We read with interest the extended essay published from Riisfeldt and are encouraged by an empirical ethics article which attempts to ground theory and its claims in the real world. However, such attempts also have real-world consequences. We are concerned to read the paper’s conclusion that clinical evidence weakens the distinction between euthanasia and normal palliative care prescribing. This is important. Globally, the most significant barrier to adequate symptom control in people with life-limiting illness is poor access to opioid analgesia. (...) Opiophobia makes clinicians reluctant to prescribe and their patients reluctant to take opioids that might provide significant improvements in quality of life. We argue that the evidence base for the safety of opioid prescribing is broader than that presented, restricting the search to palliative care literature produces significant bias as safety experience and literature for opioids and sedatives exists in many fields. This is not acknowledged in the synthesis presented. By considering additional evidence, we reject the need for agnosticism and reaffirm that palliative opioid prescribing is safe. Second, palliative sedation in a clinical context is a poorly defined concept covering multiple interventions and treatment intentions. We detail these and show that continuous deep palliative sedation is a specific practice that remains controversial globally and is not considered routine practice. Rejecting agnosticism towards opioids and excluding CDPS from the definition of routine care allows the rejection of Riisfeldt’s headline conclusion. On these grounds, we reaffirm the important distinction between palliative care prescribing and euthanasia in practice. (shrink)

Gilbertson et al present a considered analysis of the abstract problem of ‘sedation’ at the end of life,1 and it is reassuring to see the separation of multiple practises that are often grouped under the heading terminal sedation. In their work, the authors attempt to introduce and justify a new practice in the care of those dying with significant suffering—expanded terminal sedation (ETS). This analysis will not, however, help our colleagues at the bedside. Here, we will focus on the flaws (...) which are most relevant to clinicians: jurisdiction, uncertainty and reversibility. The authors’ focus on a jurisdiction that does already allow medically assisted in dying confuses their analysis. For example, either an instance of their proposed ETS does amount to intentionally hastening death, in which case it should be treated as a means of euthanasia and practised only where that is permitted, subject to its limits and regulations; or it does not amount to intentionally hastening death, in which case there is no reason to specify such jurisdictions. To explain that the most controversial elements of terminal sedation have been tacitly ‘accepted’ by the society in question does not invalidate the concerns. It is beyond the scope of this response to explore these, but to us, …. (shrink)

Where do we draw the line between individual and collective responsibilities? Can collectives be „morally responsible‟ in the same way that individuals can? This paper explores the Bystander Effect – how an individual‟s sense of personal responsibility can become „diffused‟ when they become part of a collective. This is compared to the issue of the collective responsibility of the „developed world‟ to aid the „Third World‟ that ethicists, such Peter Singer and Iris Marion Young believe to be true. I consider (...) that perhaps because their theories concentrate too heavily on collective responsibility, they are rendered practically ineffectual by the phenomenon of the Bystander Effect. I suggest that this effect may be overcome if means to „infuse‟, rather than „diffuse‟, the individuals‟ sense of personal and collective responsibility are encouraged. For example, educating people of the logic of the „prisoner‟s dilemma‟ metaphor – that is, that if each individual takes their own responsibility seriously, then the collective can become more effectual. In such ways, the Bystander Effect associated with issues of global poverty could be overcome, at least to a certain extent, by moving individuals‟ focus away from feeling uninspired by their diffusion of responsibility, and towards individual responsibility being promoted in a way that makes them feel as though their combined efforts will make an effectual collective. (shrink)

ABSTRACTPrevious research has outlined high anxiety in connection with gamma modulation, identifying that gamma-band activity correlates with processing of threat perception, attention...

This study aimed to see if context in the form of priming can alter a participants thinking style based on their level of implicit association with either a religious or paranormal belief. This was based on the theory of alief, when a person’s explicit belief and behaviour are mismatched. This was also linked to dual process theory, with alief being analogous to type one thinking styles (fast and automatic). One hundred and seventy-two participants were recruited from the University of Derby (...) and social media. Implicit association was measured using a modified Brief Implicit Association Test that looked at paranormal and religious belief. Explicit supernatural belief, cognitive reflection, metacognition, and confidence were also measured. A hierarchical multiple regression revealed that a lower belief in the supernatural (apart from psychokinesis), a religious prime and high confidence predicted reflective thinking. Common paranormal perceptions, religious prime and confidence were significant predictors in the model. It was concluded that the prime worked on a moral level and influenced someone with an already open mind to different beliefs to be more analytical, positive, and confident. This study does not support the theory of alief, however, it indicates certain beliefs are susceptible to a certain prime, and that a person can be influenced to be more analytical. (shrink)

It is well established that single crystals of B2-structured Fe-Al change from paramagnetic to ferromagnetic upon plastic deformation. This strain-induced ferromagnetism arises mostly from Fe atoms which have three or more like nearest neighbours in antiphase-boundary tubes. Such Fe atoms carry magnetic moments according to their local environment. In this study, the saturation magnetizations, M S , of cold-rolled Fe-34 at.% Al, Fe-40 at.% Al and Fe-43 at.% Al single crystals were measured in a vibrating-sample magnetometer from 77 K to (...) room temperature and transmission electron microscopy was used to confirm the presence of APB tubes. After magnetic measurements, rolled single crystals were heated in a differential scanning calorimeter at 20 K min m 1 to 973 K and the enthalpy associated with the removal of the APB tubes measured. From the enthalpy measurement, the APB tube density and the number of Fe NNs were estimated. Hence, the M S values at 0 K were calculated. These were in good agreement with the experimentally determined values. (shrink)