The idea that our conscious decisions determine our actions has been challenged by a report suggesting that the brain starts to prepare for a movement before the person concerned has consciously decided to move . Libet et al. claimed that their results show that our actions are not consciously initiated. The current article describes two experiments in which we attempted to replicate Libet et al.'s comparison of participants' movement-related brain activity with the reported times of their decisions to move and (...) also the reported times of their decisions of which hand to move. We also looked at the distribution of participants' reports over time to evaluate an alternative explanation of Libet et al.'s results. Although the Readiness Potential was usually present before all of the decisions to move, consistent with the findings of Keller and Heckhausen and Libet et al. , we found that many reported decision times were before the onset of the Lateralized Readiness Potential, which measures hand-specific movement preparation. The latter finding is consistent with the conclusion that the LRP always started after the conscious decision to move. We conclude that even though activity related to movement anticipation may be present before a conscious decision to move, the cortical preparation necessary for the movement to happen immediately may not start until after the conscious decision to move. (shrink)

Although a number of articles have addressed ethical perceptions and behaviors, few studies have examined ethics across cultures. This research focuses on measuring the job satisfaction, customer orientation, ethics, and ethical training of automotive salespersons in the U.S. and Taiwan. The relationships of these variables to salesperson performance were also investigated. Ethics training was found to be negatively related to perceived levels of ethicalness and performance. High performance U.S. salespeople reported high ethical behavior, while the opposite was true in Taiwan. (...) Customer orientation in both countries was influenced by ethics training. Managers should evaluate current ethics training programs to insure correct ethical behavior is taught and rewarded. (shrink)

Abnormalities in the ability of cells to properly degrade proteins have been identified in many neurodegenerative diseases. Recent work has implicated synaptojanin 1 (SynJ1) in Alzheimer's disease and Parkinson's disease, although the role of this polyphosphoinositide phosphatase in protein degradation has not been thoroughly described. Here, we dissected in vivo the role of SynJ1 in endolysosomal trafficking in zebrafish cone photoreceptors using a SynJ1‐deficient zebrafish mutant, nrca14. We found that loss of SynJ1 leads to specific accumulation of late endosomes and (...) autophagosomes early in photoreceptor development. An analysis of autophagic flux revealed that autophagosomes accumulate because of a defect in maturation. In addition we found an increase in vesicles that are highly enriched for PI(3)P, but negative for an early endosome marker in nrca14 cones. A mutational analysis of SynJ1 enzymatic domains found that activity of the 5'phosphatase, but not the Sac1 domain, is required to rescue both aberrant late endosomes and autophagosomes. Finally, modulating activity of the PI(4,5)P2 regulator, Arf6, rescued the disrupted trafficking pathways in nrca14 cones. Our study describes a specific role for SynJ1 in autophagosomal and endosomal trafficking and provides evidence that PI(4,5)P2 participates in autophagy in a neuronal cell type. -/- . (shrink)

In Australia research projects proposing the use of linked data require approval by a Human Research Ethics Committee . A sound evaluation of the ethical issues involved requires understanding of the basic mechanics of data linkage, the associated benefits and risks, and the legal context in which it occurs. The rapidly increasing number of research projects utilising linked data in Australia has led to an urgent need for enhanced capacity of HRECs to review research applications involving this emerging research methodology. (...) The training described in this article was designed to respond to an identified need among the data linkage units in the Australian Population Health Research Network and HREC members in Australia. (shrink)

In this international and interdisciplinary collection of critical essays, distinguished contributors examine a crucial premise of traditional readings of Plato's dialogues: that Plato's own doctrines and arguments can be read off the statements made in the dialogues by Socrates and other leading characters. The authors argue in general and with reference to specific dialogues, that no character should be taken to be Plato's mouthpiece. This is essential reading for students and scholars of Plato.

To raise the question of the nature of narrative is to invite reflection on the very nature of culture and, possibly, even on the nature of humanity itself. So natural is the impulse to narrate, so inevitable is the form of narrative for any report of the way things really happened, that narrativity could appear problematical only in a culture in which it was absent—absent or, as in some domains of Western intellectual and artistic culture, programmatically refused. As a panglobal (...) fact of culture, narrative and narration are less problems than simply data. As the late Roland Barthes remarked, narrative "is simply there like life itself . . . international, transhistorical, transcultural."1 Far from being a problem, then, narrative might well be considered a solution to a problem of general human concern, namely, the problem of how to translate knowing into telling,2 the problem of fashioning human experience into a form assimilable to structures of meaning that are generally human rather than culture-specific. We may not be able fully to comprehend specific thought patterns of another culture, but we have relatively less difficulty understanding a story coming from another culture, however exotic that culture may appear to us. As Barthes says, "narrative...is translatable without fundamental damage" in a way that a lyric poem or a philosophical discourse is not. · 1. Roland Barthes, "Introduction to the Structural Analysis of Narratives," Music, Image, Text, trans. Stephen Heath , p. 79.· 2. The words "narrative," "narration," "to narrate," and so on derive via the Latin gnārus and narro from the Sanskrit root gnâ . The same root yields γνωριμος : see Emile Boisacq, Dictionnaire étymologique de la langue grecque , under the entry for this word. My thanks to Ted Morris of Cornell, one of our greatest etymologists. Hayden White, professor in the program of history of consciousness at the University of California, Santa Cruz, is the author of The Tropics of Discourse: Essays in Cultural Criticism, The Greco-Roman Tradition, and Metahistory: The Historical Imagination in Nineteenth Century Europe. " The Narrativization of Real Events" appeared in the Summer 1981 issue of Critical Inquiry. Critical Responses to the present essay include Louis O. Mink's "Everyman His or Her Own Annalist", and Marilyn Robinson Waldman's "The Otherwise Unnoteworthy Year 711: A Reply to Hayden White," both in the Summer 1981 issue of Critical Inquiry. (shrink)

In _Sentient Flesh _R. A. Judy takes up freedman Tom Windham’s 1937 remark “we should have our liberty 'cause... us is human flesh" as a point of departure for an extended meditation on questions of the human, epistemology, and the historical ways in which the black being is understood. Drawing on numerous fields, from literary theory and musicology, to political theory and phenomenology, as well as Greek and Arabic philosophy, Judy engages literary texts and performative practices such as (...) music and dance that express knowledge and conceptions of humanity appositional to those grounding modern racialized capitalism. Operating as critiques of Western humanism, these practices and modes of being-in-the-world—which he theorizes as “thinking in disorder,” or “poiēsis in black”—foreground the irreducible concomitance of flesh, thinking, and personhood. As Judy demonstrates, recognizing this concomitance is central to finding a way past the destructive force of ontology that still holds us in thrall. Erudite and capacious, _Sentient Flesh _offers a major intervention in the black study of life. (shrink)

The aim of this article is to explore the complex forms of knowledge involved in diagnostic and interventional decision making by comparing the processes in medicine and nursing, including nurse practitioners. Many authors assert that the practice of clinical decision making involves the application of theoretical knowledge (acquired in the classroom and textbooks) as well as research evidence, upon concrete particular cases. This approach draws on various universal principles and algorithms to facilitate the task. On the other hand, others argue (...) that this involves an intuitive form of judgement that is difficult to teach, one that is acquired principally through experience. In an exploration of these issues, this article consists of three sections. A clarification of terms commonly used when discussing decision making is provided in the first section. In the second section, an epistemological analysis of decision making is presented by examining several perspectives and comparing them for their use in the nursing and medical literature. Bunge's epistemological framework for decision making (based on scientific realism) is explored for its fit with the aims of medicine and nursing. The final section presents a discussion of knowledge utilization and decision making as it relates to the implications for the education and ongoing development of nurse practitioners. It is concluded that Donald Schön's conception of reflective practice best characterizes the skilful conduct of clinical decision making. (shrink)

Technological change is often seen as something that follows its own logic -- something we may welcome, or about which we may protest, but which we are unable to alter fundamentally. This reader challenges that assumption and its distinguished contributors demonstrate that technology is affected at a fundamental level by the social context in which it develops. General arguments are introduced about the relation of technology to society and different types of technology are examined: the technology of production: domestic and (...) reproductive technology; and military technology. The book draws on authors from Karl Marx to Cynthia Cockburn to show that production technology is shaped by social relations in the workplace. It moves on to the technologies of the household and biological reproduction, which are topics that male-dominated social science has tended to ignore or trivialise -- though these are actually of crucial significance where powerful shaping factors are at work, normally unnoticed. The final section asks what shapes the most frightening technology of all -- the technology of weaponry, especially nuclear weapons. The editors argue that social scientists have devoted disproportionate attention to the effects of technology on society, and tended to ignore the more fundamental question of what shapes technology in the first place. They have drawn both on established work in the history and sociology of technology and on newer feminist perspectives to show just how important and fruitful it is to try to answer that deeper question. The first edition of this reader, published in 1985, had a considerable influence on thinking about the relationship between technology andsociety. This second edition has been thoroughly revised and expanded to take into account new research and the emergence of new theoretical perspectives. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social interaction, communication (...) involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

Abstract:Open neural tube defects or myelomeningoceles are a common congenital condition caused by failure of closure of the neural tube early in gestation, leading to a number of neurologic sequelae including paralysis, hindbrain herniation, hydrocephalus and neurogenic bowel and bladder dysfunction. Traditionally, the condition was treated by closure of the defect postnatally but a recently completed randomized controlled trial of prenatal versus postnatal closure demonstrated improved neurologic outcomes in the prenatal closure group. Fetal surgery, or more precisely maternal-fetal surgery, raises (...) a number of ethical issues that we address including who the patient is, informed consent, surgical innovation and equipoise as well maternal assumption of risk. As the procedure becomes more widely adopted into practice, we suggest close monitoring of new fetal surgery centers, in order to ensure that the positive results of the trial are maintained without increased risk to both the mother and fetus. (shrink)

Benjamin Libet has argued that electrophysiological signs of cortical movement preparation are present before people report having made a conscious decision to move, and that these signs constitute evidence that voluntary movements are initiated unconsciously. This controversial conclusion depends critically on the assumption that the electrophysiological signs recorded by Libet, Gleason, Wright, and Pearl are associated only with preparation for movement. We tested that assumption by comparing the electrophysiological signs before a decision to move with signs present before a decision (...) not to move. There was no evidence of stronger electrophysiological signs before a decision to move than before a decision not to move, so these signs clearly are not specific to movement preparation. We conclude that Libet’s results do not provide evidence that voluntary movements are initiated unconsciously. (shrink)

Various decision theories share a troubling implication. They imply that, for any finite amount of value, it would be better to wager it all for a vanishingly small probability of some greater value. Counterintuitive as it might be, this fanaticism has seemingly compelling independent arguments in its favour. In this paper, I consider perhaps the most prima facie compelling such argument: an Egyptology argument (an analogue of the Egyptology argument from population ethics). I show that, despite recent objections from Russell (...) (2023) and Goodsell (2021), the argument’s premises can be justified and defended, and the argument itself remains compelling. (shrink)

In a recent article, ‘Why lockdown of the elderly is not ageist and why levelling down equality is wrong’, Savulescu and Cameron argue that a selective lockdown of older people is not ageist because it would treat people unequally based on morally relevant differences. This response argues that a selective lockdown of older people living in long-term care homes would be unjust because it would allow the expansive liberties of the general public to undermine the basic liberties of older people, (...) and because it would discriminate on the basis of extrinsic disadvantages. (shrink)

Harm reduction initiatives such as the distribution of naloxone have been crucial in saving lives during the opioid crisis in North America. Despite these efforts, today’s drug supply contaminated...

On the morning of Friday, June 24, 2022, over half of the population of the United States was stripped of a fundamental constitutional right. And, within minutes, the reverberations of the Supreme...

Introduction -- The significance of story -- Morphogenic fields -- The universe story and Christian story -- Morphic resonance : two stories converge -- The "kingdom of God" -- Emerging capacities -- Meditation -- The power of intention -- The fields converge -- A field of compassion -- Manifesting a field of compassion -- Engaging the grace we imagine.

In this article we explore the role of data custodians in establishing and maintaining social licence for the use of personal information in health research. Personal information from population‐level data collections can be used to make significant contributions to health and medical research, but this use is dependent on community acceptance or a social licence. We conducted semi‐structured interviews with data custodians across Australia to better understand data custodians’ views on their roles and responsibilities. This inductive, thematic analysis of the (...) interview data focuses on three factors that contribute to social licence – reciprocity, non‐exploitation and the public good. While the data custodians interviewed did not explicitly frame their role in the context of social licence, their descriptions of their roles and responsibilities clearly indicated that they did have some role to play in building and maintaining social licence. (shrink)

Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

The mental patients' liberation movement, which started in the early 1970s, is a political movement comprised of people who have experienced psychiatric treatment and hospitalization. Its two main goals are developing self-help alternatives to medically-based psychiatric treatment and securing full citizenship rights for people labeled "mentally ill." The movement questions the medical model of "mental illness," and insists that people who have been labeled as "mentally ill" speak on their own behalf and not be represented by others who claim to (...) speak "for" them. The movement has developed its own philosophy, and operates a variety of self-help and mutual support programs in which ex-patients themselves control the services that are offered. Despite obstacles, the movement continues to grow and develop. (shrink)

Biobanks for long-term research pose challenges to the legal and ethical validity of consent to participate. Different models of consent have been proposed to answer some of these challenges. This paper contributes to this discussion by considering the meaning and value of consent to participants in biobanks. Empirical data from a qualitative study is used to provide a participant view of the consent process and to demonstrate that, despite limited understanding of the research, consent provides the research participants with some (...) level of control and a form of self determination that they value. Participation is framed as a moral act of a responsible citizen providing reinforcement of self identity. Consent symbolizes the trust invested in researchers and research institutions to use the biobank for the public good. The paper argues that consent continues to play an important role in biobank participation and that a participant view should inform proposals to modify consent processes. (shrink)

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

Chinese negotiators are known to have a negotiation emphasis that differs from their Western counterparts, especially in issues of face and conflict. These values, however, are not monolithic, and can change depending on the negotiation circumstance. This research examines how negotiation tactics changes when Chinese negotiators are faced with counterparts from near and distant cultures. An online conjoint simulation drew 351 respondents in Taiwan to test subjective perceptions of counterparts from the USA and Japan. Chinese respondents exhibited increased cultural accommodation (...) when the counterpart's culture was more distant – paying more attention to sacrificing self-interest and saving face for the other side. Integration in the negotiation was emphasized across both near and distant cultures above that observed for negotiation with Chinese counterparts. Saving face, ignoring conflict, and domination tactics were consistently valued, irrelevant of culture. Masculinity among Chinese respondents was exhibited in a preference for integration with male counterparts, especially for Chinese male negotiators. Results indicate practical considerations when preparing for negotiation with a Chinese counterpart by considering inconsistencies in preferences while also considering consistent values. (shrink)