Animal models of human diseases are often used in biomedical research in place of human subjects. However, results obtained by animal models may fail to hold true for humans. One way of addressing this problem is to make animal models more similar to humans by placing human tissue into animal models, rendering them chimeric. Since technical and ethical limitations make neurological disorders difficult to study in humans, chimeric models with human neural tissue could help advance our understanding of neuropathophysiology. In (...) this article, we examine whether the introduction of human neural tissue and any consequent cognitive change is relevant to the way we ought to treat chimeras. We argue that changes in cognitive abilities are morally relevant to the extent that they increase the capacities that affect the moral status of any entity, including awareness, autonomy, and sociability. We posit that no being, regardless of species, should be treated in a way that is incommensurate with its moral status. Finally, we propose a framework that can be used to guide ethical assessment of research involving chimeras with advanced cognitive capacities. We advance this framework as a useful tool for bringing relevant considerations to the forefront for those considering the ethical merit of proposed chimeric research. In doing so, we examine concepts relevant to the question of how any entity may be treated, including moral status, dignity, and capacities. (shrink)

Generative AI programs can produce high-quality written and visual content that may be used for good or ill. We argue that a credit–blame asymmetry arises for assigning responsibility for these outputs and discuss urgent ethical and policy implications focused on large-scale language models.

Recent advances in medical and information technologies, the availability of new types of medical data, the requirement of increasing numbers of study participants, as well as difficulties in recruitment and retention, all present serious problems for traditional models of specific and informed consent to medical research. However, these advances also enable novel ways to securely share and analyse data. This paper introduces one of these advances—blockchain technologies—and argues that they can be used to share medical data in a secure and (...) auditable fashion. In addition, some aspects of consent and data collection, as well as data access management and analysis, can be automated using blockchain-based smart contracts. This paper demonstrates how blockchain technologies can be used to further all three of the bioethical principles underlying consent requirements: the autonomy of patients, by giving them much greater control over their data; beneficence, by greatly facilitating medical research efficiency and by reducing biases and opportunities for errors; and justice, by enabling patients with rare or under-researched conditions to pseudonymously aggregate their data for analysis. Finally, we coin and describe the novel concept of prosent, by which we mean the blockchain-enabled ability of all stakeholders in the research process to pseudonymously and proactively consent to data release or exchange under specific conditions, such as trial completion. (shrink)

Different ideas of the normative relevance of autonomy can give rise to profoundly different action-guiding principles in healthcare. If autonomy is seen as a value rather than as a right, it can be argued that patients’ decisions should sometimes be overruled in order to protect or promote their own autonomy. We refer to this as paternalism in the name of autonomy. In this paper, we discuss different elements of autonomy (decision-making capacity, efficiency, and authenticity) and arguments in favor of paternalism (...) for the sake of autonomy that have been proposed in the bioethical debate. We argue that if autonomy is valuable, then paternalism for the sake of autonomy may be justified. However, policies allowing paternalism in the name of autonomy may be self-defeating. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly (...) rational grounds.We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views. (shrink)

: For many of us, entry into motherhood involves an ambiguous visibility and intelligibility, where our acceptance into mainstream spaces as mothers entails a loss of lesbian difference. Mann explores this loss using the work of two philosophers of lesbian difference, Monique Wittig and Judith Butler. She argues that the figure of the lesbian mother is deployed on a broad cultural scale to reinvigorate and renaturalize the myth of the happy, natural, heterosexual mother.

For many of us, entry into motherhood involves an ambiguous visibility and intelligibility, where our acceptance into mainstream spaces as mothers entails a loss of lesbian difference. Mann explores this loss using the work of two philosophers of lesbian difference, Monique Wittig and Judith Butler. She argues that the figure of the lesbian mother is deployed on a broad cultural scale to reinvigorate and renaturaUze the myth of the happy, natural, heterosexual mother.

In lieu of an abstract, here is a brief excerpt of the content:World Alienation in Feminist ThoughtThe Sublime Epistemology of Emphatic Anti-EssentialismBonnie Mann (bio)The earth is the very quintessence of the human condition.Hannah ArendtWe are tied to place undetachably and without reprieve.Edward CaseyThe alliance between feminism and postmodernism1 in the American academy has brought about a revolution in feminist epistemology. The early feminist epistemology of unmasking, of sorting through appearances to get to the real underneath, has been discredited as (...) "essentialist."2 Feminist standpoint epistemology was an attempt to respond to this accusation by using social location as a "standpoint" from which at least local and situated knowledge could be articulated.3 More recently, many feminists have taken on the epistemology of the simulacrum. Here "the real" plays a part only as that which dissolves into the appearances themselves. Behind the appearances, if there were such a place, would be only an abyss of absence.With this revolution in feminist epistemology comes a wholesale displacement [End Page 45] of the feminist project. Others have argued that the feminist political project is displaced in the alliance with postmodernism.4 On my view, the epistemological and political displacements accompany and instantiate an even deeper level of dispossession. The ultimate price we pay for the feminist alliance with postmodernism may well be a material displacement, in which we are dispossessed of our ability to inquire into and articulate our relationship to the earth itself. We find this planet we inhabit, this physical place that sustains us moment by moment, to be effectively shut out of what now passes as "good" feminist inquiry.In 1958, Hannah Arendt wrote already of "the advent of a new and yet unknown age," marked by world-alienation, a "twofold flight from the earth into the universe and from the world into the self" (1958, 6). The "unknown age" has now been named. Postmodernity takes this flight one step further than Arendt foresaw, however, and even folds the universe and the self into discourse. World-alienation has taken the form of the self-enclosed universe of the text. Our sojourn in the world of signs is so paradigmatic of "the postmodern condition," that asking the question of our relationship to the physical planet we inhabit seems naive and nostalgic. Anything we might say about the earth, after all, is already in language, already bound up in discourse. To speak of an "earth" or "nature" that exceeds discourse is to find oneself locked, even so, within discourse. Having lost our belief in the referentiality of language, in the relation between words and things, we are stuck with signs that refer only to other signs.A capitulation to our very real physical and phenomenological experience of world-alienation finds here its theoretical form. We give in to placelessness. As Edward S. Casey writes, "To say 'I have no place to go' is to admit to a desperate circumstance. Yet we witness daily the disturbing spectacle of people with no place to go: refugees from natural catastrophes or strife-torn countries, the homeless on the streets of modern cities, not to mention 'stray' animals. In fearing that 'the earth is becoming uninhabitable'—a virtual universal lament—we are fearing that the earth will no longer provide adequate places in which to live. The incessant motion of postmodern life in late-capitalist societies at once echoes and exacerbates this fear" (Casey 1993, xiii). Intellectually, we find ourselves in equally desperate circumstances, trapped as we are inside a language that can refer only to itself. This self-enclosure becomes a kind [End Page 46] of no place, a world-alienated space without place,5 and feminist thinking is set adrift from the physical places that give feminist thinkers our moment by moment sustenance. In its alliance with postmodernism, feminism has capitulated to the placelessness that so marks our phenomenological experience at the turn of the millennium.6Yet we inhabit this planet. Faced with its destruction we are compelled to make sense of our relationship to it and to act to save it. A feminist philosophy that turns its back on the earth embraces, rather than contests, the world-alienation of which Arendt spoke. Yet our alienation... (shrink)

The lies about the reasons for the U.S. war against Iraq provoked no mass public outcry in the United States against the war. What is the process of justification for this war, a process that seems to need no reasons? Mann argues that the process of justification is not a process of rational deliberation but one of aesthetic self-constitution, of rebuilding a masculine national identity. Included is a feminist reading of the National Defense University document Shock and Awe.

A reprint of the New American Library edition of 1970.

BackgroundInvoluntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.MethodsIn-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The interviews were analysed using a descriptive qualitative approach.ResultsThe answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and why it was justifiable (...) to make a decision on involuntary treatment in a specific case. Here the cons and pros of ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors affecting decisions for or against involuntary treatment were also discussed. These included issues about the Swedish Mental Care Act, healthcare organisation and the care environment.ConclusionsInvoluntary treatment was generally seen as an unwanted exception to standard care. The respondents’ judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could have been avoided, given a more patient-oriented healthcare organisation. (shrink)

FIRST MERTTENS LECTURE ON WAR AND PEACE JUSTICE AMONG NATIONS BY HORACE G. ALEXANDER, M. A. LECTURER ON INTERNATIONAL LAW AND POLITICS AT WOODBROOKE, SBLLY OAK, ...

: The lies about the reasons for the U.S. war against Iraq provoked no mass public outcry in the United States against the war. What is the process of justification for this war, a process that seems to need no reasons? Mann argues that the process of justification is not a process of rational deliberation but one of aesthetic self-constitution, of rebuilding a masculine national identity. Included is a feminist reading of the National Defense University document Shock and Awe.

In this paper I will revisit the debate over pornography by doing three things: (a) I will suggest a more sophisticated, two‐dimensional set of distinctions between positons in the debate; (b) I will then go on to attack both libertarians and the group I call “repressive feminists”; and (c) I will conclude by suggesting that by means of Hume's theory of sympathy we could support a limited form of censorship to bring women more fully into our moral and political community. (...) I turn first to the labors of definition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:World Alienation in Feminist ThoughtThe Sublime Epistemology of Emphatic Anti-EssentialismBonnie Mann (bio)The earth is the very quintessence of the human condition.Hannah ArendtWe are tied to place undetachably and without reprieve.Edward CaseyThe alliance between feminism and postmodernism1 in the American academy has brought about a revolution in feminist epistemology. The early feminist epistemology of unmasking, of sorting through appearances to get to the real underneath, has been discredited as (...) "essentialist."2 Feminist standpoint epistemology was an attempt to respond to this accusation by using social location as a "standpoint" from which at least local and situated knowledge could be articulated.3 More recently, many feminists have taken on the epistemology of the simulacrum. Here "the real" plays a part only as that which dissolves into the appearances themselves. Behind the appearances, if there were such a place, would be only an abyss of absence.With this revolution in feminist epistemology comes a wholesale displacement [End Page 45] of the feminist project. Others have argued that the feminist political project is displaced in the alliance with postmodernism.4 On my view, the epistemological and political displacements accompany and instantiate an even deeper level of dispossession. The ultimate price we pay for the feminist alliance with postmodernism may well be a material displacement, in which we are dispossessed of our ability to inquire into and articulate our relationship to the earth itself. We find this planet we inhabit, this physical place that sustains us moment by moment, to be effectively shut out of what now passes as "good" feminist inquiry.In 1958, Hannah Arendt wrote already of "the advent of a new and yet unknown age," marked by world-alienation, a "twofold flight from the earth into the universe and from the world into the self" (1958, 6). The "unknown age" has now been named. Postmodernity takes this flight one step further than Arendt foresaw, however, and even folds the universe and the self into discourse. World-alienation has taken the form of the self-enclosed universe of the text. Our sojourn in the world of signs is so paradigmatic of "the postmodern condition," that asking the question of our relationship to the physical planet we inhabit seems naive and nostalgic. Anything we might say about the earth, after all, is already in language, already bound up in discourse. To speak of an "earth" or "nature" that exceeds discourse is to find oneself locked, even so, within discourse. Having lost our belief in the referentiality of language, in the relation between words and things, we are stuck with signs that refer only to other signs.A capitulation to our very real physical and phenomenological experience of world-alienation finds here its theoretical form. We give in to placelessness. As Edward S. Casey writes, "To say 'I have no place to go' is to admit to a desperate circumstance. Yet we witness daily the disturbing spectacle of people with no place to go: refugees from natural catastrophes or strife-torn countries, the homeless on the streets of modern cities, not to mention 'stray' animals. In fearing that 'the earth is becoming uninhabitable'—a virtual universal lament—we are fearing that the earth will no longer provide adequate places in which to live. The incessant motion of postmodern life in late-capitalist societies at once echoes and exacerbates this fear" (Casey 1993, xiii). Intellectually, we find ourselves in equally desperate circumstances, trapped as we are inside a language that can refer only to itself. This self-enclosure becomes a kind [End Page 46] of no place, a world-alienated space without place,5 and feminist thinking is set adrift from the physical places that give feminist thinkers our moment by moment sustenance. In its alliance with postmodernism, feminism has capitulated to the placelessness that so marks our phenomenological experience at the turn of the millennium.6Yet we inhabit this planet. Faced with its destruction we are compelled to make sense of our relationship to it and to act to save it. A feminist philosophy that turns its back on the earth embraces, rather than contests, the world-alienation of which Arendt spoke. Yet our alienation... (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Decision-making capacity is a key concept in contemporary healthcare ethics. Previous research has mainly focused on philosophical, conceptual issues or on evaluation of different tools for assessing patients’ capacity. The aim of the present study is to investigate how the concept and its normative role are understood in Swedish psychiatric care. Of special interest for present purposes are the relationships between decisional capacity and psychiatric disorders and between health law and practical ethics.

Drugs used to provide improvement of cognitive functioning have been shown to be effective in healthy individuals. It is sometimes assumed that the use of these drugs constitutes cheating in an academic context. We examine whether this assumption is ethically sound. Beyond providing the most up-to-date discussion of modafinil use in an academic context, this contribution includes an overview of the safety of modafinil use in greater depth than previous studies addressing the issue of cheating. Secondly, we emphasize two crucial, (...) but hitherto nearly overlooked, nuances to the issues: the potential for modafinil to decrease inequality and disadvantage in academic settings, and the fact that how modafinil is used dramatically impacts its effects on health, coercion, fairness, authenticity and effort. Finally, we explicitly defend the position that there are no qualitatively morally relevant differences between modafinil use and other enhancement modalities; any such differences are in degree,... (shrink)

Is synaesthesia cognitively useful? Individuals with time–space synaesthesia experience time units as idiosyncratic spatial forms, and report that these forms aid them in mentally organising their time. In the present study, we hypothesised that time–space synaesthesia would facilitate performance on a time-related cognitive task. Synaesthetes were not specifically recruited for participation; instead, likelihood of time–space synaesthesia was assessed on a continuous scale based on participants’ responses during a semi-structured interview. Participants performed a month-manipulation task, which involved naming every second month (...) or every third month in reverse-chronological order, beginning and ending with a target month. Using hierarchical multiple regression, we found that time–space synaesthesia corresponded with faster performance on both versions of the task. We propose that time–space synaesthesia may expedite the cognitive manipulation of time-based information. Our results also indicate that synaesthesia is far less unusual than widely believed. (shrink)

The lies about the reasons for the U.S. war against Iraq provoked no mass public outcry in the United States against the war. What is the process of justification for this war, a process that seems to need no reasons? Mann argues that the process of justification is not a process of rational deliberation but one of aesthetic self-constitution, of rebuilding a masculine national identity. Included is a feminist reading of the National Defense University document Shock and Awe.

TAKING THE NAME OF SCIENCE IN VAIN CHAPTER I THE MEANING OF LIFE AND ITS VALUES 1. THE ROOT CAUSE OF THE PRESENT DISCONTENTS He in whose honor these ...

A REFERENCE UUH FOR Llb^nv, J'-t ONLY Operations Research With Special Reference to Non-Military Applications A Comprehensive Scientific Aid to Executive Decisions OPERATIONS Research (or, as the British say, Operational Research) is ...

Large language models (LLMs) such as ChatGPT or Google’s Bard have shown significant performance on a variety of text-based tasks, such as summarization, translation, and even the generation of new...