Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...) primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. (shrink)

© Ginn et al. 2016.The indexing methods currently used for serial femtosecond crystallography were originally developed for experiments in which crystals are rotated in the X-ray beam, providing significant three-dimensional information. On the other hand, shots from both X-ray free-electron lasers and serial synchrotron crystallography experiments are still images, in which the few three-dimensional data available arise only from the curvature of the Ewald sphere. Traditional synchrotron crystallography methods are thus less well suited to still image data processing. Here, a (...) new indexing method is presented with the aim of maximizing information use from a still image given the known unit-cell dimensions and space group. Efficacy for cubic, hexagonal and orthorhombic space groups is shown, and for those showing some evidence of diffraction the indexing rate ranged from 90% to 151%. Here, the indexing rate refers to the number of lattices indexed per image. (shrink)

BackgroundAn analysis of the position statements of secular US medical and surgical professional societies on physician-assisted suicide (PAS) and euthanasia have not been published recently. Available statements were evaluated for position, content, and sentiment.MethodsIn order to create a comprehensive list of secular medical and surgical societies, the results of a systematic search using Google were cross-referenced with a list of societies that have a seat on the American Medical Association House of Delegates. Societies with position statements were identified. These statements (...) were divided into 5 categories: opposed to PAS and/or euthanasia, studied neutrality, supportive, acknowledgement without statement, and no statement. Linguistic analysis was performed using RapidMinder in order to determine word frequency and sentiment respective to individual statements. To ensure accuracy, only statements with word counts > 100 were analyzed. A 2-tailed independentttest was used to test for variance among sentiment scores of opposing and studied neutrality statements.ResultsOf 150 societies, only 12 (8%) have position statements on PAS and euthanasia: 11 for PAS (5 opposing and 4 studied neutrality) and 9 for euthanasia (6 opposing and 2 studied neutrality). Although the most popular words used in opposing and studied neutrality statements are similar, notable exceptions exist (suicide,medicine, andtreatmentappear frequently in opposing statements, but not in studied neutrality statements, whereaspsychologists,law, andindividualsappear frequently in studied neutrality statements, but not in opposing statements). Sentiment scores for opposing and studied neutrality statements do not differ (mean, 0.094 vs. 0.104;P = 0.90).ConclusionsFew US medical and surgical societies have position statements on PAS and euthanasia. Among them, opposing and studied neutrality statements share similar linguistic sentiment. Opposing and studied neutrality statements have clear differences, but share recommendations. Both opposing and studied neutrality statements cite potential risks of PAS legalization and suggest that good palliative care might diminish a patient’s desire for PAS. (shrink)

India has produced several drafts of data policies. In this work, they are referred to [1] JBNSCR 2018, [2] DPDPR 2018, [3] NSAI 2018, [4] RAITF 2018, [5] PDPB 2019, [6] PRAI 2021, [7] JPCR 2021, [8] IDAUP 2022, [9] IDABNUP 2022. All of them consider Artificial Intelligence (AI) a social problem solver at the societal level, let alone an incentive for economic growth. However, these policy drafts warn of the social disruptions caused by algorithms and encourage the careful use (...) of computational technologies in various social contexts. Hence, the emerging data society and its implications in India's social contexts demand immense social science attention, which needs to be improved in the policy drafts, primarily because they are creations of industry stakeholders, technocrats, bureaucrats, and experts from tech schools. In the larger social milieu of digital infrastructure emerging, the fundamental question is whether India's national philosophy envisioned in the Indian constitution is reflected in the policy papers. The paper enquires whether the national data policy upholds the core values dispersed through the philosophy of the Indian constitution, which, among other things, is not confined only to inclusion, diversity, rights, liberty, justice and equality. By focusing on constitutional values, the paper seeks to offer a broader and more critical understanding of India's approach to AI policy by bringing together analyses of a wide array of policy documents available in the public realm. (shrink)

Background:Surveillance technology such as tag and tracking systems and video surveillance could increase the freedom of movement and consequently autonomy of clients in long-term residential care settings, but is also perceived as an intrusion on autonomy including privacy.Objective:To explore how clients in residential care experience surveillance technology in order to assess how surveillance technology might influence autonomy.Setting:Two long-term residential care facilities: a nursing home for people with dementia and a care facility for people with intellectual disabilities.Methods:Ethnographic field study.Ethical considerations:The boards (...) representing clients and relatives/proxies of the clients were informed of the study and gave their written consent. The clients’ assent was sought through a special information leaflet. At any time clients and/or proxy were given the option to withdraw from the study. The research protocol was also reviewed by a medical ethics committee.Findings:Our findings show a pattern of two themes: (1) coping with new spaces which entailed clients: wandering around, getting lost, being triggered, and retreating to new spaces and (2) resisting the surveillance technology measure because clients feel stigmatized, missed the company, and do not like being “watched.”Conclusion:Client experiences of surveillance technology appear to entail a certain ambivalence. This is in part due to the variety in surveillance technology devices, with each device bringing its own connotations and experiences. But it also lies in the devices’ presupposition of an ideal user, which is at odds with the actual user who is inherently vulnerable. Surveillance technology can contribute to the autonomy of clients in long-term care, but only if it is set in a truly person-centered approach. (shrink)

One of the gains to be reckoned from the study of nomenclature in the sepulchral inscriptions of the early empire is the gradual abandonment of attempts to distinguish between slave and freeborn on the basis of personal name or cognomen alone, especially when this is of Latin derivation. Nevertheless, one still finds personal cognomina in undated inscriptions adduced as sole evidence for the origin or status of individuals below senatorial rank. Thus in a standard work on freedmen in the early (...) empire, recently reprinted, names such as Agilis, Amandus, Auctus, Communis, Donatus, Faustus, Felix, etc., are said to be commonly servile, but others such as Aquila, Bassus, Capito, Cams, Celer, Crescens, etc., are taken as ingenuous. The criteria used in making such a distinction are subjective and arbitrary and the statistics based on them are largely valueless. It is the purpose of this note to consider briefly on this question the evidence of the personal nomenclature of the Imperial slaves and freedmen. In this group, the Familia Caesaris, no problem of status arises, and the fact that the majority of their inscriptions can be dated, at least approximately, makes it possible to trace the chronological development of the use of cognomina ingenua by one important group of servile origin from the first to the early third century A.D. Moreover, such a development is useful evidence for change in the social structure of the early empire. (shrink)

The career of the father of Claudius Etruscus is of special importance in the history of the Imperial administration in the first century A.D. In the course of a long life he rose from slave status under Tiberius to be head of the Imperial financial administration and to equestrian status under Vespasian. He was one of the most important, wealthy, and influential of the Imperial freedmen in the first century when their influence was at its peak; he is one of (...) the best documented of their number outside the pages of Tacitus; yet we do not know his personal name—he has to remain simply ‘the father of Claudius Etruscus’ —and even his nomen gentilicium and the date of his appointment to be the secretary a rationibus are subject to disput. (shrink)

At the beginning of the twentieth century in the Russian-speaking philosophical space philosophical projects emerged which brought ontology and gnoseology closer together. One can observe this process, for example, in the philosophical doctrines of the Russian intuitivists Nikolay Lossky and Semyon Frank. I demonstrate that the emergence of these doctrines and the development of their onto-gnoseological categorial apparatus were mainly connected with the criticism of the Neo-Kantian theory of cognition and the possibility of transcendent knowledge as such. The main sources (...) of my study are The Intuitive Basis of Knowledge and The World as an Organic Whole by N. O. Lossky and The Object of Knowledge and The Unknowable by S. L. Frank. My investigation makes it possible to treat Lossky’s categorial framework as the representation of a system of levels of the universe each of which is characterised by two aspects: the ontological, i.e. it is part of the unity of the world, and the gnoseological, i.e. it has an independent cognitive significance. Frank considers categories to be an organic part of the ontological proof of intuitivism. A common trend in the construction of categorial schemes by Lossky and Frank is their striving to combine gnoseological and ontological descriptions of categories. The key difference is the way an onto-gnoseological system as a whole is justified. In revealing the contradictions in Lossky’s conception, I proceed from the critical remarks of S. A. Askoldov, pointing out that these contradictions stem from an absolutisation of intuition in cognition, the renunciation of the idea of gnoseological transcendence, incompleteness of the theory of immanence and discordance between onto-gnoseological categories. Askoldov’s critical comments clarify the substantive features of Lossky’s theory and the essence of the transformations carried out in Frank’s absolute ideal-realism. (shrink)

The conceptual model presented in this article argues that corporations exhibit specific behaviors that signal their true level of moral development. Accordingly, the authors identify five levels of moral development and discuss the dynamics that move corporations from one level to another. Examples of corporate behavior which are indicative of specific stages of moral development are offered.

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

Elliott Sober''s selection for/selection of distinction has been widely used to clarify the idea that some properties of organisms are side-effects of selection processes. It has also been used, however, to choose between different descriptions of an evolutionary product when assigning biological functions to that product. We suggest that there is a characteristic error in these uses of the distinction. Complementary descriptions of function are misrepresented as mutually excluding one another. This error arises from a failure to appreciate that selection (...) processes can be described at several different theoretical levels. (shrink)

The Upanishads reveal that in the beginning, nothing existed: “This was but non-existence in the beginning. That became existence. That became ready to be manifest”. (Chandogya Upanishad 3.15.1) The creation began from this state of non-existence or nonduality, a state comparable to (0). One can add any number of zeros to (0), but there will be nothing except a big (0) because (0) is a neutral number. If we take (0) as Nirguna Brahman (God without any form and attributes), then (...) from where and how did the universe come into existence? -/- The neutral power (0) cannot produce anything without having an element of duality in it. Although Nirguna Brahman is neutral, it has a positive, negative, and neutral pole, constituting its Prakriti or nature. Prakriti has three latent Gunas (modes or qualities): Satva, Rajas, and Tamas. They are related to Gyana Shakti (the power of knowledge) Sankalpa Shakti (the power of ideation), and Kriya Shakti (the power of action). Science says that Atom is the basic element from which the universe evolved. The Atom has three nuclei- electron, pluton, and neutron. The Satva, Rajas, and Tamas in Indian spirituality are nothing but the mystical names for the nuclei of an atom. -/- According to Bhagavata Purana, Prakriti is also constituted of the elements of Time, Karma (action/destiny) and Swabhava (innate nature). Time disturbs the equilibrium of Gunas. From the aspect of Karma is produced an entity called Mahat, in the form of intelligence. Mahat is dominated by Satva and Rajas. From Mahat manifests the next evolute dominated by Tamas with three predominant qualities – Dravya (substance), Kriya (action), as well as intelligence. It forms to become the Ego principle (Ahamkara). -/- Ahamkara has three modes – Satvic, Rajasic and Tamasic. Satvic is Jnana oriented, Rajasic action-oriented and Tamasic Dravya (substance) oriented. From the Tamasic Ahankara, five gross elements are produced (ether, air, fire, water, and earth - Akash, Vayu, Agni, Jal and Prithvi). From the Satvic Ahamkara, guardian deities (the sun and moon, deities of sense organs, and organs of action) and from Rajasic Ahamkara, ten senses (Indriyas), five senses of perception, five organs of action, the faculties of intellect and Prana (life breath) are produced. -/- Bhagavata says that since these energies, elements, and faculties remained disassociated, they were combined to form a Cosmic Egg. The egg floats in the primal waters for a thousand years. Then God enters this Cosmic Egg and manifests himself as the Cosmic Purusha. He is the first nucleus, the God particle equivalent to the number (1) which is the embodiment of everything in the universe. The concept of creation and dissolution in Hinduism can be compared to the waves in an ocean that appear and disappear incessantly. The Manvantaras are such successive episodes of creation emerging from the Cosmic Person, the Manu who is embodied God-Consciousness, God himself. These episodes of creation are measured in Hinduism in terms of Manvantaras, the epochs of Manus. -/- Manu is the ‘First-Born’ (1) of God, the Cosmic Purusha from whom the world has originated. This Cosmic Person (Purusha) has been described as having fourteen biospheres (heavens) that are inhabited by various life forms in the order of evolution of consciousness. If we begin from the human biosphere (Bhuloka), there are ten astral biospheres that a man must transcend to attain liberation or Mukti from the cycle of births and deaths. -/- The number (1) produces the primary numbers up to (9) through the transmutation of the creational energies and qualities. The process can be related to the descent and cyclical evolution of (1) through ten spiritual stages, finally merging with the nondual (0). The number (10) marks the merger of (1) with (0). The Hindu worldview is that all life forms in an episode of creation must evolve to become one with the non-dual state (0) to attain liberation from the cycle of births and deaths in a cyclical process. -/- . (shrink)

A woman and a man desire to come together stirred by the primal fire of Kama and the man deposits his egg in the womb of the woman. This egg develops into a human undergoing nine or ten months of evolution. This process is the microscopic replication of the method evolved by God to create the universe. Rigveda (10.121) mentions Hiranyagarbha, the Golden Egg as the source of the creation of the universe. It is said that God, wishing to create (...) the world, produced an egg as big as the cosmos. God meditated for a thousand years sitting inside the egg and when the egg burst, the Lord himself was born out of the egg as the Progenitor of the universe (“He made Himself by Himself.”, Taitiriya Upanishad: 2.7.1). The Rishis called the Egg Brahmanda (the Cosmic Egg), and the Progenitor Manu. Scientists have discovered that the universe has an oval shape. Like the nine months of the evolution of the human egg, the Cosmic Egg also undergoes nine stages of evolution before it gets dissolved during what we call ‘Maha Pralaya’. The Puranas mention that Brahmanda has 14 biospheres, seven nether and seven upper inhabited by different types of souls. If we count from the human world, there are ten dimensions of consciousness. Rishis called these astral biospheres Mandalas/Lokas with different wavelengths and colours. Sri Karunakara Guru referred to them as Avasthas, or spiritual stages. The Buddhists and Hindu esoteric sects such as the Theosophical Society explain these levels of the Absolute in terms of Physical plane, Astral plane, Mental plane, Buddhic plane, Atmic plane, Anupadaka plane, Adi plane and Shiv and Shakti. These Avasthas are related to the expanding consciousness reaching up to the core of the Cosmic Egg, the Paramatma. Like a spider which creates a web around it sitting in the centre, and withdraws it in the end, Paramatma creates and withdraws webbed multi-dimensional universes. Nobody can say when it started and when it will end as it is a beginningless and endless process. (shrink)

The status nomenclature of the Imperial slaves, as that of the Imperial freedmen, is important mainly for its bearing on the difficult problems of dating slave sepulchral inscriptions, but also as a means of determining who were Imperial slaves belonging to the Familia Caesaris with the significant social status this implied. Bang's careful but brief treatment of the subject, published in 1919, was not based on a complete collection of the material—admittedly difficult to obtain—and much has appeared in the interval. (...) Moreover, a deeper analysis of the evidence necessitates some revision of his conclusions. (shrink)

Lily Ross Taylor in an interesting recent article on the proportion of freedmen to freeborn in the sepulchral inscriptions of Imperial Rome discusses the increasing omission of status nomenclature by freedmen in the first and second centuries A.D. and the consequent difficulty of determining the status of persons whose names appear in the epitaphs. One contributory factor to this decline in the traditional nomenclature which she mentions is the growing numbers and importance of the freedmen of the emperor, the Augusti (...) liberti. While non-imperial freedmen were anxious to record their acquisition of citizenship, but not their inferior status in the citizen body, the emperor's freedmen, on the other hand, increasingly formalized their status nomenclature so that the formula ‘Aug. lib.’ proclaimed not only the fact of their manumission within the Familia Caesaris but also the higher social status which they enjoyed. An examination of the nomenclature of the Imperial freedmen might help to throw some light on this process, particularly on the problem of dating. (shrink)