Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)

Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, (...) and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well‐understood in terms of what Bernard Williams calls “agent‐regret.” We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience. (shrink)

Three experiments investigated the relationship between subjective experience and attentional lapses during sustained attention. These experiments employed two measures of subjective experience to examine how differences in awareness correspond to variations in both task performance and psycho-physiological measures . This series of experiments examine these phenomena during the Sustained Attention to Response Task . The results suggest we can dissociate between two components of subjective experience during sustained attention: task unrelated thought which corresponds to an absent minded disengagement from the (...) task and a pre-occupation with one's task performance that seems to be best conceptualised as a strategic attempt to deploy attentional resources in response to a perception of environmental demands which exceed ones ability to perform the task. The implications of these findings for our understanding of how awareness is maintained on task relevant material during periods of sustained attention are discussed. (shrink)

Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of (...) an individual's initial injury or illness and becomes especially tragic because it could be prevented by robust policy. A failure to fulfill this normative obligation constitutes a breach of disability law, which would view post‐trial access as a means to achieve social reintegration through this neurotechnological accommodation. (shrink)

Researchers and practitioners are increasingly using machine‐generated synthetic data as a tool for advancing health science and practice, by expanding access to health data while—potentially—mitigating privacy and related ethical concerns around data sharing. While using synthetic data in this way holds promise, we argue that it also raises significant ethical, legal, and policy concerns, including persistent privacy and security problems, accuracy and reliability issues, worries about fairness and bias, and new regulatory challenges. The virtue of synthetic data is often understood (...) to be its detachment from the data subjects whose measurement data is used to generate it. However, we argue that addressing the ethical issues synthetic data raises might require bringing data subjects back into the picture, finding ways that researchers and data subjects can be more meaningfully engaged in the construction and evaluation of datasets and in the creation of institutional safeguards that promote responsible use. (shrink)

Injuries from failed suicide attempts account for a large number of patients cared for in the emergency and trauma setting. While a fundamental underpinning of clinical ethics is that patients have a right to refuse treatment, individuals presenting with life-threating injuries resulting from suicide attempts are almost universally treated in this acute care setting. Here we discuss the limitations on physician ability to determine capacity in this setting and the challenges these pose in carrying out patient wishes.

Some Indigenous Australians have embraced developmental origins of health and disease (DOHaD) and epigenetic discourses to highlight the legacies of slow violence in a settler colonial context. Despite important differences between Indigenous and scientific knowledges, some Indigenous scholars are positioning DOHaD and epigenetics as a resource to benefit their communities. This article argues that time plays a crucial role of brokering disparate knowledge spaces in Indigenous discourses of postgenomics, with both Indigenous cosmological frames and DOHaD/epigenetics centring a circular temporal model. (...) Drawing on interview data with scientists who work in Indigenous health, and broader ethnographic work in Indigenous Australian contexts where epigenetics is deployed, this article explores how different circularities of space and time become entangled to co-produce narratives of historical trauma. We use the concept of biocircularity to understand the complex ways that Indigenous and postgenomic temporalities are separated and connected, circling each other to produce a postcolonial articulation of postgenomics as a model of collective embodiment and distributed responsibility. (shrink)

We conducted a rapid review and quantitative summary of meta-analyses that have examined interventions which can be used by individuals during quarantine and social distancing to manage anxiety, depression, stress and subjective well-being. A literature search yielded 34 meta-analyses (total number of studies k = 1,390, n = 145,744) that were summarized. Overall, self-guided interventions showed small to medium effects in comparison to control groups. In particular, self-guided therapeutic approaches (including cognitive-behavioral, mindfulness, and acceptance-based interventions), selected positive psychology interventions, and (...) multi-component and activity-based interventions (music, physical exercise) showed promising evidence for effectiveness. Overall, self-guided interventions on average did not show the same degree of effectiveness as traditional guided individual or group therapies. There was no consistent evidence of dose effects, baseline differences and differential effectiveness of eHealth interventions. More research on the effectiveness of interventions in diverse cultural settings is needed. (shrink)

College students from small, medium, and large institutions with either a modified or no honor code were presented with cheating scenarios and asked to rate how dishonest they perceived the behavior to be and the likelihood that they would report it. No main effects were found for institution size or type of honor code. Student–faculty ratio was not correlated with responses to the cheating scenarios. Students from modified honor code schools perceived more severe punishments for cheating and understood the reporting (...) process better than students from non–honor code schools. Implications for modified honor code systems are discussed. (shrink)

Understanding the social context of clinical ethics is vital for making ethical discourse central in professional practice and for preventing harm. In this paper we present findings about clinical ethics from in depth interviews and consultation with 7 members of a hospital social work department. Workers gave different accounts of ethical dilemmas and resources for ethical decision making than did their managers, whereas workers and managers agreed on core-guiding ethical principles and on ideal situations for ethical discourse. We discuss the (...) research team's initial interpretations, the relevance of the extant ethics literature to organizational structures and dynamics, and alternative perspectives on clinical ethics. (shrink)

Deaths of Despair (DoD), or mortality resulting from suicide, drug overdose, and alcohol-related liver disease, have been rising steadily in the United States over the last several decades. In 2020, a record 186,763 annual despair-related deaths were documented, contributing to the longest sustained decline in US life expectancy since 1915–1918. This forum feature considers how health humanities disciplines might fruitfully engage with this era-defining public health catastrophe and help society better understand and respond to the crisis.

Phenomenological interviews with queer women in rural Nova Scotia reveal significant forms of trauma experienced during labour and birth. Situating the accounts of participants within both phenomenological and intersectional analyses reveals harms enabled by structurally embedded heteronormative and homophobic healthcare practices and policies. Our account illustrates the breadth and depth of harm experienced and outlines how these violate core ethical principles and values in healthcare.

Researchers and practitioners are increasingly using machine-generated synthetic data as a tool for advancing health science and practice, by expanding access to health data while—potentially—mitigating privacy and related ethical concerns around data sharing. While using synthetic data in this way holds promise, we argue that it also raises significant ethical, legal, and policy concerns, including persistent privacy and security problems, accuracy and reliability issues, worries about fairness and bias, and new regulatory challenges. The virtue of synthetic data is often understood (...) to be its detachment from the data subjects whose measurement data is used to generate it. However, we argue that addressing the ethical issues synthetic data raises might require bringing data subjects back into the picture, finding ways that researchers and data subjects can be more meaningfully engaged in the construction and evaluation of datasets and in the creation of institutional safeguards that promote responsible use. (shrink)

Aims and objectives. Participant narratives from a feminist and queer phe- nomenological study aim to broaden current understandings of trauma. Examin- ing structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. Background. Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have (...) an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Design. Analysis of the qualitative data was guided by feminist and queer phe- nomenology. This was well suited to understanding queer women’s storied narra- tives of trauma, including disempowering processes of structural marginalisation. Methods. Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. Results. Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that recon- structs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Conclusions. Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. Relevance to clinical practice. New trauma-informed assessment strategies recon- struct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re- experiencing the process of coming out as queer in opposition to the expectation of heterosexuality. (shrink)

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy (...) and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

The success or failure of an ineffective assistance of counsel claim turns largely on the testimony of trial counsel. It is therefore common for the government to communicate ex parte with trial co...

Psychiatric genomics research with African populations comes with a range of practical challenges around translation of psychiatric genomics research concepts, procedures, and nosology. These challenges raise deep ethical issues particularly around legitimacy of informed consent, a core foundation of research ethics. Through a consideration of the constitutive function of language, the paper problematises like‐for‐like, designative translations which often involve the ‘indigenization’ of English terms or use of metaphors which misrepresent the risks and benefits of research. This paper argues that effective (...) translation of psychiatric genomics research terminology in African contexts demands substantive engagement with African conceptual schemas and values. In developing attenuated forms of translational thinking, researchers may recognise the deeper motivational reasons behind participation in research, highlighting the possibility that such reasons may depart from the original meaning implied within informed consent forms. These translational issues might be ameliorated with a critical re‐examination of how researchers develop and present protocols to institutional ethics review boards. (shrink)

The source texts for Ovid's Heroides often contain precedents for his heroines as message senders at moments in their tradition especially ripe for elegiac refashioning. The first part of this paper suggests that the disputed first word of Heroides 1, a hanc with no apparent referent, signals Penelope's penchant for composing messages, both in Ovid's elegiac letter and in Homer's epic, and functions as a programmatic opening to the collection. The second part more briefly treats letters 4, 5, 6, 7, (...) 9, and 13 to show how their authors' previous mythographical correspondence also provides points of origin for the Heroides. (shrink)

Discussion of supported decision making has been dominated by legal scholars, philosophers, and advocates for persons with disabilities. Peterson et al.’s primary contribution is introducing...

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)

Recent judicial rulings and changes in federal and state legislation have given for-profit corporations a growing list of rights and constitutional protections, including the right to practice religion free from many types of federal or state restriction. In this paper, we highlight the implications of these developments using Rawls’ Theory of Justice to explore the consequences of for-profit corporate religious freedom for consumers and employees. We identify preliminary principles to spark a discussion as to how expanding religious freedom for businesses (...) and fair access to goods and services can coexist in the for-profit marketplace. (shrink)

Although scientific images have begun to receive significant attention from philosophers, one type of image has thus far been ignored: moving images. As techniques such as live cell imaging and videomicroscopy are becoming increasingly important in many areas of biology, however, this oversight needs to be corrected. Biologists often claim that there are relevant differences between video and static images. Most interesting is the idea that video images allow us to see causal relationships. By identifying the conditions that would be (...) required for this to be true and showing that they are not satisfied at the micro level, I will show that videomicroscopy does not provide us with special access to causal information. †To contact the author, please write to: Department of Philosophy, University of Calgary, 2500 University Dr. NW, Calgary, Alberta T2N 1N4; e-mail: mdelehan@ucalgary.ca. (shrink)

Business Ethics: A European Review, EarlyView.

Translated by Anthony Bower With an Introduction by Oliver Todd 'A conscience with style' V.S. Pritchett The Rebel (1951) is Camus's 'attempt to understand the time I live in' and a brilliant essay on the nature of human revolt. Here he makes a daring critique of communism - how it had gone wrong behind the Iron Curtain and the resulting totalitarian regimes. And he questions two events held sacred by the left wing - the French Revolution of 1789 and the (...) Russian Revolution of 1917 - that had resulted, he believed, in the use of terrorism as a political instrument. In this towering intellectual document, Camus argues that hope for the future lies in revolt with revolution - a chance to achieve change without losing our freedom. 'The last French intellectual to take the side of humanity and talk its language... a figure of immense moral stature' Sunday Times Winner of the Nobel Prize for Literature. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

For much of their history, the relationship between anthropology and psychology has been well captured by Robert Frost's poem, “Mending Wall,” which ends with the ironic line, “good fences make good neighbors.” The congenial fence was that anthropology studied what people think and psychology studied how people think. Recent research, however, shows that content and process cannot be neatly segregated, because cultural differences in what people think affect how people think. To achieve a deeper understanding of the relation between process (...) and content, research must integrate the methodological insights from both anthropology and psychology. We review previous research and describe new studies in the domain of folk biology which examine the cognitive consequences of different conceptualizations of nature and the place of humans within it. The focus is on cultural differences in framework theories among Native Americans and European American children and adults living in close proximity in rural Wisconsin. Our results show that epistemological orientations affect memory organization, ecological reasoning, and the perceived role of humans in nature. This research also demonstrates that cultural differences in framework theories have implications for understanding intergroup conflict over natural resources and are relevant to efforts to improve science learning, especially among Native American children. (shrink)

Unrecognized conventions—practices that are conventional even though their participants do not recognize them as such—play central roles in shaping our lives. They range from the indispensable (e.g. unrecognized linguistic conventions) to the insidious (e.g. some of our gender conventions). Unrecognized conventions pose a challenge for accounts of conventions because it is difficult to incorporate the distinctive arbitrariness of conventions—the fact that conventions always have alternatives—without accidentally excluding many unrecognized conventions. I develop an Accessibility Requirement that allows us to account for (...) both arbitrariness and unrecognized conventions. Specifically, I argue that a conventional practice must have at least one alternative that is at least approximately as good and at least approximately as accessible as the conventional practice itself, independent of the dominance the practice gained as it became conventional. In the course of arguing for this requirement, I also show that two prominent accounts of conventions, David Lewis’s and Ruth Garrett Millikan’s, run into problems with capturing the arbitrariness of conventions. The Accessibility Requirement opens the door to improved accounts of conventions by precisely identifying the way in which conventions are arbitrary. (shrink)

To address climate change fairly, many conflicting claims over natural resources must be balanced against one another. This has long been obvious in the case of fossil fuels and greenhouse gas sinks including the atmosphere and forests; but it is ever more apparent that responses to climate change also threaten to spur new competition over land and extractive resources. This makes climate change an instance of a broader, more enduring and - for many - all too familiar problem: the problem (...) of human conflict over how the natural world should be cared for, protected, shared, used, and managed. -/- This work develops a new theory of global egalitarianism concerning natural resources, rejecting both permanent sovereignty and equal division, which is then used to examine the problem of climate change. It formulates principles of resource right designed to protect the ability of all human beings to satisfy their basic needs as members of self-determining political communities, where it is understood that the genuine exercise of collective self-determination is not possible from a position of significant disadvantage in global wealth and power relations. These principles are used to address the question of where to set the ceiling on future greenhouse gas emissions and how to share the resulting emissions budget, in the face of conflicting claims to fossil fuels, climate sinks, and land. It is also used to defend an unorthodox understanding of responsibility for climate change as a problem of global justice, based on its provenance in historical injustice concerning natural resources. (shrink)

Walt Bower - Rethinking Durkheim and His Tradition - Journal of the History of Philosophy 44:2 Journal of the History of Philosophy 44.2 323-324 Warren Schmaus. Rethinking Durkheim and His Tradition. New York: Cambridge University Press, 2004. Pp.xii + 195. Cloth, $65.00. Warren Schmaus has offered a compelling and sophisticated reinterpretation of Émile Durkheim's sociology of knowledge in the context of the eclectic spiritualist philosophical tradition dominant during the Third French Republic. More specifically, the primary purpose of the book is (...) to examine how Durkheim's categories of understanding developed out of the way Kant was interpreted by nineteenth-century academic philosophy in France. The debate between Kantian apriorist and Humean empiricist accounts of the theory of the categories is the main epistemological dilemma for.. (shrink)

There is a long philosophical tradition of skepticism about the possibility of adequate paraphrases for metaphorical utterances. And even among those who favor paraphrasability, there is a tendency to think that paraphrases of metaphorical utterances may themselves have to be non-literal. I argue that even the most evocative and open-ended metaphorical utterances can be literally and adequately paraphrased, once we recognize that they are actually indirect speech acts—specifically, indirect directives that command the hearer to engage in an open-ended comparison. This (...) leads to an overall picture in which trite, unevocative metaphorical utterances admit of just straightforward, usually non-directive literal paraphrases, while the most evocative metaphorical utterances admit of only indirect directive paraphrases, and metaphorical utterances in a third category admit of two literal paraphrases, one of which is straightforward and usually non-directive, and the other of which takes the indirect directive form. This argument for literal paraphrasability is intended to demystify metaphor, but not to undercut metaphor’s tremendous value as a communicative device. (shrink)

The task of designing an ontology through reuse is difficult, and a major challenge in this effort is choosing between different ontologies that are candidates for reuse. To address this challenge,...

Pickering, Newton-Howes, and Young assert that the traditional view of decisional capacity, premised on assessing patients’ abilities to communicate, understand, appreciate,...

Land is becoming increasingly scarce relative to the demands of the global economy; a problem significantly exacerbated by climate change. In response, some have suggested that land should be conceptualised as a global commons. This framing might seem like an appealing way to promote sustainable and equitable land use. However, it is a poor fit for the worldʼs land because global commons are generally understood as resources located beyond state borders. I argue that land can be seen to fit the (...) definition of a global commons, if viewed in a particular way; namely, as a biogeochemical resource system that sequesters carbon emissions. The question then arises whether land should be conceptualised as a global commons. I consider this question by reference to three contemporary problems of land justice (land grabbing, forced displacement, and unfairness in land-based climate mitigation); arguing that the global-commons framing will not be conducive to understanding or responding to these problems. I leave the question of how the global community should conceptualise land in the context of climate change open, claiming that any answer must include the voices and perspectives of those whose livelihoods and identities are closely connected to the land. (shrink)