An anthropocentric scope for clinical medical ethics (CME) has largely separated this area of bioethics from environmental concerns. In this article, we first identify and reconcile the ethical issues imposed on CME by climate change including the dispersion of related causes and effects, the transdisciplinary and transhuman nature of climate change, and the historic divorce of CME from the environment. We then establish how several moral theories undergirding modern CME, such as virtue ethics, feminist ethics, and several theories of justice, (...) promote both a flourishing of human medical practice and the environment. We conclude by defining an expanded the scope of CME as inclusive of not only patients, families, physicians, and other health professionals but other humans, non-humans, and their shared environment. We then apply this scope and theory to a widely used framework for applying CME, the Four Topics model, to construct a climate conscious approach to CME. (shrink)

It is widely recognized that police performance may be hindered by psychophysiological state changes during acute stress. To address the need for awareness and control of these physiological changes, police academies in many countries have implemented Heart-Rate Variability biofeedback training. Despite these trainings now being widely delivered in classroom setups, they typically lack the arousing action context needed for successful transfer to the operational field, where officers must apply learned skills, particularly when stress levels rise. The study presented here aimed (...) to address this gap by training physiological control skills in an arousing decision-making context. We developed a Virtual-Reality breathing-based biofeedback training in which police officers perform deep and slow diaphragmatic breathing in an engaging game-like action context. This VR game consisted of a selective shoot/don’t shoot game designed to assess response inhibition, an impaired capacity in high arousal situations. Biofeedback was provided based on adherence to a slow breathing pace: the slower and deeper the breathing, the less constrained peripheral vision became, facilitating accurate responses to the in-game demands. A total of nine male police trainers completed 10 sessions over a 4-week period as part of a single-case experimental ABAB study-design. Results showed that eight out of nine participants showed improved breathing control in action, with a positive effect on breathing-induced low frequency HRV, while also improving their in-game behavioral performance. Critically, the breathing-based skill learning transferred to subsequent sessions in which biofeedback was not presented. Importantly, all participants remained highly engaged throughout the training. Altogether, our study showed that our VR environment can be used to train breathing regulation in an arousing and active decision-making context. (shrink)

There is societal consensus that cancer clinical trial participation is unjust because some sociodemographic groups have been systematically underrepresented. Despite this, neither a definition nor an ethical explication for the justice norm of equity has been clearly articulated in this setting, leading to confusion over its application and goals. Herein we define equity as acknowledging sociodemographic circumstances and apportioning resource and opportunity allocation to eliminate disparities in outcomes, and we explore the issues and tensions this norm generates through practical examples. (...) We assess how equality-based enrollment structures in clinical cancer research have perpetuated historical disparities and what equity-based alternatives are necessary to achieve representativeness and an expansive conception of participatory justice in clinical cancer research. This framework addresses the breadth from normative to applied by defining the justice norm of equity and translating it into practical strategies for addressing participation disparities in clinical cancer research. (shrink)

As neuroethics continues to grow as an established discipline, it has been charged with not being sufficiently sensitive to the way in which the identification, conceptualization, and management of the ethical issues raised by neuroscience and its applications are shaped by local systems of knowledge and structures. Recently there have been calls for explicit recognition of the role played by local cultural contexts and for the development of cross‐cultural methodologies that can facilitate meaningful cultural engagement. In this article, we attempt (...) to fill this perceived gap by providing a culturally situated analysis of the practice of electroconvulsive therapy (ECT) in Argentina. ECT was introduced as a psychiatric treatment in Argentina in the 1930s but it is largely underutilized. While the use of ECT remains low in several countries, what makes the Argentinian case interesting is that the executive branch of government has taken a stance regarding both the scientific and moral appropriateness of ECT, recommending its prohibition. Here, we begin with a recent controversy over the use of ECT in Argentina and explain the legal recommendation to ban its application. Next, we offer an overview of some of the salient aspect of the international and local discussions on ECT. We argue that the governmental recommendation to ban the procedure should be rethought. While acknowledging the role that contexts and local conditions play in shaping the identification and assessment of the relevant ethical issues, we caution against using contextual and cultural considerations to avoid a necessary ethical debate on controversial issues. (shrink)

This article investigates the role of privacy and transparency in the 4th Space and outlines their implications for the development and dissemination of conspiracy theories. We argue that privacy can be exploited by individuals and organizations to spread conspiracy theories online, while organizational transparency, intended to increase accountability and ultimately trust, can have the adverse effect and nurture conspiracy beliefs. Through the lens of the 4th Space concept, we offer suggestions on how to approach those challenges which emerge as a (...) result of the complex entanglements of both actual and virtual world across time. (shrink)

This article investigates the role of privacy and transparency in the 4th Space and outlines their implications for the development and dissemination of conspiracy theories. We argue that privacy can be exploited by individuals and organizations to spread conspiracy theories online, while organizational transparency, intended to increase accountability and ultimately trust, can have the adverse effect and nurture conspiracy beliefs. Through the lens of the 4th Space concept, we offer suggestions on how to approach those challenges which emerge as a (...) result of the complex entanglements of both actual and virtual world across time. (shrink)

As part of the Dutch national science program “Professional Games for Professional Skills” we developed a stress-exposure biofeedback training in virtual reality for the Dutch police. We aim to reduce the acute negative impact of stress on performance, as well as long-term consequences for mental health by facilitating physiological stress regulation during a demanding decision task. Conventional biofeedback applications mainly train physiological regulation at rest. This might limit the transfer of the regulation skills to stressful situations. In contrast, we provide (...) the user with the opportunity to practice breathing regulation while they carry out a complex task in VR. This setting poses challenges from a technical – as well as from a user-experience perspective. We illustrate how we approach these challenges in our training and hope to contribute a useful reference for researchers and developers in academia or industry who are interested in using biosignals to control elements in a dynamic virtual environment. (shrink)

Introduction: Physical distancing under the coronavirus disease 2019 pandemic had a significant impact on lifestyles, including exercise routines. In this study, we examined the relationship between mental health and addictive behaviors, such as excessive exercise and the use of image and performance enhancing drugs across 12 sport disciplines.Materials and methods: A large cross-sectional sample of the adult population was surveyed. The mean age was 33.09. The number of male participants was 668. The use of IPEDs was assessed in conjunction with (...) psychometric measures such as the Exercise Addiction Inventory and the Appearance Anxiety Inventory. The participants were grouped into activity group and non-activity group according to the presence or absence of their exercise habits. The results were compared between these groups, as well as across sport disciplines, while taking into account the relationship between different psychological measures and IPEDs consumption.Results: The frequency of IPEDs use was higher among AG than NAG, although AG participants reported less history of addictions than NAG. The logistic regression analysis revealed that scores equal to or above cutoff points, in both the EAI and AAI, predicted the IPEDs use. Regarding the differences across the various sport disciplines, those who were involved in practicing Weight Lifting and Cross Fit were found to be more at risk of excessive exercising and more inclined to use a wide range of IPEDs.Conclusions: Although exercise could help to increase well-being and prevent addictions during the COVID-19 pandemic, our results show that those in the AG are particularly vulnerable to excessive IPEDs use. Sport disciplines associated with higher EAI and AAI scores have also shown a higher tendency to excessive IPEDs use. Furthermore, the factor of having above the cutoff scores in EAI or AAI in each sport could indicate larger IPEDs consumption regardless of the discipline. In light of the current findings, it is necessary to better define the “non-excessive” levels of exercise in various sport disciplines and an adequate intake of IPEDs to ensure the safety and well-being of people during a pandemic. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Now?Mike AbellThe cry broke the church’s uncomfortable silence. It actually was more of a moan than a cry. It was deeper, coming from her core. I’d heard it only once before and knew it as a sound caused by a loss that will never be recovered. No one in the church had to turn to discover its source. We all knew the mother had entered to say goodbye (...) to her 19–month–old son.We watched as the now composed mother, along side her husband, followed the small casket—a family rendered incomplete. As they passed our pew, my wife clutched my arm and we wept tears of sympathy, guilt and fear.Just 15 months earlier our now, 2–and ½–year–old son, Jun, had been diagnosed with a brain tumor not dissimilar from the child in the casket. The tumor has a different name, but it’s equally complicated, and comparably rare and aggressive.Over nine months, Jun endured two craniotomies, three rounds of induction chemo, three rounds of high dose chemo with stem cell rescue, 28 days of proton radiation, a sub–dural shunt placement, a port placed and removed, a broviac placed and removed and many, many blood and [End Page 16] platelet transfusions. As of his last scan, there was no evidence of tumor.Jun has now been out of treatment for six months. His hair has grown back. He’s stronger. The meals have stopped arriving. And we no longer are the recipients of sad eyes at playgrounds and restaurants.In many ways we have returned to a somewhat normal life. If you didn’t know Jun was in remission for a brain tumor, you wouldn’t know. Despite all this, cancer still strangles us with fear.Brain tumors often come back. Too often. We’ve heard a few different numbers on the likelihood. And while we’ve never paid too much attention to statistics, they are too scary to ignore. Especially knowing that should it recur, there is no cure. This is our day–to–day reality.A lot of our time is spent analyzing, over analyzing and obsessing. We watch him closely. Every time he stumbles, coughs, or sleeps fifteen minutes longer than normal, we wonder if it’s something more. I’ve called our oncologist about a 99–degree temperature. Something I wouldn’t have done during treatment (I usually waited to 100). I’ve questioned whether hiccups are a sign of recurrence. Admittedly, I’ve even Googled that last one just to be sure.All the anxiety builds the closer you get to an MRI date. My son has scans every three months so I’m beginning to recognize the cycle. It starts a couple weeks out. Normally it begins as a twinge the moment the date is set. But each day it grows, occupying more and more of my mind. This is not to say, I don’t think about it everyday. I do. But the thoughts become more paranoid and frequent. Worst–case scenarios play out. It’s different from the time during treatment. We always had the comfort of knowing that there is still more treatment.By the time we reach MRI day, bring Jun back to the machine room, watch the anesthesiologist put him under, and leave him to be scanned for the next two and half hours, I feel close to nauseas. In my mind, at this point, someone knows. I know they may be a technician and are not necessarily trained to read an MRI. But they know. They’ve seen it before.There usually is a waiting period between the time of the scan and the time you can meet with your oncologist or someone else qualified to read and interpret the scan. I do whatever I can to make that window as narrow as possible. I leave radiology with a disc in hand and head directly to the clinic to pass it off. I’ve heard of people waiting days for an appointment. That’s not an option for me. There would be no eating, no sleeping, and no resting heart rate without knowing. Fortunately, our oncologist is... (shrink)

Le 9e siècle marque un tournant dans l'hagiographie byzantine qui devient de plus en plus sécularisée à la fois dans sa forme et dans son contenu. Deux Vitae datant de la fin du 9e siècle, la vie d'Antoine le jeune et la vie de l'impératrice Theodora jouent un rôle pivot dans ce processus de sécularisation. Elles offrent les modèles d'une piété masculine et d'une piété féminine en témoignant de deux formes antithétiques de l'expérience religieuse : celle monastique et celle (...) séculaire. Cette tension trouve ses racines dans l'iconoclasme et reste vivante dans la période post-iconoclaste dans le conflit qui oppose le patriarche Ignace à Photios. (shrink)

Resolution is an effective deduction procedure for classical logic. There is no similar "resolution" system for non-classical logics (though there are various automated deduction systems). The paper presents resolution systems for intuistionistic predicate logic as well as for modal and temporal logics within the framework of labelled deductive systems. Whereas in classical predicate logic resolution is applied to literals, in our system resolution is applied to L(abelled) R(epresentation) S(tructures). Proofs are discovered by a refutation procedure defined on LRSs, that imposes (...) a hierarchy on clause sets of such structures together with an inheritance discipline. This is a form of Theory Resolution. For intuitionistic logic these structures are called I(ntuitionistic) R(epresentation) S(tructures). Their hierarchical structure allows the restriction of unification of individual variables and/or constants without using Skolem functions. This structures must therefore be preserved when we consider other (non-modal) logics. Variations between different logics are captured by fine tuning of the inheritance properties of the hierarchy. For modal and temporal logics IRS's are extended to structures that represent worlds and/or times. This enables us to consider all kinds of combined logics. (shrink)

Using a conviction-based measure, we find that local public corruption exerts a negative effect on the lending activity of US banks. Our baseline estimations show that the difference in public corruption between, for example, Alabama, where corruption is high, and Minnesota, where corruption is low, implies that banks headquartered in the former state grant 0.55% less credit ceteris paribus. Using proxies for relationship lending and monitoring, we also find that these bank characteristics weaken the negative effect of public corruption on (...) lending. These results are robust to tests that address endogeneity, to the use of perception-based measures of corruption, and after controlling for credit demand conditions. In further analysis, we show that these effects are more evident for smaller banks and banks operating in a single state. These findings provide evidence that public corruption could facilitate information asymmetry in the lending market and, thus, could hinder local development by reducing bank credit. (shrink)

Although Kant (1998) envisaged a prominent role for logic in the argumentative structure of his Critique of Pure Reason, logicians and philosophers have generally judged Kantgeneralformaltranscendental logics is a logic in the strict formal sense, albeit with a semantics and a definition of validity that are vastly more complex than that of first-order logic. The main technical application of the formalism developed here is a formal proof that Kants logic is after all a distinguished subsystem of first-order logic, namely what (...) is known as geometric logic. (shrink)