Body integrity identity disorder is a very rare condition in which people experience long-standing anguish because there is a mismatch between their bodies and their internal image of how their bodies should be. Most typically, these people are deeply distressed by the presence of what they openly acknowledge as a perfectly normal leg. Some with the condition request that their limb be amputated. 1 We and others have argued that such requests should be acceded to in carefully selected patients.1–4 Consistent (...) with this view, a group at the University of Sydney is developing a programme to better understand and treat BIID and to offer amputation if appropriate. In a recent paper, Patrone argues that such amputations should be prohibited.5 He suggests that authors supporting amputation in BIID depend on analogies with more familiar conditions and then claim that the ‘the desires, choices and requests of BIID patients should be held to exactly the same standards and treated with exactly the same respect as the desires, choices and requests of any more conventional patient’.5 He believes that these analogies are invalid and that therefore the arguments for amputation are invalid.Patrone concentrates a great deal upon whether a decision to have a particular medical intervention is to be regarded as ‘rational’. Unfortunately, he makes no attempt to define what he …. (shrink)
Here we prove that if T and T′ are strongly minimal theories, where T′ satisfies a certain property related to triviality and T does not, and T′ is model complete, then there is no computable embedding of Mod(T) into Mod(T′). Using this, we answer a question from , showing that there is no computable embedding of VS into ZS, where VS is the class of infinite vector spaces over Q, and ZS is the class of models of Th(Z, S). Similarly, (...) we show that there is no computable embedding of ACF into ZS, where ACF is the class of algebraically closed fields of characteristic 0. (shrink)
In contrast to Di Nucci’s characterisation, my argument is not a technoapocalyptic one. The view I put forward is that systems like IBM’s Watson for Oncology create both risks and opportunities from the perspective of shared decision-making. In this response, I address the issues that Di Nucci raises and highlight the importance of bioethicists engaging critically with these developing technologies.
En su artículo de 2000, Hookway pretende argumentar que el principio de justificación inferencial de Fumerton no tiene las consecuencias escépticas que Fumerton observa en él. Nosotros consideramos que Hookway está en lo cierto. Sin embargo, después de hacer algunos comentarios acerca de sus principales consideraciones a favor de esta tesis, desarrollamos una línea argumentativa independiente que refuerce esa misma conclusión.
The hypothesis that among attempted suicides, severity of intent to die is unrelated to the menstrual cycle was investigated in a sample of regularly menstruating women, using a validated intent scale. Women making their suicide attempts in the premenstrual week demonstrated a significantly higher suicidal intent but no differences in respect of other variables were observed.
Signs of mankind's solidarity, by J. R. Nelson.--Mankind, Israel and the nations in the Hebraic heritage, by M. Greenberg.--Christian insights from biblical sources, by C. Maurer.--Muhammad and all men, by D. Rahbar.--The impact of New World discovery upon European thought of man, by E. J. Burrus.--The effects of colonialism upon the Asian understanding of man, by J. G. Arapura.--Religious pluralism and the quest for human community, by S. J. Samartha.--From Confucian gentleman to the new Chinese 'political' man, by D. A. (...) Robinson.--The scientific revolution and the unity of man, by B. Towers.--Language and communication, by E. A. Nida.--Man and the son of man, by J. Moltmann.--The potentiality of conciliarity: communion, conscience, council, by W. B. Blakemore.--Oneness must mean wholeness, by J. R. Nelson. (shrink)
It would be an exaggeration to say that the Victorian age in England was philosophically barren; but it would not be a great exaggeration. By this somewhat uncomplimentary opening, I do not mean to imply that Victorian England contained no competent philosophers at all. Indeed, if one considers thinkers of the second and lower ranks only, their literary productivity was probably greater than those of any previous period in English, or even British, history, even if in sheer numbers they can (...) hardly compete with the prolific hordes of our own century. It is at the very highest level of philosophical greatness and originality that one finds the Victorian age wanting. The great period of British philosophy, which runs roughly from the 1630s to the 1770s, contains at least three thinkers who cannot be matched in the succeeding 140 years, Hobbes, Locke and Hume. (shrink)
BackgroundIn the Canadian Alliance for Healthy Hearts and Minds cohort, participants underwent magnetic resonance imaging of the brain, heart, and abdomen, that generated incidental findings. The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants were recruited with (...) a follow-up questionnaire administered to 909 participants at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% of participants, with the highest proportions found in the brain and abdomen. The majority of participants informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)
Frank Koughan and Walt Bogdanich's response to my article, “From Pittsburgh to Cleveland: NHBD Controversies and Bioethics,” reminds me of the Shakespearean line, “The lady protests too much, methinks.” My article was not about the specifics of the 60 Minutes April 13, 1997, story on NHBD at the Cleveland Clinic Foundation , even though the story formed the basis for the reflection. I did not attack the critics, though I do believe that bioethicists are accountable for their scholarly and public (...) pronouncements. Although I do not see why the 60 Minutes' story should be treated with deference, my article was designed to raise questions for a primarily bioethics audience about the involvement of bioethicists in media coverage of bioethics topics. I am flattered that they took notice of my piece, but think their efforts to set the record straight only obfuscate matters further. (shrink)
The objectively best language is intended to refer to some metaphysically privileged language that ‘carves reality at its joints’ perfectly. That is, it is the kind of language that various ‘metaphysical deflationists’ have argued is impossible. One common line of argument amongst deflationists is that we have no means to compare languages that all express true facts about the world in such a way to decide which is ‘better’. For example, the language is physics is not objectively better than the (...) language of economics, as each language has the semantic purpose of expressing some domain of truths about the world inexpressible in the other language, and therefore neither could be ‘objectively best’. In this paper, I argue that metaphysical deflationists have failed to recognise a distinction between fine- and coarse-grained semantic purposes of languages, and that a recognition of that distinction provides us grounds to compare languages to see which is objectively best. I argue that once we recognise the distinction between fine- and coarse-grained semantic purposes, then we can see that it is relative to the coarse-grained purpose that we must compare putative objectively best ontological languages. (shrink)
Recent EEG studies on the early postmortem interval that suggest the persistence of electrophysiological coherence and connectivity in the brain of animals and humans reinforce the need for further investigation of the relationship between the brain’s activity and the dying process. Neuroscience is now in a position to empirically evaluate the extended process of dying and, more specifically, to investigate the possibility of brain activity following the cessation of cardiac and respiratory function. Under the direction of the Center for Healthy (...) Minds at the University of Wisconsin-Madison, research was conducted in India on a postmortem meditative state cultivated by some Tibetan Buddhist practitioners in which decomposition is putatively delayed. For all healthy baseline and postmortem subjects presented here, we collected resting state electroencephalographic data, mismatch negativity, and auditory brainstem response. In this study, we present HB data to demonstrate the feasibility of a sparse electrode EEG configuration to capture well-defined ERP waveforms from living subjects under very challenging field conditions. While living subjects displayed well-defined MMN and ABR responses, no recognizable EEG waveforms were discernable in any of the tukdam cases. (shrink)
‘The Meaning of Life’ and ‘The Philosophy of Religion’ have meant different things to different people, and so I do well to alert my reader to what these phrases mean to me and thus to the subject area of this review of recent work on their intersection. First, ‘The Meaning of Life’: within the analytic tradition, an idea has gained widespread assent; whatever the vague and enigmatic nature of the phrase ‘the meaning of life’, we may sensibly speak of meaningfulness (...) in a life as a particular, positive, normative feature that some individuals’ lives may well have, and this feature is to be distinguished from, though closely related to, other positive features – satisfaction, wellbeing, virtue and so forth. There has been much work done on these assumptions in recent years. An excellent summary of this work up to its date of publication is given by Thaddeus Metz (in his 2007 a). Many – though by no means all – philosophers retain an instinctive scepticism toward the phrase ‘the meaning of life’ and a reluctance to engage with it, for it seems to connote vague and/or impossible-to-fulfil cosmic expectations. (See Thomson , chapter 11 and Seachris 2009 for attempts to engage with it nonetheless.) But philosophers are not generally now so sceptical about talk of meaningfulness in life and thus not so sceptical about the phrase ‘the meaning of life’ if it is taken to be referring merely to this. And that is how I shall be taking it. Secondly, ‘The Philosophy of Religion’: in the analytic tradition, this has usually been taken to be philosophical reflection on the rational acceptability or otherwise of classical theism and on what God's existence, should He exist, entails ontologically, metaphysically, metaethically and so forth. Therefore, I shall be talking about recent reflection in the analytic tradition on the relationship between the God of classical theism's existence (or lack of it) and meaningfulness (or lack of it) in human lives. (shrink)
The intuitive difference between a system that choreographs the motion of its parts in the service of goals of its own formulation and a system composed of a collection of parts doing their own thing without coordination has been shaken by now familiar examples of self-organization. There is a broad and growing presumption in parts of philosophy and across the sciences that the appearance of centralized information-processing and control in the service of system-wide goals is mere appearance, i.e., an explanatory (...) heuristic we have evolved to predict behavior, but one that will eventually get swept away in the advancing tide of self-organization. I argue that there is a distinction of central importance here, and that no adequate science of complex systems can dispense with it. (shrink)
The standard approach to protecting privacy in healthcare aims to control access to personal information. We cannot regain control of information after it has been shared, so we must restrict access from the start. This ‘control’ conception of privacy conflicts with data-intensive initiatives like precision medicine and learning health systems, as they require patients to give up significant control of their information. Without adequate alternatives to the control-based approach, such data-intensive programmes appear to require a loss of privacy. This paper (...) argues that the control view of privacy is shortsighted and overlooks important ways to protect health information even when widely shared. To prepare for a world where we no longer control our data, we must pursue three alternative strategies: obfuscate health data, penalise the misuse of health data and improve transparency around who shares our data and for what purposes. Prioritising these strategies is necessary when health data are widely shared both within and outside of the health system. (shrink)