Growing literature has linked attention bias variability to the experience and treatment of posttraumatic stress disorder. Unlike assessments of attention bias in only one direction, A...

In two experiments, participants solved anagram problems while their eye movements were monitored. Each problem consisted of a circular array of five letters: a scrambled four-letter solution word containing three consonants and one vowel, and an additional randomly-placed distractor consonant. Viewing times on the distractor consonant compared to the solution consonants provided an online measure of knowledge of the solution. Viewing times on the distractor consonant and the solution consonants were indistinguishable early in the trial. In contrast, several seconds prior (...) to the response, viewing times on the distractor consonant decreased in a gradual manner compared to viewing times on the solution consonants. Importantly, this pattern was obtained across both trials in which participants reported the subjective experience of insight and trials in which they did not. These findings are consistent with the availability of partial knowledge of the solution prior to such information being accessible to subjective phenomenal awareness. (shrink)

In the context of a new global order where the logic of the market reigns virtually unopposed, there is a need for thinking that might reinvigorate a progressive political project. This collection of essays brings together the work of a number of leading scholars who are concerned to construct a convincing basis for incisive criticism. These contributors represent such contemporary critical perspectives as egalitarian liberalism, socialism, poststructuralism, psychoanalysis, hermeneutics and critical theory.

Functional MRI shows promise as a candidate prognostication method in acutely comatose patients following severe brain injury. However, further research is needed before this technique becomes appropriate for clinical practice. Drawing on a clinical case, we investigate the process of obtaining informed consent for this kind of research and identify four ethical issues. After describing each issue, we propose potential solutions which would make a patient’s participation in research compatible with her rights and interests. First, we defend the need for (...) traditional proxy consent against two alternative approaches. Second, we examine the impact of the intensive care unit environment on the informed consent process. Third, we discuss the therapeutic misconception and its potential influence on informed consent. Finally, we deal with issues of timing in recruiting participants and related factors which may affect the risks of participation. (shrink)

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

Until the advent of plastinated cadavers, few outside the medical professions have had firsthand experience with human corpses. Such opportunities are now available at the Body Worlds exhibits of Gunther von Hagens. After an overview of these exhibits, we explore visitor responses as revealed in comment books available upon exiting the exhibit. Cultural, philosophical, and religious issues raised in the comments serve as a microcosm of society at large. The conclusion considers the challenge of such exhibits in introducing the public (...) to science education, notes the image of the body as machine—so prevalent in the West—reflected in visitor comments, and finds hope that the exhibits promote, for many visitors, a sense of community among all humankind. (shrink)

Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

Philip Reed argues that laws that grant people access to euthanasia on the basis of terminal illness are discriminatory. In support of this claim, he offers an argument by analogy: it would be discriminatory to offer a person access to euthanasia because they are women or because they are disabled, as such restricted access would send the message ‘that life as a woman or as a disabled person is (very often) not worth living’.1 And so it must also be discriminatory (...) to offer people access to euthanasia because they are terminally ill. Arguments by analogies are only as good as the analogies on which they are built. Having a terminal illness, I’m going to suggest, is not relevantly similar enough to either being disabled or being a member of an oppressed social group to make Reed’s claim compelling. Let’s explore each branch of the analogy in turn. Why think that terminal illness is relevantly unlike disability, in a way that makes offering access to euthanasia in the latter case discriminatory, but not the former? For one thing, terminal illness is necessarily time-limited. When my father was dying, he found himself in constant …. (shrink)

There has been some concern m recent years that economic interests in the biotechnology area could, particularly through patenting, have a constricting influence on scientific research. Despite this concern, there have been no studies of this phenomenon beyond isolated cases. In this article we examine the evolution of the biomedical field of hybridoma/monoclonal antibody research with detailed examples of the three types of patent claims that have emerged there—basic claims, claims on application techniques, and claims on specific antibodies. We analyze (...) the impact of these claims and their legal histories on the free flow of scientific information and, the activity of scientific researchers. We conclude that such patent claims present severe restrictions for both, not only in the monoclonal area but in general, amounting to a subtle but significant shift in the political economy of science and technology. (shrink)