Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

Background Most jurisdictions that allow euthanasia and assisted suicide (AS) regulate it through the medical profession. However, the extent and nature of how medicine should be involved are debated. Swiss AS practice is unusual in that it is managed by lay AS organizations that rely on a law that permits AS when done for nonselfish reasons. Physicians are not mentioned in the law but are usually called upon to prescribe the lethal medications and perform capacity evaluations.Methods We analyzed in-depth interviews (...) of 23 Swiss AS experts including ethicists, lawyers, medical practitioners, and senior officials of AS organizations for their views on AS.Results Although there was agreement on some issues (e.g., need for better end-of-life care), the interviewees’ preferred model for AS, and the nature of preferred medical involvement, varied, which we categorized into five types: preference for AS practice as it occurred prior to lay AS organizations; preference for the current lay model; preference for a modified lay model to increase autonomy protections while limiting medical AS normalization; preference for various types of more medicalized models of AS; and, ambivalence about any specific model of medical involvement. The rationales given for each type of model reflected varying opinions on how medicine’s role would likely impact AS practice and demonstrated the experts’ attitudes toward those impacts.Conclusion The dynamics within the Swiss AS regime, as reflected in the varying views of Swiss AS experts, shed light on the dilemmas inherent to medical scope and involvement in AS, which may have implications for debates in other jurisdictions. (shrink)

A Moisés ben Maimón, nuestro Maimónides, le gustaba auto llamarse "Moisés el Español" o "Moisés el Cordobés". En una ocasión, ya largamente asentado en el viejo Cairo, escribía: "Entre nosotros, en al-Ándalus". Esta referencia, constante y repetida, a su tierra, al lugar que lo vio nacer, significa algo más que amor al terruño, a la patria chica...Las obras de Maimónides han generado y siguen generando innumerables ediciones, reediciones, traducciones y estudios que podrían llenar bibliotecas enteras. Por esto es encomiable el (...) formidable trabajo que ha realizado Mario Eduardo Cohen, quien, con admirable ahínco, con pasión y entrega, ha leído, analizado y estudiado innumerables obras, estudios, artículos, también los escritos del propio Maimónides, desgranando de manera antológica y muy pedagógica lo más preciso de su pensamiento y de su aportación a la cultura humana y al conocimiento del legado rabínico judaico. De seguro que el lector tras la lectura de esta obra divulgativa va a tomar conciencia de la grandeza de aquel hebreo cordobés, cuya obra es como un pedernal que despide la chispa creativa en quien con fuerza la golpea en la lectura y el estudio. Ahí radica el secreto de la actualidad permanente y viva de su obra y el noble afán de Mario Eduardo Cohen de hacer de las grandes obras de Maimónides una referencia viva de nuestro tiempo.EDITORIAL UNIVERSIDAD MAIMÓNIDES - ARGENTINA Este libro contiene el desarrollo de los siguientes temas, entre otros: -Época de guerras y profundos cambios-Documentos de la Guenizá de El Cairo-De Córdoba a Fostat-El Príncipe de los Médicos-Consejos para la Vida-Aportes para el Judaísmo-Guía de perplejos-Maimónides. Un canto a la solidaridad y a la humildadCon este libro usted podrá conocer mas sobre este gran pensador.¡Descargue ya este libro y comience a aprender sobre Maimónides!maimónides, maimonides, mario eduardo cohen, sefardi, sefardí, judaísmo, pedagogía. (shrink)

Le mouvement général des sciences est de fournir les moyens théoriques d'une reconstruction des phénomènes, en élaborant des lois explicitant leurs régularités sous-jacentes. Aujourd'hui, l'attitude générale en sciences repose sur l'a priori des déterminismes, quelle que soit leur forme. La pensée humaine, dans ses rapports au monde, est une confrontation permanente aux systèmes complexes qui nous habitent et dans lesquels nous habitons. Chacun des systèmes possède une histoire propre qui le rend singulier et source continue de surprises. On se prend (...) à le penser comme système autonome avec ses lois et ses degrés de liberté interne. Quand il s'agit de penser l'être humain, la tentation est encore plus forte de lui prêter un libre arbitre. La question fondamentale est donc celle de la compatibilité entre la pensée scientifique en quête de déterminismes, et la compréhension des complexités, génératrice d'indéterminismes. Comment obtenir une conciliation quand, de la physique à l'éthique, en passant par la cellule biologique, les êtres multicellulaires et les sociétés, on remonte les niveaux d'organisation? Peut-on y parvenir quant à l'être humain et la société sans remettre en question certains aspects cruciaux comme la responsabilité et l'éthique? Ce livre a pour but de revisiter ce débat fondamental, auquel fleuri Atlan a consacré une grande partie de son œuvre, en s'appuyant, d'une part, sur les approches récentes de la modélisation des systèmes complexes et, d'autre part, sur la tradition philosophique multimillénaire. (shrink)

El presente ensayo sostiene que los principios de justicia de Rawls proporcionan una fundamentación normativa para la teoría de los stakeholders. Los principios articulan (en un nivel abstracto) los derechos de los ciudadanos; estos derechos crean intereses en todos los aspectos de la sociedad, incluyendo el ámbito de la actividad económica; y, por lo tanto, los stakeholders –en calidad de ciudadanos–tienen intereses legítimos en dicho ámbito. Así, la obra de Rawls nos obliga a fundamentar cuestiones de la ética de la (...) empresa en la filosofía política: los derechos e intereses de los stakeholders (que son los derechos e intereses de los ciudadanos en la esfera económica) están protegidos en el nivel institucional, por lo que no pueden venir determinados por los directivos ni las corporaciones. (shrink)

Aristotle's claim in Metaphysics Z.6 that "each substance is the same as its essence" has long puzzled commentators. For it seems to conflict with two other Aristotelian theses: (1) primary substances are individuals (e.g., Socrates and Callias), and (2) essences are universals (e.g., Man and Horse). Three traditional solutions to this difficulty are considered and rejected. Instead, to make the Z.6 equation consistent with (1) and (2), I propose that it be interpreted to be making something other than a straightforward (...) identity claim. Callias is the same as his essence in the sense that to be identical to Callias is to be the same man as Callias (where Man is the essence of Callias). In general, x is identical to y if, and only if, x and y are the same E (where E specifies the "what it is to be" for x, i.e., the essence of x). So each of Socrates and Callias is the same as his essence, and Man is that essence, but Socrates and Callias are not identical, for they are not the same man. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:29. CONTRARIETY AND CAUSALITY IN HUME Hume's notion of contrariety ranks among the most obscure in his theory of relations. To make matters worse, the puzzling account of contrariety he offers can be shown inconsistent in the following way. The Treatise (T69-82) divides all relations into two disjoint classes - one class containing relations of knowledge (in the strict sense) ascertained by the mere comparison of ideas, the other (...) containing those of probability or 'uncertain knowledge' requiring 'experience' or empirical evidence. Causality is the paradigm of a probability relation - contrariety falls into the class of knowledge relations. Thus unlike causality the discovery of a contrary relation appears to require no experience. Yet in direct contradiction Hume claims that with the exception of existence and non-existence (which are singled out for special attention), all knowledge of contrary relations demands experience: no two ideas are in themselves contrary, except those of existence and non-existence.... All other objects, such as fire and water, heat, and cold, are only found to be contrary from experience, and from the contrariety of their 'causes ' or effects '. (T15) The charge of inconsistency appears inevitable. However, I shall argue that Hume escapes by implicitly operating with two distinct concepts of contrariety: one (which I shall term "logical contrariety") a relation of knowledge, the other (to be called "empirical contrariety") reducible to a peculiar type of causal relation, and therefore a probability relation. To adduce independent grounds for this claim I demonstrate that acceptance of these two concepts is essential if we are to explain why Hume finds 2 it important to place the following restriction on contra- 30. riety (hereafter, R): properly speaking no objects are contrary to each other, but existence an (y exists). And (4) can hardly be said to represent a form of contrariety between existent and non-existent objects. (Indeed paradox of material implication aside, (4) is an analysis of "x causes y".) Therefore to hold R and still maintain some sense of contrariety between existent and non-existent objects, Hume must restrict contrariety to logical contrariety. 32. Hume's own remarks bear out my claim. In the Treatise he recognizes that restricting contrariety to existence and non-existence means treating it as contradiction : the flattest of all contradictions... (is)... that 'tis possible for the same thing both to be and not to be. (T19, my emphasis.)... with contrariety... No one can once doubt but existence and non-existence destroy each other, and are perfectly incompatible and contrary. (T70) And in the Enquiries he interchanges the terms 'contrary' and 'negation' : The contrary of every matter of fact is still possible ; because it can never imply a contradiction... (EU25)... No negation of a fact can involve a contradiction. (EU164) This usage indicates that if? is (logically) contrary to q,? is -q, the negation of q. In this case the conjunction of? and q spells the contradiction (q & -q). The definition of logical contrariety we adopt is the same as the definition of contradiction specialized to existential sentences, so we need not state it. It is sufficient to give as a paradigm the following contradiction: (5)(Mars exists) & - (Mars exists). Here it is the existence of Mars that is logically contrary to the non-existence of Mars and therefore the contrariety restriction R is satisfied. Again it is only the existence and non-existence of the same object that is logically contrary. Empirical contrariety is most clearly defined in terms of the Lewis counterfactual G=>, where 1O' is a monadic predicate, 'e.' and 'e.' represent distinct arbitrary events, and "0(e)" means "event e occurs": 33. 5 Here it is not the existence and non-existence or occurrence (EC) e. is empirically contrary to e. iff 0(e.) D=> ~0(e.)." and non-occurrence of distinct events that gives rise to contrariety. Rather it is the existence or occurrence of one event that is empirically contrary to the existence or occurrence of another. To establish Hume's motivation for framing the condition R in such a way as to identify contrariety with contradiction, I now turn to examine the epistemological ground of the difference between empirical and logical contrariety. The ontological distinction between empirical... (shrink)

A is for Alice and astronomers arguing about acceleration -- B is for Bernard's body-exchange machine -- C is for the Catholic cannibal -- D is for Maxwell's demon -- E is for evolution (and an embarrassing problem with it) -- F is for the forms lost forever to the prisoners of the cave -- G is for Galileo's gravitational balls -- H is for Hume's shades -- I is for the identity of indiscernibles -- J is for Henri Poincaré (...) and alternative geometries -- K is for the Kritik and Kant's kind of thought experiments -- L is for Lucretius' spear -- M is for Mach's motionless chain -- N is for Newton's bucket -- O is for Olbers' paradox -- P is for Parfit's person -- Q is for the questions raised by thought experiments quotidiennes -- R is for the rule-ruled room -- S is for Salvatius' ship, sailing along its own space-time line -- T is for the time-travelling twins -- U is for the universe, and Einstein's attempts to understand it -- V is for the vexed case of the violinist -- W is for Wittgenstein's beetle -- X is for xenophanes and thinking by examples -- Y is for counterfactuals and a backwards approach to history -- Z is for Zeno and the mysteries of infinity. (shrink)

Within the political economy of informational capitalism, commercial surveillance practices are tools for resource extraction. That process requires an enabling legal construct, which this essay identifies and explores. Contemporary practices of personal information processing constitute a new type of public domain—a repository of raw materials that are there for the taking and that are framed as inputs to particular types of productive activity. As a legal construct, the biopolitical public domain shapes practices of appropriation and use of personal information in (...) two complementary and interrelated ways. First, it constitutes personal information as available and potentially valuable: as a pool of materials that may be freely appropriated as inputs to economic production. That framing supports the reorganization of sociotechnical activity in ways directed toward extraction and appropriation. Second, the biopolitical public domain constitutes the personal information harvested within networked information environments as raw. That framing creates the backdrop for culturally situated techniques of knowledge production and for the logic that designates those techniques as sites of legal privilege. (shrink)

In 2004 a survey was conducted in the member states of the European Union designed to gain greater insight into the views on control strategies for foot and mouth disease, classical swine fever, and avian influenza with respect to the epidemiological, economic and social-ethical consequences of each of these animal diseases. This article presents the results of the social-ethical survey. A selection of stakeholders from each member state was asked to prioritize issues for the prevention and control of these diseases. (...) A majority of stakeholders chose preventive measures as the preferred issue. An analysis was done to determine whether there were differences in views expressed by stakeholders from member states with a history of recent epidemics and ones without such a history, and whether there were regional differences. There were no differences between member states with or without a history of recent epidemics. There were indeed regional differences between the priority orders from Northern and Southern Europe on the one hand, and from Eastern Europe on the other. (shrink)

LANGUAGE NOTE | Document text in Chinese; abstract also in English. 每當我們提及生命倫理學時，不可避免要提及的話題：生命倫理的終極指徵是什麼？是從道德的層面教導人類向善？還是要從技術的維度延長人類的壽命？是要規範人類的行為準則？亦或是要恪守人類的道德底線？誠然，從不同 的學科分野下，對於生命倫理學的探究一直未曾停止，但是Joseph Tham “Bioethics: Cross-Cultural Explorations”一文：卻從更為原初的層面向我們闡釋了生命或者説是理念的價值所在。(撮要取自內文首段) Emerging developments in science and technology have changed the “relationships” between people in the traditional sense, and life has been carved more and more rounded, but at the same time, it has smoothed out the “edges” of life. Science and technology have begun to erode bioethics under the guise of reason, as the standards for “good” or “evil” are no longer defined by human morality, (...) but by data. We seem to have forgotten our most original pursuit and neglected to ponder the original meaning of life. Through his work, “Bioethics: Cross-Cultural Explorations,” Tham hopes to make people stop, re-examine, and look at the values and attributes of bioethics from multiple dimensions, such as religion, history, and culture, and reawaken human beings' interest in beauty and moral cognition. (shrink)

Radical interpretation is used by Davison in his linguistic theory not only as an interesting thought experiment but also a general pattern that is believed to be able to give an essential and general account of linguistic interpretation. If the principle of charity is absolutely necessary to radical interpretation, it becomes, in this sense, a general methodological principle. However, radical interpretation is a local pattern that is proper only for exploring certain interpretation in a specific case, and consequently the principle (...) of charity is an applicable principle in the limited scope. It is neither the case that every linguistic interpretation is in nature radical nor that the principle of charity is the primary and fundamental principle for all linguistic interpretation as Davidson believes. (shrink)

Deep brain stimulation (DBS) to different sites allows interfering with dysfunctional network function implicated in major depression. Because a prominent clinical feature of depression is anhedonia--the inability to experience pleasure from previously pleasurable activities--and because there is clear evidence of dysfunctions of the reward system in depression, DBS to the nucleus accumbens might offer a new possibility to target depressive symptomatology in otherwise treatment-resistant depression. Three patients suffering from extremely resistant forms of depression, who did not respond to pharmacotherapy, psychotherapy, (...) and electroconvulsive therapy, were implanted with bilateral DBS electrodes in the nucleus accumbens. Stimulation parameters were modified in a double-blind manner, and clinical ratings were assessed at each modification. Additionally, brain metabolism was assessed 1 week before and 1 week after stimulation onset. Clinical ratings improved in all three patients when the stimulator was on, and worsened in all three patients when the stimulator was turned off. Effects were observable immediately, and no side effects occurred in any of the patients. Using FDG-PET, significant changes in brain metabolism as a function of the stimulation in fronto-striatal networks were observed. No unwanted effects of DBS other than those directly related to the surgical procedure (eg pain at sites of implantation) were observed. Dysfunctions of the reward system--in which the nucleus accumbens is a key structure--are implicated in the neurobiology of major depression and might be responsible for impaired reward processing, as evidenced by the symptom of anhedonia. These preliminary findings suggest that DBS to the nucleus accumbens might be a hypothesis-guided approach for refractory major depression. (shrink)

In two studies we investigated the association between physical cleansing and moral and immoral behavior in real-life situations. In Study 1, after a workout at the gym, participants cheated more after taking a shower than before taking one. In the second study, participants donated more money to charity before rather than after they bathed for religious purification. The results extend previous findings about moral cleansing and moral licensing and are discussed within the framework of conceptual metaphor theory.

In some cases people judge it morally acceptable to sacrifice one person’s life in order to save several other lives, while in other similar cases they make the opposite judgment. Researchers have identified two general factors that may explain this phenomenon at the stimulus level: (1) the agent’s intention (i.e. whether the harmful event is intended as a means or merely foreseen as a side-effect) and (2) whether the agent harms the victim in a manner that is relatively “direct” or (...) “personal”. Here we integrate these two classes of findings. Two experiments examine a novel personalness/directness factor that we call personal force, present when the force that directly impacts the victim is generated by the agent’s muscles (e.g., in pushing). Experiments 1a and b demonstrate the influence of personal force on moral judgment, distinguishing it from physical contact and spatial proximity. Experiments 2a and b demonstrate an interaction between personal force and intention, whereby the effect of personal force depends entirely on intention. These studies also introduce a method for controlling for people’s real-world expectations in decisions involving potentially unrealistic hypothetical dilemmas. (shrink)

Traditional theories of moral development emphasize the role of controlled cognition in mature moral judgment, while a more recent trend emphasizes intuitive and emotional processes. Here we test a dual-process theory synthesizing these perspectives. More specifically, our theory associates utilitarian moral judgment (approving of harmful actions that maximize good consequences) with controlled cognitive processes and associates non-utilitarian moral judgment with automatic emotional responses. Consistent with this theory, we find that a cognitive load manipulation selectively interferes with utilitarian judgment. This interference (...) effect provides direct evidence for the influence of controlled cognitive processes in moral judgment, and utilitarian moral judgment more specifically. (shrink)

The indispensability argument for abstract mathematical entities has been an important issue in the philosophy of mathematics. The argument relies on several assumptions. Some objections have been made against these assumptions, but there are several serious defects in these objections. Ameliorating these defects leads to a new anti-realistic philosophy of mathematics, mainly: first, in mathematical applications, what really exist and can be used as tools are not abstract mathematical entities, but our inner representations that we create in imagining abstract mathematical (...) entities; second, the thoughts that we create in imagining infinite mathematical entities are bounded by external conditions. (shrink)

On September 8, 2015, the Department of Health and Human Services issued a Notice of Proposed Rule Making to revise the Federal Policy for the Protection of Human Subjects, widely known as the “Common Rule.” The NPRM proposes several changes to the current system, including a dramatic shift in the approach to secondary research using biospecimens and data. Under the current rules, it is relatively easy to use biospecimens and data for secondary research. This approach systematically facilitates secondary research with (...) biospecimens and data, maximizing the capacity for substantial public benefit. However, it has been criticized as insufficiently protective of the privacy and autonomy interests of biospecimen and data sources. Thus, the NPRM proposes a more restrictive regime, although more so for biospecimens than data. Both the status quo and the NPRM's proposal are critically flawed. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

In 1976, The Hastings Center convened a conference to examine the validity of proposed parallels between Nazi and contemporary biomedical practices in moral argument. Charges that current medical and social practices and policies are analogous to or are the moral equivalent of Nazi programs are again in the air, and in this new feature of the Report, four commentators display and critique the use of this analogy.

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

Feelings of guilt are human emotions that may arise if a person committed an action that contradicts basic moral mores or failed to commit an action that is considered moral according to their ethical standards and values. Psychological scholarship distinguishes between altruistic guilt (AG) and deontological guilt (DG). AG results from having caused harm to an innocent victim, either by acting or failing to act, whereas DG is caused by violating a moral principle. Although physicians may be expected to experience (...) frequent feelings of guilt in their demanding and intensive work, it is surprising to find that this issue has not been explored in the professional literature on medical ethics. To that end, we conducted a qualitative study that included personal in-depth interviews with Sunni Muslim gynaecologists. These doctors provide underground infertility care and perform religiously forbidden treatments involving sex selection and gamete donation. They opened their hearts and spoke about the emotionally taxing pangs of conscience they suffer. Analysing their narratives led us to characterize their feelings of guilt as DG. We discuss the causes for their plight and the way they cope with it, compare DG to the concept of moral distress, and call for future research on clinicians’ feelings of guilt and pangs of conscience. (shrink)

Objective: To analyse the time variation of topics in bioethical publications as a proxy of the relative importance.Methods: We searched the Medline database for bioethics publications using the words “ethics or bioethics”, and for 360 specific topics publications, associating Medical Subject Heading topic descriptors to those words. We calculated the ratio of bioethics publications to the total publications of Medline, and the ratio of each topic publications to the total bioethics publications, for five-year intervals, from 1970 to 2004. We calculated (...) the time variation of ratios, dividing the difference between the highest and lowest ratio of each topic by its highest ratio. Four topics were described, selected to illustrate different patterns of variation: “Induced Abortion”, “Conflict of Interest”, “Acquired Immunodeficiency Syndrome”, “Medical Education.”Results: The ratio of bioethics publications to total Medline publications increased from 0.003 to 0.012. The variation of the topic’s ratios was higher than 0.7 for 68% of the topics. The Induced Abortion ratios decreased from 0.12 to 0.02. Conflict of Interest ratios increased from zero to 0.07. The Acquired Immunodeficiency Syndrome ratios were nearly zero in the first three intervals, had a peak of 0.06 during 1985–9, followed by a decrease to 0.01. Medical Education ratios varied few, from 0.04 to 0.03.Conclusions: There was an increase of bioethical publications in the Medline database. The topics in bioethics literature have an important time variation. Some factors were suggested to explain this variation: current legal cases, resolution of the issue, saturation of a discussion and epidemiologic importance. (shrink)

This essay discusses the new report, Heritable Human Genome Editing, by the National Academy of Medicine, the National Academy of Sciences, and the Royal Society. After summarizing the report, we argue that the report takes four quite bold steps away from prior reports, namely (1) rejecting an omnibus approach to heritable human genome editing (HHGE) in favor of a case‐by‐case analysis of possible uses of HHGE, accepting that HHGE is acceptable in some cases; (2) recognizing that the interest in having (...) children who are genetically related to both would‐be rearing parents is one that the regulation of HHGE should honor; (3) patterning a regulatory model for HHGE on the United Kingdom's approach to regulating mitochondrial replacement techniques; and (4) conveying skepticism that international regulation is possible while showing a strong preference for a default into national regulatory regimes for HHGE. (shrink)

This essay discusses the new report, Heritable Human Genome Editing, by the National Academy of Medicine, the National Academy of Sciences, and the Royal Society. After summarizing the report, we argue that the report takes four quite bold steps away from prior reports, namely (1) rejecting an omnibus approach to heritable human genome editing (HHGE) in favor of a case‐by‐case analysis of possible uses of HHGE, accepting that HHGE is acceptable in some cases; (2) recognizing that the interest in having (...) children who are genetically related to both would‐be rearing parents is one that the regulation of HHGE should honor; (3) patterning a regulatory model for HHGE on the United Kingdom's approach to regulating mitochondrial replacement techniques; and (4) conveying skepticism that international regulation is possible while showing a strong preference for a default into national regulatory regimes for HHGE. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 10-14, March‐April 2022.