In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.

The role of law in bioethics is clear. Laws are enforcement tools: they govern which conditions qualify an individual for disability benefits, or what oversight is necessary for clinical trial protocols, or how patent applications for medical devices should be regulated. I initially studied the law in order to enhance my work in bioethics, but in examining how the law works, I have become convinced that the converse opportunity also exists: there are many areas of law that would benefit from (...) greater input from those in the bioethics community. (shrink)

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

Kirsten Walsh has criticized my interpretation of Newton’s view on the certainty of his new science of color, namely, that it shifted through his long career from one of certainty to probabilism. I...

Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China’s organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained. We have collected and analysed available evidence on human rights violations in the organ procurement practice in China. We demonstrate that the (...) practice not only violates international ethics standards, it is also associated with a large scale neglect of fundamental human rights. This includes organ procurement without consent from prisoners or their families as well as procurement of organs from incompletely executed, still-living prisoners. The human rights critique of these practices will also address the specific situatedness of prisoners, often conditioned and traumatized by a cascade of human rights abuses in judicial structures. To end the unethical practice and the abuse associated with it, we suggest to inextricably bind the use of human organs procured in the Chinese transplant system to enacting Chinese legislation prohibiting the use of organs from executed prisoners and making explicit rules for law enforcement. Other than that, the international community must cease to abet the continuation of the present system by demanding an authoritative ban on the use of organs from executed Chinese prisoners. (shrink)

This article tests the impact of Walmart's corporate decisions to end the sale of handguns at its stores in 1994 and to discontinue the sale of all firearms at approximately 59% of its stores in 2006 before resuming firearms sales at some of those stores in 2011. Using a difference-in-differences framework, we find that that from 1994 to 2005 counties with Walmarts robustly experienced a reduction in the suicide rate and experienced no change in the homicide rate. These models suggest (...) that Walmart's policy change caused a 3.3 to 7.5% reduction in the suicide rate within affected counties, which represents an estimated 5,104 to 11,970 lives saved over the studied period. In contrast, Walmart's 2006 and 2011 decisions to discontinue and subsequently resume the sale of rifles and shotguns in many of its stores was not associated with a robustly measured effect on homicide or suicide rates. We do find evidence that Walmart's 2006 decision to reduce the number of its stores that sold firearms caused a statistically significant reduction in the suicide rate for counties in which Walmart did not subsequently resume firearms sales. (shrink)

The effective provision of psychotherapy services to individuals with intellectual disability requires consideration of ethical issues related to clinical competence, access to services, obligations to multiple parties, guardianship, and appropriate assessment practices. This article provides an overview of major ethical considerations with guidance for clarifying and resolving common ethical concerns. Psychologists are encouraged to expand access to psychotherapy services for this population while maintaining awareness of potential modifications, training needs, and boundaries of professional competence. The authors provide recommendations and resources (...) for effective and ethical treatment of psychotherapy clients with intellectual disabilities. (shrink)

Over 40 years of research have shown that traumatic brain injury affects brain volume. However, technical and practical limitations made it difficult to detect brain volume abnormalities in patients suffering from chronic effects of mild or moderate traumatic brain injury. This situation improved in 2006 with the FDA clearance of NeuroQuant®, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. More recent strides were made with the introduction of NeuroGage®, commercially available software that is based (...) on NeuroQuant® and extends its utility in several ways. Studies using these and similar methods have found that most patients with chronic mild or moderate traumatic brain injury have brain volume abnormalities, and several of these studies found—surprisingly—more abnormal enlargement than atrophy. More generally, 102 peer-reviewed studies have supported the reliability and validity of NeuroQuant® and NeuroGage®. Furthermore, this updated version of a previous review addresses whether NeuroQuant® and NeuroGage® meet the Daubert standard for admissibility in court. It concludes that NeuroQuant® and NeuroGage® meet the Daubert standard based on their reliability, validity, and objectivity. Due to the improvements in technology over the years, these brain volumetric techniques are practical and readily available for clinical or forensic use, and thus they are important tools for detecting signs of brain injury. (shrink)

We address how the leaders of a Catholic business school can articulate and assess how well their schools implement the following six principles drawn from Catholic social teaching : produce goods and services that are authentically good; foster solidarity with the poor by serving deprived and marginalized populations; advance the dignity of human work as a calling; exercise subsidiarity; promote responsible stewardship over resources; and acquire and allocate resources justly. We first discuss how the CST principles give substantive content and (...) meaning to the Good Goods, Good Work, and Good Wealth framework in The Vocation of the Business Leader and then discuss their congruencies and tensions with the UNGC and UNPRME principles. Next, we describe the Catholic Identity Matrix, an assessment tool that provides a quantitative and qualitative portrait of how well a Catholic business school integrates, within the scope of its mission and capacities, the three goods and related CST principles in its strategies, policies, activities, and processes. The concluding section discusses implications for ongoing UNGC and UNPRME assessment, reporting, and development efforts, and addresses the generalizability of our approach to business schools who draw their inspiration and moral principles from other faith-based or secular traditions. (shrink)

Respecting patient autonomy through the process of soliciting informed consent is a cornerstone of clinical ethics. In pediatrics, until a child becomes an adult or legally emancipated, that ethical tenet takes the form of respect for parental decision-making authority. In instances of respecting religious beliefs, doing so is not always apparent and sometimes the challenge lies not only in the healthcare provider’s familiarity of religious restrictions but also their knowledge of medical interventions themselves which might conflict with those restrictions. We (...) examine a case of a newborn receiving animal-derived surfactant, a common scenario in neonatology, and present considerations for providers to weigh when confronting when such an intervention might conflict with parent’s religious beliefs. We end with strategizing ways to address this issue as a medical community. (shrink)

Simon Schaffer has published a constructivist analysis of the acceptance of Newton’s theory of color that focuses on Newton’s experiments, the continual controversies over them, and his power and authority. In this article, I show that Schaffer’s account does not agree with the historical evidence. Newton’s theory was accepted much sooner than Schaffer holds, when and in places where Newton had little power; many successfully repeated the experiments and few contested them; and theory mattered more than experiment in acceptance. I (...) also present an alternative account of the acceptance of Newton’s theory that shows that, despite criticism when it was first published in 1672, the theory, or parts of it, gradually came to be accepted by mathematical scientists—including Huygens and Leibniz—and Scottish natural philosophers by the time of the publication of the Opticks in 1704. On the Continent, it was coming to be accepted within a decade or so after its publication, that is, before 1716, when Newton replied to a challenge, purportedly by Leibniz, that Schaffer sees as the crucial conflict that at last gave Newton’s experiments their authority. (shrink)

Medical school curricula, although traditionally and historically dominated by science, have generally accepted, appreciated, and welcomed the inclusion of literature over the past several decades. Recent concerns about medical professional formation have led to discussions about the specific role and contribution of literature and stories. In this article, we demonstrate how professionalism and the study of literature can be brought into relationship through critical and interrogative interactions based in the literary skill of close reading. Literature in medicine can question the (...) meaning of “professionalism” itself, thereby resisting standardization in favor of diversity method and of outcome. Literature can also actively engage learners with questions about the human condition, providing a larger context within which to consider professional identity formation. Our fundamental contention is that, within a medical education framework, literature is highly suited to assist learners in questioning conventional thinking and assumptions about various dimensions of professionalism. (shrink)

This study investigated whether key constructs in Coyne's (1976 Coyne, J. C. 1976. Toward an interactional description of depression. Psychiatry, 39: 28–40. [Taylor & Francis Online], [Web of Science ®], [Google Scholar]) interpersonal theory of depression, namely excessive reassurance seeking and social support, combine to confer risk for future depressive symptoms. Consistent with hypotheses, excessive reassurance seeking interacted with changes in perceived social support to predict the prospective development of depressive symptoms. Furthermore, the interaction of excessive reassurance seeking and changes (...) in perceived social support were specific to the development of depressive symptoms, but not anxious symptoms. The implications of these results for the interpersonal theories of depression are discussed. (shrink)

The book is a collection of essays on the history of science and mathematics, with especial emphasis on Newtonian themes.

Newton se rehusó a usar el término “filosofía experimental”, ampliamente usado en la Inglaterra de la Restauración al comienzo de su carrera, hasta 1712 cuando añadió un pasaje al Escolio General de los Principia que exponía brevemente su metodología anti-hipotética. No obstante, los borradores para la Cuestión 23 de la segunda edición de la Óptica (1706) (que se convertiría en la Cuestión 31 en la tercera edición) muestran que con anterioridad había intentado introducir el término para explicar su metodología. Newton (...) introdujo el término por propósitos polémicos para defender su teoría de la gravedad contra las críticas de los cartesianos y los leibnizianos pero, especialmente en los Principia, contra Leibniz mismo. La "filosofía experimental" tiene poco que ver directamente con el experimento, sino que más bien designa de manera más amplia la ciencia empírica. Los manuscritos de Newton proporcionan la oportunidad de comprender el uso que hace de la “filosofía experimental” y la formulación de su metodología, especialmente de términos claves como “deducir”, “inducción” y “fenómenos”, a comienzos del siglo XVIII. (shrink)

The study of politics seems endlessly beset by debates about method. At the core of these debates is a single unifying concern: should political scientists view themselves primarily as scientists, developing ever more sophisticated tools and studying only those phenomena to which such tools may fruitfully be applied? Or should they instead try to illuminate the large, complicated, untidy problems thrown up in the world, even if the chance to offer definitive explanations is low? Is there necessarily a tension between (...) these two endeavours? Are some domains of political inquiry more amenable to the building up of reliable, scientific knowledge than others, and if so, how should we deploy our efforts? In this book, some of the world's most prominent students of politics offer original discussions of these pressing questions, eschewing narrow methodological diatribes to explore what political science is and how political scientists should aspire to do their work. (shrink)

Regulation of the cytoplasmic stability of mRNAs has recetly been identified as a major control mechanism which governs mRNA levels in a variety of eukaryotic systems. In this review we discuss what is known about several experimental systems that exhibit regulated mRNA stability, describe the mechanisms that cells may use to achieve control of mRNA degradation, and suggest areas of future investigation likely to provide new insights into this process.

A central figure in Western history and American political thought, Thomas Paine continues to provoke debate among politicians, activists, and scholars. People of all ideological stripes are inspired by his trenchant defense of the rights and good sense of ordinary individuals, and his penetrating critiques of arbitrary power. This volume contains Paine’s explosive _Common Sense_ in its entirety, including the oft-ignored Appendix, as well as selections from his other major writings: _The American Crisis_, _Rights of Man,_ and _The Age of (...) Reason. _It also contains several of Paine’s shorter essays. All the documents have been transcribed directly from the originals, making this edition the most reliable one available. Essays by Ian Shapiro, Jonathan Clark, Jane Calvert, and Eileen Hunt Botting bring Paine into sharp focus, illuminating his place in the tumultuous decades surrounding the American and French Revolutions and his larger historical legacy. (shrink)

The 300th anniversary of the publication of Isaac Newton’s Opticks in 1704 provides an occasion to review the history of its composition and publication. As a preliminary to presenting that history, Newton’s attitude to publication and response to criticism are examined. Newton’s clashes with Hooke and his presumed role as the cause of the delay in the publication of the Opticks until after his death are also scrutinized. Rather than simply presenting Newton and Hooke as quarrelsome, which they indeed were, (...) they are presented as rivals to be England’s leading optical authority. Although Newton announced his intention to publish a book very much like the Opticks in the winter of 1675–76, he did not begin to write it until 1687. It was composed in various stages, including new experimental investigations, by 1692, except for the part on diffraction. A planned, but unfulfilled, revision of the part on diffraction was responsible for delaying its publication for a number of years. (shrink)

BackgroundIn December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners.DiscussionIn the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a (...) fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to “voluntarily donate” organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards.ConclusionsOrgan sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with “consent” are now simply labelled as “voluntarily donations from citizens”. The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain. (shrink)