The American Urological Association (AUA) and American College of Surgeons (ACS) codes of professionalism require surgeons to disclose the specific roles and responsibilities of trainees to patients during the informed consent process. The objective of this study is to analyze how these requirements are met by urology training programs. An anonymous electronic survey was distributed to the program directors (PDs) of the 143 Accreditation Council for Graduate Medical Education urology residency programs in the United States in 2021. Information was collected (...) regarding program demographics, aspects of the program’s consent process, and the disclosure to patients of the role and participation of residents in their surgery. There were 49 responses to the survey (34.3% response rate). Nearly 70 percent of PDs reported that attending physicians lead the consent process. The topics covered during consent discussion include possible complications (25%), expected recovery time (23%), length of the surgery (22%), the people involved (18%), and their specific roles (7%). Many PDs do not explicitly discuss trainee involvement (48.8%) or when a resident is to perform the majority of the case (87.8%). The majority of PDs (78.8%) communicate medical student involvement, but 73.2 percent reported having a patient decline participation of a trainee after describing their role. Despite the AUA and ACS codes of professionalism, many urologists do not disclose resident involvement in surgery to patients. Further discussions are needed to explore how to better balance resident education and patient autonomy. (shrink)

Do university ethics classes influence students’ real-world moral choices? We aimed to conduct the first controlled study of the effects of ordinary philosophical ethics classes on real-world moral choices, using non-self-report, non-laboratory behavior as the dependent measure. We assigned 1332 students in four large philosophy classes to either an experimental group on the ethics of eating meat or a control group on the ethics of charitable giving. Students in each group read a philosophy article on their assigned topic and optionally (...) viewed a related video, then met with teaching assistants for 50-minute group discussion sections. They expressed their opinions about meat ethics and charitable giving in a follow-up questionnaire (1032 respondents after exclusions). We obtained 13,642 food purchase receipts from campus restaurants for 495 of the students, before and after the intervention. Purchase of meat products declined in the experimental group (52% of purchases of at least $4.99 contained meat before the intervention, compared to 45% after) but remained the same in the control group (52% both before and after). Ethical opinion also differed, with 43% of students in the experimental group agreeing that eating the meat of factory farmed animals is unethical compared to 29% in the control group. We also attempted to measure food choice using vouchers, but voucher redemption rates were low and no effect was statistically detectable. It remains unclear what aspect of instruction influenced behavior. (shrink)

In the first controlled, non-self-report studies to show an influence of university-level ethical instruction on everyday behavior, Schwitzgebel et al. (2020) and Jalil et al. (2020) found that students purchase less meat after exposure to material on the ethics of eating meat. We sought to extend and conceptually replicate this research. Seven hundred thirty students in three large philosophy classes read James Rachels’ (2004) “Basic Argument for Vegetarianism”, followed by 50-min small-group discussions. Half also viewed a vegetarianism advocacy video containing (...) factory farm footage. A few days after instruction, 54% of students agreed that “eating the meat of factory farmed animals is unethical”, compared to 37% before instruction, with no difference between the film and non-film conditions. Also, 39% of students anonymously pledged to avoid eating factory farmed meat for 24 h, again with no statistically detectable difference between conditions. Finally, we obtained 2828 campus food purchase receipts for 113 of the enrolled students who used their Student ID cards for purchases on campus, which we compared with 5033 purchases from a group of 226 students who did not receive the instruction. Meat purchases remained constant in the comparison group and declined among the students exposed to the material, falling from 30% to 23% of purchases overall and from 51% to 42% of purchases of $4.99 or more, with the effect possibly larger in the film condition. (shrink)

In the first controlled, non-self-report studies to show an influence of university-level ethical instruction on everyday behavior, Schwitzgebel et al. (2020) and Jalil et al. (2020) found that students purchase less meat after exposure to material on the ethics of eating meat. We sought to extend and conceptually replicate this research. Seven hundred thirty students in three large philosophy classes read James Rachels’ (2004) “Basic Argument for Vegetarianism”, followed by 50-min small-group discussions. Half also viewed a vegetarianism advocacy video containing (...) factory farm footage. A few days after instruction, 54% of students agreed that “eating the meat of factory farmed animals is unethical”, compared to 37% before instruction, with no difference between the film and non-film conditions. Also, 39% of students anonymously pledged to avoid eating factory farmed meat for 24 h, again with no statistically detectable difference between conditions. Finally, we obtained 2828 campus food purchase receipts for 113 of the enrolled students who used their Student ID cards for purchases on campus, which we compared with 5033 purchases from a group of 226 students who did not receive the instruction. Meat purchases remained constant in the comparison group and declined among the students exposed to the material, falling from 30% to 23% of purchases overall and from 51% to 42% of purchases of $4.99 or more, with the effect possibly larger in the film condition. (shrink)

Recently, Doolittle and Inkpen formulated a thought provoking theory, asserting that evolution by natural selection was responsible for the sideways evolution of two radically different kinds of selective units (also called Domains). The former entities, termed singers, correspond to the usual objects studied by evolutionary biologists (gene, genomes, individuals, species, etc.), whereas the later, termed songs, correspond to re‐produced biological and ecosystemic functions, processes, information, and memes. Singers perform songs through selected patterns of interactions, meaning that a wealth of critical (...) phenomena might receive novel evolutionary explanations. However, this theory did not provide an empirical approach to study evolution in such a broadened context. Here, we show that analyzing songs and singers, using patterns of interaction networks as a common ontology for both, offers a novel, actionable, inclusive and mathematical way to analyze not only the re‐production but also the evolution and fitness of biological and ecosystemic interconnected processes. (shrink)

A central issue in philosophy and neuroscience is the problem of unified visual consciousness. This problem has arisen because we now know that an object's stimulus features (e.g., its color, texture, shape, etc.) generate activity in separate areas of the visual cortex (Felleman & Van Essen, 1991). For example, recent evidence indicates that there are very few, if any, neural connections between specific visual areas, such as those that correlate with color and motion (Bartels & Zeki, 2006; Zeki, 2003). So (...) how do unified objects arise in visual consciousness? Some neuroscientists propose that neural synchrony is the mechanism that binds an object's features into a unity (e.g., see Crick, 1994; Crick & Koch, 1990; Engel, 2003; Roelfsema, 1998; Singer, 1996; von der Malsburg, 1996, 1999). I argue, on both empirical and philosophical grounds, that neural synchrony fails to explain the unity of visual consciousness. (shrink)

In the eighteenth century the category of the aesthetic sought to bridge the gap between the prevalent dualities of Cartesian thought: art and science, history and science, prejudice and truth. This special issue of _boundary 2_ addresses current debates about the status of art in the context of global modernity. The range of arguments represented here cover a broad historical scope—from Cartesianism to present-day global modernity—of cultural discourse on the aesthetic to bring a focus to contemporary discussions of the corollary (...) concepts of beauty, virtue, taste, and truth. These essays present a rich and provocative account of the place of the aesthetic in late-twentieth-century culture. Included in this volume are considerations of the relation between theories of art and the avant-garde; art’s relation to cognition; the aesthetic as history; the aesthetic as a unique access to modernity; and its impact on problems of identity formation, ideology, and resistances to the institutional powers inherent in dominant social formations. _Contributors. _Charles Altieri, Peter Burger, David Carroll, Anthony J. Cascardi, Howard Caygill, Allen Dunn, Eric Gans, Agnes Heller, Ronald A. T. Judy, Marie-Rose Logan, Daniel T. O’Hara, Donald E. Pease, Alan Singer. (shrink)

New communication technologies such as the microcomputer, videotex/teletext systems, the videocassette recorder, and satellite receiving dishes have been available to farmers since the early 1980s. This longitudinal study examines ethical issues associated with the impact that differential patterns of adoption and use of these technologies have had on inequalities among farmers from 1982 to 1989. The results demonstrate a strong adoption and use bias toward larger scale farmers who already have well-developed skills for handling information. This bias is especially strong (...) for microcomputer and videotex/teletext systems, and it isincreasing over time. Although the same farmers are not adopting all communication innovations, there is a strong tendency toward the already information-rich making the most use of the innovations they adopt. The article concludes with several recommendations that would help minimize some of these information inequalities. (shrink)

With The Perils of Global Legalism, Eric A. Posner explains that such views demonstrate a dangerously naive tendency toward legalism—an idealistic belief that ...

Climate change and justice are so closely associated that many people take it for granted that a global climate treaty should--indeed, must--directly address both issues together. But, in fact, this would be a serious mistake, one that, by dooming effective international limits on greenhouse gases, would actually make the world's poor and developing nations far worse off. This is the provocative and original argument of Climate Change Justice. Eric Posner and David Weisbach strongly favor both a climate change agreement (...) and efforts to improve economic justice. But they make a powerful case that the best--and possibly only--way to get an effective climate treaty is to exclude measures designed to redistribute wealth or address historical wrongs against underdeveloped countries. In clear language, Climate Change Justice proposes four basic principles for designing the only kind of climate treaty that will work--a forward-looking agreement that requires every country to make greenhouse--gas reductions but still makes every country better off in its own view. This kind of treaty has the best chance of actually controlling climate change and improving the welfare of people around the world. (shrink)

Carroll Izard completed his dissertation in 1952, beginning a career spanning more than six decades that coincided with clinical psychology maturing as a profession, and the birth of clinical science and cognitive neuroscience. Izard’s focus on discrete emotions as evolved systems that organize information, prepare responses, and shape the development of personality and relationships persisted through his career, despite “emotions” often being overshadowed by psychodynamic, behavioral, or cognitive perspectives. His theoretical work anticipated and now integrates contemporary neuroscience and relational perspectives. (...) Exploration of discrete emotions has kept lines of inquiry open that enrich our understanding of psychopathology. Izard also embraced clinical science, combining basic research with effectiveness studies addressing the unmet need for mental health services via emotion-focused interventions. (shrink)

Despite the bad press, Plato has a valid argument for immortality from three premises: (1) if the natural evil of a thing cannot destroy it, then it is indestructible; (2) the natural evil of the soul is vice; and (3) vice cannot destroy the soul. These premises are contestable, of course, but Plato has some good reasons for advancing them.

Social referencing informs and regulates one’s relation with the environment as a function of the perceived appraisals of social partners. Increased emphasis on relational and social contexts in the study of emotion makes this interpersonal process particularly relevant to the field. However, theoretical conceptualizations and empirical operationalizations of social referencing are disjointed across domains and populations of study. This article seeks to unite and refine the study of this construct by providing a clear and comprehensive definition of social referencing. Our (...) perspective presents social referencing and social appraisal as coterminous processes and emphasizes the importance of a relational and interpersonal approach to the study of emotion. We conclude by outlining possible lines of research on this construct. (shrink)

To date, emotion research has primarily focused on the experience and display of the emoter. However, of equal, if not more, importance is how such displays impact and guide the behavior of an observer. We incorporate a functionalist framework of emotion to examine the development of differential responding to discrete emotion, theorize on what may facilitate its development, and hypothesize the functions that may underlie such behavioral responses. Although our review is focused primarily on development, the theoretical and methodological ideas (...) laid out are relevant for researchers of emotion at all ages. (shrink)

In a survey on research misconduct, roughly 20% of the respondents admitted that they have submitted federal grant proposals that include scholars as research participants even though those scholars were not expected to contribute to the research effort. This manuscript argues that adding such false investigators is illegal, violating multiple federal statutes including the False Statements Act, the False Claims Act, and False, Fictitious, or Fraudulent Claims. Moreover, it is not only the offending academics and the false investigators that face (...) civil and criminal penalties because administrators may also be liable if they sign off on proposals and are in a position to know that false investigators might be included. Policy recommendations that should reduce the use of false investigators include changing institutional cultures, better training and oversight of the responsible conduct of research, and, most importantly, making all grant reviews double blind. (shrink)

Armed reprisals are the limited use of military force in response to unlawful actions perpetrated against states. Historically, reprisals provided a military remedy for states that had been wronged by another state without having to resort to all-out war in order to counter or deter such wrongful actions. While reprisals are broadly believed to have been outlawed by the UN Charter, states continue to routinely undertake such self-help measures. As part of the roundtable, “The Ethics of Limited Strikes,” this essay (...) examines the doctrine of armed reprisals in light of recent instances of states using force “short of war” in this manner. We argue that the ban on reprisals has been largely ignored by states, and that recent attempts to apply the laws of armed conflict to the cyber domain are further weakening this prohibition. We conclude that this is a potentially dangerous development that lowers the bar for resorting to military force, risking escalation and thereby further destabilizing the international system. (shrink)

It is worthwhile to search for forms of coding, processing, and learning common to various cortical regions and cognitive functions. Local cortical processors may coordinate their activity by maximizing the transmission of information coherently related to the context in which it occurs, thus forming synchronized population codes. This coordination involves contextual field (CF) connections that link processors within and between cortical regions. The effects of CF connections are distinguished from those mediating receptive field (RF) input; it is shown how CFs (...) can guide both learning and processing without becoming confused with the transmission of RF information. Simulations explore the capabilities of networks built from local processors with both RF and CF connections. Physiological evidence for synchronization, CFs, and plasticity of the RF and CF connections is described. Coordination via CFs is related to perceptual grouping, the effects of context on contrast sensitivity, amblyopia, implicit influences of color in achromotopsia, object and word perception, and the discovery of distal environmental variables and their interactions through self-organization. Cortical computation could thus involve the flexible evaluation of relations between input signals by locally specialized but adaptive processors whose activity is dynamically associated and coordinated within and between regions through specialized contextual connections. Key Words: cell assemblies; cerebral cortex; context; coordination; dynamic binding; epistemology; functional specialization; learning; neural coding; neural computation; neuropsychology; object recognition; perception; reading; self-organization; synaptic plasticity; synchronization. (shrink)

For over 700 years scholastic theologians of varying degrees of allegiance to the text(s) of Thomas Aquinas have discoursed on the mystery of Christ's being (esse): Did Christ have one or two acts of existence? Yet despite this frequent and recurring quaestio, nevertheless only a handful of scholastic commentators pause to note that this is not simply a debate between rival scholastic ‘schools’ in regard to a theological mystery, but that in fact there is an inconsistency within the Angelic doctor's (...) own texts. And while in more recent scholarship this discrepancy has not only been noticed but explicated in various ways, nevertheless it is the contention of this paper that a satisfactory exposition of the meaning of esse secundarium has not yet been achieved. Consequently, I propose in this paper that esse secundarium is the created, substantial, but absolutely supernatural participation of the human nature of Jesus in the uncreated communication of the divine esse of the Word and provide a robust textual defense of this interpretation. (shrink)

The additional data, perspectives, questions, and criticisms contributed by the commentaries strengthen our view that local cortical processors coordinate their activity with the context in which it occurs using contextual fields and synchronized population codes. We therefore predict that whereas the specialization of function has been the keynote of this century the coordination of function will be the keynote of the next.

By endorsing the use of a vaccine that makes the experience of puffing on a cigarette deeply distasteful, Lieber and Millum have taken the first few tentative steps into a future filled with medical interventions that manipulate individual preferences. It is tempting to embrace the careful arguments of “Preventing Sin” and celebrate the possibility that the profound individual and social costs of smoking will finally be tamed. Yet there is something unsettling about the possibility that parental discretion may be on (...) the cusp of a radical expansion, one that involves a new and unexplored approach to behavior modification. (shrink)

The cost of health care, its growing share of the gross domestic product, and dire predictions about the future are a major political and economic issue in the U.S. The American legal system is commonly viewed as a significant part of the problem, particularly by those who believe that medical providers engage in defensive medicine in an effort to avoid malpractice litigation. Yet scholars and commentators in the U.S. have shown relatively little interest in how other nations manage legal conflict (...) over health care and whether they might learn something from abroad about the relationship between malpractice litigation and the health care system more generally.To that end, this article analyzes the Japanese health care experience, specifically the management of what are variously called adverse outcomes, medical accidents, and medical malpractice. How frequently do Japanese patients sue their doctors? Are medical malpractice litigation rates in Japan rising? If so, what is being done to control the increase and its impact on medical care? How well is Japan doing when it comes to balancing the needs of patients who believe they are victims of medical negligence with those of providers who think they are being unfairly accused? These are the questions, about Japan, that need to be asked by those interested in the nexus of law and health care in the U.S. (shrink)

Scholars in the U.S. have shown relatively little interest in the management of legal conflict over health care in other nations. This article examines the Japanese health care system, particularly litigation over medical malpractice, and asks what American scholars and policy makers can learn from the Japanese experience.

Few novel or emerging infectious diseases have posed such vital ethical challenges so quickly and dramatically as the novel coronavirus SARS‐CoV‐2. The World Health Organization declared a public health emergency of international concern and recently classified Covid‐19 as a worldwide pandemic. As of this writing, the epidemic has not yet peaked in the United States, but community transmission is widespread. President Trump declared a national emergency as fifty governors declared state emergencies. In the coming weeks, hospitals will become overrun, stretched (...) to their capacities. When the health system becomes stretched beyond capacity, how can we ethically allocate scarce health goods and services? How can we ensure that marginalized populations can access the care they need? What ethical duties do we owe to vulnerable people separated from their families and communities? And how do we ethically and legally balance public health with civil liberties? (shrink)

Attempts to explain emotion typically emphasize the interaction of evolutionary and socialization processes. However, in describing this interplay the role of the person is typically underemphasized or unaccounted for. This paper lays out empirical and theoretical rationale for considering the person as a major contributor to emotion generation and development.

In 1864 - two years before the publication of The Communist Manifesto and 21 years before the publication of Das Kapital - Karl Marx published an essay titled Peuchet on Suicide. The essay was originally presented as a translation of excerpts from the memoirs of Jacques Peuchet, a leading French police administrator, economist and statistician. Plaut and Anderson reveal that Marx's Peuchet on Suicide is not a straightforward translation, but is an edited version in which Marx adds passages of his (...) own, altering the emphasis of the text from a moral and psychological focus to a profoundly social one. Thus, the essay very strongly reflects Marx's own position on this controversial subject. Sociologist Kevin Anderson provides an extensive introduction situating the essay in the context of Marx's work, especially that on gender; Plaut's essay focuses on the psychological aspects of the work, in particular contrasting Marx's thoughts on suicide with those of Freud and Durkheim. (shrink)

Human rights law does not appear to enjoy as high a level of compliance as the laws of war, yet is institutionalized to a greater degree. This Article argues that the reason for this difference is related to the strategic structure of international law. The laws of war are governed by a regime of reciprocity, which can produce selfenforcing patterns of behavior, whereas the human rights regime attempts to produce public goods and is thus subject to collective action problems. The (...) more elaborate human rights institutions are designed to overcome these problems but fall prey to second-order collective action problems. The simple laws of war institutions have been successful because they can exploit the logic of reciprocity. The Article also suggests that limits on military reprisals are in tension with self-enforcement of the laws of war. The U.S. conflict with Al Qaeda is discussed. (shrink)

Although much legal scholarship discusses the meaning of the religion clauses of the U.S. Constitution, very few articles analyze the ways in which state regulation affects actors' incentives to engage in religious behavior. Yet the question of how a law influences religious behavior is important for determining whether various laws are desirable, and whether they violate constitutional constraints. This article draws on recent economic models of religious organization to analyze the ways in which laws affect the behavior of religious groups. (...) Religious groups produce collective goods for their members, and the effect of laws can be analyzed by examining how they modify the payoffs members receive for cooperating or free riding. The article examines the use of laws to establish religious groups, to subsidize them with cash or tax benefits, to provide accommodations for them, to provide symbolic support for them, to provide secular substitutes for the collective goods they produce, and to regulate disputes between members. The article also briefly discusses the constitutional implications of the analysis. (shrink)

The mutations that cause many forms of inherited retinal degenerations have been identified, yet the mechanisms by which these mutations lead to death of photoreceptor cells of the retina are not completely understood. Investigations of the pathways from mutation to retinal degeneration have focused on spontaneous and engineered animal models of disease. Based on the studies performed to date, four major categories of degeneration mechanism can be identified. These include disruption of photoreceptor outer segment morphogenesis, metabolic overload, dysfunction of retinal (...) pigment epithelial cells, and chronic activation of phototransduction. Future investigations will likely identify additional mechanisms of photoreceptor damage. This review will summarize what has been learned from studying animal models of non-syndromic inherited retinal degenerations. BioEssays 23:605–618, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

This chapter contains section titled: Introduction Welfarism: Law and Economics Nonwelfarist theories Historical Explanations Topics in Contract Theory Conclusion: Whither Contract Theory? References.