Dr Gray leaves us with a question at the conclusion of his article--how should we choose priorities? He says that the debate so far has been mainly on what we should choose, but perhaps we should consider how to choose even more. Under the various subheadings of Criteria, Principles and Persons Dr Gray sets out the pros and cons of the arguments in the priority debates and tries to offer some more specific guidelines to offset the criticism that (...) the government's priority discussions have been too generalised. Yet this is a difficult task when everyone's priorities are so different. (shrink)

Section 47 of the 1948 National Assistance Act allows incompetent people, usually old people, to be removed from their homes. It can be considered as a repressive tool, designed to infringe personal liberty, but in this article it is argued that it can also be considered as being legislation which governs and controls professional practice and protects the old person from public prejudice.

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and (...) anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

Evolutionary psychologists claim that the mind contains “hundreds or thousands” of “genetically specified” modules, which are evolutionary adaptations for their cognitive functions. We argue that, while the adult human mind/brain typically contains a degree of modularization, its “modules” are neither genetically specified nor evolutionary adaptations. Rather, they result from the brain’s developmental plasticity, which allows environmental task demands a large role in shaping the brain’s information-processing structures. The brain’s developmental plasticity is our fundamental psychological adaptation, and the “modules” that result (...) from it are adaptive responses to local conditions, not past evolutionary environments. If different individuals share common environ- ments, however, they may develop similar “modules,” and this process can mimic the development of genetically specified modules in the evolutionary psychologist’s sense. (shrink)

Editorial for ‘One Christ—Many Witnesses: Marking the Completion of the Regnum Edinburgh Centenary Series’, a special issue to celebrate the Regnum Edinburgh Centenary Issue.

On the ethics of extending human life: healthy people have a right to carry on livingHumanity has long demonstrated a paradoxical ambivalence concerning the extension of a healthy human lifespan. Modest health extension has been universally sought, whereas extreme health extension has been regarded as a snare and delusion—a dream beyond all others at first blush, but actually something we are better off without. The prevailing pace of biotechnological progress is bringing ever closer the day when humanity will be able (...) to act on the latter view by rejecting a clear and present opportunity for much longer healthy lives. Indeed, some biogerontologists contend that that day has already arrived, to the extent that our hesitation in embarking on a vigorous “war on ageing” is already delaying the point at which a cure for ageing will be developed. Here I consider whether our present caution concerning the wisdom of truly curing ageing is likely to survive the increased scrutiny that it will receive in coming years as a result of these technical advances. I conclude that it will not, because of its irreconcilability with values that are more deeply held by the large majority of humanity than any values that argue against the quest for a cure. I further conclude that all the major current reasons given for not curing ageing are mere crutches to help us cope with the immutability of ageing that we have been brought up to accept. Our failure to set aside such irrationality is already shortening potential longevity—quite probably of those already alive today—to a staggering degree. Once we realise this, our determination to consign human ageing to history will be second …. (shrink)

The particular design of any technology may have profound social implications. Computing technologies are deeply intermeshed with the activities of daily life, playing an ever more central role in how we work, learn, communicate, socialize, and participate in government. Despite the many ways they have improved life, they cannot be regarded as unambiguously beneficial or even value-neutral. Recent experience shows they can lead to unintended but harmful consequences. Some technologies are thought to threaten democracy through the spread of propaganda on (...) online social networks, or to threaten privacy through the aggregation of datasets that include increasingly personal information, or to threaten justice when machine learning is used in such high-stakes, decision-making contexts as loan application reviews, employment procedures, or parole hearings. It is insufficient to ethically assess technology after it has produced negative social impacts, as has happened, for example, with facial recognition software that discriminates against people of color and with self-driving cars that are unable to cope with pedestrians who jay-walk. Developers of new technologies should aim to identify potential harmful consequences early in the design process and take steps to eliminate or mitigate them. This task is not easy. Designers will often have to negotiate among competing values—for instance, between efficiency and accessibility for a diverse user population, or between maximizing benefits and avoiding harm. There is no simple recipe for identifying and solving ethical problems. -/- Computer science education can help meet these challenges by making ethical reasoning about computing technologies a central element in the curriculum. Students can learn to think not only about what technology they could create, but also whether they should create that technology. Learning to reason this way requires courses unlike those currently standard in computer science curricula. A range of university courses on topics in areas of computing, ethics, society and public policy are emerging to meet this need. Some cover computer science broadly, while others focus on specific problems like privacy and security; typically, these classes exist as stand-alone courses in the computer science curriculum. Others have integrated ethics into the teaching of introductory courses on programming, artificial intelligence, and human-computer interaction. (shrink)

Protection of human participants is a fundamental facet of biomedical research. We report the activities of a health service research study in which there were three institutional review boards (IRBs), three legal departments and one research administration department providing recommendations and mandating changes in the study methods. Complying with IRB requirements can be challenging, but can also adversely affect study outcomes. Multiple protocol changes mandated from multiple IRBs created a research method that was not reflective of how substance use screening (...) would be performed in a clinical setting. There was direct conflict between the IRBs' perceptions of participants' protection with the researchers' need to use research methodology that assures the clinical relevancy of results. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

The present study examined whether a dissociation among formats for rational numbers can be obtained in tasks that require comparing a number to a non-symbolic quantity. In Experiment 1, college students saw a discrete or else continuous image followed by a rational number, and had to decide which was numerically larger. In Experiment 2, participants saw the same displays but had to make a judgment about the type of ratio represented by the number. The magnitude task was performed more quickly (...) using decimals, whereas the relation task was performed more accurately with fractions. The pattern observed for percentages was very similar to that for decimals. A dissociation between magnitude comparison and relational processing with rational numbers can be obtained when a symbolic number must be compared to a non-symbolic display. (shrink)

Current debates about “Darwinizing culture” have typically focused on the validity of memetics. In this article we argue that meme-like inheritance is not a necessary requirement for descent with modification. We suggest that an alternative and more productive way of Darwinizing culture can be found in the application of phylogenetic methods. We review recent work on cultural phylogenetics and outline six fundamental questions that can be answered using the power and precision of quantitative phylogenetic methods. However, cultural evolution, like biological (...) evolution, is often far from treelike. We discuss the problems reticulate evolution can cause for phylogenetic analyses and suggest ways in which these problems can be overcome. Our solutions involve a combination of new methods for the study of cultural evolution , and the triangulation of different lines of historical evidence. Throughout we emphasize that most debates about cultural phylogenies can only be settled by empirical research rather than armchair speculation. (shrink)

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)