BackgroundThe COVID-19 pandemic has had a significant impact on the health system worldwide. The organ and tissue donation and transplantation (OTDT) system is no exception and has had to face ethical challenges related to the pandemic, such as risks of infection and resource allocation. In this setting, many Canadian transplant programs halted their activities during the first wave of the pandemic.MethodTo inform future ethical guidelines related to the COVID-19 pandemic or other public health emergencies of international concern, we conducted a (...) literature review to summarize the ethical issues.ResultsThis literature review identified three categories of ethical challenges. The first one describes the general ethical issues and challenges reported by OTDT organizations and transplantation programs, such as risks of COVID-19 transmission and infection to transplant recipients and healthcare professionals during the transplant process, risk of patient waitlist mortality or further resource strain where transplant procedures have been delayed or halted, and resource allocation. The second category describes ethical challenges related to informed consent in the context of uncertainty and virtual consent. Finally, the third category describes ethical issues related to organ allocation, such as social considerations in selecting transplant candidates.ConclusionThis literature review highlights the salient ethical issues related to OTDT during the current COVID-19 pandemic. As medical and scientific knowledge about COVID-19 increases, the uncertainties related to this disease will decrease and the associated ethical issues will continue to evolve. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Phenomenology and Modern Behavioral PsychologyLindsay B. Fletcher (bio) and Steven C. Hayes (bio)Keywordsacceptance, contextualism, defusion, relational-frame-theoryPérez-Álvarez and Sass (2008) deserve praise for examining the philosophical roots of clinical psychological science. Modern psychology has moved away from the development of philosophy and theory that is needed to ground scientific investigation within a coherent system. The result is increasingly ill-defined constructs and research programs that each operate within their own divergent (...) paradigm. B.F. Skinner is one of the few modern experimental behavioral psychologists who attempted to build a coherent science of behavior based on observable events with testable hypotheses. Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, and Wilson 1999) and its associated basic science of cognition, Relational Frame Theory (RFT; Hayes, Barnes-Holmes, and Roche 2001), build on Skinner’s work to produce a more progressive science.Psychology and philosophy are different disciplines and how they are approached is defined by the objective. The purpose of philosophy from a scientific point of view is not the same as from a philosophical point of view. It is fine to compare radical behaviorism and phenomenology, but it seems important to ask whether and how this will lead to a more progressive science of behavior.In this commentary, we discuss the philosophy and theory that underlie ACT/RFT and show how they reflect on the relevant points made by the authors regarding the shared features of phenomenology and radical behaviorism. We make two adjustments to the explanation of radical behavioral concepts presented in the current paper to create a more coherent analysis. Finally, we show here how the development of a theory based on applied goals directly informs the methods used in clinical settings.Philosophical AssumptionsThe field of behavior analysis that originated with Skinner has different strands. Some are holistic and pragmatic, whereas others are elementalistic and mechanistic (Hayes, Hayes, and Reese 1988). ACT is based on an a-ontological philosophy termed functional contextualism (Hayes 1993), which views behavior analysis from a holistic and pragmatic perspective. Functional contextualism (AKA radical behaviorism) shares some of the assumptions of phenomenology, as has long been noted (Day 1969). For example, Pérez-Álvarez and Sass (2008) identify a-dualism, or monism, as a common feature. In functional contextualism, the whole is divided into functional units for the purpose of prediction and influence. A three-term contingency (antecedent–behavior–consequence) in behavior analysis is viewed as a [End Page 255] whole event with pragmatically distinguishable aspects, not an assemblage. As the authors point out, this results in a dialectic tension between stimulus control, action, and reinforcer because none are distinct units, and each is defined with reference to the others much as the front of a coin cannot exist without the back. These are not ontological entities, but functional units that are abstracted from the whole for pragmatic purposes. What is “radical” about radical behaviorism is that the philosopher, psychologist, or researcher participates in the event they are observing, and their own acts of scientific observation are identified based on their own functional properties.Behavioral ThinkingIn the service of further developing this philosophical and theoretical foundation and considering it along side phenomenology, we need to examine two aspects of the target article. The first regards the role of the environment in shaping behavior that is central to behavioral and contextual theories. The authors object to behaviorism’s notion of environment and suggest replacing it with the concept of the world, stating that “animals have environment, but man has world.” What is missing is an account of that shift. We believe that modern behavior analysis provides that account.Similarly, the paper argues that “reinforcers are not just things that follow behavior, but also, and above all, values that guide our life.” Again what is missing is an account of the precise behavioral basis for the distinction.In an attempt to do this, the authors incorrectly analyze operant behavior as future oriented, even appealing to final causality. In the three-term contingency, the discriminative stimulus sets the occasion for reinforcement of a particular behavior. The behavior of interest has been reinforced in similar contexts in the past, which gives... (shrink)

These essays draw on work in the history and philosophy of science, the philosophy of mind and language, the development of concepts in children, conceptual..

Scientific heritage can be found in every teaching and research institution, large or small, from universities to museums, from hospitals to secondary schools, from scientific societies to research laboratories. It is generally dispersed and vulnerable. Typically, these institutions lack the awareness, internal procedures, policies, or qualified staff to provide for its selection, preservation, and accessibility. Moreover, legislation that protects cultural heritage does not generally apply to the heritage of science. In this paper we analyse the main problems that make scientific (...) heritage preservation so difficult to address. We discuss the concept and present existing preservation tools, including recent surveys, legislation, policies, and innovative institutional approaches. We briefly analyse two recent initiatives for the preservation of scientific heritage, at the Universities of Lisbon and Cambridge. (shrink)

This paper provides an empirically informed perspective on the notion of responsibility using an ethical framework that has received little attention in the engineering-related literature to date: ethics of care. In this work, we ground conceptual explorations of engineering responsibility in empirical findings from engineering student’s writing on the human health and environmental impacts of “backyard” electronic waste recycling/disposal. Our findings, from a purposefully diverse sample of engineering students in an introductory electrical engineering course, indicate that most of these engineers (...) of tomorrow associated engineers with responsibility for the electronic waste problem in some way. However, a number of responses suggested attempts to deflect responsibility away from engineers towards, for example, the government or the companies for whom engineers work. Still other students associated both engineers and non-engineers with responsibility, demonstrating the distributed/collective nature of responsibility that will be required to achieve a solution to the global problem of excessive e-waste. Building upon one element of a framework for care ethics adopted from the wider literature, these empirical findings are used to facilitate a preliminary, conceptual exploration of care-ethical responsibility within the context of engineering and e-waste recycling/disposal. The objective of this exploration is to provide a first step toward understanding how care-ethical responsibility applies to engineering. We also hope to seed dialogue within the engineering community about its ethical responsibilities on the issue. We conclude the paper with a discussion of its implications for engineering education and engineering ethics that suggests changes for educational policy and the practice of engineering. (shrink)

Critical discussion of Jerry Fodor's Concepts: Where Cognitive Science Went Wrong (1998).

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

Provides a firm theoretical grounding for the increasing movement of cognitive psychologists, neuropsychologists and their students beyond the laboratory, in an ...

Ensuring that life-saving antimicrobials remain available as effective treatment options in the face of rapidly rising levels of antimicrobial resistance will require a massive and coordinated global effort. Setting a collective direction for progress is the first step towards aligning global efforts on AMR. This process would be greatly accelerated by adopting a unifying global target — a well-defined global target that unites all countries and sectors. The proposed pandemic instrument — with its focus on prevention, preparedness and response — (...) represents an ideal opportunity to develop and adopt a unifying global target that catalyzes global action on AMR. We propose three key characteristics of a unifying global target for AMR that — if embedded within the pandemic preparedness instrument — could rally public support, funding, and political commitment commensurate with the scale of the AMR challenge. (shrink)

Reprinted, with modification, from Wilson and Keil 1998.

Quantum mechanics (QM) is a favorite area of physics to feature in “science and religion” discussions. We argue that this is at least partly because the arcane results of QM can be deployed to make big theological claims by the linguistic sleight of hand of “register switching”—sliding imperceptibly from technical into everyday language using the same vocabulary. We clarify the discussion by deploying the formal mapping of QM into classical statistical mechanics (CSM) via the mathematical device of “Wick rotation.” This (...) equivalence between QM and CSM suggests caution in claiming distinctiveness for quantum theologizing. After outlining two areas in which quantum insights nevertheless resonate with longstanding themes in theological reflection (hiddenness and visualizability), we suggest that both QM and CSM point to a theology of science in which scientists participate in the divine gaze on creation as imago Dei. (shrink)

We use the format of a hypothetical case study to review issues related to pharmaceutical product approval and physician prescribing practices. In this case, a new FDA-approved drug is recommended for a patient who subsequently experiences an adverse event that may or may not be related to the prescription. This case raises a number of ethical and legal considerations physicians routinely face when deciding whether to recommend such drugs for their patients. Despite the need for ongoing observation by the regulatory (...) apparatus, physicians should be cognizant of the limitations of the drug approval system and the post-approval prescription drug surveillance system. We discuss physicians’ ethical obligations when faced with a newly approved drug, including seeking out independent sources of learning, reporting adverse effects, and notifying patients about limitations in available knowledge about therapeutic recommendations. (shrink)

Antimicrobial resistance (AMR) is one of the defining global health threats of our time, but no international legal instrument currently offers the framework and mechanisms needed to address it. Fortunately, the actions needed to address AMR have considerable overlap with the actions needed to confront other pandemic threats.

More than 1.5 billion students experienced disruption to education as a result of COVID-19, representing the most substantial interruption to global education in modern history. Many educational institutions transitioned to emergency remote teaching (ERT) overnight, which has presented an array of distinct challenges for educators. Using virtual interviews and an experiential approach to thematic analysis, the study examined Scottish primary teachers’ (n = 10) lived experiences of adapting to ERT practice. Findings demonstrated three main themes; ‘Meeting Learners’ Needs,’ ‘Influencing Engagement’, (...) and ‘The Impact of ERT on Teachers’. Key findings suggested that differentiating learning, engaging, and communicating with learners is more difficult during ERT than face-to-face teaching. Parental engagement is vital, however, is influenced by several mitigating factors. Finally, ERT is likely to have substantial effects on the wellbeing of those involved. Implications of these findings are considered and discussed. (shrink)

The ACA shifted U.S. health policy from centering on principles of actuarial fairness toward social solidarity. Yet four legal fixtures of the health care system have prevented the achievement of social solidarity: federalism, fiscal pluralism, privatization, and individualism. Future reforms must confront these fixtures to realize social solidarity in health care, American-style.

The objective of the study was to investigate the relationship between childhood IQ of parents and characteristics of their adult offspring. It was a prospective family cohort study linked to a mental ability survey of the parents and set in Renfrew and Paisley in Scotland. Participants were 1921-born men and women who took part in the Scottish Mental Survey in 1932 and the Renfrew/Paisley study in the 1970s, and whose offspring took part in the Midspan Family study in 1996. There (...) were 286 offspring from 179 families. Parental IQ was related to some, but not all characteristics of offspring. Greater parental IQ was associated with taller offspring. Parental IQ was inversely related to number of cigarettes smoked by offspring. Higher parental IQ was associated with better education, offspring social class and offspring deprivation category. There were no significant relationships between parental IQ and offspring systolic blood pressure, diastolic blood pressure, cholesterol, glucose, lung function, weight, body mass index, waist hip ratio, housing, alcohol consumption, marital status, car use and exercise. Structural equation modelling showed parental IQ associated with offspring education directly and mediated via parental social class. Offspring education was associated with offspring smoking and social class. The smoking finding may have implications for targeting of health education. (shrink)

The occurrence of hiccoughs (hiccups) is very widespread and yet their neuronal origin and physiological significance are still unresolved. Several hypotheses have been proposed. Here we consider a phylogenetic perspective, starting from the concept that the ventilatory central pattern generator of lower vertebrates provides the base upon which central pattern generators of higher vertebrates develop. Hiccoughs are characterized by glottal closure during inspiration and by early development in relation to lung ventilation. They are inhibited when the concentration of inhaled CO2 (...) is increased and they can be abolished by the drug baclofen (an agonist of the GABAB receptor). These properties are shared by ventilatory motor patterns of lower vertebrates, leading to the hypothesis that hiccough is the expression of archaic motor patterns and particularly the motor pattern of gill ventilation in bimodal breathers such as most frogs. A circuit that can generate hiccoughs may persist in mammals because it has permitted the development of pattern generators for other useful functions of the pharynx and chest wall muscles, such as suckling or eupneic breathing. BioEssays 25:182–188, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

This research focuses on how children negotiate gender boundaries in middle childhood play. Over a nine-week period, children were observed creating, defining, and altering gender codes in a summer day camp. When girls and boys disregarded pre-described boundaries, they entered an area we refer to as the gender transgression zone. This area of activity, where boys and girls conduct heterosocial relations in hopes of either maintaining or expanding gender boundaries in child culture, is where gender transgression takes place. The study (...) revealed that high-status boys used hegemonic masculinity to regulate both girls' and boys' boundaries by reserving the authority to sanction all gender transgressions. While race and class were salient for girls' homosocial organization and behavior, within this age group they did not appear to influence the boys' status system. (shrink)