Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Introduction: the age of reflexion Part I. Romanticism: 1. Romanticism and the sciences David Knight 2. Schelling and the origins of his Naturphilosophie S. R. Morgan 3. Romantic philosophy and the organization of the disciplines: the founding of the Humboldt University of Berlin Elinor S. Shaffer 4. Historical consciousness in the German Romantic Naturforschung Dietrich Von Engelhardt 5. Theology and the sciences in the German Romantic period Frederick Gregory 6. Genius in Romantic natural philosophy Simon Shaffer Part II. Sciences of (...) the Organic: 7. Doctors contra clysters and feudalism: the consequences of a Romantic revolution Nelly Tsouyopoulos 8. Morphotypes and the historical-genetic method in Romantic biology Timothy Lenoir 9. ’Metaphorical mystifications’: the Romantic gestation of nature in British biology Evelleen Richards 10. Transcendental anatomy Philip F. Rehbock 11. Romantic thought and the origins of cell theory L. S. Jacyna 12. Alexander von Humbolt and the geography of vegetation Malcolm Nicholson Part III. Sciences of the Inorganic: 13. Goethe, colour, and the science of seeing Dennis L. Sepper 14. Johann Wilhelm Ritter: Romantic physics in Germany Walter D. Wetzels 15. The power and the glory: Humphrey Davy and Romanticism Christopher Lawrence 16. Oersted’s discovery of electromagnetism H. A. M. Snelders 17. Caves, fossils and the history of the earth Nicholas A. Rupke Part IV. Literature and the Sciences: 18. Goethe’s use of chemical theory in his Elective Affinities Jeremy Adler 19. Kleist’s bedlam: abnormal psychology and psychiatry in the works of Heinrich von Kleist Nigel Reeves 20. Coleridge and the sciences Trevor H. Levere 21. Nature’s book: the language of science in the American Renaissance David van Leer 22. The shattered whole: Georg Buchner and Naturphilosophie John Reddick. (shrink)

"By combining recent advances in the physical sciences with some of the novel ideas, techniques, and data of modern biology, this book attempts to achieve a new and different kind of evolutionary synthesis. I found it to be challenging, fascinating, infuriating, and provocative, but certainly not dull."--James H, Brown, University of New Mexico "This book is unquestionably mandatory reading not only for every living biologist but for generations of biologists to come."--Jack P. Hailman, Animal Behaviour , review of the first (...) edition "An important contribution to modern evolutionary thinking. It fortifies the place of Evolutionary Theory among the other well-established natural laws."--R.Gessink, TAXON. (shrink)

This study investigated the performance of boys with psychopathic tendencies and comparison boys, aged 9 to 17 years, on two tasks believed to be sensitive to amygdala and orbitofrontal cortex func- tioning. Fifty-one boys were divided into two groups according to the Psychopathy Screening Device (PSD, P. J. Frick & R. D. Hare, in press) and presented with two tasks. The tasks were the gambling task (A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) and the Intradimensional/ (...) Extradimensional (ID/ED) shift task (R. Dias, T. W. Robbins, & A. C. Roberts, 1996). The boys with psychopathic tendencies showed impaired performance on the gambling task. However, there were no group differences on the ID/ED task either for response reversal or extradimensional set shifting. The implications of these results for models of psychopathy are discussed. (shrink)

D. R. Fisher; IV*—Why Should I Be Just?, Proceedings of the Aristotelian Society, Volume 77, Issue 1, 1 June 1977, Pages 43–62, https://doi.org/10.1093/aristote.

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...

Currently, an emphasis is being placed on the integration of ethical issues into the business curriculum. This paper investigates the viability of using student group interaction to induce an upward movement in the stages of moral development as advanced by Kohlberg. The results of a classroom experiment using graduate business law students suggest that formulating groups that mix stages of moral development can provide a robust environment for upward movement. In addition, the results suggest strategies for formulating effective groups, based (...) upon entry levels as measured by the Defining Issues Test. (shrink)

Professor R. J. Getty has drawn attention to a tenth- or early eleventh-century manuscript of Statius’ Thebaid, hitherto examined only in Book I, namely Turonensis . Dr. Klotz, in his Teubner edition of 1908, gave citations from Book I, and wrote , ‘dolendum est sane de hoc codice primum tantum librum innotuisse, sed cum Roffensis libri maxime affinis accuratiorem notitiam haberemus, collatione quamvis -aegre careri posse nobis visum est.’ I have collated both T and Roffensis in full, and find firstly (...) that the citations of r by Klotz are far from accurate, especially in the last six books, and secondly that while it is indeed true thatT and r are very closely related, T is a much better representative than r of their common source. (shrink)

The work of the lay Catholic philosopher Jacques Maritain continues to provoke and inspire readers to engage in a Thomistic approach to many of the questions facing the world today. Maritain’s wide-ranging thought touched on many fields, including aesthetics, anthropology, educational theory, moral philosophy, and ethics, as well as Thomism and its relationship to other philosophical stances._ In _Being in the World: A Quotable Maritain Reader_, Mario O. D’Souza, C.S.B., has selected seven hundred and fifty of the most salient quotations (...) found in the English translations of fifty-four works by Jacques Maritain. Organized into forty thematic chapters, ordered alphabetically, the book serves as an overview of the areas that Maritain's writings addressed. By referring to entries in _Being in the World_, readers can quickly locate key passages in Maritain’s writing on a given topic and then turn elsewhere to the full texts for more in-depth study. Complete with a detailed index of key terms, the _Reader _will be an essential reference tool for the study of Maritain in English. "Fr. Mario O. D'Souza's careful selection from the works of Jacques Maritain provides the reader with an invaluable sampling of Maritain's extensive philosophical work. In it, we find examples of Maritain's almost lyrical gift of expression as well as of his trenchant wit. More than a scholarly contribution, the volume also ably serves as an introduction and entrance into Maritain's corpus." — William Sweet, St. Francis Xavier University, Canada_. (shrink)

The Sarbanes–Oxley Act of 2002 requires company executives to certify financial statements and internal controls as a means of reducing fraud. Many companies have operationalized this by instituting a sub-certification process and requiring lower-level managers to sign certification statements. These lower-level organizational members are often the individuals who are aware of fraud and are in the best position to provide information on the fraudulent act. However, the sub-certification process may have the effect of reducing employees’ intentions to report wrongdoing. We (...) suggest that subordinates with knowledge of a superior who committed a fraudulent act and certified that there is no fraud will feel less personal responsibility to report the act, thus, decreasing reporting intentions. Additionally, we suggest that if the fraud is discovered subsequent to the reports being filed with the Securities and Exchange Commission, employees will perceive lower management responsiveness to investigate the fraud, which will reduce intentions to report. Using an experimental approach, we manipulate two between-participant variables: the presence or absence of sub-certification by the transgressor and the timing of fraud discovery, either before or after the reports have been filed with the SEC. We find that when sub-certification is present, perceived personal responsibility and intentions to report were diminished compared to when sub-certification is absent. Timing of the discovery of the fraudulent act did not influence perceived management responsiveness or reporting intentions. Supplemental analysis shows that personal responsibility partially mediates the relationship between sub-certification and reporting intentions. Our findings suggest that audit committees and senior executives may want to carefully consider the costs and benefits of the sub-certification process. (shrink)

Offers a comprehensive nonmathematical treatment regarding the design and analysis of experiments, focusing on basic concepts rather than calculation of technical details. Much of the discussion is in terms of examples drawn from numerous fields of applications. Subjects include the justification and practical difficulties of randomization, various factors occurring in factorial experiments, selecting the size of an experiments, different purposes for which observations may be made and much more.

Rita Bottino,1 Santosh Nagaraju,2 Vikas Satyananda,2 Hidetaka Hara,2 Martin Wijkstrom,2 Massimo Trucco,1 David KC Cooper2 1Institute of Cellular Therapeutics, Allegheny Health Network, 2Thomas E Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA: Diabetes mellitus is increasing worldwide. Type 1 diabetes can be treated successfully by islet allotransplantation, the results of which are steadily improving. However, the number of islets that can be obtained from deceased human donors will never be sufficient to cure more than a very (...) small percentage of patients who might benefit from transplantation. Although there are some differences in glucose metabolism between pigs and humans, the use of pigs could provide an unlimited supply of islets, and the insulin produced would undoubtedly control glucose levels. Transplantation of islets into the portal vein results in islets residing in the liver; however, an early inflammatory response and rejection remain problematic, even when the recipient is receiving immunosuppressive therapy. In the long term, immunosuppressive drugs may exhibit toxicities to patients and specifically harm the islet cells. In contrast, encapsulation techniques provide islets with a physical barrier that prevents antibodies binding to the islet graft while still allowing insulin to be released into the recipient's circulation; in theory, patients receiving encapsulated grafts might not require exogenous immunosuppressive therapy. Nonhuman primates with encapsulated pig islet transplants have remained insulin-independent for several weeks, but long-term efficacy remains uncertain. Furthermore, techniques are now available to knock out genes from the pig and/or insert human genes, thus rendering the antigenic structure of pigs closer to that of humans, and providing protection from the human immune response. Islet transplantation from genetically engineered pigs has been followed by insulin independence in a small number of nonhuman primates for greater than 1 year. Neonatal islets have some advantages over adult islets in that they are easier to isolate and culture, and have the ability to proliferate during the first few months after transplantation. In 2009, the International Xenotransplantation Association set up a group to encourage and advise on clinical trials of pig islet xenotransplantation; this group's guidelines are discussed. Clinical trials of encapsulated pig islets are already under way. Keywords: diabetes, islets, pancreatic, pig, xenotransplantation. (shrink)

The use of virtual fencing in pasture-grazed farm systems is currently close to commercial reality but there are no studies applying the principles of responsible research and innovation, such as foresighting, to this technology. This paper reports results of a study aimed at foresighting potential implications associated with virtual fencing of cattle. A Delphi method was used to survey the opinions of farming practitioners and researchers, using pasture-grazed cattle farming in New Zealand as a case study. The key benefits were (...) identified as environmental protection, improved feed allocation, access to previously unavailable grazing areas, labour savings and individual animal management. The five most important potential barriers identified were device reliability, farmer perception of a value proposition, ethical issues related to community perception of negative animal welfare, lack of feed budgeting skills of farmers, and excessive training time. We suggest that more knowledge is needed on ethical issues associated with VF, including understanding public opinions of such technology developments. We suggest that development and use of VF has been focussed primarily on technical features and user benefits and needs to include consideration of wider socio-ethical principles to ensure responsible innovation processes. The findings from this study will aid focussed research and development to incorporate ethically acceptable development alongside technical factors. (shrink)

Due to the competitive nature of business as a whole, it is sometimes difficult to develop moral relationships with others. However, though friendships are possible in business, most relationships must be kept on the lower level of business acquaintanceship.

Introduction: Early recognition of prediabetes may prevent progression to diabetes, yet not all adults are aware of their prediabetes risk. To reach all adults unaware of their risk, additional risk assessment strategies are warranted. Objectives: The objective of this study was to evaluate the potential scope of benefit from prediabetes risk assessment in the dental care setting and to identify characteristics of dental patients likely to unknowingly have prediabetes or diabetes. Methods: Data from 10,472 adults in the National Health and (...) Nutrition Examination Survey from 2013 to 2014 and 2015 to 2016 were analyzed for associations among prediabetes/diabetes risk factors, health care use, and hemoglobin A1C levels according to chi-square tests and multivariate logistic regression. Results: A total of 7.73% of US adults had seen a dentist but not a medical provider in the past 12 mo. The composition of this subpopulation was significantly different from that who saw a medical provider, in ways that might affect their diabetes risk. In addition, 31.27% of this subpopulation would be identified as being at high risk for prediabetes according to the CDC Prediabetes Screening Test, and 15.83% had hemoglobin A1C levels indicative of undiagnosed prediabetes or diabetes. Screening in a dental setting would have the highest odds of identifying someone unaware of his or her diabetes risk among those who were non-White, obese, or ≥45 y old. Conclusion: Extrapolation from this analysis indicates that screening for prediabetes at dental visits has the potential to alert an estimated 22.36 million adults of their risk for prediabetes or diabetes. Incorporating prediabetes or diabetes risk assessment into routine dental visits may enable 1) those with prediabetes to take action to decrease their risk of developing diabetes and 2) those with diabetes to engage in treatment to decrease their risk of diabetes-related complications. Knowledge Transfer Statement: Screening for prediabetes and diabetes during dental visits has the potential to raise patients’ awareness of diabetes risk and prevent prediabetes from progressing to diabetes. For some patients, the dental visit may be the only point of contact with the health care system, which heightens the importance of including diabetes risk assessment for patient well-being. (shrink)

In this paper, the structure of a southeastern Spanish population was studied for the first time with respect to its inbreeding patterns and its relationship with demographic and geographic factors. Data on consanguineous marriages from 1900 to 1969 were taken from ecclesiastic dispensations. Our results confirm that the patterns and trends of inbreeding in the study area are consistent with those previously observed in most non-Cantabrian Spanish populations. The rate of consanguineous marriages was apparently stable between 1900 and 1935 and (...) then sharply decreased since 1940, which coincides with industrialization in Spain. A marked departure from Hardy-Weinberg expectations in the ratio of first cousin to second cousin marriages in the study population was observed. The high levels of endogamy and its significant steadiness throughout the twentieth century is noteworthy. Accordingly, our results show that exogamous marriages were not only poorly represented but also that this reduced mobility suggests that the choice of a mate was preferentially local. We found higher mobility in M22 with respect to M33 cousin mating. The relationships between population size and consanguinity rates and inbreeding fit power-law distributions. A significant positive correlation was observed between inbreeding and elevation. Many Spanish populations have experienced a prolonged and considerable isolation across generations, which has led to high proportions of historical and local endogamy that is associated, in general, with high \ values. Thus, assessing genomic inbreeding using runs of homozygosity in current Spanish populations could be an additional pertinent strategy for obtaining a more refined perspective regarding the population history inferred from the extent and frequency of ROH regions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:R. D. Ackerman BELIEVING IN A FICTION: WALLACE STEVENS AT THE LIMITS OF PHENOMENOLOGY The "ring of men" of "Sunday Morning" will chant their "devotion to the sun, / Not as a god, but as a god might be, / Naked among them, like a savage source" (CP, pp. 69-70).' Solar nakedness is deferred even as it is named. The problem for belief is the question of appearance and (...) representation. Things appear as and like.... The phenomenological return to things is also a turn to fiction, as Husserl understood: "If anyone loves a paradox, he can really say... that the element which makes up the life of phenomenology... is fiction. ' " The sun is divine, and it is not; it is both naked and clothed, savage and civilized, source (or end) and means. But such paradox is ultimately unsatisfying, and as we will see with Stevens, the need for belief—for an image or idea of totality—forces the issue of fiction and reality. The Stevens we will have in view is not the Stevens—as if there were such a creature. Our Stevens is the one most persuaded by promises such as those of phenomenology, the one most concerned with decreation (reduction) and fresh beginnings, with discovery and recognition, with imagination, the body, and the earth. This is the Stevens for whom the barrier of language presages at last not absence and difference but fictive recovery of presence and identity, the one for whom poetry represents a way of belief beyond mysticism even as it bodes mythic proximity. Finally, this is the Stevens who predominates throughout the prose (as well as in much of the poetry), who tries mightily to secure a belief while disencumbering himself of metaphysics—but alas, I think, with small success. Although Stevens's association of the problem of belief with the idea of fiction occurs in early poems such as "A High-Toned Old Christian 79 80Philosophy and Literature Woman" and "To the One of Fictive Music," his most intensive involvement with fiction as belief dates from the early 1940s and spans the period of his major essays and his last four volumes of poems. He recounts, for instance, a 1942 conversation with a student: "I said that I thought that we had reached a point at which we could no longer really believe in anything unless we recognized that it was a fiction. The student said that that was an impossibility, that there was no such thing as believing in something that one knew was not true. It is obvious, however, that we are doing that all the time" (L, p. 430). What does it mean to believe in a fiction? That is my main subject here, as we seek out the limits of the phenomenological Stevens. His letters of this period are preoccupied with the problem of fictive belief: "If one no longer believes in God (as truth), it is not possible merely to disbelieve; it becomes necessary to believe in something else.... A good deal of my poetry recently has concerned an identity for that thing.... In one of the short poems that I have just sent to the harvard advocate, I say that one's final belief must be in a fiction. I think that the history of belief will show that it has always been in a fiction" (L, p. 370). The poem referred to, "Asides on the Oboe," begins: The prologues are over. It is a question now, Of final belief. So, say that final belief Must be in a fiction. It is time to choose. (CP, p. 250) Acknowledging that "in the long run, poetry would be the supreme fiction" (L, pp. 430-31), Stevens nonetheless singles out the nominative function of poetry as the essence of its claim to supremacy: "Poetry means not the language of poetry but the thing itself.... The subject matter is what comes to mind when one says of the month of August... 'Thou art not August, unless I make thee so'" (L, p. 377). The quoted line (also from "Asides") underscores the paradox that for Stevens the essence of fiction (the nontrue) is its capacity to nominate the true or the real. This... (shrink)

The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke hits a great number of elderly women. Wyller et al. found that women seemed to be harder hit by stroke than men; they achieved lower scores in tests of motor, cognitive and ADL functions, (...) both in the acute phase and 1 year after stroke. It is reasonable to expect that differences in outcome among male and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir's theory can throw new light on the experiences and rehabilitation of elderly women and point to ways of improving the process of rehabilitation. (shrink)