Davis called for “extreme caution” in the use of non-invasive brain stimulation to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child’s future options. The distinction between treatment and enhancement has some normative force here. (...) As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests diminish, and the need to protect the child’s autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are themselves justified on a best interests standard. (shrink)

ObjectiveCochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation.Data sourcesWe address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community.Review methodsA systematic review using (...) three scientific online databases was performed. Included articles addressed the benefits and/or complications of cochlear implantation in young children, CI explantation with or without revision surgery and the ethical debate between the medical and Deaf communities on cochlear implantation and explantation.ConclusionsThe medical and audiological perspectives identify a host of risks related to implant removal without reimplantation, including risk from surgery, general anaesthesia, cochlear ossification and poor audiometric outcomes. The member of the deaf community and bioethicist argue that physicians need to guide the principles of beneficence, non-maleficence and patient autonomy. Taken together, patient desires should be seen as paramount, if the patient is otherwise fit for surgery and well informed.Implications for practiceSimilar to the case of device implantation, device explantation should be a multidisciplinary and collaborative decision with the patient and the family’s desires at the centre. While every case is different, we offer a CI explantation discussion to assist in clinical decision-making, patient counselling and education. (shrink)

Flexible work arrangements (FWAs) are widely offered in public accounting as a tool to retain valued professional staff. Previous research has shown that participants in FWAs are perceived to be less likely to succeed in their careers in public accounting than individuals in public accounting who do not participate in FWAs (Cohen and Single, 2001). Research has also documented an increasing backlash against family–friendly policies in the workplace as placing unfair burdens on individuals without children. Building directly on a (...) previous study in this journal (Cohen and Single, 2001), this study addresses the issue of whether the documented perceptions toward FWA participants are the result of electing to take part in the FWA or the result of bias against employees with children. The research questions are addressed in a 3 × 2 experimental setting in which we manipulate FWA participation, along with family status and gender of a hypothetical manager in a public accounting firm. Our findings indicate that FWA participants are viewed as less likely to advance and as less committed than individuals without children or individuals who had children but who were not taking part in a FWA. Male FWA participants are viewed as less likely to succeed than female FWA participants. This effect appears to arise from a perception that FWA participants are willing to make sacrifices in their careers to accommodate family needs and thus may not be as committed to making the sacrifices perceived as necessary to meet the rigorous demands of the public accounting environment. This raises the ethical question of what could be done to change the culture in public accounting to foster a substantive support system for individuals who want to balance a family and a career. (shrink)

According to many philosophers, psychological explanation canlegitimately be given in terms of belief and desire, but not in termsof knowledge. To explain why someone does what they do (so the common wisdom holds) you can appeal to what they think or what they want, but not what they know. Timothy Williamson has recently argued against this view. Knowledge, Williamson insists, plays an essential role in ordinary psychological explanation.Williamson's argument works on two fronts.First, he argues against the claim that, unlike knowledge, (...) belief is``composite'' (representable as a conjunction of a narrow and a broadcondition). Belief's failure to be composite, Williamson thinks, undermines the usual motivations for psychological explanation in terms of belief rather than knowledge.Unfortunately, we claim, the motivations Williamson argues against donot depend on the claim that belief is composite, so what he saysleaves the case for a psychology of belief unscathed.Second, Williamson argues that knowledge can sometimes provide abetter explanation of action than belief can.We argue that, in the cases considered, explanations that cite beliefs(but not knowledge) are no less successful than explanations that citeknowledge. Thus, we conclude that Williamson's arguments fail both coming andgoing: they fail to undermine a psychology of belief, and they fail tomotivate a psychology of knowledge. (shrink)

Feynman's sum-over-histories formulation of quantum mechanics has been considered a useful calculational tool in which virtual Feynman histories entering into a coherent quantum superposition cannot be individually measured. Here we show that sequential weak values, inferred by consecutive weak measurements of projectors, allow direct experimental probing of individual virtual Feynman histories, thereby revealing the exact nature of quantum interference of coherently superposed histories. Because the total sum of sequential weak values of multitime projection operators for a complete set of orthogonal (...) quantum histories is unity, complete sets of weak values could be interpreted in agreement with the standard quantum mechanical picture. We also elucidate the relationship between sequential weak values of quantum histories with different coarse graining in time and establish the incompatibility of weak values for nonorthogonal quantum histories in history Hilbert space. Bridging theory and experiment, the presented results may enhance our understanding of both weak values and quantum histories. (shrink)

Quantum entanglement is a key resource, which grants quantum systems the ability to accomplish tasks that are classically impossible. Here, we apply Feynman's sum-over-histories formalism to interacting bipartite quantum systems and introduce entanglement measures for bipartite quantum histories. Based on the Schmidt decomposition of the matrix comprised of the Feynman propagator complex coefficients, we prove that bipartite quantum histories are entangled if and only if the Schmidt rank of this matrix is larger than 1. The proposed approach highlights the utility (...) of using a separable basis for constructing the bipartite quantum histories and allows for quantification of their entanglement from the complete set of experimentally measured sequential weak values. We then illustrate the nonclassical nature of entangled histories with the use of Hardy's overlapping interferometers and explain why local hidden variable theories are unable to correctly reproduce all observable quantum outcomes. Our theoretical results elucidate how the composite tensor product structure of multipartite quantum systems is naturally extended across time and clarify the difference between quantum histories viewed as projection operators in the history Hilbert space and those viewed as chain operators and propagators in the standard Hilbert space. (shrink)

Ruchkin et al. ascribe a pivotal role to long-term memory representations and binding within working memory. Here we focus on the interaction of working memory and long-term memory in supporting on-line representations of experience available to guide on-going processing, and we distinguish the role of frontal-lobe systems from what the hippocampus contributes to relational long-term memory binding.

Although O'Regan & Noë (O&N) claim that the world may serve as the viewers' external visual memory, findings from the field of memory research have demonstrated the existence of internal visual representations. These representations are stored in the viewer's brain, contain information regarding visual objects and their relations, guide subsequent exploration of the visual world and promote change detection.

Flexible work arrangements (FWAs) are widely offered in public accounting as a tool to retain valued professional staff. Previous research has shown that participants in FWAs are perceived to be less likely to succeed in their careers in public accounting than individuals in public accounting who do not participate in FWAs (Cohen and Single, 2001). Research has also documented an increasing backlash against family–friendly policies in the workplace as placing unfair burdens on individuals without children. Building directly on a (...) previous study in this journal (Cohen and Single, 2001), this study addresses the issue of whether the documented perceptions toward FWA participants are the result of electing to take part in the FWA or the result of bias against employees with children. The research questions are addressed in a 3 × 2 experimental setting in which we manipulate FWA participation, along with family status and gender of a hypothetical manager in a public accounting firm. Our findings indicate that FWA participants are viewed as less likely to advance and as less committed than individuals without children or individuals who had children but who were not taking part in a FWA. Male FWA participants are viewed as less likely to succeed than female FWA participants. This effect appears to arise from a perception that FWA participants are willing to make sacrifices in their careers to accommodate family needs and thus may not be as committed to making the sacrifices perceived as necessary to meet the rigorous demands of the public accounting environment. This raises the ethical question of what could be done to change the culture in public accounting to foster a substantive support system for individuals who want to balance a family and a career. (shrink)

In The Virtuous Therapist, authors Elliot D. Cohen and Gale Spieler Cohen provide a systematic, philosophical approach to mental health ethics. Their comprehensive model of ethical decision making is developed to a number of difficult ethical problems counselors will experience. The issues raised in the book are timely, ethically engaging, and of practical importance to those working in the field.

Objectives To evaluate whether the requirement of “minimal risk and burden” for paediatric research without direct benefit to the subjects compromises the ability to obtain data necessary for improving paediatric care. To provide evidence-based reflections on the EU recommendation that allows for a higher level of risk. Design and setting Systematic analysis of the approval/rejection decisions made by the Dutch Central Committee on Research involving Human Subjects (CCMO). Review methods The analysis included 165 proposals for paediatric research without direct benefit (...) that were reviewed by the CCMO between January, 2000, and July, 2007. A separate, in-depth analysis of all drug studies included 18 early phase drug studies and nine other drug studies without direct benefit. Results 11 out of 165 studies were definitively rejected because the CCMO did not regard the risk and/or burden to be minimal. In three of these 11 cases (including two early phase drug studies) the requirement of minimal risk and burden was cited as the only reason for rejection. Four other early phase drug studies also involved risks and/or burdens that were not regarded to be minimal but were nevertheless approved. Conclusions The requirement of minimal risk and burden, aiming to protect research subjects, occasionally leads to rejection of protocols. Early phase drug studies relatively often do not comply with the requirement. Committees may find ways to approve important studies that formally should be rejected, but that is not a desirable solution. The regulatory framework should be revised to make such occasional exceptions to the requirement legitimate and transparent. (shrink)

Decision theory requires agents to assign probabilities to states of the world and utilities to the possible outcomes of different actions. When agents commit to having the probabilities and/or utilities in a decision problem defined by objective features of the world, they may find themselves unable to decide which actions maximize expected utility. Decision theory has long recognized that work-around strategies are available in special cases; this is where dominance reasoning, minimax, and maximin play a role. Here we describe a (...) different work around, wherein a rational decision about one decision problem can be reached by ‘interpolating’ information from another problem that the agent believes has already been rationally solved. (shrink)

The current system of ethical review for medical research in the United Kingdom is changing from the current system involving large committees of 7–18 members reviewing every individual application to a system involving pre-review by small sub-committees of National Research Ethics Officers , who have a remit to approve studies if they believe there are no material ethical issues imposed by the research. The reliability of this new system depends on the reliability of the NREAs and in particular the ability (...) of small groups to effectively identify and appropriately assess the seriousness of all the material ethical issues that may be posed by an application. There is anecdotal evidence to suggest that many individual research ethics committee members have had experience of believing that a study presents no material ethical concerns, then on reaching the committee and discussing the application they realise that the committee feels it does present significant ethical concerns. If this is the case then this casts doubt on the reliability of NREAs or small groups to effectively identify ethically problematic research and appropriately respond to this to protect research participants. In this paper we describe a small questionnaire based piece of research carried out to assess how common this and other relevant experiences are. (shrink)

Extreme conditions like savantism, autism or synaesthesia, which have a neurological 2AH, UK basis, challenge the idea that other minds are similar to our own. In this paper we report a single case study of a man in whom all three of these conditions co-occur. We suggest, on the basis of this single case, that when savantism and synaesthesia co- occur, it is worthwhile testing for an undiagnosed Autism Spectrum Condition (ASC). This is because savantism has an established association with (...) ASC, and the combination of ASC with synaesthesia may increase the likelihood of savantism. The implications of these conditions for philosophy of mind are introduced. (shrink)

Color provides an instance of a general puzzle about how to reconcile the picture of the world given to us by our ordinary experience with the picture of the world given to us by our best theoretical accounts. The Red and the Real offers a new approach to such longstanding philosophical puzzles about what colors are and how they fit into nature. It is responsive to a broad range of constraints --- both the ordinary constraints of color experience and the (...) more theoretical constraints of color science, psychology, semantics, and ontology. (shrink)

One hypothesis concerning the human dorsal anterior cingulate cortex (ACC) is that it functions, in part, to signal the occurrence of conflicts in information processing, thereby triggering compensatory adjustments in cognitive control. Since this idea was first proposed, a great deal of relevant empirical evidence has accrued. This evidence has largely corroborated the conflict-monitoring hypothesis, and some very recent work has provided striking new support for the theory. At the same time, other findings have posed specific challenges, especially concerning the (...) way the theory addresses the processing of errors. Recent research has also begun to shed light on the larger function of the ACC, suggesting some new possibilities concerning how conflict monitoring might fit into the cingulate's overall role in cognition and action. (shrink)

Porcine-derived products serve as an effective solution for a wide range of human ailments; however, there may be objections to their use due to Islamic religious prohibitions on consuming products derived from pigs. In order to enhance the cultural competence of medical practitioners who treat Muslim individuals, which constitute about one fifth of the world population, this study aimed at evaluating the knowledge and positions of Muslim patients on this subject. A questionnaire presenting 15 uses of porcine-derived materials was filled (...) out by 809 Muslims. The level of knowledge about the permissibility of these uses and participants’ position on whether it should be approved was assessed. Findings show that Muslims are not familiar with Islamic religious jurisprudence that permits the use of porcine products to save lives after it has undergone an essential transformation known as Istihala. The respondents expressed a negative attitude towards the medical use of porcine-derived substances based on imprecise knowledge about the permissibility of use of porcine-derived materials, devices and treatments. We offer recommendations for improving the informed consent obtained from Muslim patients prior to conducting porcine-based treatments. (shrink)

According to Marr, a computational-level theory consists of two elements, the what and the why. This article highlights the distinct role of the Why element in the computational analysis of vision. Three theses are advanced: that the Why element plays an explanatory role in computational-level theories, that its goal is to explain why the computed function is appropriate for a given visual task, and that the explanation consists in showing that the functional relations between the representing cells are similar to (...) the “external” mathematical relations between the entities that these cells represent. (shrink)

The prefrontal cortex has long been suspected to play an important role in cognitive control, in the ability to orchestrate thought and action in accordance with internal goals. Its neural basis, however, has remained a mystery. Here, we propose that cognitive control stems from the active maintenance of patterns of activity in the prefrontal cortex that represent goals and the means to achieve them. They provide bias signals to other brain structures whose net effect is to guide the flow of (...) activity along neural pathways that establish the proper mappings between inputs, internal states, and outputs needed to perform a given task. We review neurophysiological, neurobiological, neuroimaging, and computational studies that support this theory and discuss its implications as well as further issues to be addressed. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

The terms complexity, complex adaptive systems, and sciences of complexity are found often in recent scientific literature, reflecting the remarkable growth in collaborative academic research focused on complexity from the origin and dynamics of organisms to the largest social and political organizations. One of the great challenges in this field of research is to discover which features are essential and shared by all of the seemingly disparate systems that are described as complex. Is there sufficient synthesis to suggest the possibility (...) of an overarching science of complexity? This report describes current views on this subject held by various eminent scholars associated with the Santa Fe Institute.The physical sciences have traditionally been concerned with “simple” systems whose dynamics can be described in mathematical terms with precision and certainty. In contrast, the biological and social sciences are inevitably concerned with self-organized or social “complex” systems whose detailed behaviors appear to be unpredictable. The two categories differ greatly in size and diversity, prompting the late mathematician Stanislaus Ulam to remark that research on complex systems might be compared to the study of non-elephants. Nevertheless, certain integrative themes have begun to emerge.Rising activity in this field of research runs completely counter to the trend toward increasing fragmentation and specialization in the sciences. It has stimulated a resurgence of interest in a broad synthesis involving mathematics, computational science, physics, chemistry, biology, neuroscience, and the social sciences. The growth of effort in this very extended field has been greatly stimulated by the development of new computational tools that are capable of dealing with vast, interrelated databases. Many of the participants in complexity research feel that it is now time to reintegrate the fragmented interests of much of the academic community. The reader is encouraged to consider whether such views are sparking a historic renaissance of scholarship or represent a passing scientific diversion. (shrink)