Clinical Ethics, Ahead of Print. This paper is a response to a recent BMJ Blog: ‘The duty to treat: where do the limits lie?’ Members of the Surrey Heartlands Integrated Care Service Clinical Ethics Group reflected on arguments in the Blog in relation to resuscitation during the COVID-19 pandemic.Clinicians have had to contend with ever-changing and conflicting guidance from the Resuscitation Council UK and Public Health England regarding personal protective equipment requirements in resuscitation situations. St John Ambulance had different guidance (...) for first responders.The situation regarding resuscitation led the CEG to consider ethical aspects of health care professionals’ responses to the need for resuscitation during COVID-19. Members agreed that professionals should, ideally, have the level of PPE required for an aerosol generating procedure. However, there was no consensus regarding professionals’ duty to care when this is not available. On the one hand, it was agreed that the casualty/patient’s interests regarding resuscitation should be prioritised due to professionals’ contract with the public and professional privilege. On the other hand, risk thresholds were considered relevant to individual decision-making and professionals’ duty to care. All agreed that decision-making should not be influenced by rewards or reprimands. It was agreed also that decisions to resuscitate should not be considered as moral heroism or supererogatory - regardless of PPE availability - but rather as ‘minimally decent’. We agreed that it may be acceptable for professionals, with good reasons, to opt out of resuscitation attempts and these should be reflected on and discussed before the event. (shrink)

Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions. (...) A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom -based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms. Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician’s duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical digital communication. The ethical implications of clinical digital communication are complex and go beyond concerns about confidentiality and consent. Any development of this form of communication should consider its impact on the patient-clinician-relationship, and include appropriate safeguards to ensure that professional ethical obligations are adhered to. (shrink)

Philosophical Investigations, Volume 45, Issue 3, Page 381-384, July 2022.

For decades now, researchers in the social sciences and humanities have been expressing a deep dissatisfaction with the process of research-ethics review in academia. Continuing the ongoing critique of ethics review begun in Will C. van den Hoonard's Walking the Tightrope and The Seduction of Ethics, The Ethics Rupture offers both an account of the system's failings and a series of proposals on how to ensure that social research is ethical, rather than merely compliant with institutional requirements. Containing twenty-five essays (...) written by leading experts from around the world in various disciplines, The Ethics Rupture is a landmark study of the problems caused by our current research-ethics system and the ways in which scholars are seeking solutions. (shrink)

Animal and human studies suggest that parenting style is transmitted from one generation to the next. The hypotheses of this study were that a mother’s rearing experiences would predict her own parenting resources and current maternal mood, motivation to care for her offspring, and relationship with her parents would underlie this association. In a subsample of 201 first-time mothers participating in the longitudinal Maternal Adversity, Vulnerability and Neurodevelopment project, we assessed a mother’s own childhood maltreatment and rearing experiences using the (...) Childhood Trauma Questionnaire and the Parental Bonding Instrument. At 6 months postpartum, mothers completed questionnaires on parenting stress, symptoms of depression, maternal motivation, and current relationship with their own parents. The sample consisted of mostly high socioeconomic status mothers recruited from Montréal or Hamilton, Canada, with an age range from 18 to 43 years. More severe maltreatment and less supportive rearing by the mother’s parents predicted increased parenting stress at 6 months. These associations were mediated through distinct psychosocial pathways: maltreatment on parenting stress through symptoms of depression ; maternal rearing on parenting stress through maternal motivation and symptoms of depression ; and paternal rearing on parenting stress through current relationship with the father. Maternal rearing experiences predict a mother’s own parenting resources though distinct psychosocial pathways, including depressed mood, maternal motivation, and social support. (shrink)

Figure emblématique de l’art de l’installation, Ann Hamilton crée depuis près de quarante ans des environnements immersifs complexes et poétiques, constitués d’objets et de matériaux divers convoquant tous les sens du spectateur et dont les surprenantes associations, ou leur importante accumulation, provoquent chez ce dernier de multiples réponses affectives et cognitives, bien souvent difficiles à décrire ou à restituer par le simple langage. Absorbé par la présence physique et sensible de ce qui l’entoure, le spectateur est invité à s’abandonner (...) aussi longtemps que possible dans ce qu’il éprouve, à se mettre à l’écoute de la situation et du savoir intuitif que lui livre son corps en interaction avec le lieu. L’expérience de l’œuvre, pour Ann Hamilton, est en effet avant tout un « acte d’attention ». Cette notion d’attention est particulièrement importante, à une époque où la surenchère de stimuli, l’immédiateté et l’accélération qui caractérisent les rythmes de nos vies de plus en plus désincarnées ne nous permettent plus de percevoir et de donner sens à ce que nous ressentons, ni à ce qui nous entoure. Phénomène singulier d’ouverture à soi, aux autres et au monde, l’expérience des installations d’Ann Hamilton engage un certain mode d’être, une « qualité de présence » dont dépendent nos capacités de mémoire, de pensée, d’imagination et d’action. À partir de l’analyse de quelques grandes installations, de tropos à the event of the thread, il s’agira d’établir plus précisément les processus phénoménologiques et cognitifs mis en œuvre chez le spectateur par le dispositif immersif, et d’en éclairer les enjeux. For nearly forty years, Ann Hamilton, an iconic figure in the art of installation, has been creating complex and poetic immersive environments, made up of objects and various materials which summon all the viewer’s senses. The astonishing associations and significant accumulation trigger multiple emotional and cognitive responses, often difficult to put simply into words. Absorbed by the physical and sensitive presence of what surrounds them, the viewers are invited to abandon themselves as long as possible in what they are experiencing as well as pay attention to the situation and the intuitive knowledge they receive from their own physical interaction with the space. For Ann Hamilton, experiencing the art is above all an “act of attention”. The notion of attention is particularly important at a time when continuous stimuli, immediacy and acceleration, which characterize the rhythms of our evermore fragmented lives, no longer allow us to perceive and give meaning to what we feel, or what surrounds us. Ann Hamilton’s installations call for an openness to oneself, to others and to the world. They involve a certain mode of being, a “quality of presence” upon which our ability to remember, think, imagine and act depends. Based on the observation of several large installations, we will explore and analyze the phenomenological and cognitive processes which occur as the viewer is immersed in her works. (shrink)

This article analyzes the experiences of ecologists who used data they did not collect themselves. Specifically, the author examines the processes by which ecologists understand and assess the quality of the data they reuse, and investigates the role that standard methods of data collection play in these processes. Standardization is one means by which scientific knowledge is transported from local to public spheres. While standards can be helpful, the results show that knowledge of the local context is critical to ecologists' (...) reuse of data. Yet, this information is often left behind as data move from the private to the public world. The knowledge that ecologists acquire through fieldwork enables them to recover the local details that are so critical to their comprehension of data collected by others. Social processes also play a role in ecologists' efforts to judge the quality of data they reuse. (shrink)

Three female physicians were interviewed as part of a comprehensive investigation into the narratives of female and male physicians and nurses, concerning their experience of being in ethically difficult care situations in the care of elderly people. The interviewees expressed great concern for the low status of care for elderly people, and the need to fight for the specialty and for the care and rights of their patients. All the interviewees’ narratives concerned problems relating to perspectives of both action ethics (...) and relational ethics. The main focus was on problems concerning the latter perspective, expressed as profound concern and respect for the individual patient. Secondary emphasis was placed on relationships with relatives and other professionals. The most common themes in an action ethics perspective were too little treatment and the lack of health services for older patients, together with overtreatment and death with dignity. These results were discussed in the light of Løgstrup’s ethics, which emphasize that human life means expressing oneself, in the expectation of being met by others. Both Ricoeur’s concept of an ethics of memory and Aristotle’s virtue ethics are presented in the discussion of too little and too much treatment. (shrink)

Involuntary autobiographical memories are spontaneously arising memories of personal events, whereas voluntary memories are retrieved strategically. Voluntary remembering has been studied in numerous experiments while involuntary remembering has been largely ignored. It is generally assumed that voluntary recall is the standard way of remembering, whereas involuntary recall is the exception. However, little is known about the actual frequency of these two types of remembering in daily life. Here, 48 Danish undergraduates recorded their involuntary versus voluntary autobiographical memories during a day (...) using a mechanical counter. Involuntary memories were reported three times as frequently as voluntary memories. Compared to voluntary memories, they were associated less with problem solving and social sharing and more with day dreaming, periods of boredom, no reasons for remembering and predominantly came to mind during unfocused attention. The findings suggest that involuntary recall is a typical way of accessing the personal past. (shrink)

The controversy between hunting apologists and their anti-hunting antagonists continues to escalate. Numerous attempts to settle the issue have failed in part because the participants have often not distinguished and treated separately the various activities labeled “hunting.” Those who participate in hunting fall into one of two categories: shooters or sport hunters. Shooters are those whose ultimate goals do not depend on hunting but can be met in other ways; sport hunters are those who take immense pleasure in the hunt (...) itself and who kill in order to have had an authentic hunting experience. Discussion of the morality of hunting (as opposed to its prudence) is properly restricted to the moral evaluation of the desire of sport hunters to kill for pleasure. This desire can be explained by biological/evolutionary concepts and defended as morally neutral. Neither the animal protectionists nor the utilitarian apologists recognize that violent death is part of nature and that man’s desire to participate in it can be both natural and culturally valuable. Though well-intentioned, utilitarianism is an impotent ethical defense of hunting because it can judge only the prudence, not the morality, of hunting. (shrink)

Identifying patterns in the world requires noticing not only unusual occurrences, but also unusual absences. We examined how people learn from absences, manipulating the extent to which an absence is expected. People can make two types of inferences from the absence of an event: either the event is possible but has not yet occurred, or the event never occurs. A rational analysis using Bayesian inference predicts that inferences from absent data should depend on how much the absence is expected to (...) occur, with less probable absences being more salient. We tested this prediction in two experiments in which we elicited people's judgments about patterns in the data as a function of absence salience. We found that people were able to decide that absences either were mere coincidences or were indicative of a significant pattern in the data in a manner that was consistent with predictions of a simple Bayesian model. (shrink)

Natural language is full of patterns that appear to fit with general linguistic rules but are ungrammatical. There has been much debate over how children acquire these “linguistic restrictions,” and whether innate language knowledge is needed. Recently, it has been shown that restrictions in language can be learned asymptotically via probabilistic inference using the minimum description length (MDL) principle. Here, we extend the MDL approach to give a simple and practical methodology for estimating how much linguistic data are required to (...) learn a particular linguistic restriction. Our method provides a new research tool, allowing arguments about natural language learnability to be made explicit and quantified for the first time. We apply this method to a range of classic puzzles in language acquisition. We find some linguistic rules appear easily statistically learnable from language experience only, whereas others appear to require additional learning mechanisms (e.g., additional cues or innate constraints). (shrink)

Children learn their native language by exposure to their linguistic and communicative environment, but apparently without requiring that their mistakes be corrected. Such learning from “positive evidence” has been viewed as raising “logical” problems for language acquisition. In particular, without correction, how is the child to recover from conjecturing an over-general grammar, which will be consistent with any sentence that the child hears? There have been many proposals concerning how this “logical problem” can be dissolved. In this study, we review (...) recent formal results showing that the learner has sufficient data to learn successfully from positive evidence, if it favors the simplest encoding of the linguistic input. Results include the learnability of linguistic prediction, grammaticality judgments, language production, and form-meaning mappings. The simplicity approach can also be “scaled down” to analyze the learnability of specific linguistic constructions, and it is amenable to empirical testing as a framework for describing human language acquisition. (shrink)