On the ethics of extending human life: healthy people have a right to carry on livingHumanity has long demonstrated a paradoxical ambivalence concerning the extension of a healthy human lifespan. Modest health extension has been universally sought, whereas extreme health extension has been regarded as a snare and delusion—a dream beyond all others at first blush, but actually something we are better off without. The prevailing pace of biotechnological progress is bringing ever closer the day when humanity will be able (...) to act on the latter view by rejecting a clear and present opportunity for much longer healthy lives. Indeed, some biogerontologists contend that that day has already arrived, to the extent that our hesitation in embarking on a vigorous “war on ageing” is already delaying the point at which a cure for ageing will be developed. Here I consider whether our present caution concerning the wisdom of truly curing ageing is likely to survive the increased scrutiny that it will receive in coming years as a result of these technical advances. I conclude that it will not, because of its irreconcilability with values that are more deeply held by the large majority of humanity than any values that argue against the quest for a cure. I further conclude that all the major current reasons given for not curing ageing are mere crutches to help us cope with the immutability of ageing that we have been brought up to accept. Our failure to set aside such irrationality is already shortening potential longevity—quite probably of those already alive today—to a staggering degree. Once we realise this, our determination to consign human ageing to history will be second …. (shrink)

Transparency is a salutary value in our constitutional architecture. It has also been described as a necessary element in promoting accountability in the regulatory aspects of essential medicines. Despite its several incarnations, the Medicines and Related Substances Act (Medicines Act) retains a provision headed 'Preservation of secrecy' (section 34). This contributionseeks to evaluate section 34 in the context of transparency and ascertain whether it is in conflict with other legislation pertaining to the promotion of access to information and, in particular, (...) whether it is consistent with the Constitution of the Republic of South Africa. (shrink)

The Central American country of Guatemala committed itself to democratic values and processes in its election of December, 1985. Guatemala, like most other Central American countries, has been through the dictator-constitution-election revolving door many times. For almsot half a century, Guatemala has been afflicted with coups, general-presidents and dictator-presidents. Again, in 1985, Guatemala created a new constitution with provision for democratic presidential elections monitored and declared "democratic" by a score of other nations. The new president, Vinicio Cerezo, and his Minister (...) of Education, Eduardo Meyer Maldonado, emphasized that the elementary school, the only formal educational institution attended by the majority of Guatemalans, must provide those learning experiences required to develop, to nourish and to sustain democracy in Guatemala. (shrink)

The Second Edition of this celebrated book by two of the world's leading researchers in social work introduces readers to the main theories, theorists and perspectives that contribute to the debate on social work theory and social work ...

Pregnant women and their interests have been underrepresented in health research. Little is known about issues relevant to women considering research participation during pregnancy. We performed in-depth interviews with 22 women enrolled in either one of two trials sponsored by the National Institutes of Health to assess the safety and immunogenicity of the H1N1 vaccine during pregnancy. Three themes characterized women’s decisions to participate in research: they valued early access to the vaccine, they perceived a safety advantage when participating in (...) research, and they wanted to help advance scientific knowledge. However, there were also some considerations that would disincline them to participate in research—for instance, a significant risk of maternal or fetal harm, the presence of a placebo arm in a study, or a requirement to significantly change planned therapy or behavior. Pregnant women who participated in the H1N1 vaccine trials viewed research favorably, citing its advantages over standard clinical care. These findings emphasize that access to benefit should guide policy for including pregnant women in research. (shrink)

Most people in the United States agree they want some income inequality but debate exactly how much is fair. High‐status people generally prefer more inequality than low‐status individuals. Here we examine how much preferences for inequality are (or are not) driven by self‐interest. Past work has generally investigated this idea in two ways: The first is by stratifying preferences by income, and the second is by randomly assigning financial status within lab‐constructed scenarios. In this paper, we develop a method that (...) combines both experimental control and the social experience of inequality—a simulated society experiment. Across two experiments (N = 138, observations = 690), participants voted on the distribution of rewards—first behind a veil of ignorance, and then when they were randomly assigned a status within a game of chance. Status varied repeatedly across five rounds, allowing us to measure dynamic preferences. Under the veil of ignorance, people preferred inequality favoring the top status. When the veil of ignorance disappeared, self‐interest immediately influenced inequality preferences. Those who randomly landed in top positions were satisfied with the status quo established under the veil of ignorance, whereas those who randomly landed in bottom positions wanted more equality. Yet these preferences were not stable; decisions about the optimal level of inequality changed according to changes in social status. Our results also showed that, when inequality grows in a society, preferences regarding inequality become polarized by social status. Individuals in low‐status positions, particularly, tend to demand more equality. (shrink)

A model of the neuropsychology of anxiety is proposed. The model is based in the first instance upon an analysis of the behavioural effects of the antianxiety drugs in animals. From such psychopharmacologi-cal experiments the concept of a “behavioural inhibition system” has been developed. This system responds to novel stimuli or to those associated with punishment or nonreward by inhibiting ongoing behaviour and increasing arousal and attention to the environment. It is activity in the BIS that constitutes anxiety and that (...) is reduced by antianxiety drugs. The effects of the antianxiety drugs in the brain also suggest hypotheses concerning the neural substrate of anxiety. Although the benzodiazepines and barbiturates facilitate the effects of γ-aminobutyrate, this is insufficient to explain their highly specific behavioural effects. Because of similarities between the behavioural effects of certain lesions and those of the antianxiety drugs, it is proposed that these drugs reduce anxiety by impairing the functioning of a widespread neural system including the septo-hippocampal system, the Papez circuit, the prefrontal cortex, and ascending monoaminergic and cholinergic pathways which innervate these forebrain structures. Analysis of the functions of this system suggests that it acts as a comparator: it compares predicted to actual sensory events and activates the outputs of the BIS when there is a mismatch or when the predicted event is aversive. Suggestions are made as to the functions of particular pathways within this overall brain system. The resulting theory is applied to the symptoms and treatment of anxiety in man, its relations to depression, and the personality of individuals who are susceptible to anxiety or depression. (shrink)

Book reviewed in this article: The New Health Care For Profit: Doctors and Hospitals in a Competitive Environment. Edited by Bradford H. Gray The Healing Mission and the Business Ethic. By Robert M. Cunningham The Medical Industrial Complex. By Stanley Wohl.

Drawing on previous models of anxiety, intermediate memory, the positive symptoms of schizophrenia, and goal-directed behaviour, a neuropsychological hypothesis is proposed for the generation of the contents of consciousness. It is suggested that these correspond to the outputs of a comparator that, on a moment-by-moment basis, compares the current state of the organism's perceptual world with a predicted state. An outline is given of the information-processing functions of the comparator system and of the neural systems which mediate them. The hypothesis (...) appears to be able to account for a number of key features of the contents of consciousness. However, it is argued that neitherthis nor any existing comparable hypothesis is yet able to explain why the brain should generate conscious experience of any kind at all. (shrink)

Addressing Education: Purposes, Plans, and Politics is the first in the 10-volume series, Lynchburg College Symposium Readings, 3rd edition. Each volume presents primary texts organized around an interdisciplinary, liberal arts theme such as education, politics, social issues, science and technology, morals and ethics. The series has been developed by Lynchburg College faculty for use in the Senior Symposium and the Lynchburg College Symposium Readings Program (SS/LCSR). While these programs are distinctive to Lynchburg College, the texts are used on many college (...) campuses across the nation, as well as by readers interested in significant original texts on important topics. Addressing Education: Purposes, Plans, and Politics offers primary source readings on a wide range of topics in education. Here are the original writings that readers often only read about. In this volume, the educators speak for themselves in selections and excerpts from Plato (360 B.C. E.) to Paolo Freire (1968). Familiar luminaries Mann, Rousseau, DuBois, Keller, Jefferson, 21 in all gather together all in one volume to deliver these pivotal ideas with incomparable impact. Whether consumed cover-to-cover or piece-by-piece, the volume invites useful, critical debate on this important topic. (shrink)

Truly transforming the healthcare delivery and payment system turns on the ability to engage in the interoperable electronic exchange of patient health information across and beyond the care continuum. Achieving transformation requires a legal framework that supports information sharing with appropriate privacy and security protections and a trusted governance structure.

Henri Poincaré was not just one of the most inventive, versatile, and productive mathematicians of all time--he was also a leading physicist who almost won a Nobel Prize for physics and a prominent philosopher of science whose fresh and surprising essays are still in print a century later. The first in-depth and comprehensive look at his many accomplishments, Henri Poincaré explores all the fields that Poincaré touched, the debates sparked by his original investigations, and how his discoveries still contribute to (...) society today. Math historian Jeremy Gray shows that Poincaré's influence was wide-ranging and permanent. His novel interpretation of non-Euclidean geometry challenged contemporary ideas about space, stirred heated discussion, and led to flourishing research. His work in topology began the modern study of the subject, recently highlighted by the successful resolution of the famous Poincaré conjecture. And Poincaré's reformulation of celestial mechanics and discovery of chaotic motion started the modern theory of dynamical systems. In physics, his insights on the Lorentz group preceded Einstein's, and he was the first to indicate that space and time might be fundamentally atomic. Poincaré the public intellectual did not shy away from scientific controversy, and he defended mathematics against the attacks of logicians such as Bertrand Russell, opposed the views of Catholic apologists, and served as an expert witness in probability for the notorious Dreyfus case that polarized France. Richly informed by letters and documents, Henri Poincaré demonstrates how one man's work revolutionized math, science, and the greater world. (shrink)