrink)

The rise of modern natural sciences was based on the belief that knowledge about nature would increase steadily and that sooner or later it would prove useful for people and society. How these expectations shaped the self-image and the development of the natural sciences is the subject of this book. It turns out that expectations have repeatedly changed: from the universal ideal of utility of the 17th and 18th centuries to the promise of technical progress that is decisive today. The (...) unshakable belief in the usefulness of the natural sciences has always been accompanied by the insight that progress in knowledge can only be guaranteed if research is not based solely on short-term needs. In her story of the modern understanding of science, Désirée Schauz draws a bow from early modern natural research to the natural sciences of the 20th century. With its long-term perspective and its conceptual historical instruments, this book not only makes an important contribution to the modern history of science, but also provides a historically sound basis for current debates on science and innovation policy."-- publisher's website. (shrink)

Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

Ethics teaching in engineering can be problematic because of student perceptions of its subjective, ambiguous and philosophical content. The use of discipline-specific case studies has helped to address such perceptions, as has practical decision making and problem solving approaches based on some ethical frameworks. However, a need exists for a wider range of creative methods in ethics education to help complement the variety of activities and learning experiences within the engineering curriculum. In this work, a novel approach is presented in (...) which first-year undergraduate students are responsible for proposing ethics education activities of relevance to their peers and discipline area. The students are prepared for the task through a short introduction on engineering ethics, whereby generic frameworks for moral and professional conduct are discussed, and discipline and student-relevance contexts provided. The approach has been used in four departments of engineering at Imperial College London, and has led to the generation of many creative ideas for wider student engagement in ethics awareness, reflection and understanding. The paper presents information on the premise of the introductory sessions for supporting the design task, and an evaluation of the student experience of the course and task work. Examples of proposals are given to demonstrate the value of such an approach to teachers, and ultimately to the learning experiences of the students themselves. (shrink)

Summary In her highly publicised polemic, All Must Have Prizes (1996), Melanie Phillips launches a scathing attack upon the British educational establishment and various facets of policy and practice during the past three decades. She is especially critical of progressivism and approaches to teaching and learning supposedly predicated upon relativist principles (e.g. multicultural education). Our own research on primary?school children's constructions of British identity (Carrington, B. & Short, G. (1995): What makes a person British? Children's conceptions of their national (...) culture and identity, Educational Studies, 21, pp. 217?238) is singled?out for criticism. We begin this paper with a rejoinder to Phillips. Among other things, we take issue with her defence of an assimilationist approach to the curriculum. In the second part of the paper, we present the findings of a recently completed case?study of 12? and 13?year?olds? constructions of their national identity, which replicates the earlier work (criticised by Phillips) with 8? to 11?year?olds. We show that the young adolescents, in common with their counterparts in primary schools, tended to adopt a pluralist viewpoint. Once again, there was an almost complete dearth of comments that were racist or nationalistic. We conclude by briefly exploring the policy implications of the findings. [1] Paper presented to the 1997 Conference of the Association for Moral Education: The Voices of Care and Justice?enhancing dialogue among theorists, researchers and practitioners, Emory University, Atlanta, GA, USA. (shrink)

We dedicate this book to John Thibaut. He was mentor and personal friend to one of us, and his work had a profound intellectual influence on both of us. We were both strongly influenced by Thibaut's insightful articulation of the importance to psychology of the concept of pro cedural justice and by his empirical work with Laurens Walker in reactions to legal institu demonstrating the role of procedural justice tions. The great importance we accord the Thibaut and Walker work is (...) evident throughout this volume. If anyone person can be said to have created an entire field of inquiry, John Thibaut created the psychological study of procedural justice. (To honor Thibaut thus in no sense reduces our recognition of the contributions of his co-worker, Laurens Walker, in the creation of the field. We are as certain that Walker would endorse our statement as we are that Thibaut, with characteristic modesty, would demur from it. ) Even to praise Thibaut in this fashion falls short of recognizing all of his contributions to procedural justice. Not only did he initiate the psy chological study of the topic, he also built much of the intellectual foun dation upon which the study of procedural justice rests. Thibaut's work with Harold Kelley (1959; Kelley & Thibaut, 1978) created a social psy chological theory of interdependence that, among many other applica tions, serves as the basis for one of the major models of the psychology of procedural justice. (shrink)

Context: The problems that are most in need of interdisciplinary collaboration are “wicked problems,” such as food crises, climate change mitigation, and sustainable development, with many relevant aspects, disagreement on what the problem is, and contradicting solutions. Such complex problems both require and challenge interdisciplinarity. Problem: The conventional methods of interdisciplinary research fall short in the case of wicked problems because they remain first-order science. Our aim is to present workable methods and research designs for doing second-order science in (...) domains where there are many different scientific knowledges on any complex problem. Method: We synthesize and elaborate a framework for second-order science in interdisciplinary research based on a number of earlier publications, experiences from large interdisciplinary research projects, and a perspectivist theory of science. Results: The second-order polyocular framework for interdisciplinary research is characterized by five principles. Second-order science of interdisciplinary research must: 1. draw on the observations of first-order perspectives, 2. address a shared dynamical object, 3. establish a shared problem, 4. rely on first-order perspectives to see themselves as perspectives, and 5. be based on other rules than first-order research. Implications: The perspectivist insights of second-order science provide a new way of understanding interdisciplinary research that leads to new polyocular methods and research designs. It also points to more reflexive ways of dealing with scientific expertise in democratic processes. The main challenge is that this is a paradigmatic shift, which demands that the involved disciplines, at least to some degree, subscribe to a perspectivist view. Constructivist content: Our perspectivist approach to science is based on the second-order cybernetics and systems theories of von Foerster, Maruyama, Maturana & Varela, and Luhmann, coupled with embodied theories of cognition and semiotics as a general theory of meaning from von Uexküll and Peirce. (shrink)

Luck looms large in numerous different philosophical subfields. Unfortunately, work focused exclusively on the nature of luck is in short supply on the contemporary analytic scene. In his highly impressive recent book Epistemic Luck, Duncan Pritchard helps rectify this neglect by presenting a partial account of luck that he uses to illuminate various ways luck can figure in cognition. In this paper, I critically evaluate both Pritchard’s account of luck and another account to which Pritchard’s discussion draws our attention—viz., (...) that due to Nicholas Rescher. I also assess some novel analyses of luck that incorporate plausible elements of Pritchard’s and Rescher’s accounts. (shrink)