BackgroundNew disease-modifying ways to treat Parkinson’s disease (PD) may soon become a reality with intracerebral transplantation of cell products produced from human embryonic stem cells (hESCs). The aim of this study was to assess what factors influence preferences of patients with PD regarding stem-cell based therapies to treat PD in the future.MethodsPatients with PD were invited to complete a web-based discrete choice experiment to assess the importance of the following attributes: (i) type of treatment, (ii) aim of treatment, (iii) available (...) knowledge of the different types of treatments, (iv) effect on symptoms, and (v) risk for severe side effects. Latent class conditional logistic regression models were used to determine preference estimates and heterogeneity in respondents’ preferences.ResultsA substantial difference in respondents’ preferences was observed in three latent preference patterns (classes). “Effect on symptoms” was the most important attribute in class 1, closely followed by “type of treatment,” with medications as preferred to other treatment alternatives. Effect on symptoms was also the most important attribute in class 2, with treatment with hESCs preferred over other treatment alternatives. Likewise for class 3, that mainly focused on “type of treatment” in the decision-making. Respondents’ class membership was influenced by their experience in treatment, side effects, and advanced treatment therapy as well as religious beliefs.ConclusionsMost of the respondents would accept a treatment with products emanating from hESCs, regardless of views on the moral status of embryos. Preferences of patients with PD may provide guidance in clinical decision-making regarding treatments deriving from stem cells. (shrink)

BackgroundParkinson’s disease (PD) has been considered to be one of the most promising target diseases for forthcoming cell-based therapy. The aim of this study is to explore the views of individuals with cryopreserved embryos on using human embryonic stem cells for treating PD.MethodsThe study was performed as a qualitative, semi-structured interview study in June–October 2020. Participants were recruited at a private fertility clinic located in one of the larger Swedish cities. The clinic provides both publicly financed and privately financed IVF-treatments. (...) All interviews were performed by telephone and analyzed using thematic content analysis. Five main categories emerged from 27 sub-categories.ResultsIn total, 18 interviews were performed with 22 individuals, as either a couple (n = 16) or separately (n = 6). Participants had different views on what a cryopreserved embryo is. Some participants addressed cryopreserved embryos as ‘a lump of cells’, and some in terms of their ‘unborn child’. Conditions for donation of cryopreserved embryos for cell-based treatment in PD were: not losing control of what is happening to the embryo, that donating must be voluntary and based on informed consent with time for reflection, that reimbursement, equality and transparency.ConclusionsUsing cryopreserved embryos to treat PD is associated with fundamental ethical and practical issues. This study shows that IVF couples with left-over embryos may be supportive but there is a need for future research to assess people’s views on using cryopreserved embryos for cell-based treatment in PD on a more aggregated level. (shrink)

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care (...) left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. (shrink)

Purpose This paper aims to formalize long-term trajectories of human civilization as a scientific and ethical field of study. The long-term trajectory of human civilization can be defined as the path that human civilization takes during the entire future time period in which human civilization could continue to exist. -/- Design/methodology/approach This paper focuses on four types of trajectories: status quo trajectories, in which human civilization persists in a state broadly similar to its current state into the distant future; catastrophe (...) trajectories, in which one or more events cause significant harm to human civilization; technological transformation trajectories, in which radical technological breakthroughs put human civilization on a fundamentally different course; and astronomical trajectories, in which human civilization expands beyond its home planet and into the accessible portions of the cosmos. -/- Findings Status quo trajectories appear unlikely to persist into the distant future, especially in light of long-term astronomical processes. Several catastrophe, technological transformation and astronomical trajectories appear possible. -/- Originality/value Some current actions may be able to affect the long-term trajectory. Whether these actions should be pursued depends on a mix of empirical and ethical factors. For some ethical frameworks, these actions may be especially important to pursue. (shrink)

Bioethics, Volume 36, Issue 2, Page 162-169, February 2022.

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this (...) study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved. (shrink)

It may soon become possible not just to replace, but to re-grow healthy tissues after injury or disease, because of innovations in the field of Regenerative Medicine. One particularly promising innovation is a regenerative valve implant to treat people with heart valve disease. These implants are fabricated from so-called ‘smart’, ‘lifelike’ materials. Implanted inside a heart, these implants stimulate re-growth of a healthy, living heart valve. While the technological development advances, the ethical implications of this new technology are still unclear (...) and a clear conceptual understanding of the notions ‘smart' and ‘lifelike' is currently lacking. In this paper, we explore the conceptual and ethical implications of the development of smart lifelike materials for the design of regenerative implants, by analysing heart valve implants as a showcase. In our conceptual analysis, we show that the materials are considered ‘smart’ because they can communicate with human tissues, and ‘lifelike’ because they are structurally similar to these tissues. This shows that regenerative valve implants become intimately integrated in the living tissues of the human body. As such, they manifest the ontological entanglement of body and technology. In our ethical analysis, we argue this is ethically significant in at least two ways: It exacerbates the irreversibility of the implantation procedure, and it might affect the embodied experience of the implant recipient. With our conceptual and ethical analysis, we aim to contribute to responsible development of smart lifelike materials and regenerative implants. (shrink)

We apply Benacerraf’s distinction between mathematical ontology and mathematical practice to examine contrasting interpretations of infinitesimal mathematics of the seventeenth and eighteenth century, in the work of Bos, Ferraro, Laugwitz, and others. We detect Weierstrass’s ghost behind some of the received historiography on Euler’s infinitesimal mathematics, as when Ferraro proposes to understand Euler in terms of a Weierstrassian notion of limit and Fraser declares classical analysis to be a “primary point of reference for understanding the eighteenth-century theories.” Meanwhile, scholars like (...) Bos and Laugwitz seek to explore Eulerian methodology, practice, and procedures in a way more faithful to Euler’s own. Euler’s use of infinite integers and the associated infinite products are analyzed in the context of his infinite product decomposition for the sine function. Euler’s principle of cancellation is compared to the Leibnizian transcendental law of homogeneity. The Leibnizian law of continuity similarly finds echoes in Euler. We argue that Ferraro’s assumption that Euler worked with a classical notion of quantity is symptomatic of a post-Weierstrassian placement of Euler in the Archimedean track for the development of analysis, as well as a blurring of the distinction between the dual tracks noted by Bos. Interpreting Euler in an Archimedean conceptual framework obscures important aspects of Euler’s work. Such a framework is profitably replaced by a syntactically more versatile modern infinitesimal framework that provides better proxies for his inferential moves. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

In this article we present a new experimental paradigm: comparative visual search. Each half of a display contains simple geometrical objects of three different colors and forms. The two display halves are identical except for one object mismatched in either color or form. The subject's task is to find this mismatch. We illustrate the potential of this paradigm for investigating the underlying complex processes of perception and cognition by means of an eye‐tracking study. Three possible search strategies are outlined, discussed, (...) and reexamined on the basis of experimental results. Each strategy is characterized by the way it partitions the field of objects into “chunks.” These strategies are: (i) Stimulus‐wise scanning with minimization of total scan path length (a “traveling salesman” strategy), (ii) scanning of the objects in fixed‐size areas (a “searchlight” strategy), and (iii) scanning of object sets based on variably sized clusters defined by object density and heterogeneity (a “clustering” strategy). To elucidate the processes underlying comparative visual search, we introduce besides object density a new entropy‐based measure for object heterogeneity. The effects of local density and entropy on several basic and derived eye‐movement variables clearly rule out the traveling salesman strategy, but are most compatible with the clustering strategy. (shrink)

As part of the Dutch national science program “Professional Games for Professional Skills” we developed a stress-exposure biofeedback training in virtual reality for the Dutch police. We aim to reduce the acute negative impact of stress on performance, as well as long-term consequences for mental health by facilitating physiological stress regulation during a demanding decision task. Conventional biofeedback applications mainly train physiological regulation at rest. This might limit the transfer of the regulation skills to stressful situations. In contrast, we provide (...) the user with the opportunity to practice breathing regulation while they carry out a complex task in VR. This setting poses challenges from a technical – as well as from a user-experience perspective. We illustrate how we approach these challenges in our training and hope to contribute a useful reference for researchers and developers in academia or industry who are interested in using biosignals to control elements in a dynamic virtual environment. (shrink)

Did Leibniz exploit infinitesimals and infinities à la rigueur or only as shorthand for quantified propositions that refer to ordinary Archimedean magnitudes? Hidé Ishiguro defends the latter position, which she reformulates in terms of Russellian logical fictions. Ishiguro does not explain how to reconcile this interpretation with Leibniz’s repeated assertions that infinitesimals violate the Archimedean property (i.e., Euclid’s Elements, V.4). We present textual evidence from Leibniz, as well as historical evidence from the early decades of the calculus, to undermine Ishiguro’s (...) interpretation. Leibniz frequently writes that his infinitesimals are useful fictions, and we agree, but we show that it is best not to understand them as logical fictions; instead, they are better understood as pure fictions. (shrink)

Recently Robert B. Talisse has put forth a socio-epistemic justification of liberal democracy that he believes qualifies as a public justification in that it purportedly can be endorsed by all reasonable individuals. In avoiding narrow restraints on reasonableness, Talisse argues that he has in fact proposed a justification that crosses the boundaries of a wide range of religious, philosophical and moral worldviews and in this way the justification is sufficiently pluralistic to overcome the challenges of reasonable pluralism familiar from Rawls. (...) The fascinating argument that Talisse furthers is that when cognitively functional individuals reflect on some of their most basic epistemic commitments they will come to see that, in virtue of these commitments, they are also committed to endorsing key liberal democratic institutions. We argue that the socio-epistemic justification can be reasonably rejected on its own terms and thus fails as a public justification approach. This point is made by illustrating the significance of deep epistemic disagreements in liberal democracies. (shrink)

This paper analyses self-declared aims and representation of dementia patient organizations and advocacy groups in relation to two recent upheavals: the critique of social stigmatization and biomedical research focusing on prediction. Based on twenty-six semi-structured interviews conducted in 2016–2017 with members, service recipients, and board representatives of POs in Germany and Israel, a comparative analysis was conducted, based on a grounded theory approach, to detect emerging topics within and across the POs and across national contexts. We identified a heterogeneous landscape, (...) with the only Israeli PO focusing strongly on caretakers, whereas in Germany several POs claim to represent this patient collective. Shared aims of all POs were fighting social stigma, balancing the loss of patients’ individual autonomy, and the well-being of caretakers. By highlighting the emergence of new groups of dementia self-advocacy against the more traditional advocacy by others, this study highlights how advocacy and representation in the context of AD are embedded in the discursive context of stigmatization and revised disease conception. Future developments in early diagnosis and prediction of dementia, with more affected people likely to conduct dementia self-advocacy, might challenge existing representation structures even more. (shrink)

Liao and Carbonell discuss the role of (supposed) racial differences and racism in two medical devices: pulse oximeters and spirometers. They show that what might seem like cases of mere bias, are...

How does science create knowledge? Epistemic cultures, shaped by affinity, necessity, and historical coincidence, determine how we know what we know. In this book, Karin Knorr Cetina compares two of the most important and intriguing epistemic cultures of our day, those in high energy physics and molecular biology. The first ethnographic study to systematically compare two different scientific laboratory cultures, this book sharpens our focus on epistemic cultures as the basis of the knowledge society.

Precision medicine research involving human biological material is becoming an increasingly central component of healthcare, and its potential is quickly growing due to rapid technological progress...

Submission by 31st July 2021 The relationship between pragmatism and critical realism is open to many interpretations. On the one hand, compared to more traditional approaches, the two approaches s...

This study investigates how Human Factors is applied when designing and developing Immersive Visual Technologies, including Augmented Reality, Mixed Reality, and Virtual Reality. We interviewed fourteen people working at different organizations, that develop IVT applications in the Nordic region. We used thematic analysis to derive themes from the interviews. The results showed an insufficient knowledge and application of HF in IVT development, due to the lack of awareness of both scope and significance of HF, resource allocation strategy, market inertia, stakeholder's (...) involvement, standardization of HF application and IVT uses, and technology maturity. This situation could be improved by allocating experts, adjusting organizational strategy to balance resource allocation, training developers and user organizations to raise awareness and to encourage co-creative design and knowledge sharing, create a sense of ownership amongst stakeholders, and ensure the usefulness of the technology to the user's work. (shrink)

BackgroundSeveral studies identified low subjective feelings of power in women with anorexia nervosa. However, little is known about implicit power motives and the discrepancy between explicit feelings of power and implicit power motives in AN.AimThe study investigated the discrepancy between explicit feelings of power and implicit power motives and its relationship to anxiety in patients with AN.MethodFifty-three outpatients and inpatients with AN and 48 participants without AN were compared regarding subjective feelings of power and anxiety. Explicit power [investigated with the (...) Personal Sense of Power Scale and a visual analog scale ], implicit power motives [investigated with the Multi-Motive Grid ] and trait anxiety [measured with the State-Trait Anxiety Inventory ], were assessed.ResultsExplicit feelings of power were lower in patients with AN compared to non-AN participants. No differences in implicit power motives were found when comparing the groups against each other. However, looking at the groups separately, women with AN had similar levels of implicit fear of losing power and hope for power, whereas woman without AN had significantly lower fear of losing power than hope for power. Focusing on discrepancies between powerful feelings and power motives, results were mixed, depending on the subscale of the MMG. Lastly, discrepancies between implicit power motives and explicit feelings of power were positively correlated with trait anxiety in AN patients.ConclusionThese findings underline that individuals with AN display significantly lower explicit feelings of power, however, they show similar implicit power motives compared to individuals without AN. The discrepancy between explicit feelings of power and implicit power motives is related to anxiety in AN and may represent a vulnerability factor to illness maintenance. (shrink)

The introduction of chatGPT illustrates the rapid developments within Conversational Artificial Intelligence (CAI) technologies (Gordijn and Have 2023). Ethical reflection and analysis of CAI are c...

This rich and diverse collection offers a range of perspectives and practices of Philosophy for Children (P4C). P4C has become a significant educational and philosophical movement with growing impact on schools and educational policy. Its community of inquiry pedagogy has been taken up in community, adult, higher, further and informal educational settings around the world. The internationally sourced chapters offer research findings as well as insights into debates provoked by bringing children’s voices into moral and political arenas and to philosophy (...) and the broader educational issues this raises, for example: historical perspectives on the field; democratic participation and epistemic, pedagogical and political relationships; philosophy as a subject and philosophy as a practice; philosophical teaching across the curriculum; embodied enquiry, emotions and space; knowledge, truth and philosophical progress; resources and texts for philosophical inquiry; ethos and values of P4C practice and research. The Routledge International Handbook of Philosophy for Children will spark new discussions and identify emerging questions and themes in this diverse and controversial field. It is an accessible, engaging and provocative read for all students, researchers, academics and educators who have an interest in Philosophy for Children, its educational philosophy and its pedagogy. (shrink)

Food images are useful stimuli for the study of cognitive processes as well as eating behavior. To enhance rigor and reproducibility in task-based research, it is advantageous to have stimulus sets that are publicly available and well characterized. Food Folio by Columbia Center for Eating Disorders is a publicly available set of 138 images of Western food items. The set was developed for the study of eating disorders, particularly for use in tasks that capture eating behavior characteristic of these illnesses. (...) It contains foods that are typically eaten, as well as those typically avoided, by individuals with eating disorders. Each image has now been rated across 17 different attributes by a large general United States population sample via Amazon’s Mechanical Turk. Ratings included subjective attributes as well as estimates of nutrient content. Each participant rated a subset of stimulus set food items on all 17 dimensions. Additional description of the image set is provided in terms of physical image information and accurate nutritional information. Correlations between subjective ratings were calculated and an exploratory factor analysis and exploratory cluster analysis completed. Outcomes of the factor analysis suggested foods may be described along three latent factors of healthiness, tastiness, and umami taste; the cluster analysis highlighted five distinct clusters of foods varying on these same dimensions. Descriptive outcomes indicated that the stimulus set includes a range of foods that vary along multiple dimensions and thus is likely to be useful in addressing various research questions surrounding eating behavior and cognition in healthy populations, as well as in those with eating disorders. The provision of comprehensive descriptive information allows for stimulus selection that is optimized for a given research question and promotes strong inference. (shrink)

Abraham Robinson’s framework for modern infinitesimals was developed half a century ago. It enables a re-evaluation of the procedures of the pioneers of mathematical analysis. Their procedures have been often viewed through the lens of the success of the Weierstrassian foundations. We propose a view without passing through the lens, by means of proxies for such procedures in the modern theory of infinitesimals. The real accomplishments of calculus and analysis had been based primarily on the elaboration of novel techniques for (...) solving problems rather than a quest for ultimate foundations. It may be hopeless to interpret historical foundations in terms of a punctiform continuum, but arguably it is possible to interpret historical techniques and procedures in terms of modern ones. Our proposed formalisations do not mean that Fermat, Gregory, Leibniz, Euler, and Cauchy were pre-Robinsonians, but rather indicate that Robinson’s framework is more helpful in understanding their procedures than a Weierstrassian framework. (shrink)

Despite Vision Zero’s moral appeal and its expansion throughout the world, it has been criticized on different grounds. This chapter is based on an extensive literature search for criticism of Vision Zero, using the bibliographic databases Philosopher’s Index, Web of Science, Science Direct, Scopus, Google Scholar, PubMed, and Phil Papers, and by following the references in the collected documents. Even if the primary emphasis was on Vision Zero in road traffic, our search also included documents criticizing Vision Zero policies in (...) other safety areas, such as public health, the construction and mining industries, and workplaces in general. Based on the findings, we identify and systematically characterize and classify the major arguments that have been put forward against Vision Zero. The most important arguments against Vision Zero can be divided into three major categories: moral arguments, arguments concerning the rationality of Vision Zero, and arguments aimed at the practical implementation of the goals. We also assess the arguments. Of the 13 identified main arguments, 6 were found to be useful for a constructive discussion on safety improvements. (shrink)

In relation to a thesis put forward by Marx Wartofsky, we seek to show that a historiography of mathematics requires an analysis of the ontology of the part of mathematics under scrutiny. Following Ian Hacking, we point out that in the history of mathematics the amount of contingency is larger than is usually thought. As a case study, we analyze the historians’ approach to interpreting James Gregory’s expression ultimate terms in his paper attempting to prove the irrationality of \. Here (...) Gregory referred to the last or ultimate terms of a series. More broadly, we analyze the following questions: which modern framework is more appropriate for interpreting the procedures at work in texts from the early history of infinitesimal analysis? As well as the related question: what is a logical theory that is close to something early modern mathematicians could have used when studying infinite series and quadrature problems? We argue that what has been routinely viewed from the viewpoint of classical analysis as an example of an “unrigorous” practice, in fact finds close procedural proxies in modern infinitesimal theories. We analyze a mix of social and religious reasons that had led to the suppression of both the religious order of Gregory’s teacher degli Angeli, and Gregory’s books at Venice, in the late 1660s. (shrink)

Research is a global enterprise requiring participation of both genders for generalizable knowledge; advancement of science and evidence based medical treatment. Participation of women in research is necessary to reduce the current bias that most empirical evidence is obtained from studies with men to inform health care and related policy interventions. Various factors are assumed to limit autonomy amongst the Yoruba women of western Nigeria. This paper seeks to explore the experience and understanding of autonomy by the Yoruba women in (...) relation to research participation. Focus is on factors that affect women's autonomous decision making in research participation. An exploratory qualitative approach comprising four focus group discussions, 42 in-depth interviews and 14 key informant interviews was used. The study permits a significant amount of triangulation, as opinions of husbands and religious leaders are also explored. Interviews and discussions were audiotaped and transcribed verbatim. Content analysis was employed for data analysis. Findings show that concepts of autonomy varied amongst the Yoruba women. Patriarchy, religion and culture are conceived to have negative impact on the autonomy of women in respect to research participation. Among the important findings are: 1) male dominance is strongly emphasized by religious leaders who should teach equality, 2) while men feel that by making decisions for women, they are protecting them, the women on the other hand see this protection as a way of limiting their autonomy. We recommend further studies to develop culturally appropriate and workable recruitment methods to increase women's participation in research. (shrink)

Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the (...) effects of knowledge framing and its impact on ethical, medical, economical and legal decisions. (shrink)