It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

The recent corporate scandals in the United States have caused a renewed interest and focus on teaching business ethics. Business schools and their faculties are reexamining the teaching of business ethics and are reassessing their responsibilities to produce honest and truthful managers who live lives of integrity and ethical accountability. The authors recognize that no agreement exists among business schools and their faculties regarding what should be the content and pedagogy of a course in business ethics. However, the authors hold (...) that regardless of one’s biases regarding the content and pedagogy, the effective teaching of business ethics requires that the instructor in designing and delivering a business ethics course needs to focus particular attention on four principal questions: (1) what are the objectives or targeted learning outcomes of the course? (2) what kind of learning environment should be created? (3) what learning processes need to be employed to achieve the goals? and (4) what are the roles of the participants in the learning experience? The answers to these questions provide the foundations for any business ethics course. The answers are major determinants of the impact of a business ethics course on the thinking of students and the views on the ethical and professional accountabilities and responsibilities of managers in the workplace. (shrink)

BackgroundThe emergence of artificial intelligence (AI) in medicine has prompted the development of numerous ethical guidelines, while the involvement of patients in the creation of these documents lags behind. As part of the European PROFID project we explore patient perspectives on the ethical implications of AI in care for patients at increased risk of sudden cardiac death (SCD).AimExplore perspectives of patients on the ethical use of AI, particularly in clinical decision-making regarding the implantation of an implantable cardioverter-defibrillator (ICD).MethodsSemi-structured, future scenario-based (...) interviews were conducted among patients who had either an ICD and/or a heart condition with increased risk of SCD in Germany (n = 9) and the Netherlands (n = 15). We used the principles of the European Commission’s Ethics Guidelines for Trustworthy AI to structure the interviews.ResultsSix themes arose from the interviews: the ability of AI to rectify human doctors’ limitations; the objectivity of data; whether AI can serve as second opinion; AI explainability and patient trust; the importance of the ‘human touch’; and the personalization of care. Overall, our results reveal a strong desire among patients for more personalized and patient-centered care in the context of ICD implantation. Participants in our study express significant concerns about the further loss of the ‘human touch’ in healthcare when AI is introduced in clinical settings. They believe that this aspect of care is currently inadequately recognized in clinical practice. Participants attribute to doctors the responsibility of evaluating AI recommendations for clinical relevance and aligning them with patients’ individual contexts and values, in consultation with the patient.ConclusionThe ‘human touch’ patients exclusively ascribe to human medical practitioners extends beyond sympathy and kindness, and has clinical relevance in medical decision-making. Because this cannot be replaced by AI, we suggest that normative research into the ‘right to a human doctor’ is needed. Furthermore, policies on patient-centered AI integration in clinical practice should encompass the ethics of everyday practice rather than only principle-based ethics. We suggest that an empirical ethics approach grounded in ethnographic research is exceptionally well-suited to pave the way forward. (shrink)

In this article we present symmetric diffusion networks, a family of networks that instantiate the principles of continuous, stochastic, adaptive and interactive propagation of information. Using methods of Markovion diffusion theory, we formalize the activation dynamics of these networks and then show that they can be trained to reproduce entire multivariate probability distributions on their outputs using the contrastive Hebbion learning rule (CHL). We show that CHL performs gradient descent on an error function that captures differences between desired and obtained (...) continuous multivariate probability distributions. This allows the learning algorithm to go beyond expected values of output units and to approximate complete probability distributions on continuous multivariate activation spaces. We argue that learning continuous distributions is an important task underlying a variety of real‐life situations that were beyond the scope of previous connectionist networks. Deterministic networks, like back propagation, cannot learn this task because they are limited to learning average values of independent output units. Previous stochastic connectionist networks could learn probability distributions but they were limited to discrete variables. Simulations show that symmetric diffusion networks can be trained with the CHL rule to approximate discrete and continuous probability distributions of various types. (shrink)

Many of the problems studied in cognitive science are inductive problems, requiring people to evaluate hypotheses in the light of data. The key to solving these problems successfully is having the right inductive biases—assumptions about the world that make it possible to choose between hypotheses that are equally consistent with the observed data. This article explores a novel experimental method for identifying the biases that guide human inductive inferences. The idea behind this method is simple: This article uses the responses (...) produced by a participant on one trial to generate the stimuli that either they or another participant will see on the next. A formal analysis of this “iterated learning” procedure, based on the assumption that the learners are Bayesian agents, predicts that it should reveal the inductive biases of these learners, as expressed in a prior probability distribution over hypotheses. This article presents a series of experiments using stimuli based on a well-studied set of category structures, demonstrating that iterated learning can be used to reveal the inductive biases of human learners. (shrink)

Animals and robots perceiving and acting in a world require an ontology that accommodates entities, processes, states of affairs, etc., in their environment. If the perceived environment includes information - processing systems, the ontology should reflect that. Scientists studying such systems need an ontology that includes the first - order ontology characterising physical phenomena, the second - order ontology characterising perceivers of physical phenomena, and a third order ontology characterising perceivers of perceivers, including introspectors. We argue that second - and (...) third - order ontologies refer to contents of virtual machines and examine requirements for scientific investigation of combined virtual and physical machines, such as animals and robots. We show how the CogAff architecture schema, combining reactive, deliberative, and meta - management categories, provides a first draft schematic third - order ontology for describing a wide range of natural and artificial agents. Many previously proposed architectures use only a subset of CogAff, including subsumption architectures, contention - scheduling systems, architectures with Ôexecutive functionsÕ and a variety of types of ÔOmegaÕ architectures. Adding a multiply - connected, fastacting ÔalarmÕ mechanism within the CogAff framework accounts for several varieties of emotions. H - CogAff, a special case of CogAff, is postulated as a minimal architecture specification for a human - like system. We illustrate use of the CogAff schema in comparing H - CogAff with Clarion, a well known architecture. One implication is that reliance on concepts tied to observation and experiment can harmfully restrict explanatory theorising, since what an information processor is doing cannot, in general, be determined by using the standard observational techniques of the physical sciences or laboratory experiments. Like theoretical physics, cognitive science needs to be highly speculative to make progress. Ó 2004 Published by Elsevier B. V. (shrink)

Background It has been suggested that researchers are obliged to offer summary findings to research participants to demonstrate respect for persons, and that this may increase public trust in, and awareness of, the research enterprise. Yet little research explores researchers' attitudes and practices regarding the range of initiatives that might serve these ends. Methods Results of an international survey of 785 eligible authors of genetics research studies in autism or cystic fibrosis are reported. Results Of 343 researchers who completed the (...) survey (44% response rate), the majority agreed that their team should (i) inform participants of summary findings (90.7%) and (ii) ensure they gain an awareness of developments in the field (86.9%). Additionally, the majority reported that in practice, their team (i) informs participants of summary findings (69.4%) and (ii) provides other types of relevant non-results information (eg, state of science in the field, opportunities for research participation) (67.9%). Conclusion Researchers endorsed the obligation of communicating with research participants by providing summary findings and other research-related information in equal measure. In light of these findings, it is suggested that while the provision of summary results may contribute to efforts to discharge the obligation of respect for persons, it may be neither a necessary nor a sufficient means to this end. (shrink)

resumo Focado num trecho de “Position de L’inconscient”, este artigo faz a descrição gramatical das figuras de sujeito e de linguagem ali empregadas. A intenção é exclusivamente terapêutica – não se trata de propor novas teses, mas provocar o olhar para aspectos negligenciados da prática psicanalítica. palavras-chave Lacan - Wittgenstein - Linguagem - Subjetividade.

The genome is a stable repository of vastly intricate genetic information developed over eons of evolution; this information is replicated at the highest fidelity and expressed within each cell at the highest selectivity. Non‐leukemia cancers break this standard; the intricate genetic information qualitatively and progressively deteriorates, resulting in a somatic Darwinian free‐for‐all. In a process lasting several years, a genomically heterogeneous population replicates from a single cell that originally lost the ability to preserve its genomic integrity. Cells selected for their (...) abilities to proliferate and spread, while evading host defenses, inexorably expand their numbers. The clinical consequences of this become severe, as the genomically diverse cell population that evolves contains members that can evade most therapeutic approaches aimed at “the tumor cell”. BioEssays 23:1037–1046, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

In this article, we use the theory of Information Ethics to argue that deceased people have a prima facie moral right to privacy in the context of health data research, and that this should be reflected in regulation and guidelines. After death, people are no longer biological subjects but continue to exist as informational entities which can still be harmed/damaged. We find that while the instrumental value of recognising post-mortem privacy lies in the preservation of the social contract for health (...) research, its intrinsic value is grounded in respect for the dignity of the post-mortem informational entity. However, existing guidance on post-mortem data protection is available only in the context of genetic studies. In comparing the characteristics of genetic data and other health-related data, we identify two features of DNA often given as arguments for this genetic exceptionalism: relationality and embodiment. We use these concepts to show that at the appropriate Level of Abstraction, there is no morally relevant distinction between posthumous genetic and other health data. Thus, genetic data should not automatically receive special moral status after death. Instead we make a plea for ‘contextual exceptionalism’. Our analysis concludes by reflecting on a real-world case and providing suggestions for contextual factors that researchers and oversight bodies should take into account when designing and evaluating research projects with health data from deceased subjects. (shrink)

Although VL30 retrotransposable elements have been associated with certain cancers for nearly twenty years, because of their expression in rodent malignancies and recombination into murine sarcoma viruses, their causative role, if any, in cancer has been uncertain and enigmatic. Recent findings suggest loss of normal transcriptional control of specific VL30 element expression may make a critical contribution to tumor progression at a step associated with malignant conversion, by bringing into play a cellular program normally involved in wound healing. This program, (...) the fibroblast anoxic response system, includes an adaptation to glycolytic metabolism, secretion of metalloproteinases, and activation of an endonuclease. While appropriate for facilitating debris removal during wound healing, loss of control of this program in a cell which has already progressed to the benign neoplastic state has the potential to simultaneously produce the invasiveness and genomic instability charateristic of malignancy. Examination of tumors and tumor derived cell lines has confirmed that key aspects of this system are in fact activated in cancer. (shrink)

In this new and third edition, the additional fragments contained in the appendix of the second edition have been incorporated in the main text. Some further discoveries have been included, and reference has been made to the results of recent research on the relative placing of certain papyrus fragments. The index of names has been brought up to date.

The notion of autonomy commonly employed in medical ethics literature and practices is inadequate on three fronts: it fails to properly identify nonautonomous actions and choices, it gives a false account of which features of actions and choices makes them autonomous or nonautonomous, and it provides no grounds for the moral requirement to respect autonomy. In this paper I offer a more adequate framework for how to think about autonomy, but this framework does not lend itself to the kinds of (...) practical application assumed in medical ethics. A general problem then arises: the notion of autonomy used in medical ethics is conceptually inadequate, but conceptually adequate notions of autonomy do not have the practical applications that are the central concern of medical ethics. Thus, a revision both of the view of autonomy and the practice of “respect for autonomy” are in order. (shrink)

I propose to begin with some fairly unexciting and uncontroversial remarks about possibility-statements, and then in their light to examine two problems philosophers have raised about certain statements of this kind which might be made in Christian theology where it touches on the doctrine of the Incarnation.