I question whether, in those cases where physician-assisted suicide is invoked to alleviate unbearable pain and suffering, there can be such a thing as voluntary euthanasia. The problem is that when a patient asks to die under such conditions there is good reason to think that the decision to die is compelled by the pain, and hence not freely chosen. Since the choice to die was not made freely it is inadvisable for physicians to act in accordance with it, for (...) this may be contrary to the patient's genuine wishes. Thus, what were thought to be cases of voluntary euthanasia might actually be instances of involuntary euthanasia. (shrink)

Multiteam systems are complex organizational forms comprising interdependent teams that work towards their own proximal goals within and across teams to also accomplish a shared superordinate goal. MTSs operate within high-stakes, dangerous contexts with high consequences for suboptimal performance. We answer calls for nuanced exploration and cross-context comparison of MTSs “in the wild” by leveraging the MTS action sub-phase behavioral taxonomy to determine where and how MTS failures occur. To our knowledge, this is the first study to also examine how (...) key MTS attributes influence MTS processes and performance. We conducted historiometric analysis on 40 cases of failed MTS performance across various contexts to uncover patterns of within- and between-team behaviors of failing MTSs, resulting in four themes. First, component teams of failing MTSs over-engaged in within-team alignment behaviors by enacting acting, monitoring, and recalibrating behaviors more often within than between teams. Second, failing MTSs over-focused on acting behaviors and tended to not fully enact the action sub-phase cycle. Third and fourth, boundary status and goal type exacerbated these behavioral patterns, as external and physical MTSs were less likely to enact sufficient between-team behaviors or fully enact the action sub-phase cycle compared to internal and intellectual MTSs. We propose entrainment as a mechanism for facilitating MTS performance wherein specific, cyclical behavioral patterns enacted by teams align to facilitate goal achievement via three multilevel behavioral cycles. We argue that the degree to which these cycles are aligned both between teams and with the overarching MTS goal determines whether and how an MTS fails. Our findings add nuance beyond single-context MTS studies by showing that the identified behavioral patterns hold both across contexts and almost all types of MTS action-phase behaviors. We show that these patterns vary by MTS boundary status and goal type. Our findings inform MTS training best practices, which should be structured to integrate all component teams and tailored to both MTS attributes and situation type. (shrink)

ABSTRACT Global biodiversity declines are increasingly recognized as profound ecological and social crises. In areas subject to colonialization, these declines have advanced in lockstep with settler colonialism and imposition of centralized resource management by settler states. Many have suggested that resurgent Indigenous-led governance systems could help arrest these trends while advancing effective and socially just approaches to environmental interactions that benefit people and places alike. However, how dominant management and conservation approaches might be decolonized (i.e., how their underlying colonial structure (...) might be addressed, transformed, and replaced) is not always clear. Here, we describe a ‘Decolonial Model of Environmental Management and Conservation’ as an alternative paradigm to dominant approaches of conservation and management. The tenets of the model describe characteristics that might be expected of decolonized management, contrasted with those of dominant state-led approaches such as those embedded in the North American Model of Wildlife Conservation. The model does not prescribe how Indigenous governments or communities ought to govern their own territories, but instead offers insights into how external management and conservation agencies and practitioners might support (or stop impeding) Indigenous-led governance. We illustrate the model with a conservation ‘bright spot’: grizzly bear stewardship in the area now referred to as the Great Bear Rainforest in British Columbia, Canada, with a focus on work led by or in collaboration with, and within the territories of, the Haíɫzaqv, Kitasoo/xai’xais, Nuxalk, and Wuikinuxv First Nations. While acknowledging the important context-specific variability among place-based management and conservation applications, we also discuss the model’s broader applicability. (shrink)

Healthcare Ethics, Law and Professionalism: Essays on the Works of Alastair V Campbell features 15 original essays on bioethics, and healthcare ethics specifically. The volume is in honour of Professor Alastair V Campbell, who was the founding editor of the internationally-renowned Journal of Medical Ethics, and the founding director of three internationally leading centres in bioethics, in Otago, New Zealand, Bristol, UK, and Singapore. Campbell was trained in theology and philosophy and throughout his career worked with colleagues (...) from various disciplines, including law and various branches of healthcare. The diversity of topics and depth of contributors' insights reflect the breadth and impact of Campbell's philosophical work and policy contributions to healthcare ethics. Throughout his long academic career, Campbell's emphasis on healthcare ethics being practice-oriented, yet driven by critical reflection, has shaped the field in vital ways. The chapters are authored by leading scholars in healthcare ethics and law. Directly engaging with Campbell's work and influence, the essays discuss essential questions in healthcare ethics relating to its methodology and teaching, its intersection with law and policy, medical professionalism, religion, and its translation in different cultural settings. Chapters also grapple with specific enduring topics, such as the doctor-patient relationship, justice in health and biomedical research, and treatment of the human body and the dead. (shrink)

Class inclusion theory asserts that one cannot reverse the topic and vehicle of a metaphor and produce a new, meaningful metaphor that is based on the same interpretive ground. In 2 experiments we test that claim. In Study 1 we replicate the procedures employed by Glucksberg, McGlone, & Manfredi (1997) that provided support for the assertion. However we now add experimental conditions in which the target metaphors, either with the topic and vehicle in its canonical order or reversed, are placed (...) in discourse contexts that provide support for a meaningful interpretation based on the same ground. In contrast to the prediction of class inclusion theory, fully 72% of the cases the reversed metaphors were rated as interpretable and interpretation was based on the same ground used in interpreting the metaphors in their canonical order. In Study 2, the online processing of the metaphors in context are examined in a word-by-word reading task. We find that canonical and reversed order metaphors were read at the same rate throughout and both sets exhibited the same reading patterns: increased reading time of the noun-phrase (NP) that contains the metaphoric vehicle and of the first word in the text that follows the metaphor. We take these data to indicate that nonreversibility cannot be taken as a necessary condition of metaphor. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

Despite a growing literature on identity theory in the last two decades, much of its current use in archaeology is still driven toward locating and dating static categories such as 'Phoenician,' 'Christian' or 'native.' Previous studies have highlighted the various problems and challenges presented by identity, with the overall effect of deconstructing it to insignificance. As the humanities and social sciences turn to material culture, archaeology provides a unique perspective on the interaction between people and things over the long term. (...) This volume argues that identity is worth studying not despite its slippery nature, but because of it. Identity can be seen as an emergent property of living in a material world, an ongoing process of becoming which archaeologists are particularly well suited to study. The geographic and temporal scale of the papers included is purposefully broad to demonstrate the variety of ways in which archaeology is redefining identity. Research areas span from the Great Lakes to the Mediterranean, with case studies from the Mesolithic to the contemporary world by emerging voices in the field. The volume contains a critical review of theories of identity by the editors, as well as a response and afterword by A. Bernard Knapp"--From publisher's website. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

Using a longitudinal case study design, we have tracked the recovery of motor function following severe traumatic brain injury (TBI) through a multimodal neuroimaging approach. In 2006, Canadian Soldier Captain (retired) Trevor Greene (TG) was attacked with an axe to the head while on tour in Afghanistan. TG continues intensive daily rehabilitation, which recently included the integration of physical therapy (PT) with neuromodulation using translingual neurostimulation (TLNS) to facilitate neuroplasticity. Recent findings with PT+TLNS demonstrated that recovery of motor function occurred (...) beyond conventional time limits, currently extending past 14-years post-injury. To investigate whether PT+TLNS similarly resulted in associated cognitive function improvements, we examined event-related potentials (ERPs) with the brain vital signs framework. In parallel with motor function improvements, brain vital signs detected significant increases in basic attention (as measured by P300 response amplitude) and cognitive processing (as measured by contextual N400 response amplitude). These objective cognitive improvements corresponded with TG’s self-reported improvements, including a noteworthy and consistent reduction in ongoing symptoms of post-traumatic stress disorder (PTSD). The findings provide valuable insight into the potential importance of non-invasive neuromodulation in cognitive rehabilitation, in addition to initial indications for physical rehabilitation. (shrink)

Studying the most ethical way to allocate scarce medical resources has been of interest within the last year, due to shortages associated with the COVID-19 pandemic. This study aimed to establish differences between what healthcare providers (HCP) and laypeople consider to be the most ethical way to prioritise the distribution of scarce resources. Healthcare providers ( n = 100) and laypeople ( n = 102) were asked to rank ethical principles from most to least ethical for the allocation of ICU (...) beds in a COVID-19 outbreak, COVID-19 vaccinations and organ transplantation, and the rankings from each scenario across the two groups were compared. Results indicated that HCPs preferred utilitarian principles informed by medical knowledge, such as ‘prognosis’, whereas laypeople preferred less situation-specific and prioritarian principles, such as ‘sickest first’, replicating pre-pandemic findings. Laypeople showed increased in-group agreement when ranking principles, potentially due to the collective experience of the pandemic. Demographic variables such as older age, identifying as Black, Asian or minority ethnic and greater experience with COVID-19, were also associated with a preference for ‘prognosis’. (shrink)

Though we often “fear the worst”, worrying that unexpectedly bad things will happen, there are times when we “hope for the best”, imagining that unexpectedly good things will happen, too. The paper explores how the valence of the current situation influences people's imagining of unexpected future events when participants were instructed to think of “something unexpected”. In Experiment 1, participants (N = 127) were asked to report unexpected events to everyday scenarios under different instructional conditions (e.g., asked for “good” or (...) “bad” unexpected events), and manifested a strong negativity bias in response to non-valenced instructions (i.e., being asked to “think of the unexpected” with no valence given). They mainly reported quite “predictable” unexpected outcomes that were negative; however, a post-test (N = 31) showed that the scenarios used were predominantly positive. In Experiment 2 (N = 257), when participants were instructed to think of “something unexpected and bizarre”, under the same instructional manipulations as Experiment 1, this negativity bias was replicated. In Experiment 3, using a design in which positive/negative materials were matched (verified by a pre-test, N = 60), it was found that when participants (N = 102) were given negative scenarios, they reported more positive events than they do when they are given positive scenarios. Though responding still retained an overwhelming negative bias, this result provided some evidence for a weaker valence-countering strategy; that is, where a negative scenario can lead to positive unexpected events being mentioned, and a positive scenario leads to negative unexpected events being reported. The implications of these results for people's projections of unexpected futures in their everyday lives is discussed. (shrink)

So-called ‘distinctively mathematical explanations’ (DMEs) are said to explain physical phenomena, not in terms of contingent causal laws, but rather in terms of mathematical necessities that constrain the physical system in question. Lange argues that the existence of four or more equilibrium positions of any double pendulum has a DME. Here we refute both Lange’s claim itself and a strengthened and extended version of the claim that would pertain to any n-tuple pendulum system on the ground that such explanations are (...) actually causal explanations in disguise and their associated modal conditionals are not general enough to explain the said features of such dynamical systems. We argue and show that if circumscribing the antecedent for a necessarily true conditional in such explanations involves making a causal analysis of the problem, then the resulting explanation is not distinctively mathematical or non-causal. Our argument generalises to other dynamical systems that may have purported DMEs analogous to the one proposed by Lange, and even to some other counterfactual accounts of non-causal explanation given by Reutlinger and Rice. (shrink)

(Longer version - work in progress) Various accounts of distinctively mathematical explanations (DMEs) of complex systems have been proposed recently which bypass the contingent causal laws and appeal primarily to mathematical necessities constraining the system. These necessities are considered to be modally exalted in that they obtain with a greater necessity than the ordinary laws of nature (Lange 2016). This paper focuses on DMEs of the number of equilibrium positions of n-tuple pendulum systems and considers several different DMEs of these (...) systems which bypass causal features. It then argues that there is a tension between the modal strength of these DMEs and their epistemic hooking, and we are forced to choose between (a) a purported DME with greater modal strength and wider applicability but poor epistemic hooking, or (b) a narrowly applicable DME with lesser modal strength but with the right kind of epistemic hooking. It also aims to show why some kind of DMEs may be unappealing for working scientists despite their strong modality, and why some DMEs fail to be modally robust because of making ill-informed assumptions about their target systems. The broader goal is to show why such tensions weaken the case for DMEs for pendulum systems in general. (shrink)

in N. Eilan, A. Marcel and J. Bermudez, The Body and the Self, 29-42.

RésuméJaegwon Kim a montré de façon convaincante que les versions habituelles de la survenance décrivent en fait de simples relations de covariance et laissent échapper l'idée de dépendance. Mais puisque la dépendence du mental à l'endroit du physique est requise même par la version la plus faible du physicalisme, il semblerait bien que les notions actuelles de survenance n'accomplissent pas ce qu'on attendait d'elles. Je soutiens qu'en concevant la survenance dans une optique davidsonienne, comme une relation entre prédicats plutôt qu'entre (...) propriétés, on évite les inconvénients des versions plus familières, et que l'on donne prise, de la sorte, à un usage physicaliste de la survenance. (shrink)

RÉSUMÉ: Jaegwon Kim a montré de façon convaincante que les versions habituelles de la survenance décrivent en fait de simples relations de covariance et laissent échapper l’idée de dépendance. Mais puisque la dépendance du mental à l’endroit du physique est requise même par la version la plus faible du physicalisme, il semblerait bien que les notions actuelles de survenance n’accomplissent pas ce qu’on attendait d’elles. Je soutiens qu’en concevant la survenance dans une optique davidsonienne, comme une relation entre prédicats plutôt (...) qu’entre propriétés, on évite les inconvénients des versions plus familières, et que l’on donne prise, de la sorte, à un usage physicaliste de la survenance. (shrink)

Moral conclusions cannot validly be inferred from nonmoral premises – this principle, commonly called “Hume’s law,” presents a conundrum. On one hand, it seems obviously true, and its truth is often simply taken for granted. On the other hand, an ingenious argument by A. N. Prior seems to refute it. My aim here is a resolution. I shall argue, first, that Hume’s law is ambiguous, admitting both a strong and a weak interpretation; second, that the strong interpretation is false, as (...) shown by Prior’s argument; and, third, that the weak interpretation is true. (shrink)

Imaginative resistance refers to cases in which one’s otherwise flexible imaginative capacity is constrained by an unwillingness or inability to imaginatively engage with a given claim. In three studies, we explored which specific imaginative demands engender resistance when imagining morally deviant worlds and whether individual differences in emotion predict the degree of this resistance. In Study 1 (N = 176), participants resisted the notion that harmful actions could be morally acceptable in the world of a narrative regardless of the author’s (...) claims about these actions but did not resist imagining that a perpetrator of harm could believe their actions to be morally acceptable. In Study 2 (N = 167) we replicated the findings of Study 1 and showed that imaginative resistance is greatest among participants who experience more negative affect in response to imagining harm and are lower in either trait anxiety or trait psychopathy. In Study 3 (N = 210) we show that this is the case even when the harms assessed include both low-severity (i.e., emotional harm) and high-severity (i.e., killing) cases. Thus, people’s moral beliefs constrain their ability to imagine hypothetical moral alternatives, although this ability systematically varies on the basis of stable individual differences in emotion. (shrink)

RÉSUMÉ: L’«argument de la mort» de David Mackie prétend montrer que le critère psychologique de l’identité personnelle ne peut pas être adéquat, vu que les cadavres sont des gens et ne sont pourtant pas dotés de psychologie. Mackie soutient que les tenants du critère psychologique ne peuvent pas se contenter d’affirmer que le terme «personne» désigne tout simplement quelque chose qui a nécessairement des capacités psychologiques, car ce serait là, prétend-il, commettre une pétition de principe à l’encontre de sa position. (...) Et il prétend, de plus, que le langage ordinaire corrobore sa façon de voir. Je soutiens, cependant, que cet appui du langage ordinaire n’est guère concluant, et que la théorie psychologique a les ressources nécessaires pour rendre compte du discours sur les personnes mortes. (shrink)