Background The potential for transmission of blood-borne pathogens such as hepatitis B virus from infected healthcare workers to patients is an important and difficult issue facing healthcare policymakers internationally. Law and policy on the subject is still in its infancy, and subject to a great degree of uncertainty and controversy. Policymakers have made few recommendations regarding the specifics of practice restriction for health care workers who are hepatitis B seropositive. Generally, they have deferred this work to vaguely defined "expert panels" (...) which will have the power to dictate the conditions under which infected health care workers may continue to practice. Discussion In this paper we use recent Canadian policy statements as a critical departure point to propose more specific recommendations regarding disclosure of transmission risks in a way that minimizes practice restriction of hepatitis B seropositive health care workers without compromising patient safety. The range of arguments proposed in the literature are critically examined from the perspective of ethical analysis. Summary A process for considering the ethical implications of the disclosure of the sero-status of health care workers is advanced that considers the varied perspectives of different stakeholders. (shrink)

This book explains why moral beliefs can and likely do play an important role in the development and operation of market economies. It provides new arguments for why it is important that people genuinely trust others-even those whom they know don't particularly care about them-because in key circumstances institutions are incapable of combating opportunism. It then identifies specific characteristics that moral beliefs must have for the people who possess them to be regarded as trustworthy. When such moral beliefs are held (...) with sufficient conviction by a sufficiently high proportion of the population, a high trust society emerges that supports maximum cooperation and creativity while permitting honest competition at the same time. Such moral beliefs are not tied to any particular religion and have nothing to do with moral earnestness or the set of moral values-what matters is how they affect the way people think about morality. Such moral beliefs are based on abstract ideas that must be learned so they are matters of culture, not genes, and are therefore able to explain differences in economic performance across societies. (shrink)

Clinical simulation using standardized patients has become standard in medical education—and is now being incorporated into some graduate programs in bioethics—for both formative and summative evaluation. In most hospitals, though, clinical ethics consultation is done by the ethics committee (or a subset of it). This study is the first, to our knowledge, to examine the effectiveness of standardized patient simulation in training hospital ethics committees to deal with ethically complex and emotionally fraught clinical situations. Following a substantial revision of the (...) institution’s nonbeneficial treatment policy, ethics committee members underwent a simulation to determine whether a specific requested treatment should be withheld on the basis of futility. Pre- and postintervention surveys showed improvement in all domains, although the small sample size limited the power of the study, with only one measure showing a statistically significant difference. An interesting incidental finding was that one-quarter of committee members voted against a determination of futility, even though the case clearly met the definition set forth in the policy. This highlights the emotional challenges in implementing an ethically rigorous, unanimously accepted policy that ultimately determines the timing and manner of a patient’s death. (shrink)

Theological schools are well situated to create intentional cultures for the purpose of spiritual formation. Indeed, most schools of theology have this goal as an essential part of their mission as well as a requirement for continued accreditation. And yet, the measurement of spiritual formation over time is fraught with challenges. This article seeks to address some of these challenges by means of developing a meta-theory of positive change/growth which would eventually serve as a theoretical basis for the development of (...) a generalizable and reliable measurement tool. (shrink)

Intersectional feminist scholars emphasize how overlapping systems of oppression structure gender inequality, but in focusing on the gendered, classed, and racialized bases of stratification, many often overlook disability as an important social category in determining economic outcomes. This is a significant omission given that disability severely limits opportunities and contributes to cumulative disadvantage. We draw from feminist disability and intersectional theories to account for how disability intersects with gender, race, and education to produce economic insecurity. The findings from our analyses (...) of 2015 American Community Survey data provide strong empirical support for hierarchies of disadvantage, where women and racial minority groups with disabilities and less education experience the highest poverty levels, report the lowest total income, and have a greater reliance on sources outside the labor market for economic security. By taking disability into account, our study demonstrates how these multiple characteristics lead to overlapping oppressions that become embedded and reproduced within the larger social structure. (shrink)

Societal evaluation of new technologies, specifically nanotechnology and genetically engineered organisms, challenges current practices of governance and science. When a governing body is confronted by a technology whose use has potential environmental risks, some form of risk analysis is typically conducted to help decision makers consider the range of possible benefits and harms posed by the technology. Environmental risk assessment is a critical component in the governance of nanotechnology and genetically engineered organisms because the uncertainties and complexities surrounding these technologies (...) pose such risk potential. However, GEOs are unique technologies, and there is widespread, international recognition that many traditional forms of ERA are not well-suited for evaluating them. Nanotechnology products are also likely to need different models of risk assessment, as there is very little information on their fate, transport, and impacts in the environment. (shrink)

The song of the northern mockingbird, Mimus polyglottos, is notable for its extensive length and inclusion of numerous imitations of several common North American bird species. Because of its complexity, it is not widely studied by birdsong scientists. When they do study it, the specific imitations are often noted, and the total number of varying phrases. What is rarely noted is the systematic way the bird changes from one syllable to the next, often with a subtle transition where one sound (...) is gradually transformed into a related sound, revealing an audible and specific compositional mode. It resembles a common strategy in human composing, which can be described as variation of a theme. In this paper, we present our initial attempts to describe the specific compositional rules behind the mockingbird song, focusing on the way the bird transitions from one syllable type to the next. We find that more often than chance, syllables before and after the transition are spectrally related, i.e., transitions are gradual, which we describe as morphing. In our paper, we categorize four common modes of morphing: timbre change, pitch change, squeeze, and stretch. This is the first time such transition rules in any complex birdsong have been specifically articulated. (shrink)

Moral capacity is an important feature of what it means to be human. In this volume, the contributors have taken on the daunting task of trying to distinguish between legal and moral capacity. This distinction is difficult at times for clinicians, philosophers and legal scholars alike. Part of the challenge of defining moral capacity lies in the difficulty of adequately categorizing it. For this reason, the editors have chosen to divide the book into three parts. The first looks at the (...) concepts involved in the discussion of moral capacity; the second considers the role of moral capacity in the lives of professionals; and the final part reflects on case studies of moral capacity or incapacity illustrating the challenge that moral capacity presents - its definition lying between two seemingly incommensurable models, those of the threshold and continuum. This volume takes a multidisciplinary approach to the subject, and ties the disciplines of medicine, philosophy and law into the health context. It will be of interest to medical health professionals as well as researchers working in the areas of philosophy and law. (shrink)

Coordinated daily rhythms are evident in most aspects of our physiology, driven by internal timing systems known as circadian clocks. Our understanding of how biological clocks are built and function has grown exponentially over the past 20 years. With this has come an appreciation that disruption of the clock contributes to the pathophysiology of numerous diseases, from metabolic disease to neurological disorders to cancer. However, it remains to be determined whether it is the disruption of our rhythmic physiology per se (...) (loss of timing itself), or altered functioning of individual clock components that drive pathology. Here, we review the importance of circadian rhythms in terms of how we (and other organisms) relate to the external environment, but also in relation to how internal physiological processes are coordinated and synchronized. These issues are of increasing importance as many aspects of modern life put us in conflict with our internal clockwork. (shrink)

The extent to which game play is experienced as engaging is an important criterion for the playability of video games. This study investigates how video games can be designed towards increased levels of experienced engagement over time. For this purpose, two experiments were conducted in which a total of 35 participants repeatedly played a video game. Results indicate that experienced engagement is based on the extent to which the game provides rich experiences as well as by the extent to which (...) the game provides a sense of control. In view of the influence of both game features and players’ expertise on the levels of experienced richness and control, it is concluded that game features should be modified over time to maintain optimal levels of engagement. (shrink)

For decades, myxobacteria have been spotlighted as exemplars of social “wolf‐pack” predation, communally secreting antimicrobial substances into the shared public milieu. This behavior has been described as cooperative, becoming more efficient if performed by more cells. However, laboratory evidence for cooperativity is limited and of little relevance to predation in a natural setting. In contrast, there is accumulating evidence for predatory mechanisms promoting “selfish” behavior during predation, which together with conflicting definitions of cooperativity, casts doubt on whether microbial “wolf‐pack” predation (...) really is cooperative. Here, it is hypothesized that public‐goods‐mediated predation is not cooperative, and it is argued that a holistic model of microbial predation is needed, accounting for predator and prey relatedness, social phenotypes, spatial organization, activity/specificity/transport of secreted toxins, and prey resistance mechanisms. Filling such gaps in our knowledge is vital if the evolutionary benefits of potentially costly microbial behaviors mediated by public goods are to be properly understood. (shrink)

Previous research on the neural basis of cognitive control processes has mainly focused on cortical areas, while the role of subcortical structures in cognitive control is less clear. Models of basal ganglia function as well as clinical studies in neurodegenerative diseases suggest that the striatum (putamen and caudate nucleus) modulates the inhibition of interfering responses and thereby contributes to an important aspect of cognitive control, namely response interference control. To further investigate the putative role of the striatum in the control (...) of response interference, 23 patients with stroke-induced lesions of the striatum and 32 age-matched neurologically healthy controls performed a unimanual version of the Simon task. In the Simon task, the correspondence between stimulus location and response location is manipulated so that control over response interference can be inferred from the reaction time costs in incongruent trials. Results showed that stroke patients responded overall slower and more erroneous than controls. The difference in response times (RTs) between incongruent and congruent trials (known as the Simon effect) was smaller in the ipsilesional/-lateral hemifield, but did not differ significantly between groups. However, in contrast to controls, stroke patients exhibited an abnormally stable Simon effect across the reaction time distribution indicating a reduced efficiency of the inhibition process. Thus, in stroke patients unilateral lesions of the striatum did not significantly impair the general ability to control response interference, but led to less efficient selective inhibition of interfering responses. (shrink)

At the end of this century there are so many occasions, so many residues of the most violent of times, that challenge the very idea of forgivenessNorthern Ireland, Bosnia, the Tutsis and Hutus, the Shiite and Suni Moslems, the settlers and African immigrants in South Africa, indigenous populations against the dominant culture. The open violence and rapaciousness of human enmity can be viewed now in the displacement of masses of people in Kosovo. Said the U.N. High Commissioner for Refugees, Sadako (...) Ogata, about the Kosovo crisis: that this century, as in its darkest hours, should end with the mass deportation of innocent people.”. (shrink)

(2013). Can Informed Consent Go Too Far? Balancing Consent and Public Benefit in Research. The American Journal of Bioethics: Vol. 13, No. 4, pp. 1-2. doi: 10.1080/15265161.2013.778645.

This book addresses the Confucian philosophy of common good and deals with the comparative philosophy on eastern and western understandings of common good. The common good is an essentially contested concept in contemporary moral and political discussions. Although the notion of the common good has a slightly antique air, especially in the North Atlantic discussion, it has figured prominently in both the sophisticated theoretical accounts of moral and political theory in recent years and also in the popular arguments brought for (...) particular political policies and for more general orientations toward policy. It has been at home both in the political arsenal of the left and the right and has had special significance in ethical and political debates in modern and modernizing cultures. This text will be of interest to philosophers interested in Chinese philosophy and issues related to individualism and communitarianism, ethicists and political philosophers, comparative philosophers, and those in religious studies working on Chinese religion. (shrink)

Running marathons is an increasingly popular activity with an ever-increasing number of events and participants. Many participants declare that they pursue a variety of goals by running, namely, the maintenance of good health, the development of strength and improvement of fitness, the management of emotions, and the achievement of resilience and psychological wellbeing. The research has examined marathon running, like many other sports, and has studied various factors that reduce athletic performance, such as the experience of anxiety, and that enhance (...) such performance, such as an increase in general wellbeing. This article reports the results of a study on the experience of competitive anxiety among 238 male marathon runners who participated in Seville’s 26th Marathon race on February 23, 2020, and investigates the relationship between anxiety and key dimensions of wellbeing as measured by the Spanish-adapted 20-item PWB Scale. We hypothesized that participating athletes who rated high on the dimensions of PWB would experience lower levels of competitive anxiety with respect to this race. We also proposed that PWB would function as a mediating factor with respect to the experience of anxiety. The results show, as hypothesized, that marathon running enhances wellbeing and reduces anxiety. The data showed significant negative correlations between four of five wellbeing dimensions and the three types of anxiety measured, namely, somatic anxiety, worry, and concentration-impairing anxiety. Other findings supported our hypothesis that wellbeing, as measured, functions as a mediating factor for the moderation of competitive anxiety. Generalization of these findings is limited by the fact that the low number of female participants recruited did not permit valid statistical analyses in this respect. It is known that both anxiety and wellbeing are subjects to variation by gender. The future inclusion of male and female subjects in equivalent studies will undoubtedly add valuable information concerning the dynamics of anxiety and wellbeing. The implications of these findings and the limitations of the study will be discussed. (shrink)

Professor Brian Goodwin (1931-2007) was a visionary biologist, mathematician and philosopher. Understanding organisms as dynamics wholes, he worked to develop an alternate view to extreme Darwinism based solely on genetic factors. He was a pioneer in the field of theoretical biology.

Arianne Shahvisi has argued that a doctor’s conscientious objection to abortion is a misuse of their authority which unduly burdens patients and, moreover, does not succeed in its aim of exculpating objectors from participating in perceived evil. We examine these claims in this response. First, we ask what the ‘conscience clause’ really requires of doctors and whether Shahvisi has interpreted it correctly. Second, we explore the notions of vulnerability and power in the doctor–patient relationship and cast doubt on Shahvisi’s claims (...) about these. Third, we tackle Shahvisi’s claim that conscientious objection is self-defeating because it entails remaing causally implicated in a chain of events leading to abortion. We show that this claim entails absurdity, then revisit the classical framework for the ethics ethics of co-operation to show that conscientious objection can suceed in exculpating objectors from perceived wrongdoing. We briefly critically evaluate the General Medical Council’s guidance on conscie... (shrink)

This target article draws together two groups of experimental studies on the control of human movement through peripheral feedback and centrally generated signals of motor commands. First, during natural movement, feedback from muscle, joint, and cutaneous afferents changes; in human subjects these changes have reflex and kinesthetic consequences. Recent psychophysical and microneurographic evidence suggests that joint and even cutaneous afferents may have a proprioceptive role. Second, the role of centrally generated motor commands in the control of normal movements and movements (...) following acute and chronic deafferentation is reviewed. There is increasing evidence that subjects can perceive their motor commands under various conditions, but that this is inadequate for normal movement; deficits in motor performance arise when the reliance on proprioceptive feedback is abolished either experimentally or because of pathology. During natural movement, the CNS appears to have access to functionally useful input from a range of peripheral receptors as well as from internally generated command signals. The unanswered questions that remain suggest a number of avenues for further research. (shrink)

Can quantum theory provide examples of metaphysical indeterminacy, indeterminacy that obtains in the world itself, independently of how one represents the world in language or thought? We provide a positive answer assuming just one constraint of orthodox quantum theory: the eigenstate-eigenvalue link. Our account adds a modal condition to preclude spurious indeterminacy in the presence of superselection sectors. No other extant account of metaphysical indeterminacy in quantum theory meets these demands.

We argue that the analysis of cognitive attitudes should play a central role in developing more sophisticated accounts of the proper roles for values in science. First, we show that the major recent efforts to delineate appropriate roles for values in science would be strengthened by making clearer distinctions among cognitive attitudes. Next, we turn to a specific example and argue that a more careful account of the distinction between the attitudes of belief and acceptance can contribute to a better (...) understanding of the proper roles for values in a case study from paleoanthropology. (shrink)

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation... (shrink)

Student plagiarism is a rampant practice and major concern in higher education. How students perceive the overarching American cultural values and their impact on the practice will inform educators and help them to better combat the practice. It is also valuable for educators to know whether the students perceive the practice to be part of the dominant culture, currently, on college campuses. This study reports perceptions of plagiarism by students in an introductory sociology course. Open-ended questions explored perceptions of extent, (...) justifications, and American values affecting plagiarism. Participants were clear on definitions and seriousness, but most were able to justify the behavior and identify American values contributing to or deterring the practice. Findings were consistent across gender, course grade, class standing, and college major. The authors discuss the cultural values students use as justifications for plagiarizing and the larger implications for higher education. (shrink)