BackgroundAlthough patient advocates have developed templates for standard consent forms, evaluating patient preferences for first in human (FIH) and window of opportunity (Window) trial consent forms is critical due to their unique risks. FIH trials are the initial use of a novel compound in study participants. In contrast, Window trials give an investigational agent over a fixed duration to treatment naïve patients in the time between diagnosis and standard of care (SOC) surgery. Our goal was to determine the patient-preferred presentation (...) of important information in consent forms for these trials.MethodsThe study consisted of two phases: (1) analyses of oncology FIH and Window consents; (2) interviews of trial participants. FIH consent forms were analyzed for the location(s) of information stating that the study drug has not been tested in humans (FIH information); Window consents were analyzed for the location(s) of information stating the trial may delay SOC surgery (delay information). Participants were asked about their preferred placement of the information in their own trial’s consent form. The location of information in the consent forms was compared to the participants’ suggestions for placement. Results34 [17 FIH; 17 Window] of 42(81%) cancer patients approached participated. 25 consents [20 FIH; 5 Window] were analyzed. 19/20 FIH consent forms included FIH information, and 4/5 Window consent forms included delay information. 19/20(95%) FIH consent forms contained FIH information in the risks section 12/17(71%) patients preferred the same. Fourteen (82%) patients wanted FIH information in the purpose, but only 5(25%) consents mentioned it there. 9/17(53%) Window patients preferred delay information to be located early in the consent, before the “Risks” section. 3/5(60%) consents did this.ConclusionsDesigning consents that reflect patient preferences more accurately is essential for ethical informed consent; however, a one-size fits all approach will not accurately capture patient preferences. We found that preferences differed for FIH and Window trial consents, though for both, patients preferred key risk information early in the consent. Next steps include determining if FIH and Window consent templates improve understanding. (shrink)

Representation and computation are the best tools we have for explaining intelligent behavior. In our program, we explore the space of representations present in the mind by constraining them to explain data at multiple levels of analysis, from behavioral patterns to neural activity. We argue that this integrated program assuages Brette's worries about the study of the neural code.

If you trained someone to emit a particular sound at the sight of something red, another at the sight of something yellow, and so on for other colors, still he would not yet be describing objects by their colors. Though he might be a help to us in giving a description. A description is a representation of a distribution in a space (in that of time, for instance).

Hastings Center Report, Volume 52, Issue 2, Page 10-14, March‐April 2022.

This research explored the ethical issues that nurses reported in the process of elaboration and further disclosure after an initial diagnosis of a terminal illness had been given. One hundred and six hospice nurses in Norway and Denmark completed a questionnaire containing 45 items of forced-choice and open-ended questions. This questionnaire was tested and used in three countries prior to this study; for this research it was tested on Danish and Norwegian nurses. All respondents supported the ethics of ongoing disclosure (...) to terminally ill patients based on ethical principles embedded in their country’s Patients’ Rights Acts. Truth, as an intrinsic value, proved foundational to patient autonomy, the most frequent ethical principle these nurses reported to justify their ethical position on information disclosure to terminally ill people. Telling the truth about a diagnosis was not the end of ethics in hospice care, but rather the beginning because what occurs ethically in dealing with prognosis issues became central to these hospice nurses, the patients and their families. Coupled with truth-telling, compassionate interaction and care become extensions of patients’ rights. (shrink)

[1] Elul. Yamim Noraʼim. Sukot -- [2] Pesaḥ. Shevuʻot. Galut u-geʼulot. Ḥanukah. Purim.

Volume 24, Issue 8, August 2024, Page 96-98.

Lieder and Griffiths rightly urge that computational cognitive models be constrained by resource usage, but they should go further. The brain's primary function is to regulate resource usage. As a consequence, resource usage should not simply select among algorithmic models of “aspects of cognition.” Rather, “aspects of cognition” should be understood as existing in the service of resource management.

This paper offers a new formulation of the “Hilbert's Hotel Argument” (HHA) which is superior to existing formulations because it (1) demonstrates that HH is logically impossible in the concrete world, (2) takes into account the need to consider the assumptions of HHA, and (3) offers a reply to an important objection concerning the validity of HHA. In addition, this paper contributes to the discussion by using the new HHA to defend a relevant difference between the past and the future (...) by demonstrating that the HHA applies to the former but not to the latter. Finally, this paper demonstrates the significance of metaphysical arguments such as the HHA for physical cosmology. (shrink)

Deepfakes are visual and audio media that use artificial intelligence to portray people saying things they never said, doing things they never did, and experiencing events that never happened. They can be trivial (“Tom Cruise knows magic tricks?”), outlandish (“Why is Nancy Pelosi drunk on national television?”), or even dangerous (“Run, the Hollywood sign is burning!”). Because deepfakes can be both persuasive and pervasive, many commentators fear that humanity will soon take another step into the post-truth abyss. -/- This Article (...) evaluates the threat deepfakes pose to truth by anticipating how they will impact the area of law most directly concerned with truth: the law of evidence. Deepfakes present an obvious challenge to the administration of justice in modern courtrooms, where audiovisual evidence plays an important role. Solutions offered in past legal scholarship—like relying on experts to identify deepfakes or criminalizing deepfake production—are superficial. They optimistically assume that deepfakes will always have a tell. To truly appreciate the threat deepfakes pose, the law must brace itself for the likely prospect of what this Article calls “deepest” fakes, which will be indistinguishable in every respect from authentic media. -/- Drawing on tools from philosophy, legal history, and technology studies, this Article demonstrates how evidence law can and likely will adapt to a world saturated with deepest fakes. Courts have long encountered the sort of philosophical skepticism that deepest fakes threaten today. In essence, the existence of deepest fakes reduces the truth value of digital media to the level of oral testimony, creative works, other easily falsifiable evidence. While deepest fakes do raise serious problems, trial procedure only needs to change if existing safeguards fail. This Article finds that deepest fakes present no different challenge for modern courts than oral testimony, paintings, and photographs presented for their early twentieth century counterparts. The safeguard then, as now, is a nuanced adversarial process that, refusing to take evidence at face value, probes each submission with contextual indicators of reliability. What emerges is an empowering picture in which human judgment, rather than blind trust in media of any sort, is the ultimate arbiter of truth. (shrink)

Sanchez and Sanchez have selected, edited, translated, and introduced some of the most influential texts in Mexican philosophy, which constitute a unique and robust tradition that will challenge and complicate traditional conceptions of philosophy. The texts collected here are organized chronologically and represent a period of Mexican thought and culture that emerged from the Mexican Revolution of 1910 and which culminated in la filosofia de lo mexicano (the philosophy of Mexicanness). Though the selections reflect on a variety of philosophical questions, (...) collectively they represent a growing tendency to take seriously the question of Mexican national identity as a philosophical question--especially given the complexities of Mexico's indigenous and European ancestries, a history of colonialism, and a growing dependency on foreign money and culture. More than an attempt to describe the national character, however, the texts gathered here represent an optimistic period in Mexican philosophy that aimed to affirm Mexican culture and philosophy as a valuable, if not urgent, contribution to universal culture. (shrink)

In this paper, we start by comparing the two agents, Ann and Bob, who are involved in two car crashes. Whereas Ann crashes her car through no fault of her own, Bob crashes as a result of reckless driving. Unlike Ann, Bob is held criminally responsible, and the insurance company refuses to cover the car’s damages. Nonetheless, Ann and Bob both receive emergency hospital treatment that a third party covers, regardless of any assessment of personal responsibility. What warrants such apparent (...) exceptionalism with respect to personal responsibility in the healthcare context? We turn our attention to an understudied aspect of the debate on personal health responsibility, namely, the conceptualisation of the person in need of emergency hospital treatment. Drawing on the research of Joshua Knobe and Shaun Nichols, we propose that a context-dependent conceptualisation of the person may help explain a reluctance to ascribe responsibility to the individual for negative health outcomes. (shrink)

IntroductionChildren with severe physical disabilities are denied their fundamental right to move, restricting their development, independence, and participation in life. Brain-computer interfaces (BCIs) could enable children with complex physical needs to access power mobility (PM) devices, which could help them move safely and independently. BCIs have been studied for PM control for adults but remain unexamined in children. In this study, we explored the feasibility of BCI-enabled PM control for children with severe physical disabilities, assessing BCI performance, standard PM skills (...) and tolerability of BCI.Materials and methodsPatient-oriented pilot trial. Eight children with quadriplegic cerebral palsy attended two sessions where they used a simple, commercial-grade BCI system to activate a PM trainer device. Performance was assessed through controlled activation trials (holding the PM device still or activating it upon verbal and visual cueing), and basic PM skills (driving time, number of activations, stopping) were assessed through distance trials. Setup and calibration times, headset tolerability, workload, and patient/caregiver experience were also evaluated.ResultsAll participants completed the study with favorable tolerability and no serious adverse events or technological challenges. Average control accuracy was 78.3 ± 12.1%, participants were more reliably able to activate (95.7 ± 11.3%) the device than hold still (62.1 ± 23.7%). Positive trends were observed between performance and prior BCI experience and age. Participants were able to drive the PM device continuously an average of 1.5 meters for 3.0 s. They were able to stop at a target 53.1 ± 23.3% of the time, with significant variability. Participants tolerated the headset well, experienced mild-to-moderate workload and setup/calibration times were found to be practical. Participants were proud of their performance and both participants and families were eager to participate in future power mobility sessions.DiscussionBCI-enabled PM access appears feasible in disabled children based on evaluations of performance, tolerability, workload, and setup/calibration. Performance was comparable to existing pediatric BCI literature and surpasses established cut-off thresholds (70%) of “effective” BCI use. Participants exhibited PM skills that would categorize them as “emerging operational learners.” Continued exploration of BCI-enabled PM for children with severe physical disabilities is justified. (shrink)

In 1986, Elie Wiesel received the Nobel Peace Prize in recognition of his victory over “the powers of death and degradation, and to support the struggle of good against evil in the world.” Soon after, he and his wife, Marion, created the Elie Wiesel Foundation for Humanity. A project at the heart of the Foundation’s mission is its Ethics Prize—a remarkable essay-writing contest through which thousands of students from colleges across the country are encouraged to confront ethical issues of personal (...) significance. The Ethics Prize has grown exponentially over the past twenty years. “Of all the projects our Foundation has been involved in, none has been more exciting than this opportunity to inspire young students to examine the ethical aspect of what they have learned in their personal lives and from their teachers in the classroom,” writes Elie Wiesel. Readers will find essays on Bosnia, the genocide in Rwanda, sweatshops and globalization, and the political obligations of the mothers of Argentina’s Disappeared. Other essays tell of a white student who joins a black gospel choir, a young woman who learns to share in Ladakh, and the outsize implications of reporting on something as small as a cracked windshield. Readers will be fascinated by the ways in which essays on conflict, conscience, memory, illness, and God overlap and resonate with one another. These essays reflect those who are “sensitive to the sufferings and defects that confront a society yearning for guidance and eager to hear ethical voices,” writes Elie Wiesel. “And they are a beacon for what our schools must realize as an essential component of a true education.”. (shrink)

Discharges against medical advice (AMA) make up a significant number of hospital discharges in the United States, and often involve vulnerable patients who struggle to obtain adequate medical care. Unfortunately, much of the AMA discharge process focuses on absolving the medical center of liability for what happens to these patients once they leave the acute setting. Comparatively little attention is paid to the ethical obligations of the medical team once an informed decision to leave the acute care setting AMA has (...) been made. Via a case narrative, we offer an ethical framework that we believe can help guide an ethically defensible AMA discharge process. By emphasizing our duty to provide the best care possible under the circumstances, we contend, our ethical obligations to promote the patient's best interests can still be met despite their decision to leave the acute setting against medical advice. (shrink)

While health care professionals advise those who have undergone weight loss surgery to increase their levels of physical activity, research suggests that often this is not achieved. This paper explores the experiences of ten Norwegian women as they engaged in physical activity several years after weight loss surgery. In contrast to the existing literature, which explores physical activity post-WLS largely in terms of quantitative data and measurable outcomes, the present study sought to explore women’s lived experiences of physical activity, including (...) the meanings they ascribed to different forms of activity and how such meanings changed over time. The research participants, all of whom had undergone WLS more than five years earlier, described the meanings they attached to becoming physically active, as well as the different activities and movement practices they engaged in, from interval training to mountain hiking and yoga. For all the women, maintaining and increasing their level of physical activity was challenging. On the one hand, engaging in exercise after weight loss improved their sense of joy and well-being and expanded their opportunities to move and act. On the other hand, during physical activity they needed to be constantly alert to symptoms of post-surgical side-effects, including variable energy levels, digestive problems and acute illness episodes. As the women explored their new capacities, it seemed to be important for them to explore various forms of physical activity in order to find the form of exercise which best suited them or which they most enjoyed. In some cases, they constructed new meanings around activities which, prior to surgery, had seemed onerous and bereft of pleasure. We argue that such insights will benefit health professionals who provide advice on physical activity at different post-surgical stages, sometimes to persons seriously concerned about regaining weight. (shrink)

Los Comités Hospitalarios de Bioética (CHB) tienen la atribución de emitir sugerencias al personal de salud, ante casos clínicos difíciles que involucran problemas y/o dilemas bioéticos. A nivel mundial, y también en México, se encontró poca literatura relacionada, generando en ocasiones cierto grado de incertidumbre en los profesionales de la salud para su resolución. Objetivo: describir los motivos de presentación de casos clínicos de pacientes ante el CHB en un hospital de segundo nivel, desde junio de 2007 a junio de (...) 2018. Método: estudio observacional, descriptivo, retrospectivo y transversal; la muestra fue por conveniencia y se obtuvieron 48 registros de minutas. Resultados: el motivo de consulta más frecuente ante los CHB fue el apoyo en la decisión para la limitación del esfuerzo terapéutico, con 24 casos (50%). Se identificaron 34 dilemas bioéticos (71%) y 14 problemas bioéticos (29%). Conclusiones: ayudará a los servicios médicos tratantes a identificar e intervenir oportunamente, al basarse en situaciones previas sobre dilemas y/o problemas bioéticos. (shrink)

BackgroundPatients not attending their appointments without giving notice burden healthcare services. To reduce non-attendance rates, patient non-attendance fees have been introduced in various settings. Although some argue in narrow economic terms that behavioural change as a result of financial incentives is a voluntary transaction, charging patients for non-attendance remains controversial. This paper aims to investigate the controversies of implementing patient non-attendance fees.ObjectiveThe aim was to map out the arguments in the Norwegian public debate concerning the introduction and use of patient (...) non-attendance fees at public outpatient clinics.MethodsPublic consultation documents (2009–2021) were thematically analysed (n=84). We used a preconceived conceptual framework based on the works of Grant to guide the analysis.ResultsA broad range of arguments for and against patient non-attendance fees were identified, here referring to the acceptability of the fees’ purpose, the voluntariness of the responses, the effects on the individual character and institutional norms and the perceived fairness and comparative effectiveness of patient non-attendance fees. Whereas the aim of motivating patients to keep their appointments to avoid poor utilisation of resources and increased waiting times was widely supported, principled and practical arguments against patient non-attendance fees were raised.ConclusionA narrow economic understanding of incentives cannot capture the breadth of arguments for and against patient non-attendance fees. Policy makers may draw on this insight when implementing similar incentive schemes. The study may also contribute to the general debate on ethics and incentives. (shrink)

In recent years, inter-medial studies have attracted increasing attention in arts theory. The notion of 'inter-mediality' presupposes that each established art - such as theatre, painting, and cinema - indicates the existence of a particular medium, which preserves its distinct features in translations from art to art and, especially, in its combinations with others in single works. Nonetheless, this field of research is presupposed already in the traditional studies of 'ekphrasis', which focus on the verbal accounts of nonverbal works of (...) art; and in Wagner's notion of Gesamtkuntswerk. This renewed interest generated new fields of research, such as (a) the likelihood of the arts reflecting common grounds; (b) the necessity of a shared metalanguage; (b) the possibility of inter-medial translation; and (d) the inter-medial coexistence within a single work of art, without hindering the reading, interpreting and experiencing abilities of receivers. In honor of Eli Rozik, Ph.D., professor emeritus, former head of the Department of Theatre Studies, and Dean of the Faculty of Arts, Tel Aviv University, this collection provides overviews of all these theoretical issues, and tackles the contemporary practical questions that arise from attempts to transgress the boundaries between the established disciplines of arts studies. Considering first the theoretical aspects of inter-art, inter-mediality, and nonverbal literacy, Exploring the Common Grounds of the Arts goes on to discuss by means of performance analysis; dialogues between the arts within a single work; and correspondences between visual and auditory stimuli in musical contexts. It concludes with a discussion of practical examples of inter-mediality in religious representations, official processions, and public performances. (shrink)

From Detroit Red to El-Hajj Malik El-Shabazz, the man best known as Malcolm X restlessly redefined himself throughout a controversial life. His transformations have appeared repeatedly in books, photographs, paintings, and films, while his murder set in motion a series of tugs-of-war among journalists, biographers, artists, and his ideological champions over the interpretation of his cultural meaning. This book marks the first systematic examination of the images generated by this iconic cultural figure--images readily found on everything from T-shirts and hip-hop (...) album covers to coffee mugs. Graeme Abernethy captures both the multiplicity and global import of a person who has been framed as both villain and hero, cast by mainstream media during his lifetime as "the most feared man in American history," and elevated at his death as a heroic emblem of African American identity. As Abernethy shows, the resulting iconography of Malcolm X has shifted as profoundly as the American racial landscape itself. Abernethy explores Malcolm's visual prominence in the eras of civil rights, Black Power, and hip-hop. He analyzes this enigmatic figure's representation across a variety of media from 1960s magazines to urban murals, tracking the evolution of Malcolm's iconography from his autobiography and its radical milieu through the appearance of Spike Lee's 1992 biopic and beyond. Its remarkable gallery of illustrations includes reproductions of iconic photographs by Richard Avedon, Eve Arnold, Gordon Parks, Henri Cartier-Bresson, and John Launois. Abernethy reveals that Malcolm X himself was keenly aware of the power of imagery to redefine identity and worked tirelessly to shape how he was represented to the public. His theoretical grasp of what he termed "the science of imagery" enabled him both to analyze the role of representation in ideological control as well as to exploit his own image in the interests of black empowerment. This provocative work marks a startling shift from the biographical focus that has dominated Malcolm X studies, providing an up-to-date--and comprehensively illustrated--account of Malcolm's cultural afterlife, and addressing his iconography in relation to images of other major African American figures, including Martin Luther King, Jr., Angela Davis, Kanye West, and Barack Obama. Analyzing the competing interpretations behind so many images, Abernethy reveals what our lasting obsession with Malcolm X says about American culture over the last five decades. (shrink)

Eli Alshanetsky considers how we make our thoughts clear to ourselves in the process of putting them into words and examines the paradox of those difficult cases where we do not already know what we are struggling to articulate.

Einstein Versus Bohr is unlike other books on science written by experts for non-experts, because it presents the history of science in terms of problems, conflicts, contradictions, and arguments. Science normally "keeps a tidy workshop." Professor Sachs breaks with convention by taking us into the theoretical workshop, giving us a problem-oriented account of modern physics, an account that concentrates on underlying concepts and debate. The book contains mathematical explanations, but it is so-designed that the whole argument can be followed with (...) the math omitted. Professor Sachs' story begins with classical and nineteenth century physics, describes the early discoveries in particle theory, and introduces the "old" quantum theory, which evolved into the quantum mechanics of the Copenhagen School. Such important ideas as the Einstein Photon Box experiment and the Einstein-Podolsky-Rosen Paradox, and Schrodinger's Cat Paradox are clearly expounded, followed by a completely fresh explanation of relativity in conceptual terms, showing how apparent paradoxes can be removed by Einstein's own interpretation, especially that of his later years. Professor Sachs gives a detailed comparison of the fundamentals of the quantum and relativity theories, suggesting how the contradictions might be resolved. In an epilogue, he makes suggestions, with reference to religious notions, Taoism, and Buber's theory of I-Thou, for generalizing Einstein's approach beyond physics. (shrink)

According to one view, death is bad for the one who dies. The challenge for this view is to explain exactly why and when death is bad for the one who dies. According to an alternative view, death is not actually bad for the one who dies. There is a third alternative, according to which the thought of one’s own death elicits an experience that reveals the horror of one’s own death in a way that is ineffable. This paper explores (...) this third alternative. (shrink)

This introductory piece provides context for this symposium on Richard Shusterman's new book, Philosophy and the Art of Writing. The piece reflects on the symposium genre from Plato's classic dialogue to its form today. It claims that Shusterman's work asks us to take this kind of philosophical writing more seriously, and for that reason the symposium itself has taken on a different structure. The piece discusses how each of the contributors responding to the book (with Shusterman leading the way), Eli (...) Kramer, Randall Auxier, and Charles Johnson, have engaged in practicing, nurturing, and supporting broad modes of philosophical writing, and in turn why they have chosen to do so in this context. (shrink)

In this book, Eli Hirsch focuses on identity through time, first with respect to ordinary bodies, then underlying matter, and eventually persons.

En 1936, Hubert Elie publiait une these remarquable: Le complexe significabile, accompagnee de l'edition et de la traduction du Traitee de l'infini de Jean Mair. Sous le terme technique de complexe significabile se trouve abordee la question du signifiable par complexe, c'est-a-dire du signifie de la proposition et de son statut objectif. L'ouvrage propose ainsi une double approche de la notion de signification et de ses rapports a la reference ontologique: l'analyse classique depuis Gregoire de Rimini a Leibniz, les points (...) de vue contemporains tels que Meinong ou Russell. (shrink)

In Mortal Imitations of Divine Life, Diamond offers an interpretation of De Anima, which explains how and why Aristotle places souls in a hierarchy of value. Aristotle’s central intention in De Anima is to discover the nature and essence of soul—the prin­ciple of living beings. He does so by identifying the common structures underlying every living activity, whether it be eating, perceiving, thinking, or moving through space. As Diamond demonstrates through close readings of De Anima, the nature of the soul (...) is most clearly seen in its divine life, while the embodied soul’s other activi­ties are progressively clearer approximations of this principle. This interpretation shows how Aristotle’s psychology and biology cannot be properly understood apart from his theological conception of God as life, and offers a new explanation of De Anima’s unity of purpose and structure. (shrink)

If we want to be fair judges of all situations, first of all, we must convince ourselves that none of us are without fault. "seneca".