Recent reports of the discovery of a “God module” in the human brain derive from the fact that epileptic seizures in the left temporal lobe are associated with ecstatic feelings sometimes described as an experience of the presence of God. The brain area involved has been described as either (a) the seat of an innate human faculty for experiencing the divine or (b) the seat of religious delusions.In fact, religious experience is extremely various and involves many parts of the brain, (...) including some that are prehuman in their evolutionary history and some that are characteristically human. In the continuing integration of such experiences, spiritual formation takes place. Thus the entire human brain might be described as a “God module.”Such a process is only possible because of the brain's complexity. The human brain is the most complex entity for its size that we know of. As used here, complexity is a specialized term denoting the presence of a web of interlinked and significant connections—the more intricate the web, the more complex the entity. Complex systems develop only in a milieu that provides both lawfulness and freedom, and they tend to be self‐organizing, becoming more complex and more effective as a result of both inward and outward experience. The evidence suggests that both personal growth and spiritual growth are processes of complexification of character, and of the brain itself. This thesis is tested in light of the work of William James and James W. Fowler. (shrink)

a comprehensive, somewhat Gricean theory of speech acts, including an account of communicative intentions and inferences, a taxonomy of speech acts, and coverage of many topics in pragmatics -/- .

Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health (...) care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly. (shrink)

Ayudha Puja, a South Indian festival translated as “worship of the machines,” is a dramatic example of how religion and science intertwine in political life. Across South India, but especially in the state of Karnataka, scientists and engineers celebrate the festival in offices, laboratories, and workshops by attending a puja led by a priest. Although the festival is noteworthy in many ways, one of its most immediate valences is political. In this article, we argue that Ayudha Puja normalizes Brahminical Hinduism (...) within scientific culture through the inclusion of non-Hindus and through scientists' description of the festival as “cultural” rather than “religious.”. (shrink)

Mindreading (or folk psychology, Theory of Mind, mentalizing) is the capacity to represent and reason about others’ mental states. The Simulation Theory (ST) is one of the main approaches to mindreading. ST draws on the common-sense idea that we represent and reason about others’ mental states by putting ourselves in their shoes. More precisely, we typically arrive at representing others’ mental states by simulating their mental states in our own mind. This entry offers a detailed analysis of ST, considers theoretical (...) arguments and empirical data in favour of and against it, discusses its philosophical implications, and illustrates some alternatives to it. (shrink)

Recent studies of early development in a number of ivertebrate and vertebrate species have suggested that growth factors and their receptors may play important roles in differentiation as well as cell proliferation. In the mouse embryo, the expression of the receptors for insulin and insulin‐like growth factors I and II (IGF‐I and ‐II) are temporally regulated. The ontogeny of receptor and ligand expression within the insulin and IGF gene family suggests that the very earliest stages of mammalian embryogenesis may be (...) subject to regulation by autocrine and paracrine factors from maternal and embryonic sources. (shrink)

One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.

A paediatric clinical trial conducted in a developing country is likely to encounter conditions or illnesses in participants unrelated to the study. Since local healthcare resources may be inadequate to meet these needs, research clinicians may face the dilemma of deciding when to provide ancillary care and to what extent. The authors propose a model for identifying ancillary care obligations that draws on assessments of urgency, the capacity of the local healthcare infrastructure and the capacity of the research infrastructure. The (...) model lends itself to a decision tree that can be adapted to the local context and resources so as to provide procedural guidance. This approach can help in planning and establishing organisational policies that govern the provision of ancillary care. (shrink)

Volume 20, Issue 5, June 2020, Page 40-42.

Determining whether a research risk meets or exceeds a regulatory standard of risk acceptability is difficult. Recently a framework called the systematic evaluation of research risks (SERR) has been proposed as a method of comparing research risks with predetermined standards of acceptability. SERR purports to offer a systematic and largely determinate (definite) way to compare risks and say whether a specific research risk falls below or above an acknowledged standard of acceptable risk. Here the authors review some philosophical problems with (...) this framework, which they take to be representative of determinate approaches to risk comparison, and conclude that it should not be used in a stand-alone or determinate fashion. Instead, the authors suggest that a deliberative approach may be a more viable candidate for future development. Such an approach could be informed by methods such as SERR without being rigidly bound to them. (shrink)

Book reviewed in this article: The New Health Care For Profit: Doctors and Hospitals in a Competitive Environment. Edited by Bradford H. Gray The Healing Mission and the Business Ethic. By Robert M. Cunningham The Medical Industrial Complex. By Stanley Wohl.

The visibility of transhumanism in pop culture reveals its dramatic advance in twenty-first-century life. The more widespread the movement becomes, the more important it is to consider how transhumanism might be made relevant to global humanity. This article orients technological progress by drawing transhumanism into conversation with minjung theology from Korea. Minjung theology offers global tech culture—and its pursuit of technological salvation—an ethical foundation through attention to Han (an emotion specific to those who suffer from individual, sociopolitical, economic, and cultural (...) oppression but have been unable to express it adequately) and the lived reality of those who are often excluded from benefits of technological society. Working in the other direction, transhumanist perspectives on technology offer minjung theology an opportunity to expand its reach through the development of a transcendent theological perspective. (shrink)

For more than sixty years, surgeons have used bioethical strategies to promote patient self‐determination, many of these now collectively described as “informed consent.” Yet the core framework—understanding, risks, benefits, and alternatives—fails to support patients in deliberation about treatment. We find that surgeons translate this framework into an overly complicated technical explanation of disease and treatment and an overly simplified narrative that surgery will “fix” the problem. They omit critical information about the goals and downsides of surgery and present untenable options (...) as a matter of patient choice. We propose a novel framework called “better conversations.” Herein, surgeons provide context about clinical norms, establish the goals of surgery, and comprehensively delineate the downsides of surgery to generate a deliberative space for patients to consider whether surgery is right for them. This paradigm shift meets the standards for informed consent, supports deliberation, and allows patients to anticipate and prepare for the experience of treatment. (shrink)

Previous studies have documented the fallibility of attempts by surrogates and physicians to act in a substituted judgment capacity and predict end-of-life treatment decisions on behalf of patients. We previously reported that physicians misperceive their patients' preferences and substitute their own preferences for those of their patients with respect to four treatments: cardiopulmonary resuscitation (CPR) in the event of cardiac arrest, ventilator for an indefinite period of time, medical nutrition and hydration for an indefinite period of time, and hospitalization in (...) the event of pneumonia. (shrink)

Sperm motility and respiration are tightly coupled processes, both activated by an increased intracellular pH (pHi). As the sperm pHi increases, the flagellar motor driving motility is activated, leading to ATP consumption. Energy for motility is provided by mitochondrial respiration; energy transport from sperm mitochondrion to tail involves distinct isozymes of creatine kinase that effect a phosphorylcreatine shuttle. The activation of sperm motility and respiration can be described as a linked series of biochemical reactions that form a cell behavioural pathway (...) analogous to the reaction sequences of intermediary metabolism. (shrink)

Sperm motility and respiration are tightly coupled processes, both activated by an increased intracellular pH (pHi). As the sperm pHi increases, the flagellar motor driving motility is activated, leading to ATP consumption. Energy for motility is provided by mitochondrial respiration; energy transport from sperm mitochondrion to tail involves distinct isozymes of creatine kinase that effect a phosphorylcreatine shuttle. The activation of sperm motility and respiration can be described as a linked series of biochemical reactions that form a cell behavioural pathway (...) analogous to the reaction sequences of intermediary metabolism. (shrink)

Olszewski and Goldkind's (2018) article on pediatric decision making in the clinical care setting is articulate and well written. The authors understand the challenges in ensuring that pediatric pa...

Background and aims: Recent investigations have highlighted the value of neuropsychological testing for the assessment and screening of Alcohol-Related Brain Damage. The aim of the present study was to evaluate the suitability of the Addenbrooke’s Cognitive Examination and the Repeatable Battery for the Assessment of Neuropsychological Status for this purpose. Methods: Comparing 28 participants with ARBD and 30 alcohol-dependent participants without ARBD we calculated Area Under the Curve statistics, sensitivity and specificity values, base-rate adjusted predictive values, and likelihood ratios for (...) both tests. Results: High levels of screening accuracy were found for the total scores of both the ACE-III and RBANS at multiple cut-off points. Removing participants with a history of polysubstance from the samples improved the diagnostic capabilities of the RBANS substantially, while only minor improvements to the ACE-III’s accuracy were observed. Conclusions: Overall, both the ACE-III and RBANS are suitable tools for ARBD screening within an alcohol-dependent population, though the RBANS is the superior of the two. Clinicians using these tools for ARBD screening should be cautious of false-positive outcomes and should therefore combine them with other assessment methods and more detailed neuropsychological testing before reaching diagnostic decisions. (shrink)

In this accessible and comprehensive work, Robert Solomon and Kathleen Higgins cover the entire history of philosophy--ancient, medieval, and modern, from cultures both East and West--in its broader historical and cultural contexts. Major philosophers and movements are discussed along with less well-known but interesting figures. The authors examine the early Greek, Indic, and Chinese philosophers and the mythological traditions that preceded them, as well as the great religious philosophies, including Christianity, Hinduism, Judaism, and Taoism. Easily understandable to students without (...) specialized knowledge of philosophy, A Short History of Philosophy demonstrates the relevance of philosophy to our times, illuminating the impact of the revolutions wrought by science, industry, colonialism, and sectarian warfare; the two world wars and the Holocaust; and the responses of philosophy in the schools of existentialism, postmodernism, feminism, and multiculturalism. In addition, the authors provide their own twists and interpretations of events, resulting in a broad view of the nature of philosophy as an intellectual discipline and its sometimes odd and dramatic consequences. (shrink)

In celebration of the fortieth anniversary of the publication of Beauchamp and Childress’s Principles of Biomedical Ethics, a review is undertaken to compare the lists of principles in various bioethical theories to determine the extent to which the various lists can be reconciled. Included are the single principle theories of utilitarianism, libertarianism, Hippocratism, and the theories of Pellegrino, Engelhardt, The Belmont Report, Beauchamp and Childress, Ross, Veatch, and Gert. We find theories all offering lists of principles numbering from one to (...) ten. Many of the differences can be reconciled, but some critical differences remain. (shrink)

When a new, brain-based definition of death was proposed fifty years ago, no one realized that the issue would remain unresolved for so long. Recently, six new controversies have added to the debate: whether there is a right to refuse apnea testing, which set of criteria should be chosen to measure the death of the brain, how the problem of erroneous testing should be handled, whether any of the current criteria sets accurately measures the death of the brain, whether standard (...) criteria include measurements of all brain functions, and how minorities who reject whole-brain-based definitions should be accommodated. These controversies leave little hope of consensus on how to define death for social and public policy purposes. Rather, there is persistent disagreement among proponents of three major groups of definitions of death: whole-brain, cardiocirculatory or somatic, and higher-brain. Given the persistence and reasonableness of each of these groups of definitions, public policy should permit individuals and their valid surrogates to choose among them. (shrink)

The tension between economic policy and health policy is a longstanding dilemma, but one that was brought to the fore with the World Trade Organization’s Trade-Related Aspects of Intellectual Property Rights Agreement in 1994. The pharmaceutical industry has long argued that intellectual property protection is vital for innovation. At the same time, there are those who counter that strong IPP negatively impacts the affordability and availability of essential medicines in developing countries. However, actors on both sides of the debate were (...) in agreement that something needed to be done to address the HIV/AIDS crisis, especially in developing countries. In response to sustained and significant pressure from civil society groups, members of the World Trade Organization agreed to the Declaration on the TRIPS Agreement and Public Health in 2001. The Declaration clarified that countries unable to manufacture the needed pharmaceuticals could obtain more affordable generics elsewhere if necessary. (shrink)

Clinicians cannot obtain valid consent to treatment because they cannot guess which treatment option will serve a particular patient's best interests. These guesses could be made more accurately if patients were paired with providers who share their deep values.

_Minds, Brains, Computers_ serves as both an historical and interdisciplinary introduction to the foundations of cognitive science.

Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the (...) circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals? perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research. (shrink)

In its October 2001 issue, this journal published a series of articles questioning the Whole-Brain-based definition of death. Much of the concern focused on whether somatic integration - a commonly understood basis for the whole-brain death view - can survive the brain's death. The present article accepts that there are insurmountable problems with whole-brain death views, but challenges the assumption that loss of somatic integration is the proper basis for pronouncing death. It examines three major themes. First, it accepts the (...) claim of the "disaggregators" that some behaviors traditionally associated with death can be unbundled, but argues that other behaviors (including organ procurement) must continue to be associated. Second, it rejects the claims of the "somaticists," that the integration of the body is critical, arguing instead for equating death with the irreversible loss of "embodied consciousness," that is, the loss of integration of bodily and mental function. Third, it defends higher-brain views against the charge that they are necessarily "mentalist," that is, that they equate death with losing some mental function such as consciousness or personhood. It argues, instead, for the integration of bodily and mental function as the critical feature of human life and that its irreversible loss constitutes death. (shrink)