Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, (...) digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care. (shrink)

Pediatric critical careCritical care refers to the health care of children with life-threatening illness or following major surgery or severe injury. This care is offered in different contexts across the globe. In well-resourced environments, critical careCritical care may be provided in pediatric intensive care units, which provide highly complex medical care with advanced, potentially expensive technological devices aimed primarily at sustaining life; whereas in poorly resourced regions, only primary care may be available for critically ill or injured childrenInjured children. Even (...) where PICU facilities are available, they are a scarce and expensive resource. The knowledge and ability to sustain a critically ill or injured child’sInjured children life, potentially with effects on the child and family’s quality of lifeQuality of life and at the expense of other children’s health care, leads to frequent ethical challenges. Ethical issues related to how best to ensure optimal quality of lifeQuality of life and the fair distribution of scarce resources are common. In-depth knowledge and understanding of the individual patient’s medical, scientific and psychosocial context, through interdisciplinary discussion and collaboration; as well as familiarity with the overriding, relevant ethico-legal policiesPolicy and principles is essential for appropriate decision-makingDecision-making. Truthful communicationCommunication with the family is essential, using a shared decision-makingDecision-making process, and the child’s best interestBest interest must be central to every decision. This chapter presents an overview of the recommended approach to, and important considerations for, ethical decision-makingDecision-making in the PICU, using a hypothetical case example. (shrink)

The question of a new journal and the philosophical debate of 1947 In 1922-43 Soviet philosophers had their own journal titled Pod znamenem marksizma [Under the Banner of Marxism]. It came into being in early 1922 and its third issue contained Lenin's programmatic article "On the Significance of Militant Materialism" [O znachenii voinstvuiushchego materializma]. This journal published many good combative articles in its twenty years. But during the War it fell ill and in mid-1943 ceased to exist. It was not (...) discontinued. No, it simply lacked the strength to appear. Thereafter, we Soviet philosophers did not have our own journal for several years. The lack was felt especially keenly after the end of the Great Patriotic War when philosophical studies developed quickly in our country. A wide discussion of philosophical questions, especially contentious, controversial questions—and there were quite a few of them—became necessary but there was no forum for discussing them. This was also true of the critical analysis of the philosophical literature that was coming out: a rare review appeared from time to time in the existing journals, but it was clearly inadequate and, most importantly, it did not give a comprehensive evaluation of the merits and shortcomings of the published philosophical work. It seemed to us then that an unhealthy situation such as the one involving G. F. Aleksandrov's book The History of Western European Philosophy [Istoriia zapadnoevropeiskoi filosofii], which was not evaluated on its merits and, despite its serious flaws, was praised by admirers of the author's talent, could only arise in the absence of a philosophical journal. Had there been a journal, it could have helped to prevent such stuffy situations from arising in certain sections of the philosophical front. Obviously, this opinion was quite naive: at the time many of us did not understand that if Aleksandrov had had "his" man on the journal, no criticism of his book would have been permitted. We realized this later. (shrink)

It has long become established practice, on the part of the editors of Voprosy filosofii, to hold round table discussions on various pressing problems of philosophy and related disciplines.

We know that the Philosophical Notebooks do not constitute a finished work, but are working digests done by Lenin, not for publication but only for himself, and as a basis for further work on questions of dialectics. This circumstance must always be remembered when one turns to the Philosophical Notebooks. Here are recorded and collected Lenin's remarkable thoughts as they developed upon reading the works of Hegel and other philosophers as well as certain natural scientists, and Lenin's exceedingly valuable plans (...) and notions pertaining to further work on theoretical problems of the materialist dialectic. But, at the same time, the Philosophical Notebooks contain numerous passages copied by Lenin as he did the digests of the philosophical works he read. Moreover, it is sometimes difficult to say for what purpose and toward what end Lenin did this copying: was it in order subsequently to adduce these extracts and quotations in support of his own views and postulates; was it for purposes of criticism — to demonstrate that the propositions of Marxist dialectics were incompatible with them; or was it merely as the roughest kind of material for work he would subsequently do? Many of the copied extracts in the Philosophical Notebooks are accompanied by Lenin's critical remarks, negative and positive, in brief analyses and rather extensive commentaries. But some of them remained open questions for Lenin himself. In such an instance he noted for his own information that it would be necessary to return again to the proposition he had copied, because it was something that he did not fully understand: it seemed to him that at the given point Hegel wished to say this or that; but perhaps that is not the case. (shrink)

Usage of psychotropics during pregnancy and lactation has always been a topic of debate and controversy. The debate stems from the potential adverse effects on the growing fetus or infants due to the transfer of psychotropic drugs through placenta or breast milk of mothers receiving them; and the problem of discontinuing psychotropics in lactating mother considering chances of relapse. However, most of the psychotropics are found to be relatively safe when used cautiously during the lactation phase. This article describes available (...) data on the use of psychotropics in lactating mothers, in particular, in relation to the safety profile of infants. (shrink)

There can be no doubt that the process of differentiation of the sciences today is going forward with rising intensity. This process is expressed in two ways: in the appearance of new sciences and disciplines outside those already existing, and as the further subdivision of existing sciences into narrower and more fragmented disciplinary branches.

In the recent spate of philosophers' writing on legal ethics, most contend that lawyers' professional role exposes them to great risk of moral wrongdoing; and some even conclude that the role's demands inevitably corrupt lawyers' characters. In assessing their arguments, I take up three questions: (1) whether philosophers' training and experience give them authority to scold lawyers; (2) whether anything substantive has emerged in the scolding that lawyers are morally bound to take to heart; and (3) whether lawyers ought to (...) defer to philosophers' claims about moral principle. I return a negative answer to each. (shrink)

Emoji faces, which are ubiquitous in our everyday communication, are thought to resemble human faces and aid emotional communication. Yet, few studies examine whether emojis are perceived as a particular emotion and whether that perception changes based on rendering differences across electronic platforms. The current paper draws upon emotion theory to evaluate whether emoji faces depict anatomical differences that are proposed to differentiate human depictions of emotion. We modified the existing Facial Action Coding System to apply to emoji faces. An (...) equivalent “emoji FACS” rubric allowed us to evaluate two important questions: First, Anatomically, does the same emoji face “look” the same across platforms and versions? Second, Do emoji faces perceived as a particular emotion category resemble the proposed human facial expression for that emotion? To answer these questions, we compared the anatomically based codes for 31 emoji faces across three platforms and two version updates. We then compared those codes to the proposed human facial expression prototype for the emotion perceived within the emoji face. Overall, emoji faces across platforms and versions were not anatomically equivalent. Moreover, the majority of emoji faces did not conform to human facial expressions for an emotion, although the basic anatomical codes were shared among human and emoji faces. Some emotion categories were better predicted by the assortment of anatomical codes than others, with some individual differences among platforms. We discuss theories of emotion that help explain how emoji faces are perceived as an emotion, even when anatomical differences are not always consistent or specific to an emotion. (shrink)

To help people study Marxist-Leninist philosophy, it is particularly necessary to be careful about the accuracy of philosophical terminology. Vague and ambiguous expressions must be firmly eliminated. Among them, in our view, is the saying, current among us, to the effect that "the world as a whole" is the subject matter of philosophy, Marxist philosophy included. The present article is devoted to criticism of that view.

The 1995 Encyclopedia of Bioethics is an almost complete reworking of the original 1978 edition, due to the expanding nature of the field. The following article focuses on how the second edition of the Encyclopedia deals with the topic of “clinical ethics” and three related topics: “nursing ethics”, “trust”, and “conflict of interest”. We assess their relevance to the current developments in these fields and the Encyclopedia's usefulness as a resource to ethics consultants, researchers and clinicians. We emphasize the heterogeneity (...) of clinical ethics as a still new and evolving field. (shrink)

From pre-Christian times until the present day, philosophers have discussed whether, given evil, belief in God can logically be maintained. Theists and non-theists remain unconvinced by one another's arguments. This study re-examines the question of God and evil from a neutral standpoint and claims that neither side has come to adequate grips either with the question itself or with the other side's case, chiefly because of failure to distinguish the kinds of problem raised by evil.

This chapter highlighted some salient trends in pediatric ethicsEthics, pediatric from different parts of the globe. It is interesting to note that although diverse, there are many similarities between ethical challenges in pediatrics in different parts of the world.

A first-person account of some victims of the virus, the author puts faces and circumstances to the tragedy of the Covid-19 pandemic. Told from a chaplain’s point of view, these narratives will take the reader beyond the numbers and ask questions like: What is the cost of keeping families separated at the end of life, and, if patient/family centered care is so central to healthcare these days, why was it immediately discarded? Is potentially saving human lives worth the risk of (...) damaging them beyond repair? (shrink)

The title of this article might quite well be given the more hackneyed form, Has Kant answered Hume? Much of the discussion pertains to this latter question, but as the aim is also to emphasize some points concerned with Kant himself a deviation in title may be permissible.

No one who is interested in the problem of value and attempts to read through the literature on the subject can fail to be struck by the extraordinary diversity of opinion. Some of this difference of view is traceable to ambiguities in language; there are various terms employed, each of which, of course, may or may not express anyvalid idea—terms like value, values, kinds of value, sorts of things that have value, value-objects, things that have value. The terms value and (...) values are subject to and lead to much confusion, even on the part of those who are aware of the existence of such a danger. Much of the difference may probably be due to two other importantfactors: first, the education and training in earlier years whereby emotional reactions to words instead of intelligent understanding of their meaning and validity are induced, and, second, the continual reliance upon moral experience, which reliance may seem to be necessary, but which may be invalidated by the consideration, generally overlooked and unappraised, that moral, like social, experience might not be what it is if certain views were not entertainedand did not prevail. The latter possibility would put moral and social studies on a plane quite different from that of physical investigations, for the moral and social inquirer would always have to bear in mind that the facts with which he is confronted, and to which he seeks to appeal, may exist to confront him and his fellowmen only in the sense that they arise from the acceptance and effectuation of a belief or theory, and would not be but for the effectuation of the belief or theory. The other factor, that of the influence of education and training upon emotional reactions, is also important in relation to a study of value, for it is necessary to be on guard against confusing reactions to words and reactions to objects, things, or situations. (shrink)

The subject of the present paper is the central conception of a philosophy that has been particularly dominant and influential, and the following remarks are prompted because of difficulties experienced in the attempt to understand that philosophy. The aim of the paper is to point out what seems to be a serious defect in that type of philosophy; but it is even more its aim to emphasize the danger into which philosophy in all its forms may easily fall, and against (...) which it must exercise precautions. (shrink)

It is well known to readers of the Republic that, according to Plato's representation, a casual meeting of several friends develops into a sederunt for the express purpose of finding a solution to the question, what is justice? The question has its origin in the remark of the aged Cephalus, quoting Pindar, that whoever lives a life of justice and holiness, Sweet hope, the nourisher of age, his heart Delighting, with him lives; which most of all Governs the many veering (...) thoughts of man. (shrink)

Causes for celibacy, divorces and successful marriage are discussed in the article. Absence of true love and inability to build and keep it are the main reasons for family disruption. Amorousness, immature love and various forms of false or flawed love substitute the true feeling. It is caused by increased women’s independence, loss of mutual understanding and trust (due to infidelity or jealousy), incompatibility of characters or values. Celibacy is often conditioned by physical disability, revaluation of freedom and independence, huge (...) requirements to partners, consumer attitude to life, infertility, alcohol and drug abuse, abnormalities in personality and sexuality. (shrink)

We analyse the effect of the regulatory T cells (Tregs) in the local control of the immune responses by T cells. We obtain an explicit formula for the level of antigenic stimulation of T cells as a function of the concentration of T cells and the parameters of the model. The relation between the concentration of the T cells and the antigenic stimulation of T cells is an hysteresis, that is unfold for some parameter values. We study the appearance of (...) autoimmunity from cross-reactivity between a pathogen and a self antigen or from bystander proliferation. We also study an asymmetry in the death rates. With this asymmetry we show that the antigenic stimulation of the Tregs is able to control locally the population size of Tregs. Other effects of this asymmetry are a faster immune response and an improvement in the simulations of the bystander proliferation. The rate of variation of the levels of antigenic stimulation determines if the outcome is an immune response or if Tregs are able to maintain control due to the presence of a transcritical bifurcation for some tuning between the antigenic stimuli of T cells and Tregs. This behavior is explained by the presence of a transcritical bifurcation. (shrink)