Background: Informed consent is fundamental to the autonomous decision-making of patients, yet much is still unknown about the process in the clinical setting. In an evolving healthcare landscape, nurses must be prepared to address patient understanding and participate in the informed consent process to better fulfill their well-established role as patient advocates. Research objective: This study examines hospital-based nurses’ experiences and understandings of the informed consent process. Research design: This qualitative descriptive study utilized a semi-structured interview approach identifying thematic concerns, (...) experiences, and knowledge of informed consent across a selected population of clinically practicing nurses. Participants and research context: In all, 20 baccalaureate prepared registered nurses practicing in various clinical settings (i.e. critical care, oncology, medical/surgical) at a large northeastern academic medical center in the United States completed semi-structured interviews and a demographic survey. The mean age of participants was 36.6 years old, with a mean of 12.2 years of clinical experience. Ethical considerations: Participation in this study involved minimal risk and no invasive measures. This study received Institutional Review Board approval from the University of Pennsylvania. All participants voluntarily consented. Findings: The majority of participants (N = 19) believe patient safety is directly linked to patient comprehension of the informed consent process. However, when asked if nurses have a defined role in the informed consent process, nearly half did not agree (N = 9). Through this qualitative approach, three major nursing roles emerged: the nurse as a communicator, the nurse as an advocate, and the clerical role of the nurse. Discussion and conclusion: This investigation contributes to the foundation of ethical research that will better prepare nurses for patient engagement, advance current understanding of informed consent, and allow for future development of solutions. Nurses are at the forefront of patient–provider interactions and they are often presented opportunities to learn about and engage in the informed consent process. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Minding Brain Injury, Consciousness, and Ethics: Discourse and DeliberationsJoseph J. Fins (bio) and James Giordano (bio)The annual John Collins Harvey Lecture at the Georgetown University’s Pellegrino Center for Clinical Bioethics is a forum for addressing contemporary topics at the intersection of medicine and bioethics. This year, in marking the decadal anniversary of the launch of the Brain Research through Advancing Innovative Neurotechnology (BRAIN) Initiative, the Harvey Lecture provided (...) an interactive discussion with renowned clinician, researcher, scholar, and author, Joseph J. Fins, MD—who is the E. William Davis, Jr., MD Professor of Medical Ethics, Chief of the Division of Medical Ethics, and a Professor of Medicine at Weill Cornell Medical College—conducted by James Giordano, PhD, MPhil—who is a Professor of Neurology and Biochemistry, and Chief of the Pellegrino Center’s Neuroethics Studies Program at the Georgetown University Medical Center. The discourse focused upon the topic of covert consciousness, and the ways in which current and developing brain science technologies, together with revised practices of medicine, in general, may afford new opportunities in patient care, but may also give rise to issues, questions, challenges, and opportunities for neuroethics.Prof. James GIORDANO:Prof. Fins, your most recent book, Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness (Fins 2015), addresses your ongoing work to employ current and emerging neurological approaches to reveal conscious functions in patients with profound brain injury and disease. To be sure, the destination—if you will—is to talk about covert consciousness. But in commencing this discussion, I’d like to propose a route, which traces your professional journey to this point in your career, and how it led you on your search to reveal consciousness in those patients who lack expressive capability. You went into palliative care first, and that brought you to where you are today. [End Page 227]Prof. Joseph J. FINS:First, let me thank you and the Pellegrino Center for the honor of giving the John Harvey Collins Lecture in such an interactive manner. The forefront of neurological care—and the neuroethical issues and methods focal to such practice—wasn’t what I initially intended to do professionally, but I think that therein is a good lesson for young people’s career aspirations. Simply put, one doesn’t always know where they’ll end up at the beginning of the journey, and as Kierkegaard said, life is lived forward, but is understood backwards (Kierkegaard 1843).In the nineties and the early 2000s, I was trying to help improve the quality of care of people at the end of life, and I wrote a book, entitled The Palliative Ethic of Care: Clinical Wisdom at Life’s End (Fins 2006), in which I addressed notions of phronesis—practical wisdom—in integrating theory and practice toward improving how people die. I became interested in the Quinlan case (Quinlan 1976), and the right to die, and around the same time, I ran into a colleague of mine at Cornell: Dr. Nicholas D. Schiff. Dr. Schiff is a neurologist, who was a protégé of Fred Plum, who was the originator of the concept of the vegetative state with Bryan Jennett, back in 1972. Fred was both of our teachers here at Cornell. Niko (Dr. Schiff) was interested in patients with disorders of consciousness, and was beginning to envision doing work—that ultimately, we did—using deep brain stimulation (DBS) to try to treat patients in the minimally conscious state, a category that was subsequently codified in 2002.I realized that a whole population of people—with these disorders of consciousness—had been somewhat marginalized, and their neglect essentially devolves back to the considerations of the right to die. The right to die was established in the Quinlan case because Judge Hughes—the presiding chief judge of the New Jersey Supreme Court—talked about Ms. Quinlan’s loss of a cognitive, sapient state as being the moral warrant for her right to die, given the fact that it was viewed as a futile situation. I recognized, over the ensuing years—from my background in palliative and end-of-life care—[1] that we had over-generalized notions of futility... (shrink)

Giordano Bruno was a philosopher in his own right. However, he was famous through the centuries due to his execution as a heretic. His pronouncements against teachings of the Catholic Church, his defence of the cosmology of Nicholas Copernicus, and his provocative personality, all this made him a paradigmatic figure of modernity. Bruno’s way of philosophizing is not looking for outright solutions but rather for the depth of the problems; he knows his predecessors and their strategies as well (...) as their weaknesses, which he exposes satirically. This introduction helps to identify the original thought of Bruno who proudly said about himself: “Philosophy is my profession!” His major achievements concern the creativity of the human mind studied through the theory of memory, the infinity of the world, and the discovery of atomism for modernity. He never held a permanent office within or without the academic world. Therefore, the way of thinking of this “Knight Errant of Philosophy” will be presented along the stations of his journey through Western Europe. (shrink)

Giordano Bruno (1548-1600) was a philosopher in his own right. However, he was famous through the centuries due to his execution as a heretic. His pronouncements against teachings of the Catholic Church, his defence of the cosmology of Nicholas Copernicus, and his provocative personality, all this made him a paradigmatic figure of modernity. Bruno’s way of philosophizing is not looking for outright solutions but rather for the depth of the problems; he knows his predecessors and their strategies as (...) well as their weaknesses, which he exposes satirically. This introduction helps to identify the original thought of Bruno who proudly said about himself: “Philosophy is my profession!” His major achievements concern the creativity of the human mind studied through the theory of memory, the infinity of the world, and the discovery of atomism for modernity. He never held a permanent office within or without the academic world. Therefore, the way of thinking of this “Knight Errant of Philosophy” will be presented along the stations of his journey through Western Europe. (shrink)

Researchers have proposed that blocking facial feedback via glabellar-region botulinum toxin injections can reduce depression. Random-effects meta-analyses of studies that administered GBTX...

Proper conduct of an AIDS vaccine trial in Africa must be informed not only by the epidemiology and biology of HIV infection in African settings, but also by the ethical norms and cultural constraints prevailing in African settings.

Management scholarship and practice continues to incorporate nature and business dependencies and impacts on ecosystems. The humanistic management approach seeks to shift management practice away from prioritizing economic outcomes and toward prioritizing human dignity and wellbeing. This paper explores humanistic management’s ontological assumption about nature, which tends to be an anthropocentric ontology that prioritizes humans as superior to and separate from nature and justifies destroying nature if doing so benefits human wellbeing. However, there is increasing pressure to conduct business in (...) ways that do not destroy nature but instead conserve or restore nature. I build on research about the diverse values and valuations of nature and identify awareness practices that humanistic management scholars and practitioners might use to become aware of and practice alternative ontologies about nature. Non-anthropocentric ontologies have the potential to lessen the tension between increasing human wellbeing and the destruction of nature and other-than-human beings. Alternative ontologies can be combined with the concept of stewardship to align humanistic management with broader sustainability goals, including notions of nature as sacred and of other-than-human beings as equal to humans in kinship and community. These ideas might provide a way for humanistic management to maintain its focus on human wellbeing while also acknowledging the dignity and wellbeing of other-than-human living beings and nature broadly. (shrink)

We agree with Branigan & Pickering that structural priming experiments should supplant grammaticality judgments for testing linguistic representation. However, B&P overlook a vast linguistic literature that converges with – but extends – the experimental findings. B&P conclude that syntax is functionally independent of the lexicon. We argue that a broader approach to priming reveals cracks in the façade of syntactic autonomy.

Acoustical changes in the prosody of mothers’ speech to infants are distinct and near universal. However, less is known about the visible properties of mothers’ infant-directed speech, and their relation to speech acoustics. Mothers’ head movements were tracked as they interacted with their infants using ID speech, and compared to movements accompanying their adult-directed speech. Movement measures along three dimensions of head translation, and three axes of head rotation were calculated. Overall, more head movement was found for ID than AD (...) speech, suggesting that mothers exaggerate their visual prosody in a manner analogous to the acoustical exaggerations in their speech. Regression analyses examined the relation between changing head position and changing acoustical pitch over time. Head movements and voice pitch were more strongly related in ID speech than in AD speech. When these relations were examined across time windows of different durations, stronger relations were observed for shorter time windows. However, the particular form of these more local relations did not extend or generalize to longer time windows. This suggests that the multimodal correspondences in speech prosody are variable in form, and occur within limited time spans. (shrink)

Giordano Bruno was a philosopher in his own right. However, he was famous through the centuries due to his execution as a heretic. His pronouncements against teachings of the Catholic Church, his defence of the cosmology of Nicholas Copernicus, and his provocative personality, all this made him a paradigmatic figure of modernity. Bruno’s way of philosophizing is not looking for outright solutions but rather for the depth of the problems; he knows his predecessors and their strategies as well (...) as their weaknesses, which he exposes satirically. This introduction helps to identify the original thought of Bruno who proudly said about himself: “Philosophy is my profession!” His major achievements concern the creativity of the human mind studied through the theory of memory, the infinity of the world, and the discovery of atomism for modernity. He never held a permanent office within or without the academic world. Therefore, the way of thinking of this “Knight Errant of Philosophy” will be presented along the stations of his journey through Western Europe. (shrink)

Freedom to smoke is part and parcel of overall freedom. The former cannot be abrogated without violating the latter. The present paper applies this insight to the regulations placed on the tobacco industry and smoking in general. We find that government interventions into people’s lives regarding smoking are highly incompatible with libertarian principles. We examine many regulations such as prohibiting youths from smoking, preventing second hand smoke, restrictions on advertising, taxing the industry, and liability issues.

Nicholas of Cusa (1402-1464) explored the boundaries of human reason for the sake of making religious belief believable. Unwillingly, he became a milestone in the process of rationalizing Christian theology. Giordano Bruno (1548-1600) is a proof to this perspective by the way he makes use of Cusanus’s approach. In his ’Spaccio de la bestia trionfante’, Bruno discusses Cusanus’s attempts at the geometrical problem of squaring the circle. Bruno not only promotes his atomistic geometry, he also uses the metaphoric (...) meaning of triangle for Trinity as an occasion to supplant ’faith’ with ’sincerity’. For Bruno faith is not anymore the true belief of religion, but rather ’good faith’ and fidelity, i.e., social and political virtues. (shrink)

This article examines Abu Nasr al-Farabı (c. 872–950/1) on the topic of intentionality, with particular focus on how intentionality is integral for the constitution of the intellect within his psychology. Unfortunately, targeted study of al-Farabı’s doctrine of intentionality has been largely neglected since Kwame Gyekye’s 1971 essay, The Terms ‘Prima Intentio’ and ‘Secunda Intentio’ in Arabic Logic. Gyekye showed that the Arabic (and thus the Latin) doctrine of first and second intention originated within the texts of al-Farabı,not the texts of (...) Avicenna, as had been previously thought. In response, this article aims to show three things. First, while the doctrine of first and second intention appears in al-Farabı’s texts, it is not as clearly developed or defined as is presented in Gyekye’s 1971 article. al-Farabı both lacks consistent technical terminology for the doctrine (as he discusses it across disparate sciences, in unrelated contexts) and develops it far too little to fully flesh out his doctrine. Second, even given the fact that al-Farabı’s discussion of intentionality is underdeveloped, Gyekye was right to credit the doctrine to him. And third, al-Farabı’s doctrine of first and second intention is not merely important to understand his positions regarding signification and universals; they play a pivotal role in the constitution of the human intellect. (shrink)

Humans' spatial representations enable navigation and reaching to targets above the ground plane, even without direct perceptual support. Such abilities are inconsistent with an impoverished representation of the third dimension. Features that differentiate humans from most terrestrial animals, including raised eye height and arms dedicated to manipulation rather than locomotion, have led to robust metric representations of volumetric space.