The 2006 Centers for Disease Control and Prevention (CDC) revised recommendations for HIV testing in clinical settings contained seven specific changes to how health care facilities should provide HIV testing. These seven elements have been both supported and challenged in the lay and medical literature. Our first paper in BMC Medical Ethics presented an analysis of the three HIV testing procedural changes included in the recommendations. In this paper, we address the four remaining elements that concern HIV screening policy changes: (...) (1) nontargeted HIV screening, (2) making HIV screening similar to screening for other treatable conditions, (3) increasing HIV screening without assured additional funding for linkage to care, and (4) making patients bear the costs of increased HIV screening in health care settings. (shrink)

Human moral judgement may have evolved to maximize the individual's welfare given parochial culturally constructed moral systems. If so, then moral condemnation should be more severe when transgressions are recent and local, and should be sensitive to the pronouncements of authority figures (who are often arbiters of moral norms), as the fitness pay-offs of moral disapproval will primarily derive from the ramifications of condemning actions that occur within the immediate social arena. Correspondingly, moral transgressions should be viewed as less objectionable (...) if they occur in other places or times, or if local authorities deem them acceptable. These predictions contrast markedly with those derived from prevailing non-evolutionary perspectives on moral judgement. Both classes of theories predict purportedly species-typical patterns, yet to our knowledge, no study to date has investigated moral judgement across a diverse set of societies, including a range of small-scale communities that differ substantially from large highly urbanized nations. We tested these predictions in five small-scale societies and two large-scale societies, finding substantial evidence of moral parochialism and contextual contingency in adults' moral judgements. Results reveal an overarching pattern in which moral condemnation reflects a concern with immediate local considerations, a pattern consistent with a variety of evolutionary accounts of moral judgement. (shrink)

Intent and mitigating circumstances play a central role in moral and legal assessments in large-scale industrialized societies. Al- though these features of moral assessment are widely assumed to be universal, to date, they have only been studied in a narrow range of societies. We show that there is substantial cross-cultural variation among eight traditional small-scale societies (ranging from hunter-gatherer to pastoralist to horticulturalist) and two Western societies (one urban, one rural) in the extent to which intent and mitigating circumstances influence (...) moral judgments. Although participants in all societies took such factors into account to some degree, they did so to very different extents, varying in both the types of considerations taken into account and the types of violations to which such considerations were applied. The particular patterns of assessment characteristic of large-scale industrialized societies may thus reflect relatively recently culturally evolved norms rather than inherent features of human moral judgment. (shrink)

Recently, many critics have argued that disgust is a morally harmful emotion, and that it should play no role in our moral and legal reasoning. Here we defend disgust as a morally beneficial moral capacity. We believe that a variety of liberal norms have been inappropriately imported into both moral psychology and ethical studies of disgust: disgust has been associated with conservative authors, values, value systems, and modes of moral reasoning that are seen as inferior to the values and moral (...) emotions that are endorsed by liberal critics. Here we argue that the meta-ethical assumptions employed by the critics of disgust are highly contentious and in some cases culture bound. Given this, we should avoid adopting simplified meta-ethical positions in experimental moral psychology, as these can skew the design and interpretation of experiments, and blind us to the potential value of moral disgust harnessed in the service of liberal ends. (shrink)

The Treatment Escalation Plan (TEP) was introduced into our trust in an attempt to improve patient involvement and experience of their treatment in hospital and to embrace and clarify a wider remit of treatment options than the Do Not Resuscitate (DNR) order currently offers. Our experience suggests that the patient and family are rarely engaged in DNR discussions. This is acutely relevant considering that the Mental Capacity Act (MCA) now obliges these discussions to take place. The TEP is a form (...) that the doctor completes, ideally with the competent patient or close relative, documenting what treatment options would be appropriate if that patient were to become acutely unwell. Ventilation of the lungs, cardiac resuscitation, renal replacement therapy, intravenous fluids and antibiotics are all discussed. The study evaluated patient and relative experiences with the TEP. 55 patients or their relatives were interviewed regarding their experience of the TEP and thoughts regarding the process. 96% of patients and relatives evaluated thought that the TEP was a good idea. Free text comments were all positive and only 34% of patients claimed to feel anxious when completing the form. Following this study, the TEP has been expanded hospital wide and into the community within our trust. Discussions are currently taking place in hospitals within our region to introduce the TEP form into other local trusts. (shrink)

Previous studies have shown that children retreat from argument‐structure overgeneralization errors (e.g., *Don’t giggle me) by inferring that frequently encountered verbs are unlikely to be grammatical in unattested constructions, and by making use of syntax‐semantics correspondences (e.g., verbs denoting internally caused actions such as giggling cannot normally be used causatively). The present study tested a new account based on a unitary learning mechanism that combines both of these processes. Seventy‐two participants (ages 5–6, 9–10, and adults) rated overgeneralization errors with higher (...) (*The funny man’s joke giggled Bart) and lower (*The funny man giggled Bart) degrees of direct external causation. The errors with more‐direct causation were rated as less unacceptable than those with less‐direct causation. This finding is consistent with the new account, under which children acquire—in an incremental and probabilistic fashion—the meaning of particular constructions (e.g., transitive causative = direct external causation) and particular verbs, rejecting generalizations where the incompatibility between the two is too great. (shrink)

In response to comments on my book, Being Realistic about Reasons, by Justin Clarke-Doane, David Enoch and Tristram McPherson, and Gideon Rosen, I try to clarify my domain-based view of ontology, my understanding of the epistemology of normative judgments, and my interpretation of the phenomenon of supervenience.

High-spin states have been studied in Pr-135(59), populated through the Cd-116(Na-23,4n) reaction at 115 MeV, using the Gammasphere gamma-ray spectrometer. The negative-parity yrast band has been significantly extended to spin similar to 45 (h) over bar and excitation energy 21.5 MeV, showing evidence for several rotational alignments. The positive-parity yrast band of Ce-135(58), populated through the p4n channel of this reaction, was also populated to spin similar to 38 (h) over bar and excitation energy 18 MeV. Cranking calculations indicate that (...) these nuclei are soft with respect to the triaxiality parameter gamma and that several competing nuclear shapes occur at high spin. (shrink)

Medium- and high-spin states of Pr-134 were populated using the Cd-116(Na-23, 5n) reaction and studied with the GAMMASPHERE spectrometer. Several new bands have been found in this nucleus, one of them being linked to the previously observed chiral-candidate twin-band structure. The ground state of Pr-134 could be determined through establishing a level structure that connects the two previously known long-lived isomeric states. Unambiguous spin-parity assignments for the excited states could be performed based on the known 2(-) spin-parity of the ground (...) state combined with the present experimental data. Intrinsic single-particle configurations have been assigned to the newly observed bands on the basis of the measured B(M1)/B(E2) ratios, alignments, band-crossing frequencies, bandhead spins, the observed single-particle configurations in the neighboring nuclei, and taking into account the predictions of total Routhian surface and tilted-axis cranking calculations. (shrink)

C. i., p. 2, 12 dicit Peliae regi se eo uelle ire si uires sociique non deessent. Pelias … Argum … iussit … nauim aedificaret.Considering the next sentence read perhaps n a u e s for uires.C. ii., p. 3, 25. Graeci aduentare nauibus. mittit ad portam.M reads nauibus uti. May this conceal e t i t a ? cf. p. II , 2. For change of tense cf. opening lines of C. iii.

Eddington, A. The decline of determinism.--Heisenberg, W. and others. Dialogue concerning science and philosophical positions.--Sinnott, E. Biology and freedom.--Nuttin, J. The unconscious and freedom.--Nagel, E. Determinism in history.--Ayer, A. J. Freedom and necessity.--Campbell, C. A. Philosophical defence of freedom.--Hare, R. M. Freedom and reason.--Dewey, J. Freedom as a problem.--Sartre, J.-P. Freedom and total responsibility.--Camus, A. Freedom and rebellion.--Rand, A. Freedom and individualism.--Thévenaz, P. Freedom and action.--Luijpen, W. A. Phenomenology of freedom.--Teilhard de Chardin, P. Cosmic freedom.--Jaspers, K. Freedom and society.--Macmurray, J. (...) Freedom in the personal nexus.--Brunner, A. Incarnation of freedom.--Ricoeur, P. Freedom as human creativity.--Finance, J. de. Freedom and existence.--Bibliography (p. 243-251). (shrink)

In this paper we argue that predictive processing (PP) theory cannot account for the phenomenon of affect-biased attention prioritized attention to stimuli that are affectively salient because of their associations with reward or punishment. Specifically, the PP hypothesis that selective attention can be analyzed in terms of the optimization of precision expectations cannot accommodate affect-biased attention; affectively salient stimuli can capture our attention even when precision expectations are low. We review the prospects of three recent attempts to accommodate affect with (...) tools internal to PP theory: Miller and Clark’s (2018) embodied inference; Seth’s (2013) interoceptive inference; and Joffily and Coricelli’s (2013) rate of change of free energy. In each case we argue that the account does not resolve the challenge from affect-biased attention. For this reason, we conclude that prediction error minimization is not sufficient to explain all mental phenomena, contrary to the claim that the PP framework provides a unified theory of all mental phenomena or the brain ‘s cognitive functioning. Nevertheless, we suggest that empirical investigation of the interaction between affective salience and precision expectations should prove helpful in understanding the limits of PP theory, and may provide new directions for the application of a Bayesian perspective to perception. (shrink)

High-spin states in the odd-odd N = Z nucleus Co-54 have been investigated by the fusion-evaporation reaction Si-28(S-32,1 alpha 1p1n)Co-54. Gamma-ray information gathered with the Ge detector array Gammasphere was correlated with evaporated particles detected in the charged particle detector system Microball and a 1 pi neutron detector array. A significantly extended excitation scheme of Co-54 is presented, which includes a candidate for the isospin T = 1, 6(+) state of the 1f(7/2)(-2) multiplet. The results are compared to large-scale shell-model (...) calculations in the fp shell. Effective interactions with and without isospin-breaking terms have been used to probe isospin symmetry and isospin mixing. A quest for deformed high-spin rotational cascades proved negative. This feature is discussed by means of cranking calculations. (shrink)

A Greek English Lexicon of the New Testament, being Grimm's Wilke's Clavis Novi Testamenti. Translated, Revised and Enlarged by Joseph Henry Thayer, D.D., Bussey Professor of New Testament Criticism and Interpretation in the Divinity School of Harvard University. Edinburgh, T. and T. Clark. 1886. 4to. pp. 726. 36s.Biblico Theological Lexicon to New Testament Greek. by Hermann Cremer, D.D., Professor of Theology in the University of Greifswald. Third English Edition. With Supplement. Translated from the latest German Edition by William Uewick, (...) M.A. Edinburgh, T. and T. Clark. 1886. 4to. pp. 943. 38s. (shrink)

This paper defends a minimal desert thesis, according to which someone who is blameworthy for something deserves to feel guilty, to the right extent, at the right time, because of her culpability. The sentiment or emotion of guilt includes a thought that one is blameworthy for something as well as an unpleasant affect. Feeling guilty is not a matter of inflicting suffering on oneself, and it need not involve any thought that one deserves to suffer. The desert of a feeling (...) of guilt is a kind of moral propriety of that response, and it is a matter of justice. If the minimal desert thesis is correct, then it is in some respect good that one who is blameworthy feel guilty—there is some justice in that state of affairs. But if retributivism concerns the justification of punishment, the minimal desert thesis is not retributivist. Its plausibility nevertheless raises doubt about whether, as some have argued, there are senses of moral responsibility that are not desert-entailing. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Arrows of Apollo BROOKE CLARK To Aachchi If thou beest he; But O how fallen, how changed From him who in the happy realms of light Clothed with transcendent brightness didst outshine Myriads though bright— —Milton, Paradise Lost i. Today, slumped at my desk, I glimpsed the sun. I wasn’t certain how long I had sat facing my own face’s dim reflection in my computer screen—chin ringed (...) with fat, the sharp-lined contours of my youth long gone, my cheekbones hidden, my bright gaze gone flat— and then—there—on the left side of my face a glow my slightest movement would erase. How that stippling brought me back to life: I felt like I was walking once again through woods where sunlight touched the trees in leaf. I felt warmth prickle up beneath my skin as though the flesh responded to the brief caress of light which brought hope rushing in, as though Apollo had reached down and laid his brilliant fingertips on what he’d made. A sharp, metallic rattle cut the air; Helen had stood up to close the blinds— Helen, too devoid of soul to care that some of us might greet the sun as friends. Her only comment was, “Jeez, what a glare!” arion 27.2 fall 2019 Sweet moments often come to such harsh ends: some people are too coarse for fragile joys, and spoil light with darkness, peace with noise. Helen was such a woman: lumpy, heavy, seemingly formed exclusively of fat, barely mobile yet constantly sweaty, like some malevolent Buddha, she sat and meditated acts of petty cruelty; each time she closed the blinds I heard, “Take that!” in their harsh snap, and felt as if she knew I longed for light, so wouldn’t let it through. Another bitter, desk-bound endomorph (although she would have seemed an Aphrodite to those who carved the Venus of Willendorf), and fated by her own obesity to be struck down and swiftly carried off by a sudden, massive coronary, in line at some all-you-can-eat buffet— she wasn’t worth my notice anyway, although she kept impinging on my sight, but then I caught the slight trace of a smirk when I turned back towards the vanished light (instead of going quietly back to work) and said, “The blinds were fine—it’s not too bright for me—without a window, it feels dark.” Helen snorted: “No thanks—too hot out there. I’m roastin’ like a turkey over here.” Who would not hate the court from which there lies no avenue or hope for an appeal? Her desk was on the coveted window side while mine sat boxed against an inside wall, and that gave Helen power over blinds and sunlight—that was office protocol. 64 the arrows of apollo I longed to feel Apollo’s fingertips but this slug-goddess ruled in grim eclipse. I felt like Milton’s Satan when he fell, plumbing so great a depth from such a height and measuring the lowest pits of Hell, prostrate, near dead—I sat, deprived of light, walled in by my grey-sided cubicle, and sank beneath my own despair’s dead weight. But why should Helen have the power to plunge me into darkness? I deserved revenge— revenge for all the time I’d wasted here, revenge for every hope that slowly died, revenge for every minute of every year, revenge for every bold attempt untried, revenge for every lonely, bitter tear I’d swallowed, choked back, or held in, uncried. Helen became, in that one poisoned moment, the symbol and the source of all my torment. Brooke Clark 65 ii. Boredom was my soul mate; the days slid by unused and empty; I sat and watched them go, hardly recalling that once even I had clung to aspirations—but it was so uncomfortably easy to let them die. I’d turned into a man I didn’t know: in youth, I’d never compromise or settle— so it seemed now—but memory gilds the nettle. Instead of working, I listened to the flies that mobbed the windows, struggling to get out; freedom stretched away... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Participation and Immersion in Walton and CalvinoM. Carleton SimpsonThe novel begins in a railway station, a locomotive huffs, steam from a piston covers the opening of the chapter, a cloud of smoke hides part of the first paragraph... The pages of the book are clouded like the windows of an old train, the cloud of smoke rests on the sentences.1Part of Kendall Walton's theory of psychological participation, explicated in (...) Mimesis as Make-Believe, is that representations that display or draw attention to their fictionality discourage participation; part of our enjoyment of representational art is our psychological participation with the representation. The activity of participating comprises the game world, while the material representation comprises the work world. We play games of make-believe with representations, much as children play games with toys or other props. For Walton, the fullest psychological participation arises from the fullest immersion in the game world. Immersion means ignoring or being unaware of the materiality of the work world, attending only to the fictional reality of the work world. It is to "look past" the painted surface, or to become engrossed in the novel's narrative.To the extent that we consider the material of the work, we are distracted from participating in the game prescribed by the work: we do either the one or the other. So, Walton claims "One obvious way in which works sometimes discourage participation is by prominently declaring or displaying their fictionality, betraying their own pretense" (p. 275).2 For example, "The conspicuous brush strokes of Van Gogh's Starry Night call attention to themselves and to their record of the process by which paint was applied to the canvas, possibly intruding on the viewer's participation in his game... One can ignore the brush [End Page 321] strokes enough to lose oneself in the fictional world" (p. 277). In response to prodding by Patrick Maynard, Walton tempers this position: "Prominent brush strokes, as in many of Vincent van Gogh's paintings, can have an inhibiting effect, especially if the observer isn't used to such. Then they not only constitute a plain indication that what one is seeing is a mere painted canvas, but force this fact on the viewer's attention" (italics added).3Ernst Gombrich endorsed this position in Art and Illusion, attributing it to Kenneth Clark.4 Gombrich tells of Clark attempting to see both the brush strokes and the representation, and his failure to "observe what went on when the brush strokes and dabs of pigment on the canvas transformed themselves into a vision of transfigured reality as he stepped back" (p. 6). Walton intends his theory of psychological participation to be widely applicable to the representational arts; he argues that what holds for visual representations holds also for verbal representations. When reading a novel our ability to participate in the story is diminished to the extent the novel draws attention to its fictionality. We either immerse ourselves in the fictional world of the novel or attend to the historical production or materiality of the novel.Attending is contained in Walton's notion of appreciation. Appreciation without participation results when some representations "positively discourage participation, especially the psychological participation that would constitute the experience of being caught up in the story" (p. 274). Works like these employ a variety of strategies, "deliberately 'distancing' the appreciator from the fictional world... For if one does not imagine a proposition, it is unlikely to be fictional that one knows or believes it; and if one imagines it with minimal vivacity, one is unlikely to have the experience of fictionally being concerned or upset or relieved or frightened or overjoyed by the fact that it is true" (p. 274). Just as children imagine themselves to be participants in games of make-believe, more mature imaginings require us to imagine we are participants, not simply observers. Reflexive imagining is central to Walton's theory, and is a point he extensively develops.I argue against this disjunction of activities. My thesis is that participation need not arise from immersion at the expense of awareness. I am also critical of Walton's distinction between appreciation and participation—they are... (shrink)

A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with (...) sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness. (shrink)

ABSTRACT Twenty years ago Leif Lewin made the case that altruistic motives are more common than selfish motives among voters, politicians, and bureaucrats. We propose that motives and beliefs emerge as reactions to immediate feedback from technical-causal, material-economic, and moral-social aspects of the political task environment. In the absence of certain kinds of technical-causal and material-economic feedback, moral-social feedback leads individuals to the altruism Lewin documents, but also to righteousness (moralized regard for the in-group and disregard for the out-group) and (...) myopia (disregard for distant consequences). The mix of altruism, righteousness, and myopia increases the focus on winning the next high-stakes election rather than on discovering or enforcing socially productive institutions. (shrink)

Twenty years ago Leif Lewin made the case that altruistic motives are more common than selfish motives among voters, politicians, and bureaucrats. We propose that motives and beliefs emerge as reactions to immediate feedback from technical-causal, material-economic, and moral-social aspects of the political task environment. In the absence of certain kinds of technical-causal and material-economic feedback, moral-social feedback leads individuals to the altruism Lewin documents, but also to righteousness (moralized regard for the in-group and disregard for the out-group) and myopia (...) (disregard for distant consequences). The mix of altruism, righteousness, and myopia increases the focus on winning the next high-stakes election rather than on discovering or enforcing socially productive institutions. (shrink)