Many children in the USA are prescribed psychotropic drugs that have not been fully investigated in paediatric clinical trials. The common practice of prescribing psychotropic drugs off-label poses unknown and potentially serious short- and long-term consequences for these children. This paper briefly reviews the factors associated with the lack of paediatric clinical trials. We advocate a shift toward increasing paediatric trials with psychotropic drugs through a combination of adequate safety controls, additional reimbursement/compensation, a more organised and large-scale effort to collate (...) results and outcomes across researchers and studies and additional public education about the importance of this research. In addition, we encourage the re-examination of the ethical standards for children's participation in phase 1 clinical trials as well as argue for longitudinal developmental studies on children who are prescribed off-label psychotropic drugs. (shrink)

The Nuffield Council on Bioethics (NCOB) is delighted to pick up the mantel of the Ethics briefings. For readers less familiar with the NCOB’s work, we are a leading independent policy and research centre, and the foremost bioethics body in the UK. We identify, analyse and advise on ethical issues in biomedicine and health so that decisions in these areas benefit people and society.1 Established in 1991, the NCOB has tackled a wide range of bioethics and medical ethics issues over (...) its thirty-two years, including issues relating to the beginning and end of life, health and society, data and technology, and research ethics. Early reports in the 1990s included, for example, ‘Genetics screening: the ethical issues’ and ‘Animal-to-human transplants: the ethics of Xenotransplantation’. More recent projects include setting out an ethical framework in the report ‘The future of ageing: ethical considerations for research and innovation’2 and a current joint project with the Ada Lovelace Institute3 considering the potential ethical implications of the convergence of AI and genomics technologies.4 In recent years, NCOB has increasingly focused on horizon scanning. What current and future national and international developments are likely to raise ethical issues in the short, medium and long-term? Insights for 2023 will soon be available at www.nuffieldbioethics.org/what-we-do/horizon-scanning, with new developments likely to be included alongside ongoing areas of medical and scientific research that we are tracking progress in, for example, in vitro derived gametes, surrogacy, biosafety and novel neurotechnologies. Disagreements between parents and healthcare teams about …. (shrink)

In recent years researchers have begun to investigate how the perceptual, motor and cognitive activities of two or more individuals become organized into coordinated action. In the first part of this introduction we identify three common threads among the ten papers of this special issue that exemplify this new line of research. First, all of the papers are grounded in the experimental study of online interactions between two or more individuals. Second, albeit at different levels of analysis, the contributions focus (...) on the mechanisms supporting joint action. Third, many of the papers investigate empirically the pre‐requisites for the highly sophisticated forms of joint action that are typical of humans. In the second part of the introduction, we summarize each of the papers, highlighting more specific connections among them. (shrink)

This article combines a philosophical critique of the idea that public health nurses are primary technicians who neutrally hand over scientifically established facts on risks to the public and an empirical analysis of the actual work of public health nurses. It is argued that the relationship between facts and values in public health is complex and that, despite the introduction of several scientifically-based standards and guidelines, public health nurses are not technicians. They do moral work and experience ethical dilemmas. To (...) get a grip on the specific character of this moral work, we distance ourselves from the idea that there are ethical dilemmas in public health nursing for which we can provide general ethical rules and principles. Instead we suggest a contextual ethical approach, in which several different kinds of consideration may be important. To illustrate this, we analysed 15 in-depth interviews with nurses involved in the prevention of cot deaths in the Netherlands. It is shown that these nurses do not neutrally pass on the epidemiological facts on the risks of prone sleeping, warm bedclothes and passive smoking, but they are the moral architects of this preventive practice. It is also shown that this moral work and the ethical dilemmas they experience cannot be characterized in terms of general ethical rules and principles. It becomes clear that the moral work of nurses differs according to the three main risks at stake: the balance between virtue, risk taking and responsibility depends on the specific context. (shrink)

It is widely accepted that public discourse as we know it is less than ideal from an epistemological point of view. In this paper, we develop an underappreciated aspect of the trouble with public discourse: what we call the Listening Problem. The listening problem is the problem that public discourse has in giving appropriate uptake and reception to ideas and concepts from oppressed groups. Drawing on the work of Jürgen Habermas and Nancy Fraser, we develop an institutional response to the (...) listening problem: the establishment of what we call Receptive Publics, discursive spaces designed to improve listening skills and to give space for counterhegemonic ideas. (shrink)

We explore the idea that a group or ‘team’ of individuals can be an agent in its own right and that, when this is the case, individual team members use team reasoning, a distinctive mode of reasoning from that of standard decision theory. Our approach is to represent team reasoning explicitly, by means of schemata of practical reasoning in which conclusions about what actions should be taken are inferred from premises about the decision environment and about what agents are seeking (...) to achieve. We use this theoretical framework to compare team reasoning with the individual reasoning of standard decision theory, and to compare various theories of team agency and collective intentionality. (shrink)

This volume offers perspectives on the theme of surprise crossing philosophical, phenomenological, scientific, psycho-physiology, psychiatric, and linguistic boundaries. The main question it examines is whether surprise is an emotion. It uses two main theoretical frameworks to do so: psychology, in which surprise is commonly considered a primary emotion, and philosophy, in which surprise is related to passions as opposed to reason. The book explores whether these views on surprise are satisfying or sufficient. It looks at the extent to which surprise (...) is also a cognitive phenomenon and primitively embedded in language, and the way in which surprise is connected to personhood, the interpersonal, and moral emotions. Many philosophers of different traditions, a number of experimental studies conducted over the last decades, recent works in linguistics, and ancestral wisdom testimonies refer to surprise as a crucial experience of both rupture and openness in bodily and inner life. However, surprise is a theme that has not been dealt with directly and systematically in philosophy, in the sciences, in linguistics, or in spiritual traditions. This volume accomplishes just that. (shrink)

BackgroundDeep brain stimulation is approved for treating refractory obsessive-compulsive disorder in adults under the US Food and Drug Administration Humanitarian Device Exemption, and studies hav...

BackgroundConsent for data research in acute and critical care is complex as patients become at least temporarily incapacitated or die. Existing guidelines and regulations in the European Union are of limited help and there is a lack of literature about the use of data from this vulnerable group. To aid the creation of a patient-centred framework for responsible data research in the acute setting, we explored views of patients and next-of-kin about the collection, storage, sharing and use of genetic and (...) health-related data for observational research.MethodsWe conducted qualitative interviews (n = 19) with Dutch sudden cardiac arrest survivors who donated clinical and socio-economic data and genetic samples to research. We also interviewed their next-of-kin. Topics were informed by ethics literature and we used scenario-sketches to aid discussion of complex issues.ResultsSudden cardiac arrest survivors displayed limited awareness of their involvement in health data research and of the content of their given consent. We found that preferences regarding disclosure of clinically actionable genetic findings could change over time. When data collection and use were limited to the medical realm, patients trusted researchers to handle data responsibly without concern for privacy or other risks. There was no consensus as to whether deferred consent should be explicitly asked from survivors. If consent is asked, this would ideally be done a few months after the event when cognitive capacities have been regained. Views were divided about the need to obtain proxy consent for research with deceased patients’ data. However, there was general support for the disclosure of potentially relevant post-mortem genetic findings to relatives.ConclusionsSudden cardiac arrest patients’ donation of data for research was grounded in trust in medicine overall, blurring the boundary between research and care. Our findings also highlight questions about the acceptability of a one-time consent and about responsibilities of patients, researchers and ethics committees. Finally, further normative investigation is needed regarding the (continued) use of participants’ data after death, which is of particular importance in this setting. Our findings are thought to be of relevance for other acute and life-threatening illnesses as well. (shrink)

Successful communication is important for both society and people’s personal life. Here we show that people can improve their communication skills by interacting with multiple others, and that this improvement seems to come about by a greater tendency to take the addressee’s perspective when there are multiple partners. In Experiment 1, during a training phase, participants described figures to a new partner in each round or to the same partner in all rounds. Then all participants interacted with a new partner (...) and their recordings from that round were presented to naïve listeners. Participants who had interacted with multiple partners during training were better understood. This occurred despite the fact that the partners had not provided the participants with any input other than feedback on comprehension during the interaction. In Experiment 2, participants were asked to provide descriptions to a different future participant in each round or to the same future participant in all rounds. Next they performed a surprise memory test designed to tap memory for global details, in line with the addressee’s perspective. Those who had provided descriptions for multiple future participants performed better. These results indicate that people can improve their communication skills by interacting with multiple people, and that this advantage might be due to a greater tendency to take the addressee’s perspective in such cases. Our findings thus show how the social environment can influence our communication skills by shaping our own behavior during interaction in a manner that promotes the development of our communication skills. (shrink)

We develop an approach to automatically identify the most probable multiword constructions used in children’s utterances, given syntactically annotated utterances from the Brown corpus of CHILDES. The found constructions cover many interesting linguistic phenomena from the language acquisition literature and show a progression from very concrete toward abstract constructions. We show quantitatively that for all children of the Brown corpus grammatical abstraction, defined as the relative number of variable slots in the productive units of their grammar, increases globally with age.

Language experience clearly affects the perception of speech, but little is known about whether these differences in perception extend to non-speech sounds. In this study, we investigated rhythmic perception of non-linguistic sounds in speakers of French and German using a grouping task, in which complexity was manipulated. In this task, participants grouped sequences of auditory chimeras formed from musical instruments. These chimeras mimic the complexity of speech without being speech. We found that, while showing the same overall grouping preferences, the (...) German speakers showed stronger biases than the French speakers in grouping complex sequences. Sound variability reduced all participants’ biases, resulting in the French group showing no grouping preference for the most variable sequences, though this reduction was attenuated by musical experience. In sum, this study demonstrates that linguistic experience, musical experience, and complexity affect rhythmic grouping of non-linguistic sounds and suggests that experience with acoustic cues in a meaningful context is necessary for developing a robust grouping preference that survives acoustic variability. (shrink)

Background: Fetal alcohol spectrum disorder (FASD), a complex diagnosis that includes a wide range of neurodevelopmental disabilities, results from exposure to alcohol in the womb. FASD remains poorly understood by Canadians, which could contribute to reported stigma faced by both people with FASD and women who drink alcohol while pregnant. Methods: To better understand how information about FASD is presented in the public sphere, we conducted content analysis of 286 articles from ten major English-language Canadian newspapers (2002-2015). We used inductive (...) coding to derive a coding guide from the data, and then iteratively applied identified codes back onto the sample, checking inter-coder reliability. Results: We identified six major themes related to clinical and scientific media content: 1) prevalence of FASD and of women’s alcohol consumption; 2) research related to FASD; 3) diagnosis of FASD; 4) treatment of FASD and maternal substance abuse; 5) primary disabilities associated with FASD; and 6) effects of alcohol exposure during pregnancy. Discussion: Across these six themes, we discuss three instances of ethically consequential exaggeration and misrepresentation: 1) exaggeration about FASD rates in Indigenous communities; 2) contradiction between articles about the effects of prenatal alcohol exposure; and 3) scientifically accurate information that neglects the social context of alcohol use and abuse by women. Respectively, these representations could lead to harmful stereotyped beliefs about Indigenous peoples, might generate confusion about healthy choices during pregnancy, and may unhelpfully inflame debates about sensitive issues surrounding women’s choices. (shrink)

Conflict framing is key in political communication. Politicians use conflict framing in their online messages (e.g., criticizing other politicians) and journalists in their political coverage (e.g., reporting on political tensions). Conflicts can take a variety of forms and can provoke different reactions. However, the literature still lacks a systematic and theoretically-grounded conceptual framework that accounts for the multi-dimensionality of political conflict frames. Based on literature from political epistemology, political communication, and related fields such as psychology, we present four conceptual dimensions (...) of political conflicts: (1) the style (civil/uncivil); (2) the subject (personal/substantive); (3) whether it is about underlying moral/epistemic principles or not (deep/superficial conflict); and (4) whether it concerns a normative or factual issue. Results of a content analysis of newspaper articles and politicians’ tweets confirm the usage of these conflict dimensions in the Netherlands during a non-election period. Interestingly, most of the conflicts are civil, substantive, and do not highlight deep fundamental clashes. In light of the current societal concerns about the lack of respect in political debates and the deepening of our political divides, these findings can be considered encouraging. (shrink)

International media have reported cases of pregnant women who have had their children apprehended by social services, or who were incarcerated or forced into treatment programs based on a history of substance use or lack of adherence to addiction treatment programs. Public discourse on the biology of addiction has been criticized for generating stigma and a diminished perception of self-control in individuals with an addiction, potentially contributing to coercive approaches and criminalization of women who misuse substances during pregnancy. We explored (...) whether this is the case based on literature from social psychology, ethics, addiction research, science communication, and philosophy. The literature shows that the relationship between public discourse on biological aspects of addiction and issues such as stigma and perceptions of diminished self-control are unclear, largely due to the complexity of these phenomena. However, concerns about the biological approach are nevertheless legitimate given the broader social and policy context of women’s health. (shrink)

The UK’s 100,000 Genomes Project has the aim of sequencing 100,000 genomes from UK National Health Service (NHS) patients while concomitantly transforming clinical care such that whole genome sequencing becomes routine clinical practice in the UK. Policymakers claim that the project will revolutionize NHS care. We wished to explore the 100,000 Genomes Project, and in particular, the extent to which policymaker claims have helped or hindered the work of those associated with Genomics England – the company established by the Department (...) of Health to deliver the project. We interviewed 20 individuals linked to, or working for Genomics England. Interviewees had double-edged views about the context within which they were working. On the one hand, policymakers’ expectations attached to the venture were considered vacuous “genohype”; on the other hand, they were considered the impetus needed for those trying to advance genomic research into clinical practice. Findings should be considered for future genomes projects. (shrink)

Lower levels of news use are generally understood to be associated with less political engagement among citizens. But while some people simply have a low preference for news, others avoid the news intentionally. So far little is known about the relationship between active news avoidance and civic engagement in society, a void this study has set out to fill. Based on a four-wave general population panel survey in the Netherlands, conducted between April and July 2020 (N = 1,084) during a (...) crisis situation, this research-in-brief investigates the development of news avoidance and pro-social civic engagement over time. Results suggest that higher news topic avoidance results in higher levels of civic engagement. The study discusses different explanations for why less news can mean more engagement. (shrink)

Social media are increasingly important in the news menu of media users. Differences in news production processes between traditional and social media may lead to differences in how political and social issues are depicted, and this may, eventually, have consequences for the information that reaches citizens about an issue. Against this background, this study compares content across the two media types to examine whether and how the framing of a sociopolitical issue differs between newspaper articles and posts on social media. (...) The empirical analyses are based on a content analysis of newspaper articles (n = 414) and social media messages (n = 2,771) conducted in the context of the socially contested issue of raising the retirement age in the Netherlands. Findings suggest that different content production processes can still lead to similar outcomes as both media types emphasize problems with (instead of solutions to) the retirement age issue. Our findings also confirm differences across traditional and social media, although these differences are substantially relatively small. While traditional news media emphasize conflict-related frames more often than social media, social media present more frame diversity in solutions. (shrink)

The term ‘identity politics’ is used to refer to a wide range of political movements. In this paper, we look at the theoretical ideas underpinning two strongly, mutually opposed forms of identity politics, and identify some crucial differences between them. We critically compare the identitarian ideology of the New Right with feminist standpoint theory, focusing on two issues: relativism and essentialism. In carrying out this critical comparison we illuminate under-theorized aspects of both new right identitarianism and standpoint theory; demonstrate how (...) the two are distinct; reveal the depth and pervasiveness of the new right ideology’s flaws; and show what a coherent left-wing identity politics could look like. (shrink)

While the declared global “refugee crisis” has received considerable scholarly attention, little of it has focused on the intersecting dynamics of oppression, discrimination, violence, and subjugation. Introducing the special issue, this article defines feminist “intersectionality” as a research framework and a no-borders activist orientation in transnational and anti-national solidarity with people displaced by war, capitalism, and reproductive heteronormativity, encountering militarized nation-state borders. Our introduction surveys work in migration studies that engages with intersectionality as an analytic and offers a synopsis of (...) the articles in the special issue. As a whole, the special issue seeks to make an intersectional feminist intervention in research produced about (forced) migration. (shrink)

The purpose of the current study was to apply and evaluate a procedure to elicit expert judgments about correlations, and to update this information with empirical data. The result is a face-to-face group elicitation procedure with as its central element a trial roulette question that elicits experts' judgments expressed as distributions. During the elicitation procedure, a concordance probability question was used to provide feedback to the experts on their judgments. We evaluated the elicitation procedure in terms of validity and reliability (...) by means of an application with a small sample of experts. Validity means that the elicited distributions accurately represent the experts' judgments. Reliability concerns the consistency of the elicited judgments over time. Four behavioral scientists provided their judgments with respect to the correlation between cognitive potential and academic performance for two separate populations enrolled at a specific school in the Netherlands that provides special education to youth with severe behavioral problems: youth with autism spectrum disorder (ASD), and youth with diagnoses other than ASD. Measures of face-validity, feasibility, convergent validity, coherence, and intra-rater reliability showed promising results. Furthermore, the current study illustrates the use of the elicitation procedure and elicited distributions in a social science application. The elicited distributions were used as a prior for the correlation, and updated with data for both populations collected at the school of interest. The current study shows that the newly developed elicitation procedure combining the trial roulette method with the elicitation of correlations is a promising tool, and that the results of the procedure are useful as prior information in a Bayesian analysis. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

When two or more people coordinate their actions in space and time to produce a joint outcome, they perform a joint action. The perceptual, cognitive, and motor processes that enable individuals to coordinate their actions with others have been receiving increasing attention during the last decade, complementing earlier work on shared intentionality and discourse. This chapter reviews current theoretical concepts and empirical findings in order to provide a structured overview of the state of the art in joint action research. We (...) distinguish between planned and emergent coordination. In planned coordination, agents' behavior is driven by representations that specify the desired outcomes of joint action and the agent's own part in achieving these outcomes. In emergent coordination, coordinated behavior occurs due to perception action couplings that make multiple individuals act in similar ways, independently of joint plans. We review evidence for the two types of coordination and discuss potential synergies between them. (shrink)

A common belief about the nature of agent regret is that regretting some event E is closely linked to being sorry for the occurrence of E. Or more specifically, that if one is sorry for E then she must regret E. I will call this ‘the sorry-regret hypothesis’. My contention is that one may be sorry for some action but not regret it. I take the rejection of this ‘truism’ to be a positive development. I offer two lines of argument (...) for rejecting the sorry-regret hypothesis. One line of argument is based on counterexamples. The second attacks the validity of a reconstructed argument for the sorry-regret hypothesis. It is desirable to reject the sorry-regret hypothesis since there is a component of regret that many will not wish to be saddled with as a condition of apologizing. To regret an act, one must wish that she had not performed that act. Since a person is the person she is (speaking loosely) because of the actions she has performed, for many actions, if one regrets an action, then she wishes that she were a different person. This is a worrisome consequence. (shrink)

Conflict framing is key in political communication. Politicians use conflict framing in their online messages (e.g., criticizing other politicians) and journalists in their political coverage (e.g., reporting on political tensions). Conflicts can take a variety of forms and can provoke different reactions. However, the literature still lacks a systematic and theoretically-grounded conceptual framework that accounts for the multi-dimensionality of political conflict frames. Based on literature from political epistemology, political communication, and related fields such as psychology, we present four conceptual dimensions (...) of political conflicts: (1) the style (civil/uncivil); (2) the subject (personal/substantive); (3) whether it is about underlying moral/epistemic principles or not (deep/superficial conflict); and (4) whether it concerns a normative or factual issue. Results of a content analysis of newspaper articles and politicians’ tweets confirm the usage of these conflict dimensions in the Netherlands during a non-election period. Interestingly, most of the conflicts are civil, substantive, and do not highlight deep fundamental clashes. In light of the current societal concerns about the lack of respect in political debates and the deepening of our political divides, these findings can be considered encouraging. (shrink)

Abstract:This article correlates the physical composition of the built environment with social interactions and human relationships. The resulting framework draws on an embodied cognitive position through interdisciplinary knowledge with priority given to architectural theory and cognitive linguistics. This approach does not address idiosyncratic, phenomenological descriptions of experiences of place but the potential relationship of human bodies through situated semantics suggested by spatial composition. In this article we ask how the physical arrangement of a space can provide information for analyzing the (...) probable social relations such as positions of hierarchy, power, and authority. We identify two theoretical models, namely latent embodied cognitive operations and space as a situated concept, which can be used to correlate physical arrangements with social meaning. (shrink)

ObjectiveFatigue after burns is often attributed to the hyperinflammatory and hypermetabolic response, while it may be best understood from a bio-psychological perspective, also involving the neuro-endocrine system. This longitudinal multi-center study examined the course of fatigue up to 18 months postburn. The contribution of bio-psychological factors, including burn severity, pain, and acute PTSD symptoms, to the course and persistence of fatigue was studied in a multifactorial model.MethodsParticipants were 247 adult burn survivors. Fatigue symptoms were assessed with the Multidimensional Fatigue Inventory (...) during the acute phase and subsequently at 3, 6, 12, and 18 months postburn, and were compared to population norms. Age, gender, burn severity, acute PTSD symptoms and pain were assessed as potential predictors of fatigue over time in a latent growth model.ResultsAt 18 months postburn, 46% of the burn survivors reported fatigue, including 18% with severe fatigue. In the acute phase, higher levels of fatigue were related to multiple surgeries, presence of pain, and higher levels of acute PTSD symptoms. Fatigue gradually decreased over time with minor individual differences in rate of decrease. At 18 months, pain and acute PTSD symptoms remained significant predictors of fatigue levels.ConclusionsProtracted fatigue after burns was found in almost one out of five burn survivors and was associated with both pain and acute PTSD symptoms. Early detection of PTSD symptoms and early psychological interventions aimed at reducing PTSD symptoms and pain may be warranted to reduce later fatigue symptoms. (shrink)

Researchers in the social and behavioral sciences often have clear expectations about the order/direction of the parameters in their statistical model. For example, a researcher might expect that regression coefficient β 1 is larger than β 2 and β 3. The corresponding hypothesis is H : β 1 > {β 2, β 3 } and this is known as an (order) constrained hypothesis. A major advantage of testing such a hypothesis is that power can be gained and inherently a smaller (...) sample size is needed. This article discusses this gain in sample size reduction, when an increasing number of constraints is included into the hypothesis. The main goal is to present sample-size tables for constrained hypotheses. A sample-size table contains the necessary sample-size at a pre-specified power (say, 0.80) for an increasing number of constraints. To obtain sample-size tables, two Monte Carlo simulations were performed, one for ANOVA and one for multiple regression. Three results are salient. First, in an ANOVA the needed sample-size decreases with 30–50% when complete ordering of the parameters is taken into account. Second, small deviations from the imposed order have only a minor impact on the power. Third, at the maximum number of constraints, the linear regression results are comparable with the ANOVA results. However, in the case of fewer constraints, ordering the parameters (e.g., β 1 > β 2 ) results in a higher power than assigning a positive or a negative sign to the parameters (e.g., β 1 > 0). (shrink)

Many believe that the ethical problems of donation after cardiocirculatory death (DCD) have been "worked out" and that it is unclear why DCD should be resisted. In this paper we will argue that DCD donors may not yet be dead, and therefore that organ donation during DCD may violate the dead donor rule. We first present a description of the process of DCD and the standard ethical rationale for the practice. We then present our concerns with DCD, including the following: (...) irreversibility of absent circulation has not occurred and the many attempts to claim it has have all failed; conflicts of interest at all steps in the DCD process, including the decision to withdraw life support before DCD, are simply unavoidable; potentially harmful premortem interventions to preserve organ utility are not justifiable, even with the help of the principle of double effect; claims that DCD conforms with the intent of the law and current accepted medical standards are misleading and inaccurate; and consensus statements by respected medical groups do not change these arguments due to their low quality including being plagued by conflict of interest. Moreover, some arguments in favor of DCD, while likely true, are "straw-man arguments," such as the great benefit of organ donation. The truth is that honesty and trustworthiness require that we face these problems instead of avoiding them. We believe that DCD is not ethically allowable because it abandons the dead donor rule, has unavoidable conflicts of interests, and implements premortem interventions which can hasten death. These important points have not been, but need to be fully disclosed to the public and incorporated into fully informed consent. These are tall orders, and require open public debate. Until this debate occurs, we call for a moratorium on the practice of DCD. (shrink)