The American Journal of Bioethics, Volume 11, Issue 11, Page 26-27, November 2011.

There is a growing trend of refusal of blood transfusions from COVID-19 vaccinated donors. We highlight three cases where parents have refused blood transfusions from COVID-19 vaccinated donors on behalf of their children in the setting of congenital cardiac surgery. These families have also requested accommodations such as explicit identification of blood from COVID-19 vaccinated donors, directed donation from a COVID19 unvaccinated family member, or use of a non-standard blood supplier. We address the ethical challenges posed by these issues. We (...) describe the current screening and safety processes for standard blood donation and explore the importance of donor anonymity and challenges with directed donation and non-standard blood suppliers. We present an ethical framework using the Best Interest Standard, the Zone of Parental Discretion, and the Harm Principle when considering these refusals. Finally, we provide recommendations for how to approach these requests as they potentially become more commonplace in pediatrics. (shrink)

There is a growing trend of refusal of blood transfusions from COVID-19 vaccinated donors. We highlight three cases where parents have refused blood transfusions from COVID-19 vaccinated donors on behalf of their children in the setting of congenital cardiac surgery. These families have also requested accommodations such as explicit identification of blood from COVID-19 vaccinated donors, directed donation from a COVID-19 unvaccinated family member, or use of a non-standard blood supplier. We address the ethical challenges posed by these issues. We (...) describe the current screening and safety processes for standard blood donation and explore the importance of donor anonymity and challenges with directed donation and non-standard blood suppliers. We present an ethical framework using the Best Interest Standard, the Zone of Parental Discretion, and the Harm Principle when considering these refusals. Finally, we provide recommendations for how to approach these requests as they potentially become more commonplace in pediatrics. (shrink)

Families and clinicians approaching a child’s death in the paediatric intensive care unit (PICU) frequently encounter questions surrounding medical decision-making at the end of life (EOL), including defining what is in the child’s best interest, finding an optimal balance of benefit over harm, and sometimes addressing potential futility and moral distress. The best interest standard (BIS) is often marshalled by clinicians to help navigate these dilemmas and focuses on a clinician’s primary ethical duty to the paediatric patient. This approach does (...) not consider a clinician’s potential duty to the patient’s family. This paper argues that when a child is dying in the PICU, the physician has a duty to serve both the patient and the family, and that in some circumstances, the duty to serve the family becomes as important as that owed to the child. We detail the limitations of the BIS in paediatric EOL care and propose the relational potential standard as an additional ethical framework to guide our decisions. (shrink)

Programmes serving international patients are increasingly common throughout the USA. These programmes aim to expand access to resources and clinical expertise not readily available in the requesting patients’ home country. However, they exist within the US healthcare system where domestic healthcare needs are unmet for many children. Focusing our analysis on US children’s hospitals that have a societal mandate to provide medical care to a defined geographic population while simultaneously offering highly specialised healthcare services for the general population, we assume (...) that, given their mandate, priority will be given to patients within their catchment area over other patients. We argue that beyond prioritising patients within their region and addressing inequities within US healthcare, US institutions should also provide care to children from countries where access to vital medical services is unavailable or deficient. In the paper, we raise and attempt to answer the following: (1) Do paediatric healthcare institutions have a duty to care for all children in need irrespective of their place of residence, including international patients? (2) If there is such a duty, how should this general duty be balanced against the special duty to serve children within a defined geographical area to which an institution is committed, when resources are strained? (3) Finally, how are institutional obligations manifest in paradigm cases involving international patients? We start with cases, evaluating clinical and contextual features as they inform the strength of ethical claim and priority for access. We then proceed to develop a general prioritisation framework based on them. (shrink)

The advances in treatment of HIV and the introduction of polymerase chain reaction assay for the virus now make it acceptable for HIV discordant couples where the male partner is seropositive to attempt to conceive through artificial insemination by husband (AIH) or via in vitro fertilisation. With undetectable viral load and washed sperm, there is minimal risk of transmission of HIV to the female partner, children, other patients, or staff. We describe the development of a programme of AIH for HIV (...) discordant couples and the reasoning behind offering such a programme. (shrink)

Understanding what makes governance 'good' or 'bad' has been impeded by construct ambiguity. Contemporary governance research has struggled to define 'governance' and related constructs such as 'ownership', 'agency', and 'management' in a way that clearly separates and distinguishes them. Often, the line between governance and management is so blurred that it is impossible to say what is good or bad 'governance' versus 'management'. Here we provide a systematic classification of key governance concepts in terms of their distinct economic functions. 'Governance', (...) for instance, is the economic function of behavioural constraint. This allows us to state what 'good' governance is and how it might be assessed. We conclude that goodness of governance is idiosyncratic to each organisation, or even to each owner. Thus, while objective measures of good governance are possible, broadly utilised criteria for measuring governance are unlikely to capture whether governance is actually good or bad. (shrink)

Antimicrobial resistance (AMR) poses an increasing threat to patient care and population health and there is a growing need for novel therapies to tackle AMR. Bacteriophage (phage) therapy is a re-emerging antimicrobial strategy with the potential to transform how bacterial infections are treated in patients and populations. Currently, in the UK, phages can be used as unlicensed medicinal products on a ‘named-patient’ basis. We make an ethical case for why it is crucially important for the UK to invest in Good (...) Manufacturing Practice (GMP) for both ongoing unlicensed and future licensed phage therapy. Access to phages produced to GMP (GMP phages) will ensure effective patient care and better outcomes as well as health systems benefits. The UK also has the potential to become a global leader in the timely and cost-efficient manufacturing and supply of a therapy that meets internationally recognised standards. (shrink)

High-spin states in the odd-odd N = Z nucleus Co-54 have been investigated by the fusion-evaporation reaction Si-28(S-32,1 alpha 1p1n)Co-54. Gamma-ray information gathered with the Ge detector array Gammasphere was correlated with evaporated particles detected in the charged particle detector system Microball and a 1 pi neutron detector array. A significantly extended excitation scheme of Co-54 is presented, which includes a candidate for the isospin T = 1, 6(+) state of the 1f(7/2)(-2) multiplet. The results are compared to large-scale shell-model (...) calculations in the fp shell. Effective interactions with and without isospin-breaking terms have been used to probe isospin symmetry and isospin mixing. A quest for deformed high-spin rotational cascades proved negative. This feature is discussed by means of cranking calculations. (shrink)

Two rotational bands have been identified and characterized in the proton-magic N = Z + 1 nucleus Ni-57. These bands complete the systematics of well-and superdeformed rotational bands in the light nickel isotopes starting from doubly magic Ni-56 to Ni-60. High-spin states in Ni-57 have been produced in the fusion-evaporation reaction Si-28(S-32, 2p1n)Ni-57 and studied with the gamma-ray detection array GAMMASPHERE operated in conjunction with detectors for evaporated light charged particles and neutrons. The features of the rotational bands in Ni-57 (...) are compared to those of neighbouring isotopes and interpreted by means of configuration-dependent cranked Nilsson-Strutinsky calculations. The two observed high-spin bands are considered signature partners and assigned to configurations with one 1g(9/2) proton and one 1g(9/2) neutron, resulting in an unambiguous understanding of the energetically favoured signature alpha = -1/2 band but a somewhat less satisfactory description of the signature alpha = +1/2 band. (shrink)

Lawrence Kohlberg's Approach to Moral Education presents what the late Lawrence Kohlberg regarded as the definitive statement of his educational theory. Addressing the sociology and social psychology of schooling, the authors propose that school culture become the center of moral education and research. They discuss how schools can develop as just and cohesive communities by involving students in democracy, and they focus on the moral decisions teachers and students face as they democratically resolve problems. As the authors put it: "...we (...) propose an educational renewal of our democratic society.... We have attempted to establish schools that do more than just teach about democratic citizenship, that are themselves democratic societies.". (shrink)

Debate on free will with Christian List, Gregg Caruso, and Cory Clark. The exchange is focused on Christian List's book Why Free Will Is Real.

A central theme in western philosophy was to find formal methods that can reliably discover empirical relationships and their explanations from data assembled from experience. As a philosophical project, that ambition was abandoned in the 20th century and generally dismissed as impossible. It was replaced in philosophy by neo-Kantian efforts at reconstruction and justification, and in professional statistics by the more limited ambition to estimate a small number of parameters in pre-specified hypotheses. The influx of “big data” from climate science, (...) neuropsychology, biology, astronomy and elsewhere implicitly called for a revival of the grander philosophical ambition. Search algorithms are meeting that call, but they pose a problem: how are their accuracies to be assessed in domains where experimentation is limited or impossible? Increasingly, the answer is through simulation of data from models of the kind of process in the domain. In some cases, these innovations require rethinking how the accuracy and informativeness of inference methods can be assessed. Focusing on causal inference, we give an example from neuroscience, but to show that the model/simulation strategy is not confined to causal inference, we also consider two classification problems from astrophysics: identifying exoplanets and identifying dark matter concentrations. (shrink)

Three experiments explored how hypocrisy affects attributions of criminal guilt and the desire to punish hypocritical criminals. Study 1 established that via perceived hypocrisy, a hypocritical criminal was seen as more culpable and was punished more than a non-hypocritical criminal who committed an identical crime. Study 2 expanded on this, showing that negative moral emotions (anger and disgust) mediated the relationships between perceived hypocrisy, criminal guilt, and punishment. Study 3 replicated the emotion finding from Study 2 using new scenarios where (...) group agents were clearly aware of the hypocrisy of their actions, yet acted anyway. Again, perceived hypocrisy worked through moral emotions to affect criminal guilt and punishment. The current studies provide empirical support for theories relating hypocrisy and moral transgressions to moral emotions, also informing the literature on the role of moral emotions in moral reasoning and legal decision making. (shrink)

Objectives: To analyse legislation and medical professional positions concerning the doctor’s role in assisted dying in western Europe, and to discuss their implications for doctors.Method: This paper is based on country-specific reports by experts from European countries where assisted dying is legalised , or openly practiced , or where it is illegal .Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide is not illegal in either Germany or Switzerland, but a doctor’s (...) participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not.Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This “neutral” stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a “medical end-of-life decision” since the 1970s.Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions. (shrink)

Australia and New Zealand boast an active community of scholars working in the field of history, philosophy and social studies of science. Australasian Studies in History and Philosophy of Science aims to provide a distinctive publication outlet for their work. Each volume comprises a group of thematically-connected essays edited by scholars based in Australia or New Zealand with special expertise in that particular area. In each volume, a majority ofthe contributors are from Australia or New Zealand. Contributions from elsewhere are (...) by no means ruled out, however, and are actively encouraged wherever appropriate to the balance of the volume in question. Earlier volumes in the series have been welcomed for significantly advancing the discussion of the topics they have dealt with. I believe that the present volume will be greeted equally enthusiastically by readers in many parts of the world. R. W. Home General Editor Australasian Studies in History And Philosophy of Science viii ACKNOWLEDGEMENTS The majority of the papers in this collection had their origin in the 2001 Australasian Association for History, Philosophy, and Social Studies of Science annual conference, held at the University of Melbourne, where streams of papers on the themes of scientific realism and commonsense were organised. (shrink)

In this bold, challenging book, D. S. Clarke outlines reasons for accepting panpsychism and defends the doctrine against its critics.

For language to function we clearly need two formal ordering principles: lexical entries and rules. Clahsen's target article provides multiple empirical evidence for this distinction, but this may be simply to overconfirm the undeniable and to overlook the hidden motor of language use and language development, namely, function. Since at least 1859, linguists have argued for the primacy of function, and these arguments are worth rediscovering today.

This article explores a German philosophy of metaphor, which proposed a close link between the body and the mind as the basis for metaphor, debunked the view that metaphor is just a decorative rhetorical device and questioned the distinction between the literal and the figurative. This philosophy of metaphor developed at the intersection between a reflection on language and thought and a reflection on the nature of beauty in aesthetics. Thinkers such as Giambattista Vico, Johann Wolfgang von Goethe, Jean Paul (...) and others laid the foundations for this philosophy and it was successively refined by Gustav Gerber, Alfred Biese and Friedrich Nietzsche. It influenced in its turn in various ways the linguistic study of metaphor and the psychology of metaphor as elaborated, for instance, by a lesser-known American scholar, Gertrude Buck. All these thinkers contributed to a philosophy and psychology of the metaphoric according to which metaphors are not only nice, but necessary for the structure and growth of human thought and language. Obvious parallels between this 19th-century philosophy of metaphor and the 20th-century theory of metaphor developed by Lakoff and his followers are examined throughout. (shrink)

In this paper, we discuss the macroscopic quantum behavior of simple superconducting circuits. Starting from a Lagrangian for electromagnetic field with broken gauge symmetry, we construct a quantum circuit model for a superconducting weak link (SQUID) ring, together with the appropriate canonical commutation relations. We demonstrate that this model can be used to describe macroscopic excitations of the superconducting condensate and the localized charge states found in some ultrasmall-capacitance weak-link devices.