The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

Measuring outcomes using quantitative analytic methods is the hallmark of scientific research in healthcare. For clinical ethics support services (CESS), tangible outcome metrics are lacking and literature examining CESS quality is limited to evaluation of single cases or the influence on individual healthcare professional’s perceptions or behaviour. This represents an enormous barrier to implementing and evaluating ethics initiatives to improve quality. In this context, Kok _et al_ propose a theoretical framework for how moral case deliberation (MCD) can drive quality at (...) an organisational-level, termed _morisprudence_ 1. By offering mechanistic insights into how MCD can lead to organisational learning and quality improvement (QI), they provide a roadmap for actionable items to measure quality. As conceptualised, _morisprudence_ follows accumulation of organisational practical wisdom from a repertoire of ‘paradigmatic’ MCDs, aiding identification of patterns of morally important features. Here, there are parallels between healthcare professionals’ clinical judgement, where past experience... (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Euthanasia and physician assisted-suicide are terms used to describe the process in which a doctor of a sick or disabled individual engages in an activity which directly or indirectly leads to their death. This behavior is engaged by the healthcare provider based on their humanistic desire to end suffering and pain. The psychiatrist's involvement may be requested in several distinct situations including evaluation of patient capacity when an appeal for euthanasia is requested on grounds of terminal somatic illness or when (...) the patient is requesting euthanasia due to mental suffering. We compare attitudes of 49 psychiatrists towards euthanasia and assisted suicide with a group of 54 other physicians by means of a questionnaire describing different patients, who either requested physician-assisted suicide or in whom euthanasia as a treatment option was considered, followed by a set of questions relating to euthanasia implementation. When controlled for religious practice, psychiatrists expressed more conservative views regarding euthanasia than did physicians from other medical specialties. Similarly female physicians and orthodox physicians indicated more conservative views. Differences may be due to factors inherent in subspecialty education. We suggest that in light of the unique complexity and context of patient euthanasia requests, based on their training and professional expertise psychiatrists are well suited to take a prominent role in evaluating such requests to die and making a decision as to the relative importance of competing variables. (shrink)

Siegel defends "Limited Intentionism", a theory of what secures the semantic reference of uses of bare demonstratives ("this", "that" and their plurals). According to Limited Intentionism, demonstrative reference is fixed by perceptually anchored intentions on the part of the speaker.

_The purpose_ of the article is to comprehend the Husserlian model of constituting temporal modes through the ability of intentional "retentional-protentional" consciousness, as well as to clarify the possibility of interpreting its positions in the reconstruction of the concept of anthropic time. _Theoretical basis._ The theoretical framework of the research includes: 1) the interpretation of the phenomenological reflection of "time-consciousness" by E. Husserl in the context of solving the problem of phased-differentiation of this form of temporality; 2) the concept of (...) anthropic time (V. Khanzhy). _Originality._ For the first time in research literature, the possibilities of applying the ideas of Husserl to the reconstruction of the concept of anthropic time are considered through the interpretation of the phenomenological solution to the problem of temporality, proposed and specified in Husserl’s "time-consciousness" concept. _Conclusions._ The comprehension of the Husserlian model of intentionality of consciousness through the "grasping-from-now" and the constitution of phases of phenomenological time through the component of "exiting-from-now" showed that solving the problem of phased-differentiation of phenomenological time leads to the observation of the impossibility of isolating the modes of past, present, and future as self-sufficient and unconditional. More accurate indications, based on the constitutive intentionality of consciousness on the "grasping-from-now" phases of time (as conventional), are as follows: a) the abilities of retention and recollection are the foundation for the constitution of the past and its connections to the present; b) the perception establishes the basis for the phase of the present itself; c) the possibilities of protention and anticipation (as forms of imagination) constitute the future and its connections to the present. By the concept of retention, Husserl fixes a certain primary memory (the present "now" of a past interval), which enables retaining the past in the present. The category of recollection or secondary memory is used by the philosopher to refer to the self-sufficient reproduction of past experiences (without being joined to present perception). The fundamental difference between recollection and retention is that the former _re-_presents a temporal interval, grasping its content and reproducing it as it was in the past, while in the latter, the perceived duration is presented as a fragment of time that has just passed. According to the German philosopher, the "grasping" of the present phase is performed by perception. Through the constitutive intentionality of consciousness, perception synthesizes the results of primary-actual activity and retentional holding of duration. The second part of the article will present solutions to the following research tasks: 1) analysis of the possibilities of protention and anticipation in constituting the future and its connections with the present; 2) understanding the possibility of using interpreted forms of Husser’s ideas in reconstructing the concept of anthropic time. (shrink)

The political philosophy of health care has been characterized by considerable conceptual inflation in recent years. First, the concept of health that lies at its core has come to encompass ever-increasing aspects of individuals’ existences. And second, the emergence of the public health perspective has increased the range of resources relevant to health equity. This expansion has not been without cost. The decision to include more rather than less within the ambit of "health" is ultimately a moral/political rather than an (...) ontological or metaphysical one, and there are several ethical reasons to define the scope of theories of distributive justice in health narrowly. (shrink)

Abduction is or subsumes a process of inference. It entertains possible hypotheses and it chooses hypotheses for further scrutiny. There is a large literature on various aspects of non-symbolic, subconscious abduction. There is also a very active research community working on the symbolic (logical) characterisation of abduction, which typically treats it as a form of hypothetico-deductive reasoning. In this paper we start to bridge the gap between the symbolic and sub-symbolic approaches to abduction. We are interested in benefiting from developments (...) made by each community. In particular, we are interested in the ability of non-symbolic systems (neural networks) to learn from experience using efficient algorithms and to perform massively parallel computations of alternative abductive explanations. At the same time, we would like to benefit from the rigour and semantic clarity of symbolic logic. We present two approaches to dealing with abduction in neural networks. One of them uses Connectionist Modal Logic and a translation of Horn clauses into modal clauses to come up with a neural network ensemble that computes abductive explanations in a top-down fashion. The other combines neural-symbolic systems and abductive logic programming and proposes a neural architecture which performs a more systematic, bottom-up computation of alternative abductive explanations. Both approaches employ standard neural network architectures which are already known to be highly effective in practical learning applications. Differently from previous work in the area, our aim is to promote the integration of reasoning and learning in a way that the neural network provides the machinery for cognitive computation, inductive learning and hypothetical reasoning, while logic provides the rigour and explanation capability to the systems, facilitating the interaction with the outside world. Although it is left as future work to determine whether the structure of one of the proposed approaches is more amenable to learning than the other, we hope to have contributed to the development of the area by approaching it from the perspective of symbolic and sub-symbolic integration. (shrink)

Plotinus maintains that our intellect is always thinking. This is due to his view that our intellect remains in the intelligible world and shares a natural kinship with the hypostasis Intellect, whose being and activity consists in eternal contemplation of the Forms. Moreover, Plotinus maintains that although our intellect is always thinking we do not always apprehend our thoughts. This is due to his view that “we“ descend into the sensible world while our intellect remains in the intelligible world. Furthermore, (...) Plotinus maintains that it is only when logoi unfold the content of our thoughts into the imagination that we apprehend them. This is due to a complex account between, on the one hand, the relationship between intellect and discursive reasoning, and on the other hand, the relationship between discursive reasoning and language. Plotinus tells this story with remarkable brevity in Ennead 4.3.30. In this paper I explain the role the imagination plays in the apprehension of thoughts through a close analysis of this treatise in connection with Ennead 1.4.10. (shrink)

The publish-or-perish paradigm is a prevailing facet of science. We apply game theory to show that, under rather weak assumptions, this publication scenario takes the form of a prisoner’s dilemma, which constitutes a substantial obstacle to beneficial delayed publication of more complete results. One way of avoiding this obstacle while allowing researchers to establish priority of discoveries would be an updated “pli cacheté”, a sealed envelope concept from the 1700s. We describe institutional rules that could additionally favour high-quality work and (...) publications and provide examples of such policies that are already in place. Our analysis should be extended to other publication scenarios and the role of other stakeholders such as scientific journals or sponsors. (shrink)

Literally before our eyes, the modeling of global development, or world modeling, has, during the past five to seven years, advanced from the initial experiments of individual groups of enthusiasts to the status of an independent sphere of scientific research enriched each year by new and ever larger teams of experts and by whole institutes.