Bangladesh emerged as an independent country in the South Asia in 1971 after being separated from Pakistan. In 1971 it was a very poor country. The general people had a hope and dream that the political parties will develop the country and will eradicate poverty gradually, will provide jobs to the 50% unemployed people, will educate the 60% illiterate people; but their holy hope and dream have not been fulfilled due to frequent hostile political culture, beating, killing among the political (...) party members, no patriotism among the political leaders, massive corruption, unnecessary frequent strike, unnecessary opposition to the government policy etc. This paper has narrated the past and current social and political situation in Bangladesh briefly with the help of data collected from newspapers and statements given by intellectuals and political leaders. Descriptive and analytical research methodology has been applied in this paper to narrate the situation. (shrink)

The police are one of the most powerful and important forces for any country. The main task of the police is to install a sense of security in the ordinary citizens and to protect their life and property when they are in danger. Bangladeshi Police have a glorious past with tremendous achievement. Especially in our great liberation war in 1971, they played an important role in achieving our liberation. Eliminating terrorism & militancy and others several operation that leads with the (...) risk of their life. But there are still a lot of accusations against the police force. Like- abusing of power, Misconducting with the people, Committing crossfire defying the high-court order, Wearing white dress when they move to detain criminals, Arresting without warrant, and many other including Bribery, Extortion, Trading Drug and Yaba, Playing partisan role, keeping Bad association, Filing case against deceased man, Charging sheet against the infant who has not been born yet, Enforcing disappearance, Suppressing the freedom of express, Violating Human rights, Doing anti-social activities such as rape, forcible extortion, drinking alcohol, etc. are the real scenario of Bangladesh Police. Policing ethics or related unethical behaviors, in particular, are shaped by both societal perceptions and organizational socialization of the police personnel on how authority should be exercised, as well as the latter's relationship with the socio-political and economic structures overtime. This paper proposes to explain the role of police as the main law enforcement agency in any democratic country. An Attempt has been made to bring different perspectives of ethics which comprises views of Aristotle, Machiavelli, Immanuel Kant, J S Mill and John Rawls. The paper focuses on police Ethics. Police ethics’ reflects the society and the regulations that shape the policing system. Discuss the results and analysis of the consequences of moral degradation caused by the Police. Explore the police brutality because of the lack of Ethics to highlight the public's attitude towards police. The ethical standards and the code of conduct Police practitioners should actually abide by is an ongoing debate. (shrink)

Business companies are at an unconventional and non-material risk that threatens their business reputation or brand potential in the market. (Cyber Risk), so insurance companies have introduced specialized insurance contracts designed to mitigate the impact of this devastating risk. The need for commercial companies to purchase cyber risk insurance policies has recently increased due to persistent and increasing threats to their operating systems containing the company's database and customers. It has become necessary for businesses to take note of how the (...) cyber risk policy can be covered. At the same time, it is difficult to identify common exceptions in cyber risk insurance contracts because it is relatively recent. In addition, there is a kind of confusion between the insurance contract of cyber risk and some contracts that you may suspect on the other hand. (shrink)

This cross sectional study was carried out among the workers of British American Tobacco Company, Dhaka with a view to explore their nutritional status, personal hygiene and health seeking behavior as because they are working on a tobacco processing company. The sample size was 179 which were selected purposively. The study showed that out of 179 respondents 89 (49.7%) were in the age groups of 30-39 years and the mean age of the respondents were 31.99 ± 6.01 years. A large (...) number of respondents (55.9%) had monthly family income of Taka 10001-20000 and the mean family income was Taka 12776.54 ± 5230.13. Maximum respondents (73.7%) were Muslim, more than half (54.2%) were shift in charge, 39.1% of the respondents consisted of 4 family members, 43.6% respondents were accustomed to other type of eating habit and 38.5% respondents knew that malnutrition was the effect of lack of proper nutrition, 59.8% of the respondents knew that night blindness was the disease due to malnutrition, most of the respondents (91.6%) performed duties to maintain health, majority (62.0%) respondents used to do nothing to maintain healthcare for their children and 35.9% visited doctor’s single time in a month, 40.2% of the respondents told regular tooth brushing as type of healthy habits. Majority (64.8%) respondents used to brush twice a day, majority (50.8%) respondents used to wash hand after toileting, majority (62.08%) respondents used to bath daily, 43.0% and 31.8% of the respondents told that dysentery and diarrhea was due to eating without proper hand washing respectively. Majority (53.6%) respondents informed that they learned about personal hygiene from television, 45.8% respondents understood that use of safe water in every work as sanitation. Majority (50.84%) came from nuclear family; most (84.92%) had exercise habit and 40.22% had education level of class VIII. Most (75.42%) of the respondents had semi pucca houses and majority (69.83%) of the respondents used only water as materials for hand washing. This study provided some important information which might help the concerned authority to take appropriate measures to improve the health status of the workers. (shrink)

PurposeThe main purpose of this study is to assess the effects of COVID-19 on the restaurant businesses of Bangladesh. It examines the socio-economic impacts of the humanitarian disaster of the COVID-19 pandemic from the perspective of restaurant owners. The study also intends to provide recommendations to mitigate effects on the restaurant business.Design/Methodology/ApproachA qualitative research approach was adopted to explore the effects of the COVID-19 pandemic on the restaurant businesses of Bangladesh. A total of 22 in-depth interviews were conducted with the (...) top-ranked restaurant owners in the Rajshahi City Corporation area of Bangladesh. Thematic analysis technique was applied for analyzing the collected data.FindingsThe study found that the restaurant owners were compelled to reduce their number of employees, and forced to ensure social distancing and proper sanitization which increased the expenses. Although online orders and home delivery services have increased significantly, restaurant business operation is gradually turning critical owing to the lack of financial support. Thus, restaurant owners urge the govenrment for financial assistance.Research Limitations/ImplicationsSince this research only focused on one city in Bangladesh, the outcomes of study may have a dearth of generalizability. Hence, the investigators are encouraged to extend the study area.Practical ImplicationsThis study will help restaurant owners and policymakers in formulating contemporary business policies and strategies. Thus, it will be supportive of improving the present condition of the restaurant businesses in developing countries like Bangladesh.Originality/ValueThis paper identified the truculent scenario of the restaurant business during the COVID-19 pandemic. (shrink)

Collecting data using an appropriate sampling technique is a challenging task for a researcher to do. The researchers will be unable to collect data from all possible situations, which will preclude them from answering the study’s research questions in their current form. In light of the enormous number and variety of sampling techniques/methods available, the researcher must be knowledgeable about the differences to select the most appropriate sampling technique/method for the specific study under consideration. In this context, this study also (...) looks into the basic concepts in probability sampling, kinds of probability sampling techniques with their advantages and disadvantages. Social science researchers will benefit from this study since it will assist them in choosing the most suitable probability sampling technique for completing their research smoothly and successfully. (shrink)

The most prominent form of human communication and interaction is speech. It plays an indispensable role for expressing emotions, motivating, guiding, and cheering. An ill-intentioned speech can mislead people, societies, and even a nation. A misguided speech can trigger social controversy and can result in violent activities. Every day, there are a lot of speeches being delivered around the world, which are quite impractical to inspect manually. In order to prevent any vicious action resulting from any misguided speech, the development (...) of an automatic system that can efficiently detect suspicious speech has become imperative. In this study, we have presented a framework for acquisition of speech along with the location of the speaker, converting the speeches into texts and, finally, we have proposed a system based on long short-term memory which is a variant of recurrent neural network to classify speeches into suspicious and nonsuspicious. We have considered speeches of Bangla language and developed our own dataset that contains about 5000 suspicious and nonsuspicious samples for training and validating our model. A comparative analysis of accuracy among other machine learning algorithms such as logistic regression, SVM, KNN, Naive Bayes, and decision tree is performed in order to evaluate the effectiveness of the system. The experimental results show that our proposed deep learning-based model provides the highest accuracy compared to other algorithms. (shrink)

The overall objective of the study was to examine the pros and cons of the participatory approach adopted in natural resource management in the ecologically protected areas of the Sundarbans mangrove of Bangladesh. A comparative study was done between the people who are involved and non-involved in this approach. Empirical data was collected through personal interviews with a structured questionnaire. The Gini coefficient was measured first and then embedded with the Lorenz curve to draw a line between perfect equality and (...) inequality vis-a-vis. The study revealed that the co-management built awareness in favor of biodiversity conservation and the efficient use of natural resources. Contradictorily, a segment of different hierarchical committees was involved in destructive activities like poisoning the wetlands for fishing. Therefore, a mixed outcome was found. The findings will help the policymakers in identifying the pitfalls and bottlenecks rooted in co-management. Hence, the study recommends revising the approach to ensure the community’s active participation on an equal basis and take action against them who degrade those resources. Exploring profitable alternative income-generating activities is warranted to narrow down the dependency on the Sundarbans mangrove’s natural resources. In order to address the tragedy of the commons, the study advocates for the unity of all knowledge ranging from science to humanistic scholarship for sound policymaking. (shrink)

One of the challenging problems in large scale cyber-argumentation platforms is that users often engage and focus only on a few issues and leave other issues under-discussed and under-acknowledged. This kind of non-uniform participation obstructs the argumentation analysis models to retrieve collective intelligence from the underlying discussion. To resolve this problem, we developed an innovative opinion prediction model for a multi-issue cyber-argumentation environment. Our model predicts users’ opinions on the non-participated issues from similar users’ opinions on related issues using intelligent (...) argumentation techniques and a collaborative filtering method. Based on our detailed experimental results on an empirical dataset collected using our cyber-argumentation platform, our model is 21.7% more accurate, handles data sparsity better than other popular opinion prediction methods. Our model can also predict opinions on multiple issues simultaneously with reasonable accuracy. Contrary to existing opinion prediction models, which only predict whether a user agrees on an issue, our model predicts how much a user agrees on the issue. To our knowledge, this is the first research to attempt multi-issue opinion prediction with the partial agreement in the cyber-argumentation platform. With additional data on non-participated issues, our opinion prediction model can help the collective intelligence analysis models to analyze social phenomena more effectively and accurately in the cyber argumentation platform. (shrink)

Adaptive training adjusts a training task with the goal of improving learning outcomes. Adaptive training has been shown to improve human performance in attention, working memory capacity, and motor control tasks. Additionally, correlations have been observed between neural EEG spectral features (4–13 Hz) and the performance of some cognitive tasks. This relationship suggests some EEG features may be useful in adaptive training regimens. Here, we anticipated that adding a neural measure into a behavioral-based adaptive training system would improve human performance (...) on a subsequent transfer task. We designed, developed, and conducted a between-subjects study of 44 participants comparing three training regimens: Single Item Fixed Difficulty (SIFD), Behaviorally Adaptive Training (BAT), and Combined Adaptive Training (CAT) using both behavioral and EEG measures. Results showed a statistically significant transfer task performance advantage of the CAT-based system relative to SIFD and BAT systems of 6 and 9 percentage points, respectively. Our research shows a promising pathway for designing closed-loop BCI systems based on both users' behavioral performance and neural signals for augmenting human performance. (shrink)

This study investigates whether and how the intensity of social distancing from the Coronavirus disease 2019 (COVID-19) pandemic influences the corporate social responsibility (CSR) disclosure index. An empirical examination is carried out based on data from the Shanghai Stock Exchange from 2020 to 2022. CSR disclosure index is measured by the percentage of CSR-related press releases from the total press releases published on a certain day. The intensity of the COVID-19 pandemic is measured by the daily confirmed cases among the (...) population in China. This research uses the two-stage least squares regression model to alleviate the endogeneity issues. Findings reveal a reverse correlation between the intensity of the COVID-19 pandemic and the CSR disclosure. The results are consistent and robust to endogeneity tests and sensitivity analyses. Findings support the stakeholder–agency theory and indicate that Chinese managers tend to satisfy the shareholders' interests rather than those of other broad stakeholders. Moreover, Chinese managers tend to choose short-term survival rather than long-term development in times of social distancing. (shrink)

Purpose This study aims to analyze how English-language versions of e-newspapers in the first two countries affected, China and Japan, which are non-English-speaking countries and have different socio-economic and political settings, have highlighted Coronavirus disease 2019 pandemic news and informed the global community. Design/methodology/approach A text-mining approach was used to explore experts’ thoughts as published by the two leading English-language newspapers in China and Japan from January to March 2020. This study analyzes the Opinion section, which mainly comprises editorial and (...) the op-ed section. The current study groups all editorial discussions and highlights into ten major aspects, which cover health, economy, politics, culture and others. Findings Within the first three months, the media in both China and Japan shifted their focus from health and preparedness to the economy, politics and social welfare. Governance and social welfare were key concerns in China’s news media, while, in contrast, global politics received the highest level of attention from experts in Japan’s news media. Environment and technologies aspects did not receive much attention by the expert’s columns. Originality/value At the initial stage of a world crisis, how leading nations and initially affected nations deal with the problem, how media play their role and guide mass population with experts’ thoughts are highlighted here. The understanding developed in this study can provide guidance to news media in other countries in playing effective roles in the management of this health crisis and catastrophes. (shrink)

Pharmaceutical promotion is a negative influencing force for prescribing. However, very few regulatory initiatives are taken to overcome this unwarranted influence. The present research was conducted in such context with an attempt to review the regulatory documents related to pharmaceutical promotion in Bangladesh including Code of Pharmaceutical Marketing Practices (CPMP), and to compare CPMP with different global guidelines. The studied guidelines demonstrate effort to regulate promotion, though that varies to a great extent, particularly in enforcement aspects. Clearly defined ethical and (...) legal prohibitions, provisions of punishment for violations and entrusted agency with defined authority are crucial. (shrink)

Bioethics is a vital part of a sustainable development. In this paper we discuss why developed country incorporate bioethics along with development of science and technology; and why bioethics decision-making is important to long term development of Bangladesh.

This work has aimed to investigate the consumers’ green product purchase attitudes and behavioral intention during COVID-19 pandemic. Data was collected through a survey method of 503 consumers in Malaysia. Data were analyzed using the partial least square method. The findings revealed that fear of COVID-19 pandemic has a significant impact on green product behavioral intention. Green product literacy, green product orientation, and social influence have a significant influence on green product purchase attitudes. The results also indicated that consumers’ green (...) product purchase attitudes mediate the effect of green product literacy, green product orientation, and social influence on behavioral intention. The findings of this work will provide strategically relevant references to green marketers and retail managers in the understanding of consumers’ green product purchase attitudes and green product behavioral intention during the ongoing uncertainty of the COVID-19 pandemic. (shrink)

In this paper, we focus on the human upper limb rehabilitation scheme that utilizes the concept ofteleoperation. Teleoperation can help the therapist demonstrate different rehab exercises to a different group of people at the same time remotely. Different groups of people from a different place connected to the same network can get therapy from the same therapist at the same time using the telerehabilitation scheme. Here, we presented a humanoid robot NAO that can be operated remotely by a therapist to (...) demonstrate the exercise to a patient. To mimic the movement demonstrated by the therapist, Kinect V2 sensor which is a markerless vision-based motion-tracking device, was used. Modified Denavit-Hartenberg (DH) convention was used for the kinematic modeling of the human upper arm. From the Kinect data, a geometric solution was developed to find a unique inverse kinematic solution of human upper-extremity. Experimental results revealed that NAO could be teleoperated successfully to instruct and demonstrate patients to perform different arm movement exercises in real-time. (shrink)

The temperament of the body is an essential constituent for health conservancy and diagnosis of several diseases. Hence, general body temperament and uterine dystemperament with abnormal vaginal discharge need evaluation. In addition, we also applied a computational intelligence technique for enhancing scientific validity to classify the warm-cold and wet-dry temperaments. This trial included a total of 66 participants with a vaginal discharge of reproductive age. Data included demographic characteristics of the participants, symptoms associated with vaginal discharge, women’s general temperament, and (...) symptoms of uterine dystemperament. Correlation between general body temperament and age, abnormal vaginal discharge, and its associated symptoms was also performed. Additionally, we used the Support Vector Machine-Radial Basis Function model to classify the warm-cold and wet-dry temperaments. Warm general temperament was highly prevalent, followed by moderate on the warm-cold temperament scale. In wet-dry temperament, moderate general body temperament was more prevalent. In warm-cold and wet-dry scores, 78.78% and 74.24% had warm and wet uterine dystemperament, respectively. The age and symptoms were correlated with general temperament. A strong positive correlation was found between warm general temperament and warm dystemperament of the uterus. In addition, our SVM-RBF CV-5 classification model achieved the highest accuracy. Our results showed that vaginal discharge is more common in warm general temperament and warm-wet dystemperament of the uterus. The same has been proven by computational intelligence. Nevertheless, vaginal discharge can also happen in normal and other temperaments. (shrink)

During my (Hafiz) childhood in Bangladesh, I experienced the negative impact of the educational system. My experiences initiated a process of conscientization leading to values-driven activism through the establishment of Education for Development and Sustainability (EDS), a child-friendly community of practice, with Trine and Alamin. In encounters with Erling and Sigrid, we became aware that our activities were in accordance with action research based on cooperative inquiry (Heron & Reason, 2008). From that point of departure, we developed our own collaborative (...) living theory. In this paper, we explore the research question “How did we become action researchers and what is our driving force?” by using Stoller’s (1989) autobiographical narrative method to analyse selected, lived experiences. Sharing lived experiences and engaging in activism with each other and the EDS children became the base for our conscientization, radical empiricism and contemplating involvement in EDS. Value based activism can create empathic relations and emotions through shared engagement for social justice and the realization that we create a shared reality. Hence, conducting action research with children/youth is in our experience a key to sustainable development. However, to increase the transparency and validity of our research, we needed to explore how our experiences and actions have influenced our values, emotions and decisions to conduct research, our research topic and the research in itself. Therefore, we have engaged co-researchers and participants to critically question the research practice and made it open for discussion and comments in order to see alternative ways of interpreting situations and processes. (shrink)

Through a close analysis of various moments within two hours of video-taped interaction, we investigate properties of the setting that the participants cannot ignore even as they transform them in various ways. These properties are not under local control. What is under control is revealed in the participants' “play” with the properties, including dangerous, “deep” play. In this process, some properties of the participants are rarely mentioned (e.g., that the laboring woman is an MD), others are repeatedly emphasized (e.g. the (...) strength of contractions). And others appear in ways that have not been dealt with adequately in current theoretical frameworks. To deal with life-threatening lies, and jokes about lies, we must move away from theories of hegemonic particularity that rely on a habitus. Rather we must acknowledge the practical understandings revealed in the collective submergence of that which may be actively noted as potentially relevant and then set aside so that other tasks can be foregrounded and achieved. (shrink)

20th Asian Bioethics conference has been organized by Bangladesh Bioethics Society incooperation with SSRC, Planing Division, Ministry of Planning; PMR, DGHS, Ministry of Health &Family Welfare, Bangladesh Medical Research Council (BMRC), Asian Bioethics Association (ABA) and Eubios Ethics Institute on Friday, 22 Nov, 2019 at NEC Auditorium, Planning Ministry, Agargoan, Dhaka. M. A. Mannan MP, Honorable Minister, Ministry of Planning, Government of the People's Republic of Bangladesh has kindly consented to grace the occasion as the Chief Guest. Dr. Md. Murad (...) Hassan MP, Honorable State Minister, Ministry of Information, Government of the People's Republic of Bangladesh; Md. Nurul Amin, Secretary, Planning Division, Ministry of Planning; Prof Dr Abul Kalam Azad, DG, Directorate General of Health Services, Ministry of Health & Family welfare (MOH&FW) will present as Special Guests. Drlegates from 40 couuntries will attend the ABC 20 at Dhaka. (shrink)

Asian Bioethics Conference (ABC20) was held on 22-25 Nov. 2019 at DGHS (Directorate General of Health Services) auditorium, Mohakhali and NEC (National Election Commission) Auditorium, Agargoan, Dhaka. Conference was organized by Bangladesh Bioethics Society (BBS) in cooperation of DGHS, Ministry of Health & Family Welfare; Social Science Research Council Bangladesh, Ministry of Planning; Bangladesh Medical Research Council, Mohakhali Dhaka; Asian Bioethics Association (ABA) and Eubios Ethics Institute, Thailand, New Zealand’s and Japan. Mr MA Mannan MP, Honorable Planning Minister, Government of (...) the People’s Republic of Bangladesh was the Chief Guest. Dr. Md. Murad Hassan MP, Honorable State Minister, Ministry of Information, Government of the People's Republic of Bangladesh was present as Special Guest. Md. Nurul Amin, Secretary, Planning Division, Ministry of Planning and Dr Iqbal Kabir, Director, Planning, Monitoring, & Research and Coordinator, DGHS were also present as Special Guests. Bioethics promotes strong ethical values, practice of ethics and morality in Science, Social Science, Commerce and Arts. The conference brought together scholars and policy makers from different disciplines from all around the world to discuss and deliberate the latest issues of bioethics in biomedicine, biotechnology, science, social science, education and research. Around 300 participants from different universities and government officials including 40 foreign delegates from Asia & Pacific and beyond were present at the conference. (shrink)

_House MD_ is a globally successful and long-running medical drama. _House: The Wounded Healer on Television_ employs a Jungian perspective to examine the psychological construction of the series and its namesake, Dr Gregory House. The book also investigates the extent to which the continued popularity of _House MD_ has to do with its representation of deeply embedded cultural concerns. It is divided into three parts - _Diagnosing House, Consulting House and Dissecting House,_ - and topics of discussion include: specific details, (...) themes, motifs and tropes throughout the series narrative, character and visual structure the combination of performative effects, text and images of the doctor and his team the activities of the hero, the wounded healer and the _puer aeternus_. Offering an entirely fresh perspective on _House MD_, with contributions from medical professionals, academics and therapists, this book is essential reading for students and scholars of Jungian psychology. The inclusion of a glossary of Jungian terms means that this book can also be enjoyed by fans of _House MD_ who have been seeking a more in-depth analysis of the series. (shrink)

Dear Readers,Welcome to this issue of our beloved Bangladesh Journal of Bioethics! In this sweltering heat we are all seeking for some cool and comfort. We bring this issue of BJB on different ethical practices and bring up related questions. Are we respecting the rights of every human being when we are either doing research or practicing health service provision? What are the minimum norms and standards to be maintained or are we circumventing those? The issue looks into different issues (...) and provides us with indepth information, queries, fears and reservations.In the article on Knowledge, attitude and practice of medical ethics among medical intern students in a Medical College in Kathmandu, Ramesh P Aacharyaand Yagya L Shakya, report on a Knowledge Attitude and Practice survey of 46 medical undergraduate interns of Maharajgunj Medical Campus. The result of the survey is quite interesting. ‘Doctors know the best irrespective of patients’ opinion was agreed upon by 35 %, ‘Confidentiality cannot be kept in modern era and should be abandoned’ was strongly disagreed by 34.8% and disagreed by 60.9%. The Authors hope that the findings will assist the faculties to strengthen the teaching of medical ethics and guiding the interns for ethical professional conduct. In the article titled Organizational Justice and Employee’s Service Behavior in the Healthcare Organizations in Bangladesh is an agenda for Research, Md. Nuruzzaman and Md. Humayun Kabir Talukder present a conceptual framework and a set of hypotheses regarding the relationships among distributive justice, procedural justice, interactional justice, employee’s citizenship behaviour, role prescribed behaviour and counterproductive behavior in the healthcare organizations in Bangladesh. The authors state that the purpose is to assist the policy makers and service providers in identifying desirable and undesirable HRM practices in order to maintain optimum level of employee commitment for ensuring quality and efficient service delivery to the communities. Though the article is theoretical it may be useful for the policy makers and service providers. If an operational research could be carried out to test the hypothesis the practical utility of the concept could be tested in Bangladesh.Zoheb Rafique in the article Ethical Justification of Conducting Research Trials in Lower and Middle Income Countries Including Pakistan: The Responsibilities of Research Enterprises explores the ethical aspects of research sponsored by commercial agencies. He looks into the factors that influence selection of a study site for a sponsored trial particularly in traditional countries like Pakistan where cultural values add to the problem in assuring that research is conducted in an ethical manner. In this paper, the Author discusses the responsibilities of researchers and funders in low and middle income countries like Pakistan and the ethical justifications of doing research trials in developing countries. He concludes that research participants should be fully informed about the research trial and their participation and it is their right to know all risks and benefits so that they have the option of rejecting participation.The article on Ethical aspects of Dhaka University Tele-medicine System by Ahmed Raihan Abir provides and analysis of the tele- medicine system in Dhaka University. The Author is a member of an extended group at Dhaka University (DU) which has been developing telemedicine equipment and data acquisition software to promote telemedicine practice in Bangladesh. Recently the Telemedicine group of DU and a local NGO named SAMAMA with support from Service innovation fund (SIF) of the Prime Minister Office (PMO) of Bangladesh took the initiative to establish eight rural telemedicine centers and one expert center for the field trial of telemedicine in Bangladesh. The aim of this paper is to examine the ethical challenges of such health care system and the effort to overcome these problems before starting the field trial. The author looks into the details of Data confidentiality and security, Responsibilities of Doctor and Rural Technician, Quality of service and Implications of telemedicine in Bangladesh. He concludes that DU telemedicine project will essentially bring the services of qualified medical experts to the doorsteps of the common people throughout the country, even in the remote rural areas. Although a telemedicine cannot match a face to face consultation, DU tele-medicine system is much better than no consultation at all.Sifat Rahman in the article on Ethical Issues of Fair Subject Selection in Research provides an overview of the criterion for maintaining ethical standards for conducting research. The Author reviews the three fundamental conditions to be met for adhering to strict ethical standards which are: Respect for Persons by protecting the autonomy of people, treating them with courtesy and respect and obtaining informed consent.; Beneficence which incorporates the philosophy of "Do no harm" while maximizing benefits for the research project and minimizing risks to the research subjects; and Justice by ensuring that reasonable, non-exploitative, and well-considered procedures are administered fairly. Finally the Author concludes that Researchers must be truthful and conduct no deception.Dear Readers, as you can see from the above ethics and maintaining the values in research and services are of utmost importance in the improvement of the quality of life. Through our queries, questions and sense of respect for every living being can our endeavors to ensure ethics in all spheres of development be successful.Dear Readers, please keep on sending your articles, notes or thoughts to us. Your participation will make a difference in the quality of our lives.Best regardsTahera AhmedEditor. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Human Genome Research in an Interdependent WorldAlexander Morgan Capron (bio)This has been the year of agenda-setting conferences for the ambitious ELSI (ethical, legal and social issues) program of the Human Genome Project (HGP). But of the dozen or more major meetings of this sort held across the country, the one held at the National Institutes of Heakh (NIH) in Bethesda, MD, June 2-4, 1991, was distinctive in several respects.1As (...) its name implies, "Human Genome Research in an Interdependent World" was a global look at the issues raised by gene mapping and sequencing. Unlike previous conferences, however, this meeting looked beyond a comparative analysis of clinical and domestic legal issues, and concentrated on topics that may require responses on a truly international level if they are to be successfully resolved.The meeting's organizers gathered an impressive group of more than seventy participants from fifteen countries, including the first significant contingent of Soviet and Japanese scientists, physicians, and philosophers at an ELSI meeting. In addition to talks by the heads of the genome projects in the Soviet Union, Japan, and the United States, the meeting was keynoted by Dr. James Wyngaarden, director general of the Human Genome Organization (HUGO), and I had the honor of serving as its general chairman.The goal of the meeting was to consider an array of issues that scientists, philosophers, and lawyers from around the world suggested might have international significance, with an eye to deciding three things: (1) Does the issue deserve further attention? (2) Is the issue best addressed in an international or domestic context? and (3) Do structures exist to which the issue can be referred for resolution? In the final sessions, the entire group debated proposed resolutions on the various topics and narrowed the list needing further, intensive exploration.To provide an international framework for this process, the conference [End Page 247] established a Global Steering Committee on Ethical and Social Issues in Genome Research, which will coordinate the efforts of several task forces charged with refining the tentative resolutions adopted by the conference participants on June 4. The task forces are expected to be able to complete work on some topics by the time of the steering committee's first meeting, which was described by one participant as a "check point," probably within the coming year; on other topics, the task forces will provide interim reports and arrange to continue their analysis. Several topics—less complex or more embryonic—were referred directly to the steering committee. On all issues, a major objective will be to ascertain what existing or newly created structure or structures are capable of implementing the group's recommendations and then to monitor the issue to ensure that appropriate implementation is occurring.Issues to be Explored by Task ForcesInsurance and EmploymentWhile individuals may derive medically useful information from the expanded range of genetic tests that will flow from the HGP, they could also be harmed if test results become a basis for discrimination. An area of particular concern at the conference in Bethesda was whether genetic information should be used to decide eligibility for employment or the scope and cost of health and life insurance. The complexity of this issue is increased as barriers to worker migration fall (especially in Europe) and as more firms carry on business internationally. Furthermore, questions arise about the limits of required testing and whether individuals may decline to be informed of the results of tests.The task force will not only gather information on practices and legal standards throughout the world—especially in light of the differences among nations with regard to the linkage of employment and various forms of insurance—but will also examine international anti-discrimination laws as a possible means of supplementing domestic statutes and regulations. As a starting point, the Bethesda meeting agreed on a set of principles for the task force to refine.2ForensicsAlthough their legal status is not fully resolved, DNA tests are being used increasingly in judicial proceedings and civil and criminal investigations as a highly probative means to identify people. Most forensic uses of "DNA fingerprints" are domestic, but international cooperation among investigative bodies... (shrink)

When the first edition of Pediatric Psychopharmacology published in 2002, it filled a void in child and adolescent psychiatry and quickly establishing itself as the definitive text-reference in pediatric psychopharmacology. While numerous short, clinically focused paperbacks have been published since then, no competitors with the scholarly breadth, depth, and luster of this volume have emerged. In the second edition, Christopher Kratochvil, MD, a highly respected expert in pediatric psychopharmacology, joins the outstanding editorial team led by Dr. Martin and Dr. Scahill. (...) In the new edition, the editors streamline the flow of information to reflect the growth in scientific data since the first edition appeared. The overall structure of the book remains the same, with major sections on underlying biology; somatic interventions; assessment and treatment; and special considerations. (shrink)

Editor's note: This fragment by Roger T. Simonds was the last essay he wrote before his death from leukemia on 10 September 1995. It has been edited by Dr Peggy Muñoz Simonds. Please send all correspondence to Peggy Muñoz Simonds, 5406 Beech Ave., Bethesda, MD 20814, USA.

In lieu of an abstract, here is a brief excerpt of the content:Editorial changes at PPPWelcomes and ThanksJohn Z. Sadler, MDAfter 30 years of co-editing (with Bill Fulford) and editing Philosophy, Psychiatry, & Psychology, I thought it was time for me to step down, and last fall the Association for the Advancement of Philosophy and Psychiatry Executive Council assembled an international search team to select a new Editor-in-Chief. This thoughtful and efficient group, led by Robyn Bluhm, completed the search and (...) selection in a matter of a few months! All of us in the field are grateful to the search committee members for their congenial, disciplined, and fruitful work: Derek Bolton, David Crepaz-Keay, Anthony Fernandez, Brent Kious, Guilherme Messas, and Michael Wong. We are excited about the future of the journal with our new Editor-in-Chief, Professor Werdie van Staden. Briefly, Werdie is the Nelson Mandela Professor of Philosophy and Psychiatry and Director of the Centre for Ethics and Philosophy of the Health Sciences, the University of Pretoria, South Africa.Students, trainees, and early career scholars in our field often ask about how senior scholars found their way to, and through, the field of philosophy/psychiatry. The reading of Werdie's biography, in chronological order, would befuddle a reader trying to predict where he would end up by 2024. In the youth of his adulthood, Werdie was heading toward a career in music, collecting several degrees in music theory, composition, and performance. Indeed, music would occupy a big piece of his life over the decades. Dr. van Staden has continued his musical career as a composer of two symphonies, a concerto, as well as multiple choral and chamber works. He has performed as a flautist for the Pretoria Symphony Orchestra since 2006, and was the Principal for 8 years.However, he was also an individual directed toward service to his fellow human beings. He completed his MBChB medical degree in 1990 and went on to several degree qualifications in medicine, psychiatry, and philosophy. Most significant for us was his early experience with Bill Fulford's master's degree program in the Philosophy of Mental Health at the University of Warwick, later completing a doctoral degree. His Mandela Professorship at Pretoria was the first endowed Professorship in our philosophy/psychiatry multidisciplinary field. Since then his intellectual work has ranged over clinical and research ethics, philosophy of language and psychopathology, Ubuntu virtue theory, person-centered medicine, medical education, and many more areas, making him a most versatile scholar. Over the past three [End Page 91] decades he has functioned as a practicing clinician, a department chair, a clinical trialist, a partner to Bill Fulford in developing and disseminating the Values-Based Practice approach to clinical medicine, a leader in many professional organizations, an editor of the South African Journal of Psychiatry, not to overlook serving as an author, reviewer, and Senior Editor at PPP at various points since the journal's inception. His professional and intellectual activities and accomplishments are too numerous to recount; suffice to say we are delighted to have him bring his vision, creativity, and vigor to us by adding PPP to his to-do list!We congratulate and thank Professor Nancy Potter on her retirement from academia as well as one of our first Senior Editors of PPP. Nancy's path to philosophy/psychiatry was by way of work in the correctional system in her youth, followed by philosophical field work in the emergency psychiatry department at the University of Louisville Hospital, with her psychiatrist colleague Rafi El-Mallakh, MD. However, philosophy has been her first priority, with work in feminist theory, philosophy of peace, virtue theory, and standpoint/social epistemology over her career. Never satisfied with armchair philosophy, Dr. Potter has immersed herself in settings, traditions, and practices to understand them from inside as well as out. As a PPP Senior Editor, Nancy was instrumental in developing the service-user voice, as well as diversifying our authorship in many other ways. I will miss her even-tempered, yet rigorous editorial voice in the journal.My last appointment of a Senior Editor turned out to be one of Dr. van Staden's students. I welcome Dr. Mohammed Abouelleil Rashed as our newest... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Minding Brain Injury, Consciousness, and Ethics: Discourse and DeliberationsJoseph J. Fins (bio) and James Giordano (bio)The annual John Collins Harvey Lecture at the Georgetown University’s Pellegrino Center for Clinical Bioethics is a forum for addressing contemporary topics at the intersection of medicine and bioethics. This year, in marking the decadal anniversary of the launch of the Brain Research through Advancing Innovative Neurotechnology (BRAIN) Initiative, the Harvey Lecture provided an (...) interactive discussion with renowned clinician, researcher, scholar, and author, Joseph J. Fins, MD—who is the E. William Davis, Jr., MD Professor of Medical Ethics, Chief of the Division of Medical Ethics, and a Professor of Medicine at Weill Cornell Medical College—conducted by James Giordano, PhD, MPhil—who is a Professor of Neurology and Biochemistry, and Chief of the Pellegrino Center’s Neuroethics Studies Program at the Georgetown University Medical Center. The discourse focused upon the topic of covert consciousness, and the ways in which current and developing brain science technologies, together with revised practices of medicine, in general, may afford new opportunities in patient care, but may also give rise to issues, questions, challenges, and opportunities for neuroethics.Prof. James GIORDANO:Prof. Fins, your most recent book, Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness (Fins 2015), addresses your ongoing work to employ current and emerging neurological approaches to reveal conscious functions in patients with profound brain injury and disease. To be sure, the destination—if you will—is to talk about covert consciousness. But in commencing this discussion, I’d like to propose a route, which traces your professional journey to this point in your career, and how it led you on your search to reveal consciousness in those patients who lack expressive capability. You went into palliative care first, and that brought you to where you are today. [End Page 227]Prof. Joseph J. FINS:First, let me thank you and the Pellegrino Center for the honor of giving the John Harvey Collins Lecture in such an interactive manner. The forefront of neurological care—and the neuroethical issues and methods focal to such practice—wasn’t what I initially intended to do professionally, but I think that therein is a good lesson for young people’s career aspirations. Simply put, one doesn’t always know where they’ll end up at the beginning of the journey, and as Kierkegaard said, life is lived forward, but is understood backwards (Kierkegaard 1843).In the nineties and the early 2000s, I was trying to help improve the quality of care of people at the end of life, and I wrote a book, entitled The Palliative Ethic of Care: Clinical Wisdom at Life’s End (Fins 2006), in which I addressed notions of phronesis—practical wisdom—in integrating theory and practice toward improving how people die. I became interested in the Quinlan case (Quinlan 1976), and the right to die, and around the same time, I ran into a colleague of mine at Cornell: Dr. Nicholas D. Schiff. Dr. Schiff is a neurologist, who was a protégé of Fred Plum, who was the originator of the concept of the vegetative state with Bryan Jennett, back in 1972. Fred was both of our teachers here at Cornell. Niko (Dr. Schiff) was interested in patients with disorders of consciousness, and was beginning to envision doing work—that ultimately, we did—using deep brain stimulation (DBS) to try to treat patients in the minimally conscious state, a category that was subsequently codified in 2002.I realized that a whole population of people—with these disorders of consciousness—had been somewhat marginalized, and their neglect essentially devolves back to the considerations of the right to die. The right to die was established in the Quinlan case because Judge Hughes—the presiding chief judge of the New Jersey Supreme Court—talked about Ms. Quinlan’s loss of a cognitive, sapient state as being the moral warrant for her right to die, given the fact that it was viewed as a futile situation. I recognized, over the ensuing years—from my background in palliative and end-of-life care—[1] that we had over-generalized notions of futility... (shrink)

Are you a Reluctant Metaphysician? A career change, an upsetting external event, a serious illness, a painful breakup, or an unravelling culture can all be invitations to enter a deeper world behind the world. You may not have chosen to go there, but you evolve thereby. This book weaves together stories and reflections to introduce teachings and practices from ancient wisdom traditions that illuminate our unique life path.The Path of a Reluctant Metaphysician speaks to the importance of a holistic spiritual (...) philosophy in our current times of the "great unraveling" of our political, economic, cultural, and ecological world. Here you will find an approach to finding your life stance in such troubled times. The metaphysical path is an "all vector approach" that incorporates both "spiritual" and "soulful" pathways, traditions of postural initiation such as Tai Chi, mythology, depth psychology, bodymind healing methods, a non-deterministic approach to astrology, and a multi-dimensional approach to the political sphereDr. Mayer transmits stories, teachings, and practices from his multifaceted career that are so captivating, they may lead you to reluctantly take time out of your busy everyday life. Be forewarned if you read this book you too may become a Reluctant Metaphysician! Kirkus Reviews says: "A meaningful contribution to the spiritual self-help library...A psychologist blends spiritual paths from the East, West, and beyond for an innovative approach to healing...an expansive tale told with humility and insight." Larry Dossey, MD says, Dr. Mayer's revelations in various metaphysical domains are a guide for anyone who desires a richer and more fulfilling experience of life. If you think life must contain more juice than you have known so far, this book is for you. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

On Monday, June 25, 2018, H. Tristram Engelhardt, Jr., PhD, MD, co-founder of The Journal of Medicine and Philosophy, was laid to rest in the beautiful Hill Country of Texas near Comal County. Professor Engelhardt co-founded The Journal of Medicine and Philosophy in 1976 with Dr. Edmund Pellegrino. Engelhardt first served as Associate Editor, and then Editor and Senior Editor from 1976 until 2018. The Journal thrived for more than four decades through his energy, vision, and dedication. One of the (...) intellectual founders of the fields that would become known as bioethics and the philosophy of medicine, Engelhardt’s seminal scholarship has framed the philosophical debates surrounding healthcare policy and medical practice throughout the world. The Journal of Medicine and Philosophy mourns his passing. (shrink)

This case looks at the question of how to consider obligations of confidentiality by a mental health professional who works for an institution and learns that a student has been using a drug intended for an animal research project. Dr. Paul Appelbaum, MD, a psychiatrist at Columbia University, examines the issue of the limits of confidentiality. Nicholas Steneck, PhD, a scholar in research misconduct at the University of Michigan, explores the obligations to report research misconduct. Walter Limehouse, MD, an ethicist (...) at the Medical University of South Carolina, considers the systems issues raised by this case and offers some suggestions that might change the institutional environment. (shrink)

With the rapid advancements made in biotechnology, bioethical discourse has become increasingly important. Bioethics is a multidisciplinary and interdisciplinary field that goes beyond the realm of natural sciences, and has involved fields in the domain of the social sciences. One of the important areas in bioethical discourse is religion. In a country like Malaysia, where Muslims make up the majority of the population, Islam plays a crucial role in providing the essential guidelines on the permissibility and acceptability of biotechnological applications (...) in various fields such as medicine, agriculture, and food processing. This article looks at the framework of a complementary model of bioethics derived from the perspective of Islam. The framework is based on ‘maqasid al-shariah’ (purposes or objectives of Islamic law) which aims to protect and preserve mankind’s faith, life, intellect, progeny, and property. It is proposed that ‘maqasid al-shariah’ be used as a pragmatic checklist that can be utilized in tackling bioethical issues and dilemmas. (shrink)

Sir Sayyed Ahmed Khan -- Sir Dr. Muhammad Iqbal -- Dr. Fazlur Rahman.

Bangladesh is a Muslim-majority society with more than 163 million people. Most Bangladeshis hold the ideals of Islamic norms and values which is manifest in all sorts of socio-cultural behaviour. In reference to such values, the tradition of legitimizing child marriage in Bangladesh is the issue that needs to be addressed in a holistic yet rigorous approach. Currently Bangladesh ranks 4th in the world and 1st in Asia in terms of child marriage. Recently the Child Marriage Restraint Act 1929 has (...) been abolished and it has been replaced by the Act of 2017 preserving article 2 of the previous statute, the legal age for marriage for a boy 21 and for a girl 18. This Act adds article 19 which legalizes minors (below 18 years of age) to be married off with the consent of the parents/guardians at the presence of a magistrate under “special circumstances” deemed with securing the best interest for them. The law artfully coincides with the Muslim Marriage Law which allows participants of 15 years and above to get legally married and as such contradicts the international law and the Act of 2017 itself. In the West intimate relationships including extra-marital cohabitation before reaching 18 years of age are culturally accepted. In contrast, such extra-marital and intimate relationships are strictly prohibited in Muslim-majority societies, which are dearly adhered in Bangladeshi Muslim culture. This study examines how the religious cultural and socio-economic realities influence child marriage practice in Bangladesh. Along with secondary documents, we interviewed 22 individuals including the Deputy Commissioner, the District Women and Children Affairs Officer, elected Union Parishad Chairman and Members, Social Workers, married couples and their parents/guardians at Manikganj district. In addition, we also conducted a mass survey with 62 randomly selected participants, and a voluntary online survey where the opinion of another 53 young students were collected to find broad opinion. We also collected stories of how marriages take place at the rural, urban and sub-urban areas in Bangladesh. The study has revealed that Bangladeshis does not support marriage at early ages but socio-economic reality often pushes poor into getting their children married at early ages. Many view that the special provision may encourage child marriage in the country. This study suggests that the government of Bangladesh should redefine public policy in regard to finding a middle ground between Islamic ethics and international values by exploring isomorphic mimicry and other socio-culturally accepted measures with a view to abolishing child marriage successfully. (shrink)

Purpose: The purpose of the study was to examine the success of CoG-Kenya projects in poverty alleviation in Emuhaya District, Western KenyaMethodology: This study was a cross-sectional research that sought to give an examining and descriptive scrutiny of the CoG-K’s activities in Emuhaya District of Western Kenya. This study sampled a total of 312 respondents (1 Bishop, 1 General Secretary, 1 General Assembly Trustee, 1 General Assembly Treasurer, 16 Directors, 282 Pastors, and 10 Elders) through purposive sampling method. Oral interviews, (...) questionnaire methods and focus group discussion were used to collect data from the respondents. Observation method was used to validate the information obtained through oral interviews and questionnaires. Secondary data was sourced from published and unpublished literature. Data was analyzed using the theological method of induction (TMI).Results: The study proved that the CoG-K has a role to play through her programs like Sisi kwa Sisi, Child Development Centres, Health care Units and education, thus these institutions make a significant contribution to sustainable development in Emuhaya District and are useful instruments for spearheading alleviation of poverty in the said district. The CoG-K’s development is founded upon a spirituality of mutual sustenance and transformation through its concern for the adherents’ struggle with poverty. This study found out that faith activities and the related projects implicitly advance the poverty alleviation cause, thus all development revolves around spirituality. From this perspective the CoG-K has the responsibility to engage in all aspects of development within spirituality as the foundation of such engagement.Unique contribution to theory, practice and policy: The study recommends that development experts, theologians, policy makers and practitioners should cultivate long-term relationship with the church in general and the CoG-K in particular so as implement policy for development consequently alleviating poverty. (shrink)

The aim of this paper is to find how much AI can be useful or as an aid in developing listening skill. A review has been made to past studies as well as the recent developments and innovations made by linguists and teaching community, yielding relevant observations. The present writing is an attempt at exhibiting how much the latest technology is effective which has been tailor-made to suit determined purpose directed at developing the listening skills of EFL learners. It is (...) well established being significant and continues to gain importance in serving needs of education, sparking interest among students and teachers, the latter for innovating delivery of lessons. Teaching EFL college level students uses English as the medium of instruction for language teaching subjects. It is, however, noticed that difficulties crop up at school, where the students use native language for learning syllabi-related subjects, and where it is noticed that there is low comprehension capacity in the learners that needs to be pushed up to learn second language with success. The present research effort has brought to light the difficulties experienced by students in English learning as they struggle to reach a reasonable level of learning with success. This is despite there being other materials to use where old/traditional system is otherwise thought adequate. Modern approaches were brought into use by which AI-powered tools have removed difficulties they used to experience learning the traditional way resorting to written prescribed books; they experienced that books were monotonous and boring. The researchers made quite a few studies in different educational institutions and recognized the ability of AI aided media to make listening skill learning and teaching of English interesting and easy. AI has enabled educators to develop material and make it user-friendly and student-oriented for facilitating language learning easy. Language Listening builds enhanced capacity enabling EFL students to hear sounds of words of English using AI-aided tools. The present paper has discovered the utility of modern virtual tools as significant in facilitating learners’ success in developed listening skill. Tools which are created using AI have proved very help as they extend tremendous help in increasing and developing practical listening skills of not only the teachers but also, and primarily, the EFL students. (shrink)

The contemporary debate centering round the circumference of feminist discourse has of late been very potent in addressing the issues of certain prejudiced notions in our existing patriarchal structure. This paper is an attempt to show the ongoing paradox existing in the world of feminism which has thoroughly critiqued the patriarchal culture and has naturalized sexual identities, thereby glorifying man’s supremacy and dominion. The patriarchal culture lionized the ideals of brevity, courageousness, and intellect and thought of these as the only (...) special possessions of man in society. The qualities of being submissive, kind and caring in nature is considered to be “ideal” and exclusive qualities of a woman. Even though these qualities are “ideal” to women, they are discarded from being considered as universal in nature and are thought of as insignificant in the mainstream societal structure. These qualities are treated as inferior, and exclusively womanly and hence cannot make their stand in the conventional patriarchal social order. For this reason a dilemmatic situation arises here. My effort is to show that this dilemma cannot be exposed in the sense of gender specific human qualities. (shrink)

The paper concentrates on the most pressing question of Indian philosophy: what is the exact connotation of a word or what sort of entity helps us to identify the meaning of a word? The paper focuses on the clash between Realism (Nyāya) and Apoha vāda (Buddhist) regarding the debate whether the meaning of a word is particular/universal or both. The paper asserts that though Naiyāyikas and Mīmāṁsakas challenged against Buddhist Apoha vāda, yet they realized that to establish an opinion in (...) support of a word that conceptually denotes a negative meaning first would be a very difficult task. (shrink)