Turkey has a complex character, which has differences from the Western world or Eastern Asia as well as common points. Even after more than a century of efforts to modernise and integrate with the West, Turkish society has values that are different from those of the West, as well as having Western values. It is worth questioning whether ordinary Turkish people show an individualistic character. The principle of respect for individual autonomy arises from a perception of oneself as an individual, (...) and the person’s situation may affect the applicability of the principle. Patients who perceive themselves to be members of a community rather than free persons and who prefer to participate in the common decisions of the community and to consider the common interest and the common value system of the community concerning problems of their life rather than to decide as independent, rational individuals may not be competent to make an autonomous choice. Expectations that such patients will behave as autonomous individuals may be unjustified. The family, rather than the patient, may take a primary role in decisions. A flexible system considering cultural differences in the concept of autonomy may be more feasible than a system following strict universal norms. (shrink)

This study examines the role of acculturation in shaping consumers’ views of ethics. Specifically, it examines the relationships between the desire to keep one’s original culture, the desire to adopt the host culture, and the four dimensions of the Muncy and Vitell (Journal of Business Research Ethics 24(4), 297, 1992) consumer ethics scale. Using two separate immigrant populations – one of former Middle-Eastern residents now living in the U.S. and the other of Asian immigrants in the U.S. – results indicate (...) that those who want to keep their original culture are less tolerant of unethical consumer activities, while those who are more willing to adopt the host culture are more tolerant of these same consumer activities. Furthermore, the immigrants in both studies who are more tolerant of unethical consumer activities are those who are generally somewhat younger and with less formal education. The relationship between gender and consumer ethics was not significant. (shrink)

After acquiring knowledge of the neuroscience of learning, memory, stress and emotions, teachers incorporate more cognitive engagement and student-centered practices into their lessons. However, the role understanding neuroscience plays in teachers own affective and motivational competencies has not yet been investigated. The goal of this study was to investigate how learning neuroscience effected teachers’ self-efficacy, beliefs in their ability to teach effectively, self-responsibility and other components of teacher motivation. A pilot training-of-trainers program was designed and delivered in Liberia combining basic (...) neuroscience with information on social, emotional, behavioral and mental health issues faced by students. Tier I of the professional development was a 2 weeks workshop led by a visiting neuroscientist. A subset of the 24 Tier I secondary science teachers formed a Leadership Team who adapted the content to the Liberian context and subsequently led additional workshops and follow-up sessions for the Tier II secondary science teachers. Science teachers in both tiers completed the affective-motivational scales from the internationally vetted, multiscale Innovative Teaching for Effective Learning Teacher Knowledge Survey from the OECD. Tier II teachers completed the survey in a pre-post-delayed post design. Tier I teachers completed the survey after the workshop with their attitudes at that time and separately with retrospective projections of their pre-workshop attitudes. Ten of the 92 Tier II teachers participated in structured interviews at follow-up. Statistical analysis of survey data demonstrated improved teacher self-efficacy, self-responsibility for student outcomes, and motivation to teach. Qualitatively, teachers expressed more confidence in their ability to motivate students, engage them through active learning, and manage the class through positive rather than negative reinforcement. Teachers’ own self-regulation improved as they made efforts to build supporting relationships with students. Together, these results demonstrated that (i) teacher affective-motivational attitudes can be altered with professional development, (ii) basic neuroscience, as knowledge of how students learn, can improve teacher competency, and (iii) a training-of-trainers model can be effective in a low and middle income country for disseminating neuroscience knowledge, increasing teachers’ knowledge of students’ social and emotional needs, and promoting educational improvement. (shrink)

Introduction This article is a response to Zagouras, Ellick, and Aulisio who presented a case study justifying the questioning of the capacity and autonomy of a young woman with a physical disability who was pregnant and facing coercive pressure to terminate. Case description Julia is described as a 26-year-old woman with a neurological disability that requires her to receive assistance with activities of daily living. She was described as living with her parents who provided her with personal care assistance. Julia (...) became pregnant and her parents wished her to terminate because they did not want to care for her child in addition to her. In fact, Julia's parents threatened her with institutionalization if she did not elect to terminate the pregnancy. Her health care team questioned her decision-making capacity based on her alleged “mental age” and experiences of being sheltered and excluded. The health care team used directive tactics to convince Julia to terminate the pregnancy, which describe as both an ethical and feminist intervention. Discussion The current authors take issue with the case analysis provided by and argue that they neglected to account for numerous instances of systemic ableism that adversely affected Julia, demonstrated prejudicial and judgmental attitudes toward pregnancy and disability, inappropriately questioned her decision-making capacity by infantilizing her, misconstrued the feminist concept of relational autonomy, and colluded with coercive interference from family members. This is a classic example of discriminatory and culturally incompetent reproductive health care for a disabled woman. (shrink)

The idea that deep brain stimulation (DBS) induces changes to personality, identity, agency, authenticity, autonomy and self (PIAAAS) is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics (...) that mention putative DBS-induced changes to patients’ postoperative PIAAAS, we found a critical lack of primary empirical studies corroborating these claims. Our findings strongly suggest that the theoretical neuroethics debate on putative effects of DBS relies on very limited empirical evidence and is, instead, reliant on unsubstantiated speculative assumptions probablyin lieuof robust evidence. As such, this may reflect the likelihood of a speculative neuroethics bubble that may need to be deflated. Nevertheless, despite the low number of first-hand primary studies and large number of marginal and single case reports, potential postoperative DBS changes experienced by patients remain a critical ethical concern. We recommend further empirical research in order to enhance theoretical neuroethics work in the area. In particular, we call for the development of better instruments capable of capturing potential postoperative variations of PIAAAS. (shrink)

The phenomenological effects of deep brain stimulation (DBS) on the self of the patient remains poorly understood and under described in the literature, despite growing evidence that a significant number of patients experience postoperative neuropsychiatric changes. To address this lack of phenomenological evidence, we conducted in-depth, semistructured interviews with 17 patients with Parkinson's disease who had undergone DBS. Exploring the subjective character specific to patients' experience of being implanted gives empirical and conceptual understanding of the potential phenomenon of DBS-induced self-estrangement. (...) Our study concluded that (1) the more patients preoperatively felt alienated by their illness, the more they experienced postoperative self-estrangement, and (2) the notion of self-estrangement seems to exist in association with certain common qualitative characters, namely, loss of control, which reflects a deteriorative estrangement, and distorted perception of capacities, which reveals a restorative estrangement. These findings indicate that subjective self-reports help us to understand some aspects of the potential phenomenon of DBS-induced self-estrangement. (shrink)

Book reviewed in this article: No Longer Patient: Feminist Ethics & Health Care. By Susan Sherwin Feminist Perspectives in Medical Ethics. Edited by Helen Bequaert Holmes and Laura M. Purdy.

While new generations of implantable brain computer interface devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results (...) show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent—predictive and advisory—BCI technologies essential to prevent potential iatrogenic harms. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

In this study we use dual process theory of self-regulation to develop a framework that outlines the mediating and moderating mechanisms explaining the relationship between leader emotional exhaustion and leadership style (transformational leadership and abusive supervision). Using Glomb et al.’s (2011) framework, we identify empathy and negative emotion as mediators that are of particular importance for leaders. In addition, we propose that leader mindfulness moderates these processes to improve leadership style. Using a time-lagged survey of leaders (N = 505) we (...) found that leader empathy and negative emotion mediated the relationships between emotional exhaustion and leadership style. Furthermore, we found that leader mindfulness significantly moderated the indirect effect of leader emotional exhaustion on leadership style through negative emotion. However, leader mindfulness did not moderate the relationship between emotional exhaustion and empathy. Theoretical and practical implications are discussed. (shrink)

Artificial language learning experiments have become an important tool in exploring principles of language and language learning. A persistent question in all of this work, however, is whether ALL engages the linguistic system and whether ALL studies are ecologically valid assessments of natural language ability. In the present study, we considered these questions by examining the relationship between performance in an ALL task and second language learning ability. Participants enrolled in a Spanish language class were evaluated using a number of (...) different measures of Spanish ability and classroom performance, which was compared to IQ and a number of different measures of ALL performance. The results show that success in ALL experiments, particularly more complex artificial languages, correlates positively with indices of L2 learning even after controlling for IQ. These findings provide a key link between studies involving ALL and our understanding of second language learning in the classroom. (shrink)

Adolescence is an important yet vulnerable period of transition from childhood to adulthood. An increasing number of studies support the traditional Catholic view, which sees teens as prone to making poor decisions when influ­enced by emotions or peer pressure but capable of thriving when guided by parents and religion. However, newer policies of medical societies undermine the traditional supports of family and faith with a permissive approach toward sexual exploration. To counter this unhealthy trend, which seems to be based more (...) on postmodern ideology than robust science, Catholic physicians should become experts in adolescent behavior and sexual health. Physicians should be sensitive to opposing viewpoints but participate only in treatments which are ethical and beneficial for their patients. Specifically, Catholic physicians must avoid contraceptives, abortion, and “gender-affirming” therapies. By using good science and emulating the models of service, Socratic dialogue, and accompaniment, physicians can guide adolescents toward a virtuous, healthy adulthood. (shrink)

To conclude that there is enough or not enough evidence demonstrating that deep brain stimulation causes unintended postoperative personality changes is an epistemic problem that should be answered on the basis of established, replicable, and valid data. If prospective DBS recipients delay or refuse to be implanted because they are afraid of suffering from personality changes following DBS, and their fears are based on unsubstantiated claims made in the neuroethics literature, then researchers making these claims bear great responsibility for prospective (...) recipients' medical decisions and subsequent well-being. Our article “Deflating the ‘DBS causes personality’ bubble” reported an increase in theoretical neuroethics publications suggesting putative DBS-induced changes to personality, identity, agency, autonomy, authenticity and/or self and a critical lack of supporting primary empirical studies. This special issue of Neuroethics brings together responses to our initial publication, with our own counter-responses organized according to common themes. We provide a brief summary for each commentary and its main criticisms as well as a discussion of the way in which these responses can: 1) help clarify the meaning of PIAAAS, suggesting supplementary frameworks for understanding the impact of DBS on PIAAAS; 2) provide further empirical evidence of PIAAAS by presenting results from the researchers’ own work; and/or 3) offer a critique of our research approach and/or findings. Unintended postoperative putative changes to PIAAAS remain a critical ethical concern. It is beyond dispute that we need to develop reliable empirical and conceptual instruments able to measure complex cognitive, affective, and behavioural changes in order to investigate whether they are attributable to DBS alone. (shrink)

Geron recently announced that it had begun enrolling patients in the world's first-in-human clinical trial involving cells derived from human embryonic stem cells (hESCs). This trial raises important questions regarding the future of hESC-based therapies, especially in spinal cord injury (SCI) patients. We address some safety and efficacy concerns with this research, as well as the ethics of fair subject selection. We consider other populations that might be better for this research: chronic complete SCI patients for a safety trial, subacute (...) incomplete SCI patients for an efficacy trial, and perhaps primary progressive multiple sclerosis (MS) patients for a combined safety and efficacy trial. (shrink)

Owing to an oversight, we noted that the acknowledgement section was missing from the original published version of this paper.

Si, apres tout, les logiciens, et meme les philosophes, peuvent dire des choses sensees, alors il est possible que certains logiciens, et meme des philosophes du passe, y compris d'un passe lointain, aient dit parfois, meme si certaines lumieres leur faisaient defaut, des choses sensees. Cet hommage mesure, rendu par Ryle au passe, donne ici lieu a une brillante fantaisie sur la vie de Platon ou les faits ne cessent de repondre aux raisons, comme dans un roman anglais. Mais le (...) motif est tres serieux: la vie d'un philosophe devrait aller comme sa pensee, du plus obscur au plus clair. Las! Dans l'itineraire de Platon les faits furent les plus forts. Il faut donc secouer l'image traditionnelle de sa vie et de sa philosophie et reprendre toute la chronologie des Dialogues. A sa maniere, Ryle nous offre une meditation sur les commencements de la philosophie. (shrink)

Peak alpha frequency is known to vary not just between individuals, but also within an individual over time. While variance in this metric between individuals has been tied to working memory performance, less understood are how short timescale modulations of peak alpha frequency during task performance may facilitate behavior. This gap in understanding may be bridged by consideration of a key difference between individuals: sex. Inconsistent findings in the literature regarding the relationship between peak alpha frequency and cognitive performance, as (...) well as known sex-related-differences in peak alpha frequency and its modulation motivated our hypothesis that cognitive and neural processes underlying working memory—modulation of peak alpha frequency in particular—may differ based upon sex. Targeting sex as a predictive factor, we analyzed the EEG data of participants recorded while they performed four versions of a visual spatial working memory task. A significant difference between groups was present: females modulated peak alpha frequency more than males. Task performance did not differ by sex, yet a relationship between accuracy and peak alpha frequency was present in males, but not in females. These findings highlight the importance of considering sex as a factor in the study of oscillatory activity, particularly to further understanding of the neural mechanisms that underlie working memory. (shrink)

The article Deflating the "DBS causes personality changes" bubble, written by Frederic Gilbert, J. N. M. Viaña and C. Ineichen, was originally published electronically on the publisher’s internet portal on 19 June 2018 without open access.

In her article, Pascale Hess raises the issue of whether her proposed model may be extrapolated and applied to clinical research fields other than stem cell-based interventions in the brain (SCBI-B) (Hess 2012). Broadly summarized, Hess’s model suggests prioritizing efficacy over safety in phase 1 trials involving irreversible interventions in the brain, when clinical criteria meet the appropriate population suffering from “degenerative brain diseases” (Hess 2012). Although there is a need to reconsider the traditional phase 1 model, especially with respect (...) to first-in-human clinical trials involving novel technologies, the question arises as to whether it is appropriate to advocate for a new model that prioritizes efficacy over safety across all phase 1 clinical research trials involving irreversible interventions in the brain. -/- . (shrink)

Bioethics, Volume 36, Issue 1, Page 25-41, January 2022.

Postmortem research on the brains of American tackle football players has revealed the presence of chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repeated head trauma. Repeated concussion is a risk factor for CTE, raising ethical concerns about the long-term effects of concussion on athletes at risk for football-related concussion. Of equal concern is that youth athletes are at increased risk for lasting neurocognitive and developmental deficits that can result in behavioral disturbances and diminished academic performance. In this (...) article, we consider evidence of the effects of concussion in youth athletes, and discuss ethical duties to youth athletes and how these duties might be satisfied, given the intrinsic risks of football. Finally, we evaluate potential strategies for reducing concussions in junior football, and recommend the optimal strategy for reducing brain injury to an acceptable level while still making available the benefits of football participation for youth athletes. (shrink)

During human-human interaction, emotion plays a vital role in structuring dialogue. Emotional content drives features such as topic shift, lexicalisation change and timing; it affects the delicate balance between goals related to the task at hand and those of social interaction; and it represents one type of feedback on the effect that utterances are having. These various facets are so central to most real-world interaction, that it is reasonable to suppose that emotion should also play an important role in human-computer (...) interaction. To that end, techniques for detecting, modelling, and responding appropriately to emotion are explored, and an architecture for bringing these techniques together into a coherent system is presented. (shrink)

There has been a surge in mass media reports extolling the potential for using three-dimensional printing of biomaterials to treat a wide range of clinical conditions. Given that mass media is recognized as one of the most important sources of health and medical information for the general public, especially prospective patients, we report and discuss the ethical consequences of coverage of 3D bioprinting in the media. First, we illustrate how positive mass media narratives of a similar biofabricated technology, namely the (...) Macchiarini scaffold tracheas, which was involved in lethal experimental human trials, influenced potential patient perceptions. Second, we report and analyze the positively biased and enthusiastic portrayal of 3D bioprinting in mass media. Third, we examine the lack of regulation and absence of discussion about risks associated with bioprinting technology. Fourth, we explore how media misunderstanding is dangerously misleading the narrative about the technology. (shrink)

Teaching children to ask and answer questions is critically important if they are to learn to talk and reason effectively together, particularly during inquiry-based science where they are required to investigate topics, consider alternative propositions and hypotheses, and problem-solve together to propose answers, explanations, and prediction to problems at hand. This study involved 108 students (53 boys and 55 girls) from seven, Year 7 teachers’ classrooms in five primary schools in Brisbane, Australia. Teachers were randomly allocated by school to one (...) of two conditions: the metacognitive questioning condition (Trained condition) or the prescriptive questioning condition (Untrained condition). Data on students’ discourse and reasoning and problem-solving (RP-S) were collected across Times 1 and 2. The results showed that while there were significant differences in the discourse categories of the students in the two conditions at Time 1, the only significant difference was in questioning behaviour at Time 2 with the students in the trained condition continuing to ask more questions than their untrained peers. Given that these students had been taught to specifically ask ‘thinking’ questions that probed and interrogated information, these results are not surprising. A follow-up examination of students’ discourse during their small group discussions illustrated how these students interacted with each other to probe and interrogate information by providing explanations and reasons to make their thinking explicit and by using analogies to verbally represent concepts they were trying to express. Results on the follow-up reasoning and problem-solving (RP-S) tasks indicated that students in the Trained and Untrained conditions improved their scores from Time 1 to Time 2 although the change was not significantly different between conditions. (shrink)

Although Caenorhabditis elegans was chosen and modified to be an organism that would facilitate a reductionist program for neurogenetics, recent research has provided evidence for properties that are emergent from the neurons. While neurogenetic advances have been made using C. elegans which may be useful in explaining human neurobiology, there are severe limitations on C. elegans to explain any significant human behavior.