The mainly medical law and health economics treatise follows the interdisciplinary theoretical approach of health services research. The focus is on managing health care in Germany through minimum numbers of cases. What effects does this concept have on the quality aspect and the needs-based approach to inpatient care. Methodologically, a selective literature search is used. In a comparative analysis between the states of Saxony-Anhalt and Schleswig-Holstein, empirical data are examined. As a result, it can be stated that the actors have (...) experienced a power shift in the health system due to the relevant legislation. In the future, it will be less the hospital planning of the federal states than the intermediary Federal Joint Committee (G-BA) and corporate structural development that will drive the centralization of the care landscape. (shrink)

Low birth rates in developed societies reflect women’s difficulties in combining work and motherhood. While demographic research has focused on the role of formal childcare in easing this dilemma, evolutionary theory points to the importance of kin. The cooperative breeding hypothesis states that the wider kin group has facilitated women’s reproduction during our evolutionary history. This mechanism has been demonstrated in pre-industrial societies, but there is no direct evidence of beneficial effects of kin’s support on parents’ reproduction in modern societies. (...) Using three-generation longitudinal data anchored in a sample of grandparents aged 55 and over in 1992 in the Netherlands, we show that childcare support from grandparents increases the probability that parents have additional children in the next 8 to 10 years. Grandparental childcare provided to a nephew or niece of childless children did not significantly increase the probability that those children started a family. These results suggest that childcare support by grandparents can enhance their children’s reproductive success in modern societies and is an important factor in people’s fertility decisions, along with the availability of formal childcare. (shrink)

In the three target articles, Ellen Fox et al. present data from their seminal study on ethics consultation in US general hospitals (Fox, Danis, et al. 2022, Fox and Duke 2022, Fox, Tarzian, et al....

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

MPZL3 is a nuclear‐encoded, mitochondrially localized, immunoglobulin‐like V‐type protein that functions as a key regulator of epithelial cell differentiation, lipid metabolism, ROS production, glycemic control, and energy expenditure. Recently, MPZL3 has surfaced as an important modulator of sebaceous gland function and of hair follicle cycling, an organ transformation process that is also governed by peripheral clock gene activity and PPARγ. Given the phenotype similarities and differences between Mpzl3 and Pparγ knockout mice, we propose that MPZL3 serves as a signaling hub (...) that is regulated by core clock gene products and/or PPARγ to translate signals from these nuclear transcription factors to the mitochondria to modulate circadian and metabolic regulation. Conservation between murine and human MPZL3 suggests that human MPZL3 may have similarly complex functions in health and disease. We summarize current knowledge and discuss future directions to elucidate the full spectrum of MPZL3 functions in mammalian physiology. (shrink)

Recent findings suggest that C. elegans, albeit displaying an invariant cell lineage for embryonic development, uses the same basic strategy for embryogenesis as other organisms. The early embryo is regionalised by cell‐cell interactions.

ZusammenfassungFünfzehn Jahre nach ihrer Entstehung ist die Neuroethik ein internationales wissenschaftliches Feld mit enormer Dynamik. Innerhalb weniger Jahre wurden eigene Kongresse, Zeitschriften, Forschungsförderprogramme, Fachgesellschaften und Institute gegründet. Gleichwohl besteht erheblicher Dissens über die Definition und den Gegenstandsbereich dieses neuen Gebiets. Wir argumentieren hier für eine differenzierte Konzeption, wonach neben der Reflexion ethischer Probleme der Neurowissenschaft und ihrer überwiegend neurotechnologischen Anwendungen auch die ethische Reflexion neurowissenschaftlicher Forschung zur Moralität zur Neuroethik gehört. Dies umfasst zwar nicht neurowissenschaftliche oder neuropsychologische Studien zur Moralität, (...) wohl aber die Reflexion der Bedeutung dieser Forschung für die Ethik und das Recht. Wir geben einen Überblick über die wichtigsten Themen der Neuroethik, woraus deutlich wird, wie sehr in verschiedenen gesellschaftlichen Bereichen, auch jenseits von Medizin und Gesundheitswesen, neuroethische Fragen relevant sind. Das Potenzial der Neuroethik als eines neuen Wissenschaftsfeldes liegt darin, durch eine Verknüpfung neurophilosophischer und medizinethischer Themen sowie eine breite interdisziplinäre Vernetzung neue Antworten auf gesellschaftlich drängende Fragen zu finden. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

Dandruff is a common scalp condition, which frequently causes psychological distress in those affected. Dandruff is considered to be caused by an interplay of several factors. However, the pathogenesis of dandruff remains under‐investigated, especially with respect to the contribution of the hair follicle. As the hair follicle exhibits unique immune‐modulatory properties, including the creation of an immunoinhibitory, immune‐privileged milieu, we propose a novel hypothesis taking into account the role of the hair follicle. We hypothesize that the changes and imbalance of (...) yeast and bacterial species, along with increasing proinflammatory sebum by‐products, leads to the activation of immune response and inflammation. Hair follicle keratinocytes may then detect these changes in scalp microbiota resulting in the recruitment of leukocytes to the inflammation site. These changes in the scalp skin immune‐microenvironment may impact hair follicle immune privilege status, which opens new avenues into exploring the role of the hair follicle in dandruff pathogenesis. Also see the video abstract here: https://youtu.be/mEZEznCYtNs. (shrink)

The microbiome of human hair follicles (HFs) has emerged as an important player in different HF and skin pathologies, yet awaits in‐depth exploration. This raises questions regarding the tightly linked interactions between host environment, nutrient dependency of host‐associated microbes, microbial metabolism, microbe‐microbe interactions and host immunity. The use of simple model systems facilitates addressing generally important questions and testing overarching, therapeutically relevant principles that likely transcend obvious interspecies differences. Here, we evaluate the potential of the freshwater polyp Hydra, to dissect (...) fundamental principles of microbiome regulation by the host, that is the human HF. In particular, we focus on therapeutically targetable host‐microbiome interactions, such as nutrient dependency, microbial interactions and host defence. Offering a new lens into the study of HF – microbiota interactions, we argue that general principles of how Hydra manages its microbiota can inform the development of novel, microbiome‐targeting therapeutic interventions in human skin disease. (shrink)

Coall & Hertwig (C&H) suggest that, because grandparental investments do not impact on child mortality in low-risk societies, fitness effects are not plausible any more. We found that grandparental investments could very well alleviate contemporary constraints on fertility. Cultural factors may influence both the occurrence and impact of grandparental investments.

It was initially believed that G‐protein‐coupled receptors, such as metabotropic glutamate receptors, could simply be described as individual proteins that are associated with intracellular signal cascades via G‐proteins. This view is no longer tenable. Today we know that metabotropic glutamate receptors (mGluRs) can dimerize and bind to a variety of proteins in addition to trimeric G‐proteins. These newly identified protein interactions led to the discovery of new regulatory mechanisms that are independent of and sometimes synergistic with the classical G‐protein‐coupled second (...) messenger pathways. Notably, several of these mechanisms connect mGluR‐mediated signaling to other receptor classes, thereby creating a network of different receptor types and associated signal cascades. The intracellular C‐termini of mGluRs play a key role in the regulation of these networks, and various new protein interactions of these domains were described recently. Because mGluRs are involved in a variety of physiological and pathophysiological processes, some of the proteins interacting with this receptor class have potential as valuable pharmaceutical targets. This review will give a comprehensive overview of proteins interacting with mGluR C‐termini, highlight new evolving regulatory mechanisms for glutamatergic signal transduction and discuss possibilities for future drug development. BioEssays 29: 60–73, 2007. © 2006 Wiley Periodicals, Inc. (shrink)

Causal queries about singular cases, which inquire whether specific events were causally connected, are prevalent in daily life and important in professional disciplines such as the law, medicine, or engineering. Because causal links cannot be directly observed, singular causation judgments require an assessment of whether a co‐occurrence of two events c and e was causal or simply coincidental. How can this decision be made? Building on previous work by Cheng and Novick (2005) and Stephan and Waldmann (2018), we propose a (...) computational model that combines information about the causal strengths of the potential causes with information about their temporal relations to derive answers to singular causation queries. The relative causal strengths of the potential cause factors are relevant because weak causes are more likely to fail to generate effects than strong causes. But even a strong cause factor does not necessarily need to be causal in a singular case because it could have been preempted by an alternative cause. We here show how information about causal strength and about two different temporal parameters, the potential causes' onset times and their causal latencies, can be formalized and integrated into a computational account of singular causation. Four experiments are presented in which we tested the validity of the model. The results showed that people integrate the different types of information as predicted by the new model. (shrink)

Dealing with errors in psychotherapy is challenging, both ethically and practically. There is almost no empirical research on this topic. We aimed (1) to explore psychotherapists’ self-reported ways of dealing with an error made by themselves or by colleagues, and (2) to reconstruct their reasoning according to the two principle-based ethical approaches that are dominant in the ethics discourse of psychotherapy, Beauchamp & Childress (B&C) and Lindsay et al. (L).

We show that either of the following hypotheses imply that there is an inner model with a proper class of strong cardinals and a proper class of Woodin cardinals. 1) There is a countably closed cardinal k ≥ N₃ such that □k and □(k) fail. 2) There is a cardinal k such that k is weakly compact in the generic extension by Col(k, k⁺). Of special interest is 1) with k = N₃ since it follows from PFA by theorems of (...) Todorcevic and Velickovic. Our main new technical result, which is due to the first author, is a weak covering theorem for the model obtained by stacking mice over $K^c ||k.$. (shrink)

Background Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. Objective To examine the role of advance directives, orally expressed wishes, or the presumed will of (...) patients in a VS for family caregivers' decisions on life-sustaining treatment. Methods and sample A qualitative interview study with 14 next of kin of patients in a VS in a long-term care setting was conducted; 13 participants were the patient's legal surrogates. Interviews were analysed according to qualitative content analysis. Results The majority of family caregivers said that they were aware of aforementioned wishes of the patient that could be applied to the VS condition, but did not base their decisions primarily on these wishes. They gave three reasons for this: (a) the expectation of clinical improvement, (b) the caregivers' definition of life-sustaining treatments and (c) the moral obligation not to harm the patient. If the patient's wishes were not known or not revealed, the caregivers interpreted a will to live into the patient's survival and non-verbal behaviour. Conclusions Whether or not prior treatment wishes of patients in a VS are respected depends on their applicability, and also on the medical assumptions and moral attitudes of the surrogates. We recommend repeated communication, support for the caregivers and advance care planning. (shrink)

Jecker et al. (2024) offer seven principles with which to guide conference organizers and assess how ethically a conference is organized. While focused on bioethics, these principles are relevant t...

In the debate on epistemic injustice, it is generally assumed that testimonial injustice as one form of epistemic injustice cannot be committed (fully) deliberately or intentionally because it involves unconscious identity prejudices. Drawing on the case of sexual violence against refugees in European refugee camps, this paper argues that there is a form of testimonial injustice—willful testimonial injustice—that is deliberate. To do so, the paper argues (a) that the hearer intentionally utilizes negative identity prejudices for a particular purpose and (b) (...) that the hearer is aware of the fact that the intentionally used prejudices are in fact prejudices. Furthermore, the paper shows how testimonial injustice relates to recognition failures both in terms of a causal as well as a constitutive claim. In fact, introducing willful testimonial injustice can support the constitutive claim of such a relation that has so far received little attention. Besides arguing for a novel form of testimonial injustice and contributing to the recent debate on the relation between epistemic injustice and recognition failures, this paper is also motivated by the attempt to draw attention to the inhumane conditions for refugees at the border of Europe as well as elsewhere. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On the Trinity:An Ecumenical ConversationIsidoros C. KatsosIntroductionThis paper explores the potential impact of Fr. Thomas Joseph White's impressive new book on the Trinity for the ecumenical dialogue between the Roman Catholic and the Orthodox Churches.1 In doing so, the paper responds to the editors' kind request for an explicitly ecumenical approach to the book. Therefore, this paper concentrates on the issue of the Trinity from an ecumenical perspective. But (...) this is not a simple task. Before reading the book, the reader might have thought that Eastern and Western theologians had somehow reached a gentlemen's agreement that the insertion of the Filioque clause in the Nicene-Constantinopolitan Creed had happened sometime somewhere in the Wild West (namely, at the local Council of Toledo in 589). Building on an honest misunderstanding, the Latin Church gradually added to the initial statement of the Nicene-Constantinopolitan Creed, according to which the Spirit proceeds "from the Father" (ek tou patros), that the Spirit proceeds "from the Father and the Son" (ex Patre Filioque).2 In the absence of an ecumenical council that would have settled the issue, the creedal addition became the thorniest issue of theological contention between East and West, leading to the "Great Schism." Things took a new [End Page 493] turn during the twentieth century when Pope Paul VI and the Ecumenical Patriarch Athenagoras decided that a new rapprochement was desirable and possible.3 Since then, Eastern theologians have showed willingness, for the first time in centuries, to quiet down their concerns about the Filioque as unwarranted speculation, if not falsification, of the Trinitarian doctrine of the Church Fathers.4 In exchange, they saw their Western colleagues quieting down their own normative claims about the theological necessity of the Filioque.5 The general sentiment in the theological schools, in the East at least, was that the true reasons of the Schism had relocated from the sphere of theology to the sphere of terminology, history, and culture.6 The controversy over the Filioque could be seen as an infelix culpa that shaped Eastern and Western Christianity as religious communities, a historic misunderstanding of historical proportions. Contextual rather than doctrinal—that seemed to [End Page 494] be the shift achieved in the last century.7 After reading the book, however, the reader might think that we are about to return to the previous state. For White now argues that the Filioque is not "just" an accident of language, history, and culture, something that could have happened or not, but the only correct interpretation of the Nicene faith:When the Father spirates the Spirit from all eternity, he necessarily does so as Father of the Son and so also in the Son and with the Son.(108; emphasis mine)As to the historically contested question of the Filioque, there are … many scriptural and traditional bases in favor of its affirmation. In addition, Aquinas affirms it as a necessary component of Trinitarian theology.(504; emphasis mine)If White's argument is correct, it has serious impact on the ecumenical dialogue: it suggests that, regardless of what happened in Toledo in the sixth century, Christian theologians in East and West ought to understand the Nicene-Constantinopolitan Creed as entailing that the third person of the Trinity always proceeds from the other two together. To put it more pointedly: if the argument of the book is correct, the Orthodox rejection of the Filioque must betoken a failure to grasp something true and important about the life of the Trinity.Clearly, the resurgence of the Filioque as a normative claim poses a genuine challenge for the Orthodox reader. If the Filioque is the correct Trinitarian doctrine, what room is there left for the Orthodox contrary position? In situations like this in the past, an Orthodox theologian would consider whether to meet the argument head on by producing contrary readings of the same patristic sources or to entirely undermine it by softening its conclusions. I presume this would still be the instinctive reaction of the average Orthodox reader. I find this kind of response not conducive to ecumenical dialogue. Let me then probe here with something new. In what follows, I want to... (shrink)

God and the City, based on the Aquinas Lecture delivered at the University of Dallas in 2022, aims to think about politics ontologically. In other words, it seeks to reflect on, not some political theory or other, nor on the legitimacy of political action or the distinctiveness of particular regimes, but on the nature of political order as such, and how this order implicates the fundamental questions of existence, those concerning man, being, and God. Aristotle, and Aquinas after him, identified (...) metaphysics and politics as "architectonic" sciences, since each concerns in some respect the whole of reality, of which the particular sciences study a part. Chapter one of this book argues that, just as metaphysics, in studying being as a whole, cannot but address the question of God in some respect, so too does politics, the ordering of human life as a whole, necessarily implicate the existence of God. In this regard, the modern liberal project has deluded itself in attempting to render religion a private, rather than a genuinely political, matter. We cannot organize human existence without making some claim, whether implicitly or explicitly, about the nature of God and God's relation to the world. The second chapter approaches this theme from the anthropological dimension. As Plato affirmed, the "city is the soul writ large": if man is religious by nature, he cannot be properly understood, and the human good cannot be properly secured and fostered, if the "God question" is "bracketed out" of the properly political order. Moreover, if we fail to recognize the essentially political dimension of relation to God, we will be unable properly to grasp the presence of God in the (ecclesial and sacramental) Body of Christ: God cannot be real in the Church as Church unless he is also real in the city as city (and vice versa). In his De regno, Aquinas famously affirms that "the king is to be in the kingdom what the soul is in the body and what God is in the world." Chapter three offers a careful study of the body-soul relationship in order to illuminate, on the one hand, the nature of political authority, and, on the other, the precise way that God is present in human community. (shrink)

Self, Language, and World: Problems from Kant, Sellars, and Rosenberg Edited by James R. O'Shea and Eric M. Rubenstein Introduction KANT Willem deVries, Kant, Rosenberg, and the Mirror of Philosophy David Landy, The Premise That Even Hume Must Accept LANGUAGE AND MIND William G. Lycan, Rosenberg On Proper Names Douglas Long, Why Life is Necessary for Mind: The Significance of Animate Behavior Dorit Bar-On and Mitchell Green, Lionspeak: Communication, Expression, and Meaning David Rosenthal, The Mind and Its Expression MIND AND (...) KNOWLEDGE Jeffrey Sicha, The Manifest Image: the Sensory and the Mental Bruce Aune, Rosenberg on Knowing Joseph C. Pitt, Sellarsian Antifoundationalism and Scientific Realism Matthew Chrisman, The Aim of Belief and the Goal of Truth: Reflections on Rosenberg James O’Shea, Conceptual Thinking and Nonconceptual Content: A Sellarsian Divide ONTOLOGY Anton Koch, Persons as Mirroring the World Eric M. Rubenstein, Form and Content, Substance and Stuff Ralf Stoecker, On Being a Realist About Death William G. Lycan, Biographical Remarks on Jay F. Rosenberg Scholarly Publications of Jay F. Rosenberg. (shrink)

Sport categorization is often justified by benefits such as increased fairness or inclusion. Taking inspiration from John Rawls, Sigmund Loland’s fair equality of opportunity principle in sport (FEOPs) is a tool for determining whether the existence of an inequality ethically justifies the institution of a new category in any given sport. It is an elegant ethical normative framework, but since FEOPs does not account explicitly for athlete safety (i.e. athlete physical and mental wellbeing), we are left in an ethically dubious (...) situation where the risk of harm associated with a categorization regime might in fact prove to be greater than the risk of harm present within the sport before its introduction. To address this critical gap, I propose the ‘scales of ignorance’ ethical normative framework to weigh the relative risk of harm within a sport, crucially inserting athlete safety into the discourse surrounding ethical justification for categorization in sport. The current paper is the first explicit formulation of assessment and ethical justification of risk of harm in the familiar logic of FEOPs. The scales of ignorance framework can also be used independently of Loland’s approach. Two new concepts are also proposed: ‘insidious risk of harm’ and ‘pernicious risk of harm’. (shrink)

Early in World War I, Virginia Woolf wrote these words: ‘The future is dark, which is on the whole, the best thing the future can be […]’. It is tempting to assume that darkness simply hides the unknown and the threatening. It is more challenging to think of it as Woolf did: rich with possibility in even the most desperate times.We live in what many would readily describe as dark times. These times have brought (among much else) a once-in-a-century public (...) health crisis, the continued redemption of toxic white supremacy, declining trust in and support for public institutions, and growing evidence of impending climate devastation. ‘Dark Futures’ will consider some of the scenes of this devastation and mine them for insights into our predicaments and our prospects. (shrink)

How can a course on engineering ethics affect an undergraduate student’s feelings of responsibility about moral problems? In this study, three groups of students were interviewed: six students who had completed a specific course on engineering ethics, six who had registered for the course but had not yet started it, and six who had not taken or registered for the course. Students were asked what they would do as the central character, an engineer, in each of two short cases that (...) posed moral problems. For each case, the role of the engineer was successively changed and the student was asked how each change altered his or her decisions about the case. Students who had completed the ethics course considered more options before making a decision, and they responded consistently despite changes in the cases. For both cases, even when they were not directly involved, they were more likely to feel responsible and take corrective action. Students who were less successful in the ethics course gave answers similar to students who had not taken the course. This latter group of students seemed to have weaker feelings of responsibility: they would say that a problem was “not my business.” It appears that instruction in ethics can increase awareness of responsibility, knowledge about how to handle a difficult situation, and confidence in taking action. (shrink)

Glowacki defines peace as harmonious relationships between groups maintained without the threat of violence, where groups can be anything from families to nation states. However, defining such contentious concepts like “peace” and “groups” is a difficult task, and we discuss the implications of Glowacki's definitions for understanding intergroup relationships and their evolutionary history.

Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and marginalised (...) groups, hindering their access to and influence within medicine.2 They also undermine access to information about, and from, the WMA. Recruiting new members from, and better engaging members in, LMICs would strengthen the WMA and its influence across the medical profession, and better elevate environmental sustainability as a biomedical and bioethical concern. This would be beneficial because there is controversy among physicians, bioethicists and other stakeholders about the relevance of environmental sustainability to medicine.3 4 That its addition to the ICoME was ‘uncontentious’ hints at structural and epistemic injustices in the revision process and homogeneity of those most involved in the revisions. Based on our observations as medical educators, it appears that few medical students and physicians at our institution, and few across the Caribbean and …. (shrink)

Recently, approach-avoidance tendencies and visual perception biases have been increasingly studied using bistable point-light walkers (PLWs). Prior studies have found a facing-the-viewer bias when one is primed with general threat stimuli (e.g. angry faces), explained by the “error management theory”, as failing to detect a threat as approaching is riskier than the opposite. Importantly, no study has explored how disease threat – linked to the behavioural immune system – might affect this bias. This study aimed to explore whether disease-signalling cues (...) can alter how we perceive the motion direction of ambiguous PLWs. Throughout 3 experiments, participants indicated the motion direction of a bistable PLW previously primed with a control or disease-signalling stimuli – that is, face with a surgical mask (Experiment 1), sickness sound (Experiment 2), or face with a disease cue (Experiment 3). Results showed that sickness cues do not significantly modulate the perception of approach-avoidance behaviours. However, a pattern emerged in Experiments 2 and 3, suggesting that sickness stimuli led to more facing away percepts. Unlike other types of threat, this implies that disease-related threat stimuli might trigger a distinct perceptual bias, indicating a preference to avoid a possible infection source. Nonetheless, this finding warrants future investigations. (shrink)

Pharmacy Benefit Managers (PBM) induce drug manufacturers to offer rebates to insurers and employers by denying coverage through formulary exclusions, impeding physician prescription through prior authorization, and reducing patient drug use through cost sharing. As they tighten these access obstacles, PBMs reduce the net prices received by the manufacturers.