There are currently two legally established criteria for death: the irreversible cessation of circulation and respiration and the irreversible cessation of neurologic function. Recently, there have been technological developments that could undermine the irreversibility requirement. In this paper, I focus both on whether death should be identified as an irreversible state and on the proper scope of irreversibility in the biological definition of death. In this paper, I tackle the distinction between the commonsense definition of death and the biological definition (...) of death to show that even the commonsense concept of death is specified by biological facts. Resting on this argument, I argue that any definition of death is a posteriori. Thus, irreversibility is part of any definition of death because the actual phenomenon of death is irreversible. In addition, I show that the proper domain of irreversibility in a definition of death is circumscribed by physical possibilities and that irreversibility in the definition of death refers to current possibilities for the reversal of relevant biological processes. I conclude that, despite recent technological advancements, death is still irreversible. (shrink)

Health care providers are expected both to relieve pain and to provide anticipatory guidance regarding how much a procedure is going to hurt. Fulfilling those expectations is complicated by the cognitive modulation of pain perception. Warning people to expect pain or setting expectations for pain relief not only influences their subjective experience, but it also alters how nociceptive stimuli are processed throughout the sensory and discriminative pathways in the brain. In light of this, I reconsider the characterization of placebo analgesia (...) as pharmacologically inert and the use of it as deceptive. I show that placebo analgesia exploits the same physical mechanisms as proven analgesics and argue that it should be utilized to relieve pain. Additionally, I describe factors to help identify situations in which clinicians have the obligation to disclose the potential for pain coupled with ways of mitigating the risk of high-intensity pain by setting positive expectations. (shrink)

Neuroethics is an emerging interdisciplinary field with unsettled boundaries. Many of the ethical issues within the purview of neuroethics could be described as resulting from the clash between the scientific perspective on concepts such as free will, personal identity, consciousness, etc., and the putatively commonsense conceptions of those terms. The assumption that undergirds the framing of the conflict between these two approaches is that advances in neuroscience, psychiatry, and psychology can be used to explain phenomena covered by commonsense concepts and (...) in some cases undermine them entirely. This book is focused on the examination of the particular relationship between developments in neuroscience and commonsense moral concepts. Common sense, I argue, has been misinterpreted as a static, either foundational or degenerative, basis of our morality, when it is an ever shifting repository of theories from many domains. Within this discussion, I focus on the application of neuroscience to human beings, i.e., the ethics of neuroscience. But I also cover issues within the purview of the neuroscience of ethics, and attempt to address the infiltration of neuroscientific knowledge into everyday parlance and the impact of that on our commonsense morality and psychology. (shrink)

To cause pain, it is not enough to deliver a dose of noxious stimulation. Pain requires the interaction of sensory processing, emotion, and cognition. In this paper, I focus on the role of cognition in the felt intensity of pain. I provide evidence for the cognitive modulation of pain. In particular, I show that attention and expectation can influence the experience of pain intensity. I also consider the mechanisms that underlie the cognitive effects on pain. I show that all the (...) proposed mechanisms of pain modulation affirm the view that cognition impacts the sensory and discriminative aspects of pain. I conclude that pain perception is a cognitively penetrated phenomenon. (shrink)

In 1959 two French neurologists, Pierre Mollaret and Maurice Goullon, coined the term coma dépassé to designate a state beyond coma. In this state, patients are not only permanently unconscious; they lack the endogenous drive to breathe, as well as brainstem reflexes, indicating that most of their brain has ceased to function. Although legally recognized in many countries as a criterion for death, brain death has not been universally accepted by bioethicists, by the medical community, or by the public. I (...) this paper, I defend brain death as a biological concept. I challenge two assumptions in the brain death literature that have shaped the debate and have stood in the way of an argument for brain death as biological. First, I challenge the dualism established in the debate between the body and the brain. Second, I contest the emphasis on consciousness, which prevents the inclusion of psychological phenomena into a biological criterion of death. I propose that the term organism should apply both to the functioning of the body and the brain. I argue that the cessation of the organism as a whole should take into account three elements of integrated function. Those three elements are: 1) the loss of integrated bodily function; 2) the loss of psychophysical integration required for processing of external stimuli and those required for behavior; and, 3) the loss of integrated psychological function, such as memory, learning, attention, and so forth. The loss of those three elements of integrated function is death. (shrink)

The web is being loaded daily with a huge volume of data, mainly unstructured textual data, which increases the need for information extraction and NLP systems significantly. Named-entity recognition task is a key step towards efficiently understanding text data and saving time and effort. Being a widely used language globally, English is taking over most of the research conducted in this field, especially in the biomedical domain. Unlike other languages, Arabic suffers from lack of resources. This work presents a BERT-based (...) model to identify biomedical named entities in the Arabic text data that investigates the effectiveness of pretraining a monolingual BERT model with a small-scale biomedical dataset on enhancing the model understanding of Arabic biomedical text. The model performance was compared with two state-of-the-art models, and it outperformed both models with 85% F1-score. (shrink)

Work purpose: to present and analyze pedagogical strategies and the communicational approach to definitions of bioethics, a mutual part of the bioethics contents being realized on the university studies of Dentistry, Organization, Planning and Management in Healthcare, and professional studies of Medical Radiology at the Medical School in Rijeka. Methods: the method of content analysis was used to research and present encyclopaedic and some authorial definitions of bioethics, with special emphasis on definitions of bioethics by authors – bioethicists from Croatia; (...) the method of pattern 1: included the curriculum of Medical Ethics and Bioethics and the Ethics of Healthcare, and researched standpoints of forty-five students educated in studies where bioethics courses are being realized. The pattern is specifically stratified because it: a) included students whose curriculum is being realized in shifts – intensive lectures in a duration of two weeks, and those whose lectures are being realized each week during one semester; b) different year of education . 2. The scale of assessment was used to research and obtain standpoints of students on the contents of the curriculum, methods of its performance, and the achieved level of communication among students and communication with the professor. Expected results: the presented method of work and results obtained by the scale of assessment should display the acceptability and successfulness of the presented pedagogicalmethodological means of work and point out to weaknesses and deficiencies, and finally conclude the extent to which the presented concept, and approaches to the actualization of the definitions of bioethics contribute to the realization of dialogue and communication in which students simultaneously experience the curriculum as necessary, useful, interesting, and one that may motivate them to think, exchange ideas and offer possible solutions. The scale of assessment should point out to different standpoints of students depending on the length of their study and commitment to a method of class realization. (shrink)

Because of its uncompromising categoricalness, death is a subject that often causes an anxiety in a person and thus burdens his entire life on the earth. Christianity is a religion that preaches a marry annunciation – euangelion – which is God’s redeeming intervention that saves man from being enslaved by sin and death. Even though the Christian eschatology is essentially directed towards the reappearance of the Christ at the end of days and thereby related last judgement, there are some differences (...) in the thought of individual Christian churches. These differences mostly appear in the concept of individual issues, related to the state of the deceased or his soul immediately after his death and in the interpretation of events, a person is subjected to until the last judgement. The protestant eschatology, significantly defined by the Luther’s doctrine of justification, categorically refuses the Catholic doctrine of purgatory, prayers for the dead (practiced by the Catholic and the Orthodox church) and any possibility of change in the state of the deceased. Since the Protestant church is pretty diverse, this paper shall focus on the Luther’s eschatological doctrine and thereby on the teaching of the Lutheran or Evangelical Church, which directly origins from the reformation and is most true to its founder’s teaching. (shrink)

Upon entering the examination room, Caitlyn encounters a woman sitting alone and in distress. Caitlyn introduces herself as the hospital ethicist and tells the woman, Mrs. Dennis, that her aim is to help her reach a decision about whether to perform an autopsy on her recently deceased husband. Mrs. Dennis begins the encounter by telling the ethicist that she has to decide quickly, but that she is very torn about what to do. Mrs. Dennis adds, “My sons disagree about the (...) autopsy.” As a standardized patient, a specialized actor, the woman playing Mrs. Dennis has already delivered the same opening lines several times to different learners practicing their clinical ethics consultation skills. An SP encounter is a simulated patient encounter used for educational purposes that requires the standardization of verbal and behavioral responses. In the encounter, the simulator, or “patient,” uses a scripted medical history to enable the learner to employ a certain skill, say, the ability to perform a neurological exam. The use of standardized patients in the evaluation of clinical skills has become a staple in medical education. To tackle the challenge of teaching clinical ethics consultation skills, we have incorporated SP encounters into the curriculum of the Bioethics Program of The Union Graduate College and the Icahn School of Medicine at Mount Sinai. SP encounters are incorporated into one of our onsite classes, the Onsite Clinical Ethics Practicum, and they are part of the capstone examination, which all of our graduates must complete successfully. The inclusion of simulated encounters into the curriculum is one way in which we equip our students with the core competencies specified by the American Society for Bioethics and Humanities Task Force for clinical ethicists. (shrink)

Endorsing the view that commonsense conceptions are shaped by scientific claims provides an explanation for why microbiota-gut-brain research might become incorporated into commonsense notions of health. But scientific claims also shape notions of personal identity, which accounts for why they can become entrenched in common sense even after they have been refuted by science.

Although there is substantial literature examining the flow of foreign investments into various regions of the world, there is still a lack of research about joint ventures and foreign investment activities in the Middle East and North Africa (MENA). One objective of this paper is to remedy this neglect and extend previous empirical work by focusing on foreign investments in the MENA region. The second objective is to focus on non-traditional determinants that have tended to be overlooked or underestimated in (...) previous research. The increasing globalization has led to a reconfiguration of the ways in which multinationals pursue various types of foreign investments,and changed the motives for and the determinants of FDI. This has prompted some to suggest that non traditional determinants have become more important. In view of that, the paper will focus on factors such as governance, legal environment, and economic freedom and examine their impact on foreign investment activities in the MENA region. (shrink)

The Myners Review of the pension fund industry has started a debate on pension fund governance and the fund industry itself. This paper provides a review of pension fund trusteeship in the UK, its role, operating models and impact. It argues that deficiencies in the systems uncovered by the Myners Review stem from a tension between conflicting philosophies - that of trusteeship built on stakeholder principles but operating in shareholder markets.

Recenze seznamuje s knihou Philosophy of Mind: An Introduction, jejímž autorem je Timothy John Bayne. Recenze je zaměřena na obsah jednotlivých kapitol a celkové zhodnocení knihy. Cílem je seznámit čtenáře s klíčovými tématy, jimž se Bayne v knize věnuje, a s jeho argumentací. Klíčová slova: filosofie mysli, Timothy John Bayne, Philosophy of Mind: An Introduction.

Unrepresented patients are individuals who lack decision makingcapacity and have no family or friends to make medical decisions for them. This population is growing in number in the United States, particularly within emergency and intensive care settings. While some bioethical discussion has taken place in response to the question of who ought to make decisions for these patients, the issue of how surrogate medical decisions ought to be made for this population remains unexplored. In this paper, we argue that standard (...) applications of surrogate decision making principles in health care are not well suited to many unrepresented patients with long-term mental health diagnosis. We argue that when applied to this population, the substituted judgment standard, designed to preserve patient preferences and values, may lead to the exclusion of their preferences. We argue further that the application of the best interest standard runs the risk of leading to harmful cases of overtreatment or undertreatment. We offer an alternative interpretation of the best interest principle that is better able to promote the well-being of unrepresented patients, especially for those who lack capacity because of mental disorders. This alternative is based on the practices and principles of harm reduction and includes three components: emphasis on considering the expressed preferences of unrepresented patients, a focus on reducing harm as well as the delivery of clinical benefits, and a recognition of the importance of promoting trust. (shrink)

Ziel der Arbeit: Die Autorin präsentiert und analysiert pädagogische Strategien sowie einen bei der Bioethikdefinierung zum Tragen kommenden Kommunikationsansatz, ferner die gemeinsamen bioethischen Inhalte, die innerhalb verschiedener Studiengänge an der Medizinischen Fakultät in Rijeka gelehrt werden . Methode: Die Methode der inhaltlichen Analyse wurde eingesetzt, um bestimmte enzyklopädische Bioethikdefinitionen sowie die Definitionen einzelner weiterer Autoren, insbesondere bioethischer Autoren aus Kroatien, darzulegen und zu untersuchen; die Exemplarische Methode wurde angewandt 1) auf die Curricula der Medizinischen Ethik, der Bioethik sowie der Ethik (...) der Gesundheitsfürsorge und schloss eine Umfrage unter 45 Studenten mit ein, die im Rahmen ihres Studiums bioethische Kollegs besuchten. Die Gruppe der Umfrageteilnehmer wies eine besondere Stratifizierung auf: a) Manche Studenten besuchten die Fakultät in Turnussen, die jeweils zweiwöchig mit intensiven Lehrveranstaltungen abgehalten wurden, andere wiederum hatten allwöchentliche Vorlesungen innerhalb eines Semesters; b) an der Umfrage nahmen Studenten verschiedener Jahrgänge teil . 2) Die Bewertungsskala wurde eingesetzt, um zu ermitteln, wie von den Studenten die Lehrinhalte, Unterrichtsmethoden und die Kommunikation zu Kommillitonen und Professoren eingeschätzt werden. (shrink)

Cet article spécifie la place du serment d’Hippocrate dans le programme bioéthique des établissements professionnels de formation du personnel médical. La conceptualisation du contenu présenté et la méthodologie décrite montrent comment les contenus du curriculum, dominés par des faits historiques, s’actualisent grâce à l’application des connaissances que les étudiants ont acquis précédemment, puis se problématisent grâce à la participation active des étudiants à la collecte de nouvelles informations relatives au contenu avant d’utiliser le savoir acquis pour résoudre concrètement un sujet (...) ou un problème bioéthique. La participation active des étudiants et des enseignants a pour but de montrer leur relation de collaboration ainsi qu’une communication dans laquelle les étudiants et les enseignants se partagent des tâches dans le cadre de la réalisation du curriculum. (shrink)

Loss of personal identity in dementia can raise a number of ethical considerations, including the applicability of advance directives and the validity of patient preferences that seem incongruous with a previous history of values. In this chapter, we first endorse the self-concept view as the most appropriate approach to personal continuity in healthcare. We briefly describe two different types of dementia, Alzheimer’s dementia (AD) and behavioral-variant frontotemporal dementia (bv-FTD). We identify elements considered important for the continuation of a self-concept, including (...) continuation of memories, consistency in personality traits and personal preferences, and continued endorsement of certain moral tenets. We show that, depending on which element is considered most important for personal identity, continuity of a self-concept for individuals with distinct types of dementia will be affected and assessed differently. Utilizing a variety of empirical evidence, we argue that persistence of memory, personality traits, and preferences are not the most important for the maintenance of personal identity. Instead, as studies aimed to capture the folk-psychological view of personal continuity demonstrate, judgements about continuity depend primarily on the persistent commitment to widely shared moral beliefs. Because of that, we argue that individuals with bv-FTD are more likely to lose their sense of self than individuals whose dementia primarily affects memory, such as Alzheimer’s disease. We end the chapter by showing how the importance of moral beliefs for continuity of self can be used to provide guidance to health-care professionals when considering changes in preference by individuals with dementia. (shrink)

Ovaj članak specificira mjesto Hipokratove zakletve u programu bioetičkog obrazovanja na profesionalnim fakultetima gdje se obrazuju budući medicinski i zdravstveni radnici. Predstavljena konceptualizacija sadržaja i opisana metodologija rada pokazuje kako se sadržaji curriculuma, kojima dominiraju povijesne činjenice, aktualiziraju uporabom znanja što su ih studenti usvojili ranije, te problematiziraju aktivnim uključenjem studenata u prikupljanju nove informacije relevantne za sadržaj, a onda koriste usvojeno znanje kako bi riješili konkretni bioetički predmet ili problem. Ponuđena aktivnost studenata i nastavnika ima svrhu pokazati suradnički odnos (...) između njih, te komunikaciju u kojoj studenti i nastavnici međusobno preuzimaju zadatke u realizaciji sadržaja curriculuma. (shrink)

On the fundamentals of Hindu philosophy and doctrines.

The use of brain technology that contributes to psychological changes has spurred a debate about personal identity. Some argue that neurotechnology does not undermine personal continuity (Levy, 2011) while others argue that it does (Kreitmair, 2019; Schechtman, 2010). To make these assessments, commentators fail to identify psychological changes that cause personal discontinuity. In this paper, I present a view that identifies personal continuity with the maintenance of a self-concept. I argue that a concept of self requires the ability to self-ascribe (...) physical and psychological features and that the diachronic self emerges with self-ascriptions of features that require endurance over time. I maintain that an adequate concept of self does not depend on the maintenance of any particular combination of self-ascriptions and that it can be maintained despite even significant changes in psychological or physical traits. Finally, I apply the self-concept view to identify changes that can result in discontinuity of self. (shrink)

More than 5 billion people in the world own a smartphone. More than half of these have been used to collect and process health-related data. As such, the existing volume of potentially exploitable health data is unprecedentedly large and growing rapidly. Mobile health applications (apps) on smartphones are some of the worst offenders and are increasingly being used for gathering and exchanging significant amounts of personal health data from the public. This data is often utilized for health research purposes and (...) for algorithm training. While there are advantages to utilizing this data for expanding health knowledge, there are associated risks for the users of these apps, such as privacy concerns and the protection of their data. Consequently, gaining a deeper comprehension of how apps collect and crowdsource data is crucial. To explore how apps are crowdsourcing data and to identify potential ethical, legal, and social issues (ELSI), we conducted an examination of the Apple App Store and the Google Play Store in North America and Europe to identify apps that could potentially gather health data through crowdsourcing. Subsequently, we analyzed their privacy policies, terms of use, and other related documentation to gain insights into the utilization of users’ data and the possibility of repurposing it for research or algorithm training purposes. More specifically, we reviewed privacy policies to identify clauses pertaining to the following key categories: research, data sharing, privacy/confidentiality, commercialization, and return of findings. Based on the results of these app search, we developed an App Atlas that presents apps which crowdsource data for research or algorithm training. We identified 46 apps available in the European and Canadian markets that either openly crowdsource health data for research or algorithm training or retain the legal or technical capability to do so. This app search showed an overall lack of consistency and transparency in privacy policies that poses challenges to user comprehensibility, trust, and informed consent. A significant proportion of applications presented contradictions or exhibited considerable ambiguity. For instance, the vast majority of privacy policies in the App Atlas contain ambiguous or contradictory language regarding the sharing of users’ data with third parties. This raises a number of ethico-legal concerns which will require further academic and policy attention to ensure a balance between protecting individual interests and maximizing the scientific utility of crowdsourced data. This article represents a key first step in better understanding these concerns and bringing attention to this important issue. (shrink)

This chapter will address the axiological objection to cognitive enhancement, which is that the use of cognitive enhancers reduces the value of cognitive achievement. In a recent defense of cognitive enhancement, Carter and Pritchard (2019) utilize the extended mind hypothesis to argue that cognitive enhancers do not compromise knowledge acquisition. In this chapter, it will be demonstrated that the reliance on the extended mind hypothesis leaves some cognitive enhancers vulnerable to the axiological objection. To expand the scope of the argument, (...) it will be shown that criteria for cognitive integration are applicable even to enhancers that cause changes to cognition internal to the human organism. This chapter will begin with a description of several cognitive enhancers and with the identification of the type of cognitive process they purportedly improve. It will then be demonstrated that even when those improvements are internal, they need not affect cognitive character and do not compromise cognitive agency. (shrink)

An illustrated study of the early twentieth-century transformation from Expressionism to Constructivism and beyond in the Central European arts. Central European Avant-Gardes presents the first interpretive overview of the complex webs of interaction among the artists and intellectuals of early twentieth-century Central Europe. The key stylistic transformation of the period was from Expressionism to Constructivism, as artists and writers, against a volatile background of war and revolution, saw the opportunity literally to construct a new world through their work. The borders (...) between the visual arts, photography, film, architecture, poetry, and typography were obliterated, as artists sought to transcend the forces of traditionalism to forge an elemental visual language that would overcome national and linguistic boundaries. Yet at the same time that these artists advocated pluralism and unity, their work engaged issues such as nationalism and tradition that still resonate in artistic circles today. The book, which accompanies a major exhibition organized by the Los Angeles County Museum of Art and curated by Timothy Benson, assisted by Monika Krol, is arranged around events and situations rather than by linear, art historical categories. It features hundreds of color plates and reproductions of documents; discussions of movements from Artificialism to Zenitism; essays on figures, publications, and exhibitions; and shorter "city views" of Belgrade, Berlin, Bucharest, Budapest, Cracow, Dessau, Ljubljana, £ódz, Poznañ, Prague, Vienna, Warsaw, Weimar, and Zagreb. (shrink)