Physician-Assisted Death is the eleventh volume of Biomedical Ethics Reviews. We, the editors, are pleased with the response to the series over the years and, as a result, are happy to continue into a second decade with the same general purpose and zeal. As in the past, contributors to projected volumes have been asked to summarize the nature of the literature, the prevailing attitudes and arguments, and then to advance the discussion in some way by staking out and arguing forcefully (...) for some basic position on the topic targeted for discussion. For the present volume on Physician-Assisted Death, we felt it wise to enlist the services of a guest editor, Dr. Gregg A. Kasting, a practicing physician with extensive clinical knowledge of the various problems and issues encountered in discussing physician assisted death. Dr. Kasting is also our student and just completing a graduate degree in philosophy with a specialty in biomedical ethics here at Georgia State University. Apart from a keen interest in the topic, Dr. Kasting has published good work in the area and has, in our opinion, done an excellent job in taking on the lion's share of editing this well-balanced and probing set of essays. We hope you will agree that this volume significantly advances the level of discussion on physician-assisted euthanasia. Incidentally, we wish to note that the essays in this volume were all finished and committed to press by January 1993. (shrink)

This is the first book to offer the best essays, articles, and speeches on ethics and intelligence that demonstrate the complex moral dilemmas in intelligence collection, analysis, and operations. Some are recently declassified and never before published, and all are written by authors whose backgrounds are as varied as their insights, including Robert M. Gates, former Director of the Central Intelligence Agency; John P. Langan, the Joseph Cardinal Bernardin Professor of Catholic Social Thought at the Kennedy Institute of Ethics, Georgetown (...) University; and Loch K. Johnson, Regents Professor of Political Science at the University of Georgia and recipient of the Owens Award for contributions to the understanding of U.S. intelligence activities. Creating the foundation for the study of ethics and intelligence by filling in the gap between warfare and philosophy, this is a valuable collection of literature for building an ethical code that is not dependent on any specific agency, department, or country. (shrink)

The eight papers in this collection, which were delivered at the Fourth Annual Conference in Philosophy at the University of Georgia in February, 1971, deal with a variety of topics related to the current controversy about man’s use of his environment. The contributors, Eugene P. Odum, William T. Blackstone, Joel Feinberg, Charles Hartshorne, Walter O’Briant, Nicholas Rescher, Robert G. Burton, and Pete A. Y. Gunter, discuss such issues as overpopulation, man’s relation to nature, man’s attitude toward his environment, and (...) the proper role of technology in industrialized societies. Two especially interesting papers are Rescher’s "The Environmental Crisis and the Quality of Life" and Feinberg’s "The Rights of Animals and Unborn Generations." Rescher believes that Americans can avoid bitter disappointment only by realizing that no significant improvement in the quality of their environment is possible. He is aware that this realization will be painful because it involves surrendering the deeply held convictions that the quality of our life will continually improve and that our technology can overcome any physical obstacles. Feinberg discusses some of the complex issues involved in deciding whether people are obligated to leave a satisfactory environment for those who will come in the future. He contends that there is no obligation to add additional people; but, insofar as it is known that there will be future generations, we are obligated to consider their interests. The book has a helpful introduction by the editor which summarizes the position and arguments of each contributor.—M.G. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Womanist-Buddhist Consultation as a Reading CommunityCarolyn M. Jones MedineIn Breaking the Fall, the late Robert Detweiler (1932-2008) imagines what a reading community, "a contemporary version of the old storytelling cultures,"1 might look like. He suggests that in such a community, "The accent on community itself would offer a balance to our excessively privatizing tendencies; the communal interaction could counter our relentless drive to interpret... with attitudes of play (...) and Gelassenheit (abandonment, chance, and relaxation); the writing and reading community especially as a liminal entity, could nurture a respect for the incomprehensibility of form and a reverence for mystery."2 This description offers an entry to the work of the Womanist-Buddhist Consultations. To reach a provisional understanding of the meaning of that work, I shall reflect on first what we mean when we say that we want to read something. Second, I turn to a conversation with Robert Detweiler, who was one of my mentors, as a way to address the form of reading that we do and the form of community that we make in the Womanist-Buddhist Consultations. Third, I want to draw on the thought of the consultations themselves, using Emmanuel Levinas's work on reading and ethics, to examine the capacity the consultations have to hold tensions creatively and to allow multiple meanings to be part of them. Finally, I want to address the goals for the consultations. I am thinking specifically of Melanie Harris's desire to see the consultations as generating practices that promote peace, compassion, and justice, and Charlie Hallisey's desire to generate a more complex reading of Buddhist texts in and of themselves.The Womanist-Buddhist Consultations have met three times between 2009 and 2011. We met at Harvard Divinity School and at Texas Christian University for sessions of four days each, and for an evening at the University of Georgia between the two longer meetings. The Texas Christian meeting included some previous members from the Harvard meeting, and added new ones. The University of Georgia meeting consisted primarily of students who participated in the reading practice.In the meeting at the University of Georgia, Charles Hallisey looked askance at me when I said that Buddhism offers an entry into peace and compassion; yet Melanie Harris, when she constructed the later session at Texas Christian University, deployed the terms "peace" and "justice" as descriptors for the work of the group. Hallisey's ironic glance occurred right before we read, at the University of Georgia, a text that contained magic and murder. His glance and the content of that text have prompted [End Page 47] me to think through Harris's claims and to see how our group achieves both a reading of Buddhism and an ethical practice that generates peace and points to justice.The instructions that Hallisey gives for the reading process describe a practice of "being and reading together" as we encounter a variety of Buddhist texts.3 The group's guide is the bodhisattva Manjushri, who has overseen our work through an image gracing the wall at all our meetings. Manjushri has a sword to cut through obstacles, and holds a book, signifying wisdom. The practice of reading with friends, Hallisey told us, comes from Jewish tradition: we need a friend to help us overcome what we can and to begin to see what we cannot. The work involves three steps:1. To read passages individually.2. To read the same passages together in small groups.3. To gather again as a large group and discuss what we have discovered.The major goal of reading is to encounter levels of ourselves to which we ordinarily have no access, by examining a text that becomes "generous" to us. Reading together, Hallisey asserts, makes the generosity of the text visible to us.This process of reading, I would argue, is different from what we usually do when we read and different from what we mean when we tell students to read. Patricia O'Connell Killen, an AAR Teaching Award winner, has delineated some of what we mean when we say to our students: "Read chapter 2 of 'X' and come to class prepared."4... (shrink)

This paper is devoted to an exploration of the implications for the theory of pre-lexical syntax as developed by McCawley, and for syntactic theories in general, of an analysis of English emphatic conjunctions along the lines of Green . Among the conclusions are: The underlying representation of sentences must be much more abstract than has even been imagined previously, referring, in some as yet undiscovered way, to assumptions of the speaker about the real world, in order to account for the (...) grammatical occurrence of both terms of suppletive lexical items in otherwise identical surface strings with corresponding differences in meaning. A grammatical theory which purports to be capable of relating the sentences of a language to what they mean in a systematic way must be capable of referring directly to relevant assumptions made by the speaker of any given utterance at the time of utterance. So-called 'contrastive stress' is only one of the phenomena whose ultimate explanation depends on direct reference to such assumptions. Transformational grammars, which explicitly claim to be capable of relating in a systematic way the sentences of a language and what they mean, must be capable of referring to the sub-lexical, semantic structure of sentences, and furthermore, must be capable of doing so at an indefinite number of points in their derivation. This means that the semantic representation of a sentence must be available for reference at every stage in the derivation of the sentence. (shrink)

Why and under what conditions are individuals altruistic to family and friends in their social networks? Evolutionary psychology suggests that such behaviour is primarily the product of adaptations for kin- and reciprocal altruism, dependent on the degree of genetic relatedness and exchange of benefits, respectively. For this reason, individuals are expected to be more altruistic to family members than to friends: whereas family members can be the recipients of kin and reciprocal altruism, friends can be the recipients of reciprocal altruism (...) only. However, there is a question about how the effect of kinship is implemented at the proximate psychological level. One possibility is that kinship contributes to some general measure of relationship quality (such as ‘emotional closeness’), which in turn explains altruism. Another possibility is that the effect of kinship is independent of relationship quality. The present study tests between these two possibilities. Participants (N= 111) completed a self-report questionnaire about their willingness to be altruistic, and their emotional closeness, to 12 family members and friends at different positions in their extended social networks. As expected, altruism was greater for family than friends, and greater for more central layers of the network. Crucially, the results showed that kinship made a significant unique contribution to altruism, even when controlling for the effects of emotional closeness. Thus, participants were more altruistic towards kin than would be expected if altruism was dependent on emotional closeness alone – a phenomenon we label a ‘kinship premium’. These results have implications for the ongoing debate about the extent to which kin relations and friendships are distinct kinds of social relationships, and how to measure the ‘strength of ties’ in social networks. (shrink)

Emotional intelligence stands at the nexus between intelligence and emotion disciplines, and we outline how EI research might be better integrated within both theoretical frameworks. From the former discipline, empirical research focused upon whether EI is an intelligence and what type of intelligence it constitutes. It is clear that ability-based tests of EI form a group factor of cognitive abilities that may be integrated into the Cattell–Horn–Carroll framework; less clear is the lower order factor structure of EI. From the latter (...) discipline, research linking EI with theoretical frameworks from emotion research remain relatively sparse. Emotion regulation and appraisal theory may be key to explain how EI may reflect different processes. We propose a research agenda to advance the EI study. (shrink)

In _Hidden Questions, Clinical Musings_, M. Robert Gardner chronicles an odyssey of self-discovery that has taken him beneath and beyond the categoies and conventions of traditional psychoanalysis. His essays offer a vision of psychoanalytic inquiry that blends art and science, a vision in which the subtly intertwining not-quite-conscious questions of analysand and analyst, gradually discerned, open to ever-widening vistas of shared meaning. Gardner is wonderfully illuminating in exploring the associations, images, and dreams that have fueled his own analytic inquiries, but (...) he is no less compelling in writing about the different perceptual modalities and endlessly variegated strategies that can be summoned to bring hidden questions to light. This masterfully assembled collection exemplifies the lived experience of psychoanalysis of one of its most gifted and reflective practitioners. In his vivid depictions of analysis oscillating between the poles of art and science, word and image, inquiry and self-inquiry, Gardner offers precious insights into tensions that are basic to the analytic endeavor. Evincing rare virtuosity of form and content, these essays are evocative clinical gems, radiating the humility, gentle skepticism, and abiding wonder of this lifelong self-inquirer. Gardner's most uncommon musings are a gift to the reader. (shrink)

In _Hidden Questions, Clinical Musings_, M. Robert Gardner chronicles an odyssey of self-discovery that has taken him beneath and beyond the categoies and conventions of traditional psychoanalysis. His essays offer a vision of psychoanalytic inquiry that blends art and science, a vision in which the subtly intertwining not-quite-conscious questions of analysand and analyst, gradually discerned, open to ever-widening vistas of shared meaning. Gardner is wonderfully illuminating in exploring the associations, images, and dreams that have fueled his own analytic inquiries, but (...) he is no less compelling in writing about the different perceptual modalities and endlessly variegated strategies that can be summoned to bring hidden questions to light. This masterfully assembled collection exemplifies the lived experience of psychoanalysis of one of its most gifted and reflective practitioners. In his vivid depictions of analysis oscillating between the poles of art and science, word and image, inquiry and self-inquiry, Gardner offers precious insights into tensions that are basic to the analytic endeavor. Evincing rare virtuosity of form and content, these essays are evocative clinical gems, radiating the humility, gentle skepticism, and abiding wonder of this lifelong self-inquirer. Gardner's most uncommon musings are a gift to the reader. (shrink)

6 - Human Cockfighting in the Squared Circle -- 7 - Perfect Praxis in Aikido -- Section III - Reflexivity, Self, and Other -- 8 - Tension, Reflection, and Agency in the Life of a Hausa Grain Trader -- 9 - Reflexivity in Intersubjective and Intercultural Borderlinking -- Section IV - Reflexivity, Democracy, and Government -- 10 - The Latent Effects of the Distribution of Political Reflexivity in Contemporary Democracies -- Postscript - Reflexivity and Social Science -- Index.

Background: Genetic research involving racial/ethnic populations has novel ethical implications for various stakeholders, but ethical acceptability among stakeholders regarding such research is not clear. Methods: As part of a multifaceted National Institute of Mental Health (NIMH)/National Human Genome Research Institute (NHGRI) funded survey, we used repeated-measures factorial multivariate analysis of variance (MANOVA) to compare the perspectives of institutional review board (IRB) chairs (n = 203), investigators (n = 183), and community members (n = 192) on the ethical acceptability of participating (...) in and reporting of psychiatric genetic research focused on racial/ethnic minority groups. Stakeholder views were assessed with two sets of three questions. Results: All stakeholder groups perceived participation in genetic studies focused on racial/ethnic groups as ethically acceptable and endorsed as ethical any decisions by racial/ethnic minorities to decline to participate in such studies if concerned about possible discrimination/stigmatization based on the study findings. Stakeholders disagreed considerably on the ethical acceptability of researchers or journal editors choosing not to publish genetic study results focused on racial/ethnic minority groups based on potential harm of the study findings. Conclusion: Findings show community and professional stakeholders support participation in genetic research focused on specific racial/ethnic groups but recognize that the results of such studies may contribute to discrimination or stigmatization. Stakeholders differed in their perspectives of investigators and editors in balancing ethical issues intrinsic to advancing science versus minimizing harm to potentially vulnerable populations. (shrink)

The issue of wrongful disability arises when parents face the choice whether to produce a child whose life will be unavoidably flawed by a serious disease or disorder (Down syndrome, for example, or Huntington’s disease) yet clearly worth living. The authors of From Chance to Choice claim, with certain restrictions, that the choice to produce such a child is morally wrong. They then argue that an intuitive moral approach––a “person-affecting” approach that pins wrongdoing to the harming of some existing or (...) future person––cannot account for that wrong since the choice to produce such a child cannot, under the logic of the nonidentity problem, harm that child. The authors propose that we supplement the person-affecting approach with an “impersonal” principle that takes the form of their well-known principle N. In this paper, I argue that the authors are mistaken to suppose that a plausibly articulated person-affecting approach cannot account for the wrong of wrongful disability. We can retain an intuitive, comparative, “worse for” account of harm and still identify serious harms imposed by the choice of wrongful disability. In particular, I argue that harm, both to the impaired child and to others, comes not in the form of that procreative choice’s procreative effect but rather in the form of its many distributive effects. I also argue that the rare, residual case in which a person-affecting approach would approve of the choice of wrongful disability does not function as a counterexample to that approach. As a separate matter, I address legal claims for wrongful disability, which are closely akin to claims for wrongful life. The legal claim is brought by the impaired child, not against the parents, but rather against health care providers whose negligent failure to diagnose or inform parents of an increased risk of a genetic or congenital impairment results in the birth of the impaired child. The authors’ treatment of the moral wrong that is done as impersonal in nature suggests that courts are correct to dismiss any such claim. Once we identify harm, however, the person-affecting approach can identify a clear foundation in the law for the wrongful disability claim. (shrink)

Metaphors can provide a conceptual framework for understanding complex topics and as such, they have frequently been used in COVID-19 discourse. As previous research indicates that conceptual metaphors can influence how people reason about complex topics, the metaphors used to communicate about the pandemic can influence how it is understood and how people respond. This paper investigates the influence of metaphorical framing on emotions and reasoning. An experimental study compares BATTLE and JOURNEY metaphor frames in a hypothetical text (adapted from (...) previous studies) about the pandemic. Our aim is to examine the influence of these frames on readers’ affective state, inferences about the attitudes of others and suggestions to stop the virus from spreading. The results suggest that compared to JOURNEY metaphors, BATTLE metaphors can negatively influence affective state and may influence people to suggest more restrictive solutions to reduce the spread of the virus. Yet, metaphors were not found to influence reasoning about the attitudes of others. We interpret these results in relation to previous studies, suggesting that metaphors may influence emotions and reasoning in some ways only. The results have implications for public communication surrounding the pandemic. Limitations and avenues for future research are discussed. (shrink)

This article investigates several discussions of “chemistry,” understood as an analysts’ category referring to theories and practices dealing with the structure and transformation of matter. By reading these texts (a treatise defending kīmiyāʾ by al-Fārābī, the famous passage from Ibn Sīnā’s Shifāʾ on transmutation, Ibn Taymiyyah’s fatwā against kīmiyāʾ, Michael Psellos’s treatise On Making Gold, and the same author’s Accusation against a sitting Patriarch of Constantinople), the article aims to lay the groundwork for integrating the historiography of Byzantine and Arabic (...) alchemy into a wider western Eurasian intellectual history. (shrink)

The philosophy suggested by Jan Zwicky's expanded understanding of lyric and use of the fragment-as-method inspired this notebook of misunderstanding. Seeking to read Zwicky in the tradition of the aleatory genre and its basic form, the fragment, Roberts finds that her own sense of poetics and ethics accords generally with Zwicky's lyric philosophy and epistemology of imagination. Roberts's resonance with Zwicky's theory is conflicted by Zwicky's choice to isolate her fragment-method from the larger history of the aleatory genre (...) and its complex political evolution. Misunderstandings are compounded by Zwicky's disengagement from her contemporaries in the aleatory genre, the instability of her definitions by way of gestalt, and the impossible scale of her “ontological imperative.” In the end, Roberts is disappointed by this tempting but failed affinity. (shrink)

This article examines the dedicatory epigram of the earliest and most important witness to the Greek alchemical corpus, the tenth-century manuscript donated by Cardinal Bessarion to the Republic of Venice, Biblioteca Nazionale Marciana MS gr. 299, as a window onto the cultural coordinates of the manuscript’s middle Byzantine readers. Scrutiny of the epigram’s meter, language, literary conventions, and the handwriting of the scribe who copied it into the manuscript point to a tenth-century date not only for the manuscript but also (...) for the epigram itself and make it possible to situate the epigram, and with it the alchemical manuscript that contains it, within the mainstream of middle Byzantine elite culture. (shrink)

This introductory article frames our special issue in terms of how historicizing research integrity and fraud can benefit current discussions of scientific conduct and the need to improve public trust in science.

Beckwith‐Wiedemann syndrome is a human congenital disorder characterized by a wide variety of growth abnormalities, including developmental defects and predisposition to certain tumors. Genetic evidence has suggested a role for p57KIP2, a member of a family of cell cycle inhibitory genes, in Beckwith‐Wiedemann syndrome. Two independent groups(1,2) have reported the generation and characterization of mice lacking functional p57KIP2, These mice demonstrate a number of abnormal phenotypes which overlap with, although do not completely recapitulate, Beckwith‐Wiedemann syndrome. These findings advance the molecular (...) characterization of a human disorder, and provide insight into the interplay between regulation of cell division and development. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

The definitive book on ethics for chemical dependency treatment professionals.

An important debate in the reasoning literature concerns the extent to which inference processes are domain-free or domain-specific. Typically, evidence in support of the domain-specific position comprises the facilitation observed when abstract reasoning tasks are set in realistic context. Three experiments are reported here in which the sources of facilitation were investigated for contextualised versions of Raven's Progressive Matrices (Richardson, 1991) and non-verbal analogies from the AH4 test (Richardson & Webster, 1996). Experiment 1 confirmed that the facilitation observed for the (...) contextualised matrices was in part due to extraneous aspects of commentaries originally intended to activate domainspecific processes. Experiments 2 and 3 indicated that the remainder of the facilitation for the matrices, and all of the facilitation for the analogies, could be explained by visual salience: Converting the item elements into realistic objects had enabled them and their transitions to be identified more easily. Hence, performance at simplified abstract items was as good as, or better than, at contextualised items. It is concluded that facilitation effects cannot be interpreted as showing that domain-specific processes constitute a self-contained system separate from domain-free processes. In turn, this means that domain-free processes cannot be dismissed as being unimportant for reasoning. (shrink)

BackgroundThe Public Health Service Increased Risk designation identified organ donors at increased risk of transmitting hepatitis B, hepatitis C, and human immunodeficiency virus. Despite clear data demonstrating a low absolute risk of disease transmission from these donors, patients are hesitant to consent to receiving organs from these donors. We hypothesize that patients who consent to receiving offers from these donors have decreased time to transplant and decreased waitlist mortality.MethodsWe performed a single-center retrospective review of all-comers waitlisted for liver transplant from (...) 2013 to 2019. The three competing risk events (transplant, death, and removal from transplant list) were analyzed. 1603 patients were included, of which 1244 (77.6%) consented to offers from increased risk donors.ResultsCompared to those who did not consent, those who did had 2.3 times the rate of transplant (SHR 2.29, 95% CI 1.88–2.79, p < 0.0001), with a median time to transplant of 11 months versus 14 months (p < 0.0001), as well as a 44% decrease in the rate of death on the waitlist (SHR 0.56, 95% CI 0.42–0.74, p < 0.0001). All findings remained significant after controlling for the recipient age, race, gender, blood type, and MELD. Of those who did not consent, 63/359 (17.5%) received a transplant, all of which were from standard criteria donors, and of those who did consent, 615/1244 (49.4%) received a transplant, of which 183/615 (29.8%) were from increased risk donors.ConclusionsThe findings of decreased rates of transplantation and increased risk of death on the waiting list by patients who were unwilling to accept risks of viral transmission of 1/300–1/1000 in the worst case scenarios suggests that this consent process may be harmful especially when involving “trigger” words such as HIV. The rigor of the consent process for the use of these organs was recently changed but a broader discussion about informed consent in similar situations is important. (shrink)

This is the final paper in a four-part series which addresses the methodology of research studies under ethical review. The focus is on study conduct, governance and peer review. The nature and adequacy of peer review as a mechanism for assessing the study design and analysis are discussed. The paper argues that a properly constituted and functioning research team is crucial to the ethical conduct of a study and that an ethical review of methodology should extend beyond study design and (...) analysis to a concern with data collection, storage and availability, and publication. While ethical review committees cannot monitor study conduct, they can ensure that the protocol pays sufficient attention to appropriate monitoring structures and personnel. (shrink)

The COVID-19 pandemic brought unprecedented changes to daily life and in the first wave in the UK, it led to a societal shutdown including playing sport and concern was placed for the mental health of athletes. Identifying mood states experienced in lockdown and self-regulating strategies is useful for the development of interventions to help mood management. Whilst this can be done on a general level, examination of sport-specific effects and the experience of athletes and coaches can help develop interventions grounded (...) in real world experiences. The present study investigated perceived differences in mood states of boxers before and during COVID-19 isolation in the first lockdown among boxers. Boxing is an individual and high-contact sport where training tends to form a key aspect of their identity. Boxers develop close relationships with their coach and boxing. Hence boxers were vulnerable to experiencing negative mood, and support via the coach was potentially unavailable. Participants were 58 experienced participants. Boxers completed the Brunel Mood Scale to assess mood before COVID-19 using a retrospective approach and during COVID-19 using a “right now” time frame. Boxers responded to open-ended questions to capture mood regulation strategies used. Coaches responded to open ended questions to capture how they helped regulate boxer’s mood. MANOVA results indicated a large significant increase in the intensity of unpleasant moods and reduction in vigor during COVID-19. Using Lane and Terry conceptual framework, results showed participants reporting depressed mood also reported an extremely negative mood profile as hypothesized. Qualitative data indicated that effective mood-regulation strategies used included maintaining close coach-athlete contact and helping create a sense of making progress in training. When seen collectively, findings illustrate that mood state responses to COVID-19 were severe. It is suggested that that active self-regulation and self-care should be a feature of training programmes to aid coaches and boxers in regulating mood when faced with severe situational changes. (shrink)