As the pace of technological change accelerates, we are increasingly experiencing a state of information overload. Statistics show that we are interrupted every three minutes during the course of the work day. Multitasking between email, cell-phone, text messages, and four or five websites while listening to an iPod forces the brain to process more and more informaton at greater and greater speeds. And yet the human brain has hardly changed in the last 40,000 years. Are all these high-tech advances (...) overtaxing our Stone Age brains or is the constant flood of information good for us, giving our brains the daily exercise they seem to crave? In The Overflowing Brain, cognitive scientist Torkel Klingberg takes us on a journey into the limits and possibilities of the brain. He suggests that we should acknowledge and embrace our desire for information and mental challenges, but try to find a balance between demand and capacity. Klingberg explores the cognitive demands, or "complexity," of everyday life and how the brain tries to meet them. He identifies different types of attention, such as stimulus-driven and controlled attention, but focuses chiefly on "working memory," our capacity to keep information in mind for short periods of time. Dr Klingberg asserts that working memory capacity, long thought to be static and hardwired in the brain, can be improved by training, and that the increasing demands on working memory may actually have a constructive effect: as demands on the human brain increase, so does its capacity. The book ends with a discussion of the future of brain development and how we can best handle information overload in our everyday lives. Klingberg suggests how we might find a balance between demand and capacity and move from feeling overwhelmed to deeply engaged. (shrink)

Too often, advocates of domain-specific belief systems overlook the implications of their beliefs when choosing communications technologies and strategies, although they rarely overlook the importance of content. This essay argues that both environmentalism and sustainable agriculture, as systems of belief, favor certain strategies of generating and distributing information over others; that is, the essay argues that both the content and form of communications imply certain value preferences, hence both are subject to value-relevant choices. An additional purpose of the essay (...) is to set a context for this special edition of Agriculture and Human Values. Collectively the articles in this edition discuss a wide variety of issues, including but not limited to questions connected to information generation, access to information and information technologies, and the value systems conveyed by communications vehicles, including what is conveyed and different discussions of what should be conveyed. This essay looks at the importance of four sets of domain-specific value systems (environmentalism, sustainable agriculture, and the conventionalism counters to both of these) for two different sets of value systems connected to information generation, and further discusses each of these value sets in connection to choosing asymmetrical or symmetrical communications. It is hoped that this discussion of the flow of information, from generation to distribution, will provide a context for reading the edition as a whole. (shrink)

Chimpanzee/human technological differences are vast, reflect multiple interacting behavioral processes, and may result from the increased information-processing and hierarchical mental constructional capacities of the human brain. Therefore, advanced social, technical, and communicative capacities probably evolved together in concert with increasing brain size. Interpretations of these evolutionary and species differences as continuities or discontinuities reflect differing scientific perspectives.

Marshall et al. (2024) raise questions regarding patient refusals of care. In this commentary we address refusals of care from the lens of patient autonomy and provide suggestions for patient cente...

This article presents an overview for clinician investigators on the concepts of decision-making capacity and vulnerability as related to human subjects research. Tools for capacity assessment and unacknowledged sources of vulnerability are discussed, and the practical gaps in current informed consent requirements related to impaired capacity and potential vulnerability are described. Options are suggested for research discussions when full regulatory consent is not possible and an exception from informed consent does not apply.

Informed consent is the single most important concept for understanding decision-making capacity. There is a steady pull in the clinical world to transform capacity into a technical concept that can be tested objectively, usually by calling for a psychiatric consult. This is a classic example of medicalization. In this article I argue that is a mistake, not just unnecessary but wrong, and explain how to normalize capacity assessment.Returning the locus of capacity assessment to the attending, the (...) primary care doctor, and even to ethics consultation in today's environment will require a substantial effort to undo a strong but illusory impression of capacity assessment. Hospital attorneys as well as clinical ethicists with a sophisticated understanding of health law can be in the vanguard of this reorientation. (shrink)

We investigate a speci c model of knowledge and beliefs and their dynamics. The model is inspired by public announcement logic and the approach to puzzles concerning knowledge using that logic. In the model epistemic considerations are based on ontology. The main notion that constitutes a bridge between these two disciplines is the notion of epistemic capacities. Within the model we study scenarios in which agents can receive false announcements and can have incomplete or improper views about other agent's epistemic (...) capacities. Moreover, we try to express the description of problem speci cation using the tools from applied ontology { RDF format for information and the Protege editor. (shrink)

Behavioural variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia characterized by changes in personality, social behaviour, and cognition. Although neural abnormalities cause bvFTD patients to struggle with inhibiting problematic behaviour, they are generally considered fully autonomous individuals. Subsequently, bvFTD patients demonstrate understanding of right and wrong but are unable to act in accordance with moral norms. To investigate the ethical, legal, and social issues associated with bvFTD, we conducted a scoping review of academic literature with inclusion & exclusion (...) criteria and codes derived from our prior work. Among our final sample of fifty-six articles, four mentioned bvFTD patient-offenders as unfit to stand trial by insanity, and sixteen mentioned the use of dementia evidence in a court of law to better understand the autonomy of bvFTD patients. Additional emergent issues that were discovered include: training police officers to handle situations involving bvFTD patients and educating healthcare providers on how to help caregivers navigate bvFTD. The current literature highlights the inadequacy of traditional applications of medico-legal categories such as autonomy, capacity and competence, in informing cognitive capacity assessments in clinical and legal settings and deserves consideration by neuroethicists. (shrink)

Informed consent represents a specific protocol for obtaining consent from a fully informed human subject to take part in clinical research. Still, informed consent is not only required for clinical trials but it also represents a critical precondition before enrolment in standard everyday medical procedures. Relevant fundamental criteria for obtaining informed consent must be followed, and that is that patient must have the decisional capacity to reach autonomous decision. The patient must be adequately informed and not coerced. Evaluating decisional (...) capacity is crucial to providing the required level of care. The decision of which decisional capacity tool to use can be challenging because of various dissimilarities among the instruments. In this paper, four widely documented instruments have been evaluated, namely, the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the Hopkins Competency Assessment Test (HCAT), the Structured Interview for Competency/Incompetency Assessment Testing, Ranking Inventory (SICIATRI), and the Capacity Assessment Tool (CAT). Some of them include a fully structured interview; semi-structured forms characterise others. Most of them are adaptable for different scenarios, and yet, some are tailored for specific treatment decisions. Some evaluate all four components of decisional capacity, while others do not. Although a broad range of capacity assessment tools is available, it has been shown that they notably improve the accuracy of capacity evaluations. Given that many pathological conditions could result in impaired decisional capacity, physicians must be able to correctly and consistently assess the capacity for which education and previous experience are pivotal. (shrink)

The cognitive unbinding paradigm suggests that the synthesis of neural information is attenuated by general anesthesia. Here, we analyzed the functional organization of brain activities in the conscious and anesthetized states, based on functional segregation and integration. Electroencephalography recordings were obtained from 14 subjects undergoing induction of general anesthesia with propofol. We quantified changes in mean information integration capacity in each band of the EEG. After induction with propofol, mean information integration capacity was reduced most (...) prominently in the γ band of the EEG . Furthermore, we demonstrate that loss of consciousness is reflected by the breakdown of the spatiotemporal organization of γ waves. We conclude that induction of general anesthesia with propofol reduces the capacity for information integration in the brain. These data directly support the information integration theory of consciousness and the cognitive unbinding paradigm of general anesthesia. (shrink)

(2001). How Should IVF Programs Handle Initial Disclosure of Information to Prospective Ovum Donors? The American Journal of Bioethics: Vol. 1, No. 4, pp. 23-25.

Empirical findings from a Swedish longitudinal screening study show that many of the research subjects had a limited understanding of the study. Nevertheless they were satisfied with the understanding they had and found it sufficient for informed continued participation. Were they wrong? In this paper, it is argued that the kind of understanding that is morally required depends partly on the kind of understanding on which the research subjects want to base their decisions, and partly on what kind of knowledge (...) they lack. Researchers must ensure that the information process is not flawed and that participants receive the information they want. To achieve this, new information efforts may be needed. Researchers must also ensure that research subjects have knowledge about aspects of importance to them. Lack of understanding may, however, be the result of conscious choices by research subjects to disregard some of the information because it is not important to them. Such choices should normally be respected. (shrink)

ABSTRACT Persons generally must give their informed consent to participate in research. To provide informed consent persons must be given information regarding the study in simple, lay language. Consent must be voluntary, and persons giving consent must be legally competent to consent and possess the capacity to understand and appreciate the information provided. This paper examines the relationship between the obligation to disclose information regarding risks and the requirement that persons have the capacity to understand (...) and appreciate the information. There has been insufficient attention to the extent to which persons must be able to understand and appreciate study information in order to have their consent deemed valid when the information is provided in simple, lay language. This paper argues that (1) the capacity to understand and appreciate information that should be deemed necessary to give valid consent should be defined by the capacity of the typical, cognitively normal adult and (2) the capacity of the typical, cognitively normal adult to understand and appreciate the concept of risk is limited. Therefore, (3) all things being equal, potential subjects must possess a limited capacity to understand and appreciate risk to be deemed competent to consent to research participation. (4) In some cases investigators ought to require that persons possess a greater than typical capacity to understand and appreciate risk. (shrink)

In this article, I present an argument that suggests neuroscience should inform judgments of decision-making capacity. First, I review key behavioral and neurocognitive data to demonstrate that neuroscientific tests might be predictive of decision-making capacity, and that these tests might inform clinical judgments of capacity. Second, I argue that, consistent with the principles of autonomy and justice, such data should inform judgements of decision-making capacity. While the neuroscience of decision-making capacity still requires time to mature, (...) there is strong reason to believe that neuroscience might assist clinicians in adjudicating difficult cases in the future. This article focuses on the assessment of capacity in brain injury patients who have profound communication impairments, however, the overarching aim of the article is to highlight the potential use of neuroscience to improve our understanding of the relationship between cognition and decision-making capacity. (shrink)

In this article, I present an argument that suggests neuroscience should inform judgments of decision-making capacity. First, I review key behavioral and neurocognitive data to demonstrate that neuroscientific tests might be predictive of decision-making capacity, and that these tests might inform clinical judgments of capacity. Second, I argue that, consistent with the principles of autonomy and justice, such data should inform judgements of decision-making capacity. While the neuroscience of decision-making capacity still requires time to mature, (...) there is strong reason to believe that neuroscience might assist clinicians in adjudicating difficult cases in the future. This article focuses on the assessment of capacity in brain injury patients who have profound communication impairments, however, the overarching aim of the article is to highlight the potential use of neuroscience to improve our understanding of the relationship between cognition and decision-making capacity. (shrink)

To support older users’ accessibility and learning of the prevalent information and communication technologies, libraries, as informal learning institutes, are committed to information literacy education activities with friendly interfaces. Chatbots using Voice User Interfaces with natural and intuitive interactions have received growing research and practical attention; however, older users report regular frustrations and problems in using them. To serve as a basis for the subsequent design and development of an automated dialog mechanism in senior-friendly chatbots, a between-subject user (...) experiment was conducted with 30 older adults divided into three groups. The preliminary findings on their interactions with the voice chatbots designed with different error handling strategies were reported. Participants’ behavioral patterns, performances, and the tactics they employed in interacting with the three types of chatbots were analyzed. The results of the study showed that the use of multiple error handling strategies is beneficial for older users to achieve effectiveness and satisfaction in human-robot interactions, and facilitate their attitude toward information technology. This study contributes empirical evidence in the genuine and pragmatic field of gerontechnology and expands upon voice chatbots research by exploring conversation errors in human-robot interactions that could be of further application in designing educational and living gerontechnology. (shrink)

The Internet of Things (IoT) is, in part, an information handling system that can remove humans from the information handling process. The particular problem explored is how we are to understand privacy when considering informational systems that handle personal information in ways that impact people’s lives when there is no human operator in direct contact with that personal information. I argue that these new technologies need to take concepts like privacy into account, but also, (...) that we ought also to take these technologies into account to reconsider and perhaps reconceptualise privacy. This paper argues that while an inhuman system like the IoT does not necessarily violate the interpersonal privacy of people, if the IoT is used as part of a state surveillance program, a political notion of privacy may be violated. (shrink)

The ‘agents’ of toleration can be divided into three categories: public institutions, groups and individuals. If it is mostly accepted that both public institutions and individuals are capable of toleration, it is not clear that such a capacity can be attributed to groups, although in daily discourse we seem ready to say that a certain social group is (in)tolerant. This article aims to address this issue by investigating the relationship between collective agency and social groups. Formal groups (e.g. corporations) (...) have internal rules and collectively recognized decision-making procedures that constitute a collective behaviour. However, it is not clear if and in what sense such a capacity is also upheld by informal groups. This article discusses some competing criteria to define informal groups and proposes the shared convictions criterion. In conclusion, this criterion is applied to toleration-related issues, so as to reconcile our ordinary understanding of groups’ toleration with a more technical analysis. (shrink)

The effectiveness of complaint handling and service recovery policies in customer retention has been the focus of both scholars and service organizations. In the past decade, Justice Theory has provided the basis of the dominant theoretical framework for complaint management and service recovery. However, it does not explicitly address unfair trade practices, which constitute an ethical issue. Favorable outcomes in complaint handling may not be able to restore the reputation of a company and the potential harm perceived by (...) consumers. Using face-to-face interviews, this study applies Fairness Theory to explore the psychological responses of consumers in the post-complaint phase, particularly in ethical judgment. The findings suggest that an unfavorable outcome in the post-complaint stage leads to counterfactual thinking by the consumer about the consumer's state of well-being. The complaint must be due to the discretionary actions of the service provider whose accountability is assessed. Those harmful actions are then judged against an ethical standard. Explanations can reduce blame, and their effectiveness is moderated by outcome favorability but not ethical judgment. Favorable outcome, captured by "Would Perception," has only limited influence on Perceived Potential Harm (PPH), which is an important determinant of ethical judgment. This study makes both theoretical and practical contributions. It is the first study to validate Fairness Theory empirically and apply it to complaint handling as a complement of Justice Theory in the information and communication technology (ICT) service context. The study indicates that customers may condemn a service provider because of PPH even though the outcome is favorable. Unfair trade practices are what make customers hate ICT service providers. (shrink)

To systematically compare welfare across species, it is first necessary to explore whether welfare subjects of different species have the same or rather a different capacity for welfare. According to what seems to be the dominant philosophical view, welfare subjects with higher cognitive capacities have a greater capacity for welfare and are generally much better off than those with lower cognitive capacities. Višak carefully explores and rejects this view and argues instead that welfare subjects of different species have (...) the same capacity for welfare despite different cognitive capacities. This book prepares the philosophical ground for comparisons of welfare across species. It will inform and inspire ethicists and animal welfare scientists alike, as well as a broader readership interested in wellbeing, animals, and ethics. (shrink)

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

Schellenberg's book The unity of perception is full of innovative ideas and challenges to preconceptions. This discussion endorses several of Schellenberg's main contentions, but it also challenges her handling of several key topics, such as hallucinations and perceptual awareness of particulars, and it expresses doubts about the informativeness of her main analytic tool, the notion of a perceptual capacity.

Background: Many people participating in dementia research may lack capacity to give informed consent and the relationship between cognitive function and capacity remains unclear. Recent changes in the law reinforce the need for robust and reproducible methods of assessing capacity when recruiting people for research.Aims: To identify numbers of capacitous participants in a pragmatic randomised trial of dementia treatment; to assess characteristics associated with capacity; to describe a legally acceptable consent process for research.Methods: As part of (...) a pragmatic randomised controlled trial of Ginkgo biloba for mild-moderate dementia, we used a consenting algorithm that met the requirements of existing case law and the exigencies of the new Mental Capacity Act. We decided who had capacity to give informed consent for participation in the trial using this algorithm and sought predictors of capacity.Results: Most participants with mild-moderate dementia in this trial were unable to give informed consent according to the legal criteria. When adjusted for confounding, the Mini Mental State examination did not predict the presence of capacity.Conclusion: Cognitive testing alone is insufficient to assess the presence of capacity. Researchers and clinicians need to be aware of the challenging processes regarding capacity assessment. We outline a procedure which we believe meets the ethical and legal requirements. (shrink)

As with other areas of the social world, academic research in the contemporary healthcare setting has undergone adaptation and change. For example, research methods are increasingly incorporating citizen participation in the research process, and there has been an increase in collaborative research that brings academic and industry partners together. There have been numerous positive outcomes associated with both of these growing methodological and collaborative processes; nonetheless, both bring with them ethical considerations that require careful thought and attention. This paper addresses (...) the ethical considerations that research teams must consider when using participatory methods and/or when working with industry and outlines a novel informed consent matrix designed to maintain the high ethical standard to which academic research in the healthcare arena has traditionally adhered. (shrink)

Working memory limits are best defined in terms of the complexity of the relations that can be processed in parallel. Complexity is defined as the number of related dimensions or sources of variation. A unary relation has one argument and one source of variation; its argument can be instantiated in only one way at a time. A binary relation has two arguments, two sources of variation, and two instantiations, and so on. Dimensionality is related to the number of chunks, because (...) both attributes on dimensions and chunks are independent units of information of arbitrary size. Studies of working memory limits suggest that there is a soft limit corresponding to the parallel processing of one quaternary relation. More complex concepts are processed by or In segmentation, tasks are broken into components that do not exceed processing capacity and can be processed serially. In conceptual chunking, representations are to reduce their dimensionality and hence their processing load, but at the cost of making some relational information inaccessible. Neural net models of relational representations show that relations with more arguments have a higher computational cost that coincides with experimental findings on higher processing loads in humans. Relational complexity is related to processing load in reasoning and sentence comprehension and can distinguish between the capacities of higher species. The complexity of relations processed by children increases with age. Implications for neural net models and theories of cognition and cognitive development are discussed. (shrink)

This paper investigates the idea of reasoning, in a local (or contextual) way, under prioritized and possibly inconsistent knowledge bases. Priorities are not supposed to be given globally between all the beliefs in the knowledge base, but locally inside sets of pieces of information responsible for inconsistencies. This local stratification offers more flexibility for representing priorities between beliefs. Given this local ordering, we discuss five basic definitions of influence relations between conflicts. These elementary notions of influence between two conflicts (...) A and B exhaustively explore the situations where solving A leads to solve B. Then we propose natural approaches to restore the coherence of a knowledge base on the basis of influence relations between locally-stratified conflicts. (shrink)

Despite their importance in the history of philosophy and in particular in the work of Aristotle and Kant, mental capacities have been neglected in recent philosophical work. By contrast, the notion of a capacity is deeply entrenched in psychology and the brain sciences. Driven by the idea that a cognitive system has the capacity it does in virtue of its internal components and their organization, it is standard to appeal to capacities in cognitive psychology. The main benefit of (...) invoking capacities in an account of the mind is that it allows for an elegant counterfactual analysis of mental states: it allows us to analyze mental states on three distinct yet interrelated levels. A first level of analysis pertains to the function of mental capacities. A second level of analysis pertains to the mental capacities employed, irrespective of the context in which they are employed. A third level of analysis pertains to the mental capacities employed, taking into account the context in which they are employed. This paper develops an account of perceptual capacities. This account involves an analysis of their function, their individuation and possession conditions, the relation between perceptual capacities and their employment, as well as their informational and neural base conditions. (shrink)

Research involving minors has been the subject of much ethical debate. The growing number of longitudinal, pediatric studies that involve genetic research present even more complex challenges to ensure appropriate protection of children and families as research participants. Long-term studies with a genetic component involve collection, retention and use of biological samples and personal information over many years. Cohort studies may be established to study specific conditions (e.g. autism, asthma) or may have a broad aim to research a range (...) of factors that influence the health and development of children. Studies are increasingly intended to serve as research platforms by providing access to data and biological samples to researchers over many years. (shrink)

Technology has outpaced the capacity of researchers performing research on human participants to interpret all data generated and handle those data responsibly. This poses a critical challenge to existing rules governing human subjects research. The technologies used in research to generate images, scans, and data can now produce so much information that there is significant potential for incidental findings, findings generated in the course of research but beyond the aims of the study. Neuroimaging scans may visualize the entire (...) brain and even the entire head; computed tomography colonography research may visualize the entire torso, from the base of the lungs to the pubis; genetics studies may reveal “extra” and sometimes unwanted information about the family, such as misattributed paternity and undisclosed adoption; and genomic microarray research increasingly involves whole-genome analysis revealing an individual’s complete genotype, with enormous potential for uncovering unexpected information about an individual’s genetics and risks of developing future conditions. (shrink)

Psychiatric disorders usually do not have characteristic physical exam findings, imaging, or lab values. Psychiatrists therefore diagnose and treat patients largely based on reported or observed behavior, which makes collateral information from a patient’s close contacts especially pertinent to an accurate diagnosis. The American Psychiatric Association considers communication with patients’ supports a best practice when the patient provides informed consent or does not object to the communication. However, situations arise in which a patient’s objection to such communication is the (...) product of impaired decision-making and the benefits of obtaining collateral information represent best practice. In this article a framework for addressing these situations is proposed using a full decisional capacity evaluation, followed by an alternate decision-making process by concurrence from a second physician. It is recommended that a patient’s refusal to allow the gathering of collateral information should be addressed exactly like refusals for other diagnostic or treatment interventions. (shrink)

Changes in healthcare organizations are inevitable and occurring at unprecedented rates. Such changes greatly impact nurses and their work, yet these experiences are rarely explored. Organizational change discourses remain grounded in perspectives that explore and explain systems, often not the people within them. Change processes in healthcare organizations informed by such organizational discourses validate only certain perspectives and forms of knowledge. This fosters exclusionary practices, limiting the capacity of certain individuals or groups of individuals to effectively contribute to change (...) discourses and processes. The reliance on mainstream organizational discourses in healthcare organizations has left little room for the exploration of diverse perspectives on the subject of organizational change, particularly those of nurses. Michel Foucault's work challenges dominant discourse and suggest that strong reliance's on specific discourses effectively disqualify certain forms of knowledge. Foucault's writings on disqualified knowledge and parrhesia (truth telling and frank speech) facilitate the critical exploration of discourses that inform change in healthcare organizations and nurses capacities to contribute to organizational discourses. This paper explores the capacity of nurses to speak their truths within rapidly and continuously changing healthcare organizations when such changes are often driven by discourses not derived from nursing knowledge or experience. (shrink)

Recently, training programs in research ethics have been established to enhance individual and institutional capacity in research ethics in the developing world. However, commentators have expressed concern that the efforts of these training programs have placed ‘too great an emphasis on guidelines and research ethics review’, which will have limited effect on ensuring ethical conduct in research. What is needed instead is a culture of ethical conduct supported by national and institutional commitment to ethical practices that are reinforced by (...) upstream enabling conditions, which are in turn influenced by developmental conditions. Examining this more inclusive understanding of the determinants of ethical conduct enhances at once both an appreciation of the limitations of current efforts of training programs in research ethics and an understanding of what additional training elements are needed to enable trainees to facilitate national and institutional policy changes that enhance research practices. We apply this developmental model to a training program focused in Egypt to describe examples of such additional training activities. (shrink)