Technological developments have resulted in tremendous increases in the volume and diversity of the data and information that must be processed in the course of biomedical and clinical research and practice. Researchers are at the same time under ever greater pressure to share data and to take steps to ensure that data resources are interoperable. The use of ontologies to annotate data has proven successful in supporting these goals and in providing new possibilities for the automated processing of data and (...) information. In this chapter, we describe different types of vocabulary resources and emphasize those features of formal ontologies that make them most useful for computational applications. We describe current uses of ontologies and discuss future goals for ontology-based computing, focusing on its use in the field of infectious diseases. We review the largest and most widely used vocabulary resources relevant to the study of infectious diseases and conclude with a description of the Infectious Disease Ontology (IDO) suite of interoperable ontology modules that together cover the entire infectious disease domain. (shrink)

Technological developments have resulted in tremendous increases in the volume and diversity of the data and information that must be processed in the course of biomedical and clinical research and practice. Researchers are at the same time under ever greater pressure to share data and to take steps to ensure that data resources are interoperable. The use of ontologies to annotate data has proven successful in supporting these goals and in providing new possibilities for the automated processing of data and (...) information. In this chapter, we describe different types of vocabulary resources and emphasize those features of formal ontologies that make them most useful for computational applications. We describe current uses of ontologies and discuss future goals for ontology-based computing, focusing on its use in the field of infectious diseases. We review the largest and most widely used vocabulary resources relevant to the study of infectious diseases and conclude with a description of the Infectious Disease Ontology (IDO) suite of interoperable ontology modules that together cover the entire infectious disease domain. (shrink)

The Infectious Disease Ontology (IDO) is a suite of interoperable ontology modules that aims to provide coverage of all aspects of the infectious disease domain, including biomedical research, clinical care, and public health. IDO Core is designed to be a disease and pathogen neutral ontology, covering just those types of entities and relations that are relevant to infectious diseases generally. IDO Core is then extended by a collection of ontology modules focusing on specific diseases and pathogens. In this paper we (...) present applications of IDO Core within various areas of infectious disease research, together with an overview of all IDO extension ontologies and the methodology on the basis of which they are built. We also survey recent developments involving IDO, including the creation of IDO Virus; the Coronaviruses Infectious Disease Ontology (CIDO); and an extension of CIDO focused on COVID-19 (IDO-CovID-19).We also discuss how these ontologies might assist in information-driven efforts to deal with the ongoing COVID-19 pandemic, to accelerate data discovery in the early stages of future pandemics, and to promote reproducibility of infectious disease research. (shrink)

Research ethics guidelines grew out of several infamous episodes where research subjects were exploited. There is significant international synchronization of guidelines. However, indigenous groups in New Zealand, Canada and Australia have criticized these guidelines as being inadequate for research involving indigenous people and have developed guidelines from their own cultural perspectives. Whilst traditional research ethics guidelines place a lot of emphasis on informed consent, these indigenous guidelines put much greater emphasis on interdependence and trust. This article argues that traditional guidelines (...) are premised on relationships of equal power, and that often the researcher has more power that is not fully equalized by providing information. Where there is a relationship of unequal power, then focusing on interdependence and trust is more likely to achieve ethical safety. We illustrate this thesis by describing the detail of a research project looking at the use of interpreters, where we video-recorded live consultations and then interviewed the patient, interpreter and doctor. We conclude by suggesting that mainstream research ethics guidelines should pay more attention to the development of a trustworthy relationship between subject and researcher, and that, following the lead from clinical medicine, we should develop a culturally competent ethical framework for research on human subjects. (shrink)

This paper addresses a family of issues surrounding the biological phenomenon of resistance and its representation in realist ontologies. The treatments of resistance terms in various existing ontologies are examined and found to be either overly narrow, internally inconsistent, or otherwise problematic. We propose a more coherent characterization of resistance in terms of what we shall call blocking dispositions, which are collections of mutually coordinated dispositions which are of such a sort that they cannot undergo simultaneous realization within a single (...) bearer. A definition of ‘protective resistance’ is proposed for use in the Infectious Disease Ontology (IDO) and we show how this definition can be used to characterize the antibiotic resistance in Methicillin-Resistant Staphylococcus aureus (MRSA). The ontological relations between entities in our MRSA case study are used alongside a series of logical inference rules to illustrate logical reasoning about resistance. A description logic representation of blocking dispositions is also provided. We demonstrate that our characterization of resistance is sufficiently general to cover two other cases of resistance in the infectious disease domain involving HIV and malaria. (shrink)

This paper addresses the use of dispositions in the Infectious Disease Ontology (IDO). IDO is an ontology constructed according to the principles of the Open Biomedical Ontology (OBO) Foundry and uses the Basic Formal Ontology (BFO) as an upper ontology. After providing a brief introduction to disposition types in BFO and IDO, we discuss three general techniques for representing combinations of dispositions under the headings blocking dispositions, complementary dispositions, and collective dispositions. Motivating examples for each combination of dispositions is given (...) along with a specific use case in IDO. Description logic restrictions are used to formalize statements relating to these combinations. (shrink)

Despite ample evidence of the efficacy and effectiveness of evidence-based parenting programmes (EBPPs) within research-led environments, there is very little evidence of maintenance of effectiveness when programmes are delivered as part of regular service provision. The present study examined the effectiveness of EBPPs provided during a period of sustained service-led implementation in comparison to research-led effectiveness evaluation. Data from 3706 parents who received EBPPs during sustained implementation by services were compared to data from 1390 parents who had participated in an (...) earlier researcher-led effectiveness trial of a national roll-out of EBPPs in England. In both phases, parents completed measures of child behaviour problems, parenting style and parental mental well-being prior to starting parenting programmes (pre-test), at the end of the programmes (post) and at 12-months follow up. Results from Generalised Estimating Equations controlling for potential covariates indicated significant improvements in child behaviour problems during sustained implementation, similar to the effectiveness phase; significant improvements in parenting style which were larger than the effectiveness phase at 12-month follow up; and significant improvements in parental mental well- being. Our findings demonstrate effective maintenance of gains when EBPPs are provided as part of regular provision across a large sample of English parents. Successful long-term implementation should consider effectiveness of EBPPs across the population, given the large contextual changes that take place between researcher-led evaluations and service take-up. Our findings support the integration of EBPPs in public health approaches to addressing child behaviour problems and parent well-being. (shrink)

A repository of clinically associated Staphylococcus aureus (Sa) isolates is used to semi‐automatically generate a set of application ontologies for specific subfamilies of Sa‐related disease. Each such application ontology is compatible with the Infectious Disease Ontology (IDO) and uses resources from the Open Biomedical Ontology (OBO) Foundry. The set of application ontologies forms a lattice structure beneath the IDO‐Core and IDO‐extension reference ontologies. We show how this lattice can be used to define a strategy for the construction of a new (...) taxonomy of infectious disease incorporating genetic, molecular, and clinical data. We also outline how faceted browsing and query of annotated data is supported using a lattice application ontology. (shrink)

Vaccine research, as well as the development, testing, clinical trials, and commercial uses of vaccines involve complex processes with various biological data that include gene and protein expression, analysis of molecular and cellular interactions, study of tissue and whole body responses, and extensive epidemiological modeling. Although many data resources are available to meet different aspects of vaccine needs, it remains a challenge how we are to standardize vaccine annotation, integrate data about varied vaccine types and resources, and support advanced vaccine (...) data analysis and inference. To address these problems, the community-based Vaccine Ontology (VO) has been developed through collaboration with vaccine researchers and many national and international centers and programs, including the National Center for Biomedical Ontology (NCBO), the Infectious Disease Ontology (IDO) Initiative, and the Ontology for Biomedical Investigations (OBI). VO utilizes the Basic Formal Ontology (BFO) as the top ontology and the Relation Ontology (RO) for definition of term relationships. VO is represented in the Web Ontology Language (OWL) and edited using the Protégé-OWL. Currently VO contains more than 2000 terms and relationships. VO emphasizes on classification of vaccines and vaccine components, vaccine quality and phenotypes, and host immune response to vaccines. These reflect different aspects of vaccine composition and biology and can thus be used to model individual vaccines. More than 200 licensed vaccines and many vaccine candidates in research or clinical trials have been modeled in VO. VO is being used for vaccine literature mining through collaboration with the National Center for Integrative Biomedical Informatics (NCIBI). Multiple VO applications will be presented. (shrink)

An accurate classification of bacteria is essential for the proper identification of patient infections and subsequent treatment decisions. Multi-Locus Sequence Typing (MLST) is a genetic technique for bacterial classification. MLST classifications are used to cluster bacteria into clonal complexes. Importantly, clonal complexes can serve as a biological species concept for bacteria, facilitating an otherwise difficult taxonomic classification. In this paper, we argue for the inclusion of terms relating to clonal complexes in biomedical ontologies.

The Center for Disease Control and Prevention’s Active Bacterial Core Surveillance (CDC ABCs) Program is a collaborative effort betweeen the CDC, state health departments, laboratories, and universities to track invasive bacterial pathogens of particular importance to public health [1]. The year-end surveillance reports produced by this program help to shape public policy and coordinate responses to emerging infectious diseases over time. The ABCs case report form (CRF) data represents an excellent opportunity for data reuse beyond the original surveillance purposes.

The COVID-19 pandemic prompted immense work on the investigation of the SARS-CoV-2 virus. Rapid, accurate, and consistent interpretation of generated data is thereby of fundamental concern. Ontologies––structured, controlled, vocabularies––are designed to support consistency of interpretation, and thereby to prevent the development of data silos. This paper describes how ontologies are serving this purpose in the COVID-19 research domain, by following principles of the Open Biological and Biomedical Ontology (OBO) Foundry and by reusing existing ontologies such as the Infectious Disease Ontology (...) (IDO) Core, which provides terminological content common to investigations of all infectious diseases. We report here on the development of an IDO extension, the Virus Infectious Disease Ontology (VIDO), a reference ontology covering viral infectious diseases. We motivate term and definition choices, showcase reuse of terms from existing OBO ontologies, illustrate how ontological decisions were motivated by relevant life science research, and connect VIDO to the Coronavirus Infectious Disease Ontology (CIDO). We next use terms from these ontologies to annotate selections from life science research on SARS-CoV-2, highlighting how ontologies employing a common upper-level vocabulary may be seamlessly interwoven. Finally, we outline future work, including bacteria and fungus infectious disease reference ontologies currently under development, then cite uses of VIDO and CIDO in host-pathogen data analytics, electronic health record annotation, and ontology conflict-resolution projects. (shrink)

The COVID-19 pandemic prompted immense work on the investigation of the SARS-CoV-2 virus. Ontologies – structured, controlled, vocabularies – are designed to support consistency of interpretation, and thereby to prevent the development of data silos. This paper describes how ontologies are serving this purpose in the virus research domain, following the principles of the Open Biological and Biomedical Ontology (OBO) Foundry and drawing on the resources of the Infectious Disease Ontology (IDO) Core. We report the development of the Virus Infectious (...) Disease Ontology (VIDO), a reference ontology extending IDO Core covering viral infectious diseases. We examine newly minted terms, showcase ontology term reuse, and illustrate the use of VIDO by annotating selections from recent life science research on SAR-CoV-2, in the interest of supporting machine learning projects. (shrink)

The Cell Ontology (CL) is designed to provide a standardized representation of cell types for data annotation. Currently, the CL employs multiple is_a relations, defining cell types in terms of histological, functional, and lineage properties, and the majority of definitions are written with sufficient generality to hold across multiple species. This approach limits the CL’s utility for cross-species data integration. To address this problem, we developed a method for the ontological representation of cells and applied this method to develop a (...) dendritic cell ontology (DC-CL). DC-CL subtypes are delineated on the basis of surface protein expression, systematically including both species-general and species-specific types and optimizing DC-CL for the analysis of flow cytometry data. This approach brings benefits in the form of increased accuracy, support for reasoning, and interoperability with other ontology resources. 104. Barry Smith, “Toward a Realistic Science of Environments”, Ecological Psychology, 2009, 21 (2), April-June, 121-130. Abstract: The perceptual psychologist J. J. Gibson embraces a radically externalistic view of mind and action. We have, for Gibson, not a Cartesian mind or soul, with its interior theater of contents and the consequent problem of explaining how this mind or soul and its psychological environment can succeed in grasping physical objects external to itself. Rather, we have a perceiving, acting organism, whose perceptions and actions are always already tuned to the parts and moments, the things and surfaces, of its external environment. We describe how on this basis Gibson sought to develop a realist science of environments which will be ‘consistent with physics, mechanics, optics, acoustics, and chemistry’. (shrink)

This volume presents an English translation of Nietzsche's Unzeitgemasse Betrachtungen or, Unfashionable Observations. The common impulse that links up these four essays is Nietzsche's attitude towards all mainstream and popular movements that constituted contemporary European, and especially German culture. The work offers the foundations for Nietzsche's whole philosophy, prefiguring both his characteristic philosophical style and many of the major ideas he develops in his later writings.

We welcome Norenzayan et al.’s claim that the prosocial effects of beliefs in supernatural agents extend beyond Big Gods. To date, however, supporting evidence has focused on the Abrahamic Big God, making generalisations difficult. We discuss a recent study that highlights the need for clarity about the causal path by which supernatural beliefs affect the evolution of big societies.

“Deep Thoughts” and “Fuzzy Memories” were fan favorites as transitional pieces between larger set pieces on Saturday Night Live in the 1990s. Delivered over soothing music and serene images, Jack Handey's bits never showed his face on screen, calling to mind his observation that “the face of a child can say it all, especially the mouth part of the face.” Some dark and offbeat takes on the human condition often have an existentialist feel. Existentialism is a philosophy concerned with “the (...) individual, the experience of choice, and the absence of rational understanding of the universe with a consequent dread or sense of absurdity in human life.” In other words, human beings find themselves trying to live meaningful lives without truly comprehending the nature of what that meaning may be, or whether or not true meaning could even exist. (shrink)

PurposeThe purported benefits and risks of immediately sequential bilateral cataract surgery have been well described, yet the procedure remains controversial among UK ophthalmologists. As many of the controversies of ISBCS are underpinned by ethical dilemmas, the aim of this work was to explore the ethical perspectives of ISBCS from a variety of stakeholder viewpoints.MethodA semi-structured independent stakeholder meeting was convened at the Royal College of Ophthalmologists London headquarters in June 2018. In total, 29 stakeholders attended the meeting. The professional characteristics (...) of stakeholders included but were not limited to: ophthalmologists, patients, religious leaders, ethicists, lawyers and commissioners. Thematic qualitative analysis using methodology proposed by Braun and Clarke was conducted on the resultant transcript of the discussion.ResultsThemes identified include: beneficence and non-maleficence ; autonomy ; distributive justice.ConclusionThis analysis provides a reference point for the ethical factors surrounding ISBCS. The stakeholders concluded that this approach was an ethical undertaking provided patient autonomy was appropriately attained. This requires a patient’s interpretation of the risk-benefit balance, which must include an understanding of the low but unquantifiable risk of severe complications. A surgeon must aim to minimise risks through the adaption of accepted surgical protocols and by performing appropriate patient selection. Currently, cost savings to healthcare that may occur following the implementation of ISBCS should be considered a secondary benefit of the protocol. (shrink)

few areas of public policy have been fraught with as much controversy as bioethics. Each novel development in biomedical technology seems to spark rancorous disputes. Those averse to new technologies often express the concern that the new technology is 'unnatural' or requires us to 'play God'. Slogans such as 'Frankenfoods' and 'sanctity of life' substitute for reasoned argument. This is an ambitious book that seeks to reframe the debates surrounding current controversies in bioethics. Carefully examining and dissecting claims made by (...) many policy-makers and ethicists on topics such as assistance in dying, genetic engineering, and embryonic stem cell research, bioethicist Ronald A Lindsay shows that all too often these claims are based on instinctive reactions, beliefs that lack factual support, and religious or ideological dogma. After describing in detail the proper way to approach and resolve a dispute in bioethics, Lindsay proceeds to analyse several different cutting-edge issues. Through his insightful analysis, Lindsay demonstrates how to achieve pragmatic, progressive solutions to these controversies. An antidote for misguided thinking, "Future Bioethics" illuminates the way forward to bioethics policies appropriate for the 21st century. (shrink)

All five elements live within you, and experiences like heartache, anxiety, and procrastination are signs that one of them is out of balance. This beginner-friendly book introduces you to each of the elements--Water, Wood, Fire, Earth, and Metal--and shows you how to use them to improve your mental, emotional, and spiritual health. In Our Element weaves together Eastern medicine, Western psychology, Indigenous traditions, and African ancestral principles of spirituality. With a practical approach that incorporates journal prompts, flower essences, yoga poses, (...) and music, Lindsay Fauntleroy teaches you how to tap into the five elements for a balanced and empowered life that aligns with your soul's calling. (shrink)

This is a review essay of Lagasnerie, Judge and Punish and Fassin, The Will to Punish. It explores the way that these two books challenge conventional thinking about the relationship between crime and punishment.

Little is known about the mechanisms by which psychology graduate programs transmit responsible conduct of research (RCR) values. A national sample of 968 current students and recent graduates of mission-diverse doctoral psychology programs completed a Web-based survey on their research ethics challenges, perceptions of RCR mentoring and department climate, whether they were prepared to conduct research responsibly, and whether they believed psychology as a discipline promotes scientific integrity. Research experience, mentor RCR instruction and modeling, and department RCR policies predicted student (...) RCR preparedness. Mentor RCR instruction, department RCR policies, and faculty modeling of RCR behaviors predicted confidence in the RCR integrity of the discipline. Implications for training are discussed. (shrink)

Why is the human imagination to blame for the worst crimes of the twentieth century? Why is progress a pernicious myth? Why is contemporary atheism just a hangover from Christian faith? John Gray, author of Straw Dogsand Black Mass, is one of the most original and iconoclastic thinkers of our time. In this pugnacious and brilliantly readable collection of essays from across his career, he smashes through humanity's most cherished beliefs to overturn our view of the world, and our place (...) in it. 'If humans are different from other animals it is chiefly in being governed by myths, which are not creations of the will but creatures of the imagination.' 'No traditional myth is as untruthful as the modern myth of progress. All prevailing philosophies embody the fiction that human life can be altered at will. Better aim for the impossible, they say, than submit to fate. Invariably, the result is a cult of human self-assertion that soon ends in farce.'. (shrink)

This paper seeks to answer the question: Can contemporary forms of artificial intelligence be creative? To answer this question, I consider three conditions that are commonly taken to be necessary for creativity. These are novelty, value, and agency. I argue that while contemporary AI models may have a claim to novelty and value, they cannot satisfy the kind of agency condition required for creativity. From this discussion, a new condition for creativity emerges. Creativity requires curiosity, a motivation to pursue epistemic (...) goods. I argue that contemporary AI models do not satisfy this new condition. Because they lack both agency and curiosity, it is a mistake to attribute the same sort of creativity to AI that we prize in humans. Finally, I consider the question of whether these AI models stand to make human creativity in the arts and sciences obsolete, despite not being creative themselves. I argue, optimistically, that this is unlikely. (shrink)

All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool of resources to a population. Because many of the central issues are the same in all systems, the United States and other countries can learn from the successes and failures of countries that have explicitly addressed the question of health care priorities. We review explicit priority setting efforts in Norway, Sweden, Israel, the Netherlands, Denmark, New Zealand, the United Kingdom and the (...) state of Oregon in the US. The approaches used can be divided into those centered on outlining principles versus those that define practices. In order to establish the main lessons from their experiences we consider the process each country used, criteria to judge the success of these efforts, which approaches seem to have met these criteria, and using their successes and failures as a guide, how to proceed in setting priorities. We demonstrate that there is little evidence that establishment of a values framework for priority setting has had any effect on health policy, nor is there evidence that priority setting exercises have led to the envisaged ideal of an open and participatory public involvement in decision making. (shrink)

I argue for an account of creativity that unifies creative achievements in the arts, sciences, and other domains and identifies its characteristic value. This account draws upon case studies of creative work in both the arts and sciences to identify creativity as a kind of successful exploration. I argue that if creativity is properly understood in this way, then it is fundamentally a property of processes, something only agents can achieve, something that comes in degrees, subjectively novel, and non-formulaic. As (...) I develop the account, I show how it avoids challenges faced by other accounts of creativity, especially concerning creativity’s value. Hills and Bird (2018, 2019) have together argued that creativity is not necessarily valuable. My account challenges this view. If I am right that creativity is a kind of successful exploration, then creativity does have a characteristic value, specifically epistemic value. (shrink)

This paper argues that the discussion in which Aristotle engages in Metaphysics ΖΗ has the same starting-point as natural science: the principles of changing substances. These inquiries are nonetheless distinct because natural science uses these principles in its detailed investigations into natural substances, whereas ΖΗ reflect on the principles themselves. ΖΗ are an integral part of Aristotle’s inquiry into the principles of all substances, changing and unchanging: they are not merely preliminary to an inquiry into the latter kind. They are (...) also an integral part of Aristotle’s ‘first philosophy’, alongside theology’s study of the nature and activity of unchanging substances. (shrink)

In recent years, several prominent biologists have pointed to the relatively new field of evolutionary developmental biology as evidence of an Extended Synthesis in evolutionary biology. More particularly, these biologists claim that theoretical and empirical EvoDevo research is extending the Modern Synthesis framework of evolutionary theory through investigation of evolutionarily important concepts that are not part of the framework developed during the 20th century. To describe the current changes in evolutionary biology as an Extended Synthesis, however, is incorrect. Through review (...) of Extended Synthesis arguments and analysis of the same biological concepts used to support these arguments, I argue that the foundation of the Modern Synthesis framework, theoretical population genetics, faces significant, perhaps insurmountable challenges from the concepts highlighted by EvoDevo research. As the foundation of the Modern Synthesis framework will require considerable remodeling—if possible—in light of the concepts emphasized by EvoDevo, it is incorrect to describe the ongoing changes in evolutionary biology as an Extended Synthesis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Gonzales v. Oregon and the Politics of MedicineRonald A. Lindsay (bio)Throughout 2005, the morbid joke on Capitol Hill was that the twin inevitabilities of "death and taxes" had been replaced by "death politics and taxes." There seemed to be some truth in this observation given the highly publicized intervention by some members of Congress in the Schiavo case and the continuing controversy over government regulation of end-of-life care. (...) The Supreme Court's recent decision in Gonzales v. Oregon (74 U.S.L.W. 4068 (17 January 2006)) has resolved one of the critical issues relating to this controversy by holding that a physician may prescribe controlled substances to provide assistance in dying if such a practice is authorized by state law and not expressly prohibited by federal law. However, other issues remain. In fact, the Court's decision has underscored some of the reasons why there is not only continuing controversy over end-of-life care, but also over other aspects of the practice of medicine. First, it is apparent there is no consensus among health care professionals about the precise boundaries of the legitimate practice of medicine. Second, the regulation of the practice of medicine traverses ill-defined legal territory. In particular, there is significant uncertainty concerning the implications of some regulations as well as the allocation of regulatory authority between and within state and federal governments. This uncertainty leaves substantial room for political maneuvers.Before discussing the politics of medicine, it is worth looking at the regulation of controlled substances in some detail both because this review will provide the necessary background for understanding the ruling in Gonzales v. Oregon and because it will illustrate the uncertainty resulting from multiple sources of regulatory authority.Federal and State Regulation of Controlled SubstancesSince the Pure Food and Drug Act of 1906, the federal government has regulated certain aspects of the distribution and administration of drugs deemed susceptible to abuse. The current primary vehicle for federal regulation is the Comprehensive Drug Abuse Prevention and Control Act, enacted in 1970, of which Title II is known as the Controlled Substances Act (CSA) (21 U.S.C. § 801 et seq.). A [End Page 99] "controlled" substance is just that, a substance that is regulated under the CSA. The CSA classifies controlled substances in five categories or schedules based on their potential for abuse, their accepted medical use, and the risks associated with their use under medical supervision. Schedule I substances have a high potential for abuse and have no currently accepted use in medical treatment. Schedule II-V substances are approved for medical use but are subject to a descending hierarchy of restrictions on their use. To give a lawful prescription for a controlled substance, a physician must be registered with the appropriate federal agency, currently the Drug Enforcement Administration (DEA). Moreover, to be valid, such a prescription must be issued for "a legitimate medical purpose" (21 U.S.C. § 830(b)(3)(A)(ii)).There is little dispute that the primary purposes of the CSA are to control drug abuse and to eliminate illicit trafficking in drugs. In accomplishing these objectives, there is a division of responsibility among various federal agencies, in particular the Department of Health and Human Services and the Department of Justice. Of particular relevance to the controversy in Gonzales v. Oregon is the Attorney General's authority to revoke a physician's registration for prescribing controlled substances if the physician's registration would be inconsistent with the public interest.All 50 states have their own statutes and regulations that address various aspects of the distribution and administration of controlled substances. Most states have adopted versions of the model Uniform Controlled Substances Act, which largely mimics federal law, but several states have placed additional restrictions on a physician's ability to prescribe controlled substances, including time limits on the validity of a prescription and limits on the quantity of a drug that can be prescribed. States are the primary, but by no means the exclusive, source of regulation of medical practice in general. States license physicians, establish boards and agencies to regulate the actions of physicians, and promulgate rules and guidelines to which physicians... (shrink)

Attempts to democratize the food system and make it more equitable through food sovereignty take many forms across space. In Cuba, food sovereignty is perceived as the promotion of small-scale farming methods informed by agroecology and permaculture. However, these practices are mediated by discourses of self-sufficiency in the context of the US blockade. Simultaneously, in Basque country, Spain, food sovereignty shapes community-supported agriculture initiatives, farmer union and cooperative-based work, and a deep appreciation for regional foods. In this context, food sovereignty (...) is perceived as part of the struggle to maintain Basque identity and autonomy. In this paper, I discuss how food sovereignty is defined and understood by outside actors who traveled to either Cuba or Basque country to understand how food sovereignty is being practiced in place. As educators, farmers, students, retirees, farmworker organizers, and activists meet in these spaces, I ask how do definitions of food sovereignty differ? I argue that food sovereignty ‘sits in places’ and travelers have difficulty discerning what food sovereignty is when confronted with unfamiliar practices. Findings suggest that such educational tourism is an attempt to create a meaningful space for dialogue about food sovereignty and as a touchstone it offers opportunities for participant discussions, however, understandings of food sovereignty are subject to confusion and alternate conceptions and thus, do not always travel well. (shrink)

Background: Moral distress, which is especially high in critical care nurses, has significant negative implications for nurses, patients, organizations, and healthcare as a whole. Aim: A moral distress workshop and follow-up activities were implemented in an intensive care unit in order to decrease levels of moral distress and increase nurses’ perceived comfort and confidence in ethical decision-making. Design: A quality improvement (QI) initiative was conducted using a pre- and post-intervention design. The program consisted of a four-hour interactive workshop, followed by (...) two individual self-reflection activities at 2–3 weeks and 5–6 weeks after the workshop. Participants: Critical care nurses working in a heart and vascular intensive care unit at a large academic medical center. Ethical Considerations: This study was deemed to be a QI project by the institution’s Institutional Review Board. Participation was voluntary. Findings: Nurses experienced a significant decrease in moral distress. The participants’ average ethical confidence increased in four areas (ability to identify the conflicting values at stake, knowing role expectations, feeling prepared to resolved ethical conflict, and being able to do the right thing), with knowledge of role expectations and feeling prepared to resolve ethical conflict yielding statistically significant increases. Qualitative findings resulted in consistent themes related to causes of moral distress and ways nurses approached addressing moral distress. Discussion: This study reinforces previous evidence on moral distress and its causes in critical care nurses, and provides a mechanism for improving moral distress and ethical confidence. Conclusions: This QI study demonstrates the effectiveness of an evidence-based program for decreasing critical care nurses’ moral distress and increasing their ethical confidence. The strategies described in this paper can replicated by nursing leaders who wish to effect change at their local level, or adapted and expanded to other professions and clinical care units. (shrink)

The fifth book in the series offers an historical and conceptual account of the criminal law, as it has developed in England and spread to common law jurisdictions around the world. It traces how and why criminal law has come to be accorded with a central role in securing civil order in modernity, and justifies who and what should be treated as criminal under the law. Farmer argues that the emergence of the modern state in which criminal law is recognized (...) as an instrument of government is a result of the distinct body of rules which have emerged from the modern criminal law. (shrink)

What is it to suspend judgment about whether p? Much of the recent work on the nature and normative profile of suspending judgment aims to analyze it as a kind of doxastic attitude. On some of these accounts, suspending judgment about whether p partly consists in taking up a certain higher-order belief about one's deficient epistemic position with respect to whether p. On others, suspending judgment about whether p consists in taking up a sui generis attitude, one that takes the (...) question of whether p? as its content. In this paper, I defend an account on which suspending judgment about whether p is not a matter of taking up a doxastic attitude, but rather a way of intentionally omitting to judge whether p. I then close with a discussion of how an account like mine, which sees suspending judgment as fundamentally practical, rather than doxastic, can accommodate what appear to be distinctively epistemic reasons to suspend judgment. (shrink)

In this paper I articulate a view of doxastic control that helps defend the legitimacy of our practice of blaming people for their beliefs. I distinguish between three types of doxastic control: intention-based, reason-based, and influence-based. First I argue that, although we lack direct intention-based control over our beliefs, such control is not necessary for legitimate doxastic blame. Second, I suggest that we distinguish two types of reason-responsiveness: sensitivity to reasons and appreciation of reasons. I argue that while both capacities (...) are necessary for satisfying the control condition, neither is sufficient. Finally, I defend an influence-based view of doxastic control according to which we have the capacity to execute intentions to engage in reflection that causally influences our beliefs in positive epistemic ways. This capacity is both necessary and sufficient for satisfying the control condition for legitimate doxastic blame. I end by defending the view from two objections: that reflection is not necessary for meeting the control condition, and that it is not sufficient. (shrink)