Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

Artificial intelligence is set to transform healthcare. Key ethical issues to emerge with this transformation encompass the accountability and transparency of the decisions made by AI-based systems, the potential for group harms arising from algorithmic bias and the professional roles and integrity of clinicians. These concerns must be balanced against the imperatives of generating public benefit with more efficient healthcare systems from the vastly higher and accurate computational power of AI. In weighing up these issues, this paper applies the deliberative (...) balancing approach of the Ethics Framework for Big Data in Health and Research. The analysis applies relevant values identified from the framework to demonstrate how decision-makers can draw on them to develop and implement AI-assisted support systems into healthcare and clinical practice ethically and responsibly. Please refer to Xafis et al. in this special issue of the Asian Bioethics Review for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end of this paper. (shrink)

The infection rates of COVID-19 have been exponential in some countries despite the imposition of infectious disease control measures such as lockdowns and physical distancing, which form one of the basic principles of public health and infectious disease control. There have been significant problems with leaders and citizenry deliberately ignoring and not complying with such measures and which have directly resulted in sudden rises in infection numbers. Here, I show the nature and extent of the widespread problem and argue that (...) the problem is in large part due to our modern society characterised by liberal individualism. I apply the philosophy proposed by philosopher Alasdair MacIntrye to show that one key underlying cause of the non-compliant behaviour of citizenry is due to modern liberal individualism that has deprived the modern nation state of the opportunities and authority for it to teach or to dictate what is the common good of the society as a whole to individuals in its community. This is the first time MacIntyre’s philosophy has been applied to public health, and this paper demonstrates the need for ethics education to counter-balance liberal individualism in order to contain and to prevent another pandemic and public health crisis in modern society. (shrink)

In this article, I argue that pictorial styles are individuated in terms of different degrees of determinacy. For example, Morandi’s still-life etchings and Monet’s cathedral paintings embody different styles in that in the former, shape properties are differentiated in a fine-grained manner, and in the latter, coarse grained. I develop this view by critically examining John Kulvicki’s analysis of how we interpret pictures. According to Kulvicki, we rarely interpret pictures as differing in terms of features that belong to the vehicle (...) of representation—that is, the design-content relation. Rather, he thinks that we individuate pictorial styles in terms of the content that each picture represents. Contra Kulvicki, I argue that we interpret the vehicular features of pictures in light of our knowledge of picture production, and that the diversity of pictorial styles involves both content and vehicle. (shrink)

This paper argues that cyborg perspectives offer real possibilities for the debate around enforced caesareans and the search for a language to encompass embodied maternal subjectivity. It is suggested, with reference to the fictional narrative of Star Trek, that cyborg figures have the power to disrupt the liberal subject and the body in legal discourse, not least because the plethora of cyborgs challenges simple conceptions of connections/disconnections between bodies. Feminist readings of case law relating to enforced caesarean sections have raised (...) questions about the notion of autonomy at the heart of liberal legalism, have argued that law is complicit with white male techno-medicine's approach to childbirth and focused upon the pregnant woman's lived experience of pregnancy. The recent Court of Appeal decision in St George's Healthcare N.H.S Trust v. S., Regina v. Collins and Others, ex parte S., where the pregnant woman's self-determination was upheld, provides a good opportunity to confront both the liberal story and the idea of connectedness between mother and unborn child. (shrink)

Virtual reality is a rapidly developing technology that simulates the real world. However, for some cybersickness-susceptible people, VR still has an unanswered problem—cybersickness—which becomes the main obstacle for users and content makers. Sensory conflict theory is a widely accepted theory for cybersickness. It proposes that conflict between afferent signals and internal models can cause cybersickness. This study analyzes the brain states that determine cybersickness occurrence and related uncomfortable feelings. Furthermore, we use the electroencephalogram microstates and functional connectivity approach based on (...) the sensory conflict theory. The microstate approach is a time–space analysis method that allows signals to be divided into several temporarily stable states, simultaneously allowing for the exploration of short- and long-range signals. These temporal dynamics can show the disturbances in mental processes associated with neurological and psychiatric conditions of cybersickness. Furthermore, the functional connectivity approach gives us in-depth insight and relationships between the sources related to cybersickness. We recruited 40 males, and they watched a VR video on a curved computer monitor for 10 min to experience cybersickness. We recorded the 5-min resting state EEG and 10-min EEG while watching the VR video. Then, we performed a microstate analysis, focusing on two temporal parameters: mean duration and global explained variance. Finally, we obtained the functional connectivity data using eLoreta and lagged phase synchronization. We discovered five sets of microstates, including four widely reported canonical microstates, during baseline and task conditions. The average duration increased in microstates A and B, which is related to the visual and auditory networks. The GEV and duration decreased in microstate C, whereas those in microstate D increased. Microstate C is related to the default mode network and D to the attention network. The temporal dynamics of the microstate parameters are from cybersickness disturbing the sensory, DMN, and attention networks. In the functional connectivity part, the LPS between the left and right parietal operculum significantly decreased compared with the baseline condition. Furthermore, the connectivity between the right OP and V5 significantly decreased. These results also support the disturbance of the sensory network because a conflict between the visual and vestibular system causes cybersickness. Changes in the microstates and functional connectivity support the sensory conflict theory. These results may provide additional information in understanding brain dynamics during cybersickness. (shrink)

This article explores areas of law loosely within English equity and trusts law that have not conventionally been subject to feminist debate, and within the context of a discussion about feminist method. The particular areas examined are whistleblowing and trustees’ powers of investment, each of which calls for consideration of decision-making processes which have an ethical content. These sites are chosen because they take debate outside the all too familiar locations of woman or ‘the body of woman’, including the family (...) home, where feminist analysis in relation to equity and trusts tends to stray. In exploring these chosen fields, Hobby’s (Feminist Perspectives on Equity and Trusts, Cavendish Publishing, 2001, pp. 219–255) critique of gender dimensions in relation to whistleblowing and Dunn’s (Feminist Perspectives on Equity and Trusts, Cavendish Publishing, 2001, pp. 179–196) account of women trustees’ investment decisions are evaluated and developed. The debate within feminist legal criticism of the possibility of integrating an ‘ethics of care’ and an ‘ethics of rights’ is acknowledged. Whilst acknowledging of the difficulty of adopting an approach that recognises ‘mixed logics’, it is concluded that women (and men) do integrate the ethics of care and the ethics of rights in their decision-making. It is argued that the effort should be made to trace the specific weave in particular circumstances, thereby paying suspicious attention to the values that underlie courts’ analyses of ethical choices. (shrink)

Bone marrow is the main site for hematopoiesis in adults. It acts as a niche for hematopoietic stem cells (HSCs) and contains non‐hematopoietic cells that contribute to stem cell dormancy, quiescence, self‐renewal, and differentiation. HSC also exist in resting spleen of several species, although their contribution to hematopoiesis under steady‐state conditions is unknown. The spleen can however undergo extramedullary hematopoiesis (EMH) triggered by physiological stress or disease. With the loss of bone marrow niches in aging and disease, the spleen as (...) an alternative tissue site for hematopoiesis is an important consideration for future therapy, particularly during HSC transplantation. In terms of harnessing the spleen as a site for hematopoiesis, here the remarkable regenerative capacity of the spleen is considered with a view to forming additional or ectopic spleen tissue through cell engraftment. Studies in mice indicate the potential for such grafts to support the influx of hematopoietic cells leading to the development of normal spleen architecture. An important goal will be the formation of functional ectopic spleen tissue as an aid to hematopoietic recovery following clinical treatments that impact bone marrow. For example, expansion or replacement of niches could be considered where myeloablation ahead of HSC transplantation compromises treatment outcomes. (shrink)

Cellular events must be executed in a certain sequence during the cell division in order to maintain genome integrity and hence ensure a cell's survival. In M phase, for instance, chromosome segregation always precedes mitotic exit (characterized by mitotic kinase inactivation via cyclin destruction); this is then followed by cytokinesis. How do cells impose this strict order? Recent findings in budding yeast have suggested a mechanism whereby partitioning of chromosomes into the daughter cell is a prerequisite for the activation of (...) mitotic exit network (MEN). So far, however, a regulatory scheme that would temporally link the initiation of cytokinesis to the execution of mitotic exit has not been determined. We propose that the requirement of MEN components for cytokinesis, their translocation to the mother–daughter neck and triggering of this translocation by inactivation of the mitotic kinase may be the three crucial elements that render initiation of cytokinesis dependent on mitotic exit. BioEssays 24: 659–666, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

If we fear repetition in the signs that come to us from the world, it is because in that repetition we discover that the world's powers are always there, dozing perhaps, and surely somewhat removed, but still present and ready to swallow us as if we were a word in their language. If we feel strangely uneasy when we note that a word, automatically repeated, seems to lose all connection with its meaning, it is because at the very moment we (...) sense the weakness, the precarious nature of the act on which all culture is based. (shrink)