When shared decision making breaks down and parents and medical providers have developed entrenched and conflicting views, ethical frameworks are needed to find a way forward. This article reviews the evolution of thought about the best interest standard and then discusses the advantages of the harm principle (HP) and the zone of parental discretion (ZPD). Applying these frameworks to parental refusals in situations of complexity and uncertainty presents challenges that necessitate concrete substeps to analyze the big picture and identify key (...) questions. I outline and defend a new decision-making tool that includes three parts: identifying the nature of the disagreement, checklists for key elements of the HP and ZPD, and a “think list” of specific questions designed to enhance use of the HP and ZPD in clinical decision making. These tools together will assist those embroiled in complex disagreements to disentangle the issues to find a path to resolution. (shrink)

We present a theoretical framework bearing on the evolution of written communication. We analyze writing as a special kind of graphic code. Like languages, graphic codes consist of stable, conventional mappings between symbols and meanings, but (unlike spoken or signed languages) their symbols consist of enduring images. This gives them the unique capacity to transmit information in one go across time and space. Yet this capacity usually remains quite unexploited, because most graphic codes are insufficiently informative. They may only be (...) used for mnemonic purposes or as props for oral communication in real-time encounters. Writing systems, unlike other graphic codes, work by encoding a natural language. This allows them to support asynchronous communication in a more powerful and versatile way than any other graphic code. Yet, writing systems will not automatically unlock the capacity to communicate asynchronously. We argue that this capacity is a rarity in non-literate societies, and not so frequent even in literate ones. Asynchronous communication is intrinsically inefficient because asynchrony constrains the amount of information that the interlocutors share and limits possibilities for repair. This would explain why synchronous, face-to-face communication always fosters the development of sophisticated codes (natural languages), but similar codes for asynchronous communication evolve with more difficulties. It also implies that writing cannot have evolved, at first, for supporting asynchronous communication. (shrink)

The amount of information conveyed by linguistic conventions depends on their precision, yet the codes that humans and other animals use to communicate are quite ambiguous: they may map several vague meanings to the same symbol. How does semantic precision evolve, and what are the constraints that limit it? We address this question using a multiplayer gaming app, where individuals communicate with one another in a scaled-up referential game. Here, the goal is for a sender to use black and white (...) symbols to communicate colors. We expected that the players’ mappings between symbols and colors would grow more specific over time, through a selection process whereby precise mappings are preferentially copied. We found that players become increasingly more precise in their use of symbols over the course of their interactions. This trend did not, however, result from selective copying of precise mappings. We explore the implications of this result for the study of lexical ambiguity, Zipf's Law of Meaning, and disagreements over semantic conventions. (shrink)

Cognitive Science, Volume 46, Issue 2, February 2022.

Jason Springs’s Healthy Conflict in Contemporary American Society is a masterful attempt to practice productive conflict and democratic dialogue in the face of static antagonisms and deep‐seated divisions. In my response, I underscore Springs’s insistence on mediating between the moral imagination of Richard Rorty and the prophetic critique of Cornel West. For the author of Healthy Conflict, any hope in the survival of democracy relies on balancing critique of domination with constructive proposals for a more just and equitable world. On (...) the one hand, Springs rejects any strong distinction between moral imagination and socio‐political critique; in fact, he argues for their intertwinement, especially in the work of West. At the same time, there are moments when he suggests an opposition between expanding the moral imagination and engaging in the critical enterprise, especially as he identifies the limits in Foucault regarding normativity and democratic struggle. I respond to this slippage by arguing that Foucault, and critical theory more broadly, open up possibilities for rethinking ethics, politics, and our relationship to the violence that sustains the order of things. (shrink)

In recent years, there has been a proliferation of neuroscientific theories of consciousness. These include theories which explicitly point to EM fields, notably Operational Architectonics and, more recently, the General Resonance Theory. In phenomenological terms, human consciousness is a unified composition of contents. These contents are specific and meaningful, and they exist from a subjective point of view. Human conscious experience is temporally continuous, limited in content, and coherent. Based upon those phenomenal observations, pre-existing theories of consciousness, and a large (...) body of experimental evidence, I derived the Temporally-Integrated Causality Landscape. In brief, the TICL proposes that the neural correlate of consciousness is a structure of temporally integrated causality occurring over a large portion of the thalamocortical system. This structure is composed of a large, integrated set of neuronal elements, which contains some subsystems, defined as having a higher level of temporally-integrated causality than the System as a whole. Each Subsystem exists from the point of view of the System, in the form of meaningful content. In this article, I review the TICL and consider the importance of EM forces as a mechanism of neural causality. I compare the fundamentals of TICL to those of several other neuroscientific theories. Using five major characteristics of phenomenal consciousness as a standard, I compare the basic tenets of Integrated Information Theory, Global Neuronal Workspace, General Resonance Theory, Operational Architectonics, and the Temporo-spatial Theory of Consciousness with the framework of the TICL. While the literature concerned with these theories tends to focus on different lines of evidence, there are fundamental areas of agreement. This means that, in time, it may be possible for many of them to converge upon the truth. In this analysis, I conclude that a primary distinction which divides these theories is the feature of spatial and temporal nesting. Interestingly, this distinction does not separate along the fault line between theories explicitly concerned with EM fields and those which are not. I believe that reconciliation is possible, at least in principle, among those theories that recognize the following: just as the contents of consciousness are distinctions within consciousness, the neural correlates of conscious content should be distinguishable from but fall within the spatial and temporal boundaries of the full neural correlates of consciousness. (shrink)

Reports of children participating in hunger strikes while detained in offshore detention centres raise interrelated ethical issues and recognizable challenges for the medical decision-makers at these sites. A composite case study, informed by reports in the public domain, is employed to explore the unique challenges of consent and decision-making in these circumstances and the perennial issues inherent in adolescents’ developing capacity and autonomy. We present an amalgamated case of a fourteen-year-old adolescent who refused to consent to medical reversal of her (...) hunger strike protest. The medical team became the final arbiter when her parents, who were also in detention, could not agree with each other even after mediation. The case explores the complexity of evaluating the adolescent’s capacity to provide informed consent while influenced by the opinions of co-detainees in this extreme setting. We argue that the parents and the child had compromised decisional capacity due to the effects of detention. The challenges to the medical team are recognized and discussed. The team members faced a difficult dilemma and considered the competing values of the multiple cultural and ethical factors. Each team member integrated his or her own roles, duties, and discipline-specific professional guidelines with the primary goal of mitigating potential harms. (shrink)

Interactions between humans and bots are increasingly common online, prompting some legislators to pass laws that require bots to disclose their identity. The Turing test is a classic thought experiment testing humans’ ability to distinguish a bot impostor from a real human from exchanging text messages. In the current study, we propose a minimal Turing test that avoids natural language, thus allowing us to study the foundations of human communication. In particular, we investigate the relative roles of conventions and reciprocal (...) interaction in determining successful communication. Participants in our task could communicate only by moving an abstract shape in a 2D space. We asked participants to categorize their online social interaction as being with a human partner or a bot impostor. The main hypotheses were that access to the interaction history of a pair would make a bot impostor more deceptive and interrupt the formation of novel conventions between the human participants. Copying their previous interactions prevents humans from successfully communicating through repeating what already worked before. By comparing bots that imitate behavior from the same or a different dyad, we find that impostors are harder to detect when they copy the participants’ own partners, leading to less conventional interactions. We also show that reciprocity is beneficial for communicative success when the bot impostor prevents conventionality. We conclude that machine impostors can avoid detection and interrupt the formation of stable conventions by imitating past interactions, and that both reciprocity and conventionality are adaptive strategies under the right circumstances. Our results provide new insights into the emergence of communication and suggest that online bots mining personal information, for example, on social media, might become indistinguishable from humans more easily. (shrink)

This chapter highlighted some salient trends in pediatric ethicsEthics, pediatric from different parts of the globe. It is interesting to note that although diverse, there are many similarities between ethical challenges in pediatrics in different parts of the world.

As William Hart notes, we live in a deconstructive age. Whether we read Derrida or not, many of us in and outside of the academy are invested in destabilizing established narratives, ideas, and categories. Similarly, we are eager to show how dominant narratives and categories tend to cover over more promising ways of imagining and interpreting the world. Recently, this deconstructive spirit has been directed toward discourses about the black church, black religion, and black cultures more generally. Authors like Curtis (...) Evans, Eddie Glaude, Anthony Pinn, and Barbara Savage, for instance, have challenged hoary tendencies to imagine the black church as a monolithic whole, to assume that black folk are naturally .. (shrink)

American pragmatism, religion, and race form a strange yet generative constellation. Figures like William James, John Dewey, and George Santayana, for instance, famously reimagine religious piety in the aftermath of Darwin’s revolution against traditional metaphysical attachments. For these authors, religiosity does not require a commitment to supernatural powers or agents but can be expressed in gratitude and awe toward the immanent, natural sources of human existence. More recently, pragmatism has been helpful for authors to respond critically to the problem of (...) race within America and modern life more broadly. Although the classical pragmatists did not confront race in a systematic manner, contemporary thinkers .. (shrink)

Professional providers of mental health services are motivated to help people, including, or especially, vulnerable people. We analyse the ethical implications of mental health providers accepting employment at detention centres that operate out of the normal regulatory structure of the modern state. Specifically, we examine tensions and moral harms experienced by providers at the Australian immigration detention centre on the island of Nauru. Australia has adopted indefinite offshore detention for asylum-seekers arriving by boat as part of a deterrence strategy that (...) relies on making detainment conditions harsh. This has known deleterious mental health effects. As a token to fiduciary care obligations, Australia employs mental health professionals to work on Nauru. These providers are often motivated to make a positive difference for detainees’ lives. We examine the overall impact of the providers’ work with detainees and the implications of their presence. The strongest evidence supports that the small mitigation of harms offered by these providers does not outweigh the harms of supporting a system designed to perpetuate human suffering. For mental health professionals considering working in offshore detention, we offer specific topics to scrutinise and weigh prior to employment. Because optimising detainee’s mental health is beyond the capacity of individual providers, we call for the organisations standardising and supporting mental health professionals to oppose employment of their associates in offshore detention. Lessons from this case study are generalisable to other jurisdictions to help inform organisations that licence and support mental health providers and individual providers considering work in similar settings. (shrink)

Downie and Schuklenk1 provide a clear narrative of the development of Canadian policy on medically assisted dying. This is very helpful for considering specific aspects of the continuing deliberations in Canada. This commentary presents an alternative perspective on the authors’ argument that narrow eligibility criteria for medical assistance in dying are discriminatory and unjustified. I argue that disability or mental illness as sole reason for accessing MAiD removes protections for all people who have times in their life when they have (...) mental illness or disability combined with intolerable suffering. I claim that individuals do not make their best, self-actualising decisions at those times and the supposed protections of vague terms such as incurable, advanced and decline are not clinically useful for evaluating eligibility for individuals with chronic health conditions. Within discussion of the impact of social determinants of health on access to MAiD, the authors present the argument that decisionally capable people with mental illness or disabilities as their sole underlying condition should be allowed to access MAiD. The authors state that opposing this access sacrifices patient rights and strips people of their agency. To support their argument, they embrace the idea that people with mental illness or disabilities belong to an identifiable cohort. They claim that …. (shrink)

Human language looms large in the emergence and evolution of graphic codes. Here, I argue that language not only acts as a strong constraint on graphic codes, but it is also a precondition for their emergence and their evolution as computational devices.

A key feature of the lambda model is the hypothesis of a local spring-like muscle-reflex system defined by a central control variable that has units of position. This is intriguing, especially for a study of postural stability in large-scale systems, but it has limited direct application to skilled everyday movements. If movement is considered as a goal-directed, neuro-optimization problem, however, theavailabilityof lambda-like peripheral models (vs. conventional musculoskeletal models) deserves exploration.

In response to recent events that demonstrate the persistence of racial trauma, this essay revisits James Baldwin's claim that racism is a symptom of fundamental human tendencies and constraints. For Baldwin, we cannot understand the legacy of racism if we do not take seriously all too human attempts to evade, and deflect, death and its intimations. To flesh out this component of Baldwin's thought, I engage with the thought of Georges Bataille, an author who thinks generally about the fraught relationship (...) between the preservation of life and our responsiveness to suffering. To test the insights that Baldwin provides on racial matters, this essay engages recent discussions in black studies and queer theory around futurity, racial difference, and the category of the human. I maintain that we must think “the human” and racial difference together, as a tension-filled relationship, in order to understand the limits and possibilities regarding our efforts to change the order of things. (shrink)

Introduction Perhaps more than any other member of the Frankfurt School, Herbert Marcuse articulated a hope for a radically transfigured world. He imagined a world characterized by receptive, generous relationships rather than domination and violence. Yet Marcuse's philosophy of liberation has been placed on trial within various critical circles. Michel Foucault's rejection of the “repressive hypothesis” and his concomitant analysis of power as generative is typically interpreted as an indirect response to Marcuse's tendency to treat the social order as a (...) primarily repressive force vis-à-vis our instincts and desires.1 Martin Jay has expressed concerns about the…. (shrink)