Context The attitudes of medical professionals towards physician assisted dying have been widely discussed. Less explored is the level of agreement among physicians on the possibility of ‘rational suicide’—a considered suicide act made by a sound mind and a precondition of assisted dying legislation. Objective To assess attitudes towards rational suicide in a representative sample of senior doctors in England and Wales. Methods A postal survey was conducted of 1000 consultants and general practitioners randomly selected from a commercially available database. (...) The main outcome of interest was level of agreement with a statement about rational suicide. Results The corrected participation rate was 50%; 363 questionnaires were analysed. Overall 72% of doctors agreed with the possibility of rational suicide, 17% disagreed, and 11% were neutral. Doctors who identified themselves as being more religious were more likely to disagree. Some doctors who disagreed with legalisation of physician assisted suicide nevertheless agreed with the concept of rational suicide. Conclusions Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients. (shrink)

Reciprocal altruism involves foregoing an immediate benefit for the sake of a greater long-term reward. It follows that individuals who exhibit a stronger preference for future over immediate rewards should be more disposed to engage in reciprocal altruism – in other words, ‘patient’ people should be more cooperative. The present study tested this prediction by investigating whether participants’ contributions in a public-good game correlated with their ‘discount rate’. The hypothesis was supported: patient people are indeed more cooperative. The paper discusses (...) alternative interpretations of this result, and makes some suggestions for future research. (shrink)

To the evolutionarily oriented clinical psychiatrist, the discipline of behavioural ecology is a fertile basic science. Human psychology discusses variation in terms of means, standard deviations, heritabilities, and so on, but behavioural ecology deals with mutually incompatible alternative behavioural strategies, the heritable variation being maintained by negative frequency-dependent selection. I suggest that behavioural ecology should be included in the interdisciplinary dialogue recommended by Keller & Miller (K&M). (Published Online November 9 2006).

This is a comprehensive reference source on 18th-century authors writing in the English language about philosophical ideas and issues. It features authors taken from 1689 through to the mid-19th century, the period beginning with John Locke and ending with Dugald Stewart. The word philosophical is used in a wide, 18th-century sense. Therefore, the Dictionary includes epistemology, ethics, aesthetics, education, politics, rhetoric, science, medicine, biology, geology, chemistry and theology.

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

In which a scientist searches for an empirical explanation for phenomenal experience, spurred by his instinctual belief that life is meaningful. What links conscious experience of pain, joy, color, and smell to bioelectrical activity in the brain? How can anything physical give rise to nonphysical, subjective, conscious states? Christof Koch has devoted much of his career to bridging the seemingly unbridgeable gap between the physics of the brain and phenomenal experience. This engaging book--part scientific overview, part memoir, part futurist speculation--describes (...) Koch's search for an empirical explanation for consciousness. Koch recounts not only the birth of the modern science of consciousness but also the subterranean motivation for his quest--his instinctual belief that life is meaningful. Koch describes his own groundbreaking work with Francis Crick in the 1990s and 2000s and the gradual emergence of consciousness as a legitimate topic for scientific investigation. Present at this paradigm shift were Koch and a handful of colleagues, including Ned Block, David Chalmers, Stanislas Dehaene, Giulio Tononi, Wolf Singer, and others. Aiding and abetting it were new techniques to listen in on the activity of individual nerve cells, clinical studies, and brain-imaging technologies that allowed safe and noninvasive study of the human brain in action. Koch gives us stories from the front lines of modern research into the neurobiology of consciousness as well as his own reflections on a variety of topics, including the distinction between attention and awareness, the unconscious, how neurons respond to Homer Simpson, the physics and biology of free will, dogs, Der Ring des Nibelungen, sentient machines, the loss of his belief in a personal God, and sadness. All of them are signposts in the pursuit of his life's work--to uncover the roots of consciousness. (shrink)

Genomic research—including whole genome sequencing and whole exome sequencing—has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research—historically referred to as “incidental findings”—has generated considerable discussion as to how this information should be handled—that is, whether incidental results should be returned, and if so, which ones.Federal regulations governing most human subjects research in the United States require the disclosure of “the procedures to be followed” in (...) the research as part of the informed consent process. It seems reasonable to assume—and indeed, many commentators have concluded—that genomic investigators will be expected to inform participants about, among other procedures, the prospect that incidental findings will become available and the mechanisms for dealing with them. Investigators, most of whom will not have dealt with these issues before, will face considerable challenges in framing meaningful disclosures for research participants.To help in this task, we undertook to identify the elements that should be included in the informed consent process related to incidental findings. We did this by surveying a large number of genomic researchers (n = 241) and by conducting in‐depth interviews with a smaller number of researchers (n = 28) and genomic research participants (n = 20). Based on these findings, it seems clear to us that routine approaches to informed consent are not likely to be effective in genomic research in which the prospect of incidental findings exists. Ensuring that participants’ decisions are informed and meaningful will require innovative approaches to dealing with the consent issue. We have identified four prototypical models of a consent process for return of incidental findings. (shrink)

In ‘Naming and Necessity,’ Saul Kripke defends a number of essentialist claims. One of them is that having a certain origin is a necessary property of a material thing. Used in connection with a human being or, presumably, a living thing of another kind whose members sexually reproduce, ‘necessity of origin’ means that the organism must have been born of those individuals who are its parents, i.e., whose body tissues are sources of the sperm and egg from which it issued, (...) in the actual world. To say that the origin of an inanimate material thing is necessary is to say that having its origin in the hunk of matter from which it came is essential to it. (shrink)

Computer programs are used to obtain and store information about the online activities of users of the web. Many people are concerned about this practice because they believe that it can violate users' rights to privacy or result in violations of them. This belief is based on the assumption that the information obtained and stored with the use of the programs includes personal information. My main aim in this paper is to argue that this assumption is false. I discuss the (...) import of this result for computer ethics. If my thesis is correct, using the programs cannot violate a person's right to privacy and cannot result in violations of a right to privacy. Nevertheless it is prima facie morally wrong because, as I explain, it encourages people to perform actions that diminish the well-being of others. I discuss the implications of my thesis for the obligations of online businesses with regard to the relevant information. (shrink)

The adaptationist framework is necessary and sufficient for unifying the social and natural sciences. Gintis's “beliefs, preferences, and constraints” (BPC) model compares unfavorably to this framework because it lacks criteria for determining special design, incorrectly assumes that standard evolutionary theory predicts individual rationality maximisation, does not adequately recognize the impact of psychological mechanisms on culture, and is mute on the behavioural implications of intragenomic conflict. (Published Online April 27 2007).

Integrin‐mediated cell adhesion and subsequent cell spreading are essential for the growth and survival of many cell types. While integrin engagement is known to activate various signalling pathways, the role that cell spreading plays in the control of growth and survival is not clear. Using a novel technique, however, Chen et al.(1) demonstrate that the effect of cell spreading on growth and survival is not a consequence of increased area of contact with the extracellular matrix, supporting the hypothesis that regulation (...) through changes in cell tension and architecture play a key role. (shrink)

Each of the following sentences expresses a strong intuition about physical things: (a) a physical object is a three-dimensional spatial thing; (b) some physical things can, in the strict sense, remain the same thing through minor changes in their parts; (c) if x and y are physical things with the same spatiotemporal location, then x is strictly identical with y; (d) if x is a proper part of an existing physical thing and x occupies an occupiable region of space, then (...) x is itself an existing physical thing. There is a familiar argument that purports to prove that not all of (a)--(d) can be part of our ordinary concept of a physical thing. Its strategy for defending this claim is showing that at least one of (a)--(d) must-be false. The reason it gives for concluding that (a)--(d) are inconsistent is, appropriately, that they give rise to a paradox: according to the argument, (c) commits us to identifying products of a part-loss, yet (a), (b), and (d) yield the result that the products are different things. (shrink)

(1992). The agonic and hedonic modes: Definition, usage, and the promotion of mental health. World Futures: Vol. 35, Socio-Mental Bimodality, pp. 87-113.

Reply to a commentary by Felicitas Holzer and Ignacio Mastroleoon “Models of Consent to Return of Incidental Findings in Genomic Research.”.

The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)