Successful behavior requires actively acquiring and representing information about the environment and people, and manipulating and using those acquired representations flexibly to optimally act in and on the world. The frontal lobes have figured prominently in most accounts of flexible or goal-directed behavior, as evidenced by often-reported behavioral inflexibility in individuals with frontal lobe dysfunction. Here, we propose that the hippocampus also plays a critical role by forming and reconstructing relational memory representations that underlie flexible cognition and social behavior. There (...) is mounting evidence that damage to the hippocampus can produce inflexible and maladaptive behavior when such behavior places high demands on the generation, recombination, and flexible use of information. This is seen in abilities as diverse as memory, navigation, exploration, imagination, creativity, decision-making, character judgments, establishing and maintaining social bonds, empathy, social discourse, and language use. Thus, the hippocampus, together with its extensive interconnections with other neural systems, supports the flexible use of information in general. Further, we suggest that this understanding has important clinical implications. Hippocampal abnormalities can produce profound deficits in real-world situations, which typically place high demands on the flexible use of information, but are not always obvious on diagnostic tools tuned to frontal lobe function. This review documents the role of the hippocampus in supporting flexible representations and aims to expand our understanding of the dynamic networks that operate as we move through and create meaning of our world. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

Professor Cohen makes extensive reference to a lecture “Hypotheses relating to the brain-mind problem” which was published in Nature. He gives a succinct account of the suggestions that I put forward, and then goes on to state that they “illustrate two fallacies which are to be found in so many contributions to the study of the body-mind relationship.” Be that as it may, but Professor Cohen has chosen most unsuitable illustrations, for in both cases they are based on (...) misunderstandings of my article. (shrink)

Primarily using philosophy, but also some social science, Escape from Leviathan (EfL) explains and defends what it calls an extreme version of the implicit ‘classical liberal compatibility thesis’: liberty, welfare, and anarchy are overwhelmingly complementary in normal practice (rationality is added for its intimate theoretical connections to these categories). This is done using theories, not definitions, of each concept. This important thesis is entirely positive. Therefore, somewhat unusually, all normative issues are avoided as irrelevant distractions in this context. In addition, (...) the epistemology used is also unorthodox. A justificationist, or foundationalist, approach would be literally illogical: the self-refuting trilemma faced by ‘supporting justifications’ (as regards arguments and evidence) is of entailing infinite regresses, dogmatic starting points, or circularities. Consequently, critical rationalism is assumed: conjecture and criticism are all that is possible. Thus all aspects of the conjectured thesis are explained and defended from criticism as thoroughly as the book can encompass. It is concluded that the thesis has not been refuted and so may be critically preferred. (However, this could all still be viewed as a ‘justification’ by those thus inclined.) All of this is made clear enough in the short introductory chapter and repeated where relevant throughout. Yet some reviews do not have a firm grasp of the specific project and so reject it with unsound criticisms. We now turn to one such example. (shrink)

The Zwolinski 2013 "libertarianism and liberty" essays on libertarianism_org are argued to have the following problems: taking libertarianism to be a "commitment" to the view that "liberty is the highest political value" ; examining and rejecting the maximization of liberty without a libertarian theory of liberty; accepting a persuasive sense of "coercion" ; misunderstandingliberty in the work place; conflating, to varying degrees, freedom of action and freedom from aggression and justice/rights/morals; focusing on logically possible clashes instead of practically possible congruence (...) among utility, liberty, and justice – in particular, that "rule (preference-)utilitarianism" fits "rule libertarianism" ; failing to distinguish liberty from license (and power) concerning slavery, and so-called "civil and democratic liberties" (and everything else); the idea that any coherent reference to a quantity of liberty requires precise cardinality; failing to see that the quantity of liberty has an inherently qualitative aspect; misunderstanding property as about limiting freedom; mistaking clashing Hobbesian freedom for non-clashing Lockean liberty; adopting G. A. Cohen's confusion about freedom as the libertarian conception of freedom; assuming the – illogical – epistemology of justification" ; not realizing that both allowing and prohibiting pollution "aggresses" and so "aggressions" need to be minimized; the failure of all six of its reasons for rejecting the non-aggression principle. (shrink)

Extreme conditions like savantism, autism or synaesthesia, which have a neurological 2AH, UK basis, challenge the idea that other minds are similar to our own. In this paper we report a single case study of a man in whom all three of these conditions co-occur. We suggest, on the basis of this single case, that when savantism and synaesthesia co- occur, it is worthwhile testing for an undiagnosed Autism Spectrum Condition (ASC). This is because savantism has an established association with (...) ASC, and the combination of ASC with synaesthesia may increase the likelihood of savantism. The implications of these conditions for philosophy of mind are introduced. (shrink)

The New Evil Demon problem has been hotly debated since the case was introduced in the early 1980’s (e.g. Lehrer and Cohen 1983; Cohen 1984), and there seems to be recent increased interest in the topic. In a forthcoming collection of papers on the New Evil Demon problem (Dutant and Dorsch, forthcoming), at least two of the papers, both by prominent epistemologists, attempt to resist the problem by appealing to the distinction between justification and excuses. My primary aim (...) here is to critically evaluate this new excuse maneuver as a response to the New Evil Demon problem. -/- Their response attempts to give us reason to reject the idea that victims of the New Evil Demon have justification for believing as they do. I shall argue that this approach is ultimately unsuccessful, however much of value can be learned from these attempts. In particular, progress in the debate can be made by following those who advance the excuse maneuver and make explicit the connection between epistemic justification and epistemic norms. By doing so, the questions being debated are clarified, as is the methodology being used to attempt to answer them. (shrink)

Aim: To examine how physicians’ life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making.Methods: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland and Australia received structured questionnaires on end-of-life care, which included questions about their life stance. Response rates ranged from 53% in Australia to 68% in Denmark. General attitudes, intended behaviour with respect to two hypothetical patients, and actual behaviour were compared between all large (...) life-stance groups in each country.Results: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten the patient’s death , physicians with specific religious affiliations had significantly less accepting attitudes, and less willingness to perform it, than non-religious physicians. They had also actually performed PAD less often. However, in most countries, both Catholics and Protestants reported ever having made such a decision.Discussion: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients and circumstances. Physicians seem to embrace religious belief in a non-imperative way, allowing adaptation to particular situations. (shrink)

Objective: To analyse the time variation of topics in bioethical publications as a proxy of the relative importance.Methods: We searched the Medline database for bioethics publications using the words “ethics or bioethics”, and for 360 specific topics publications, associating Medical Subject Heading topic descriptors to those words. We calculated the ratio of bioethics publications to the total publications of Medline, and the ratio of each topic publications to the total bioethics publications, for five-year intervals, from 1970 to 2004. We calculated (...) the time variation of ratios, dividing the difference between the highest and lowest ratio of each topic by its highest ratio. Four topics were described, selected to illustrate different patterns of variation: “Induced Abortion”, “Conflict of Interest”, “Acquired Immunodeficiency Syndrome”, “Medical Education.”Results: The ratio of bioethics publications to total Medline publications increased from 0.003 to 0.012. The variation of the topic’s ratios was higher than 0.7 for 68% of the topics. The Induced Abortion ratios decreased from 0.12 to 0.02. Conflict of Interest ratios increased from zero to 0.07. The Acquired Immunodeficiency Syndrome ratios were nearly zero in the first three intervals, had a peak of 0.06 during 1985–9, followed by a decrease to 0.01. Medical Education ratios varied few, from 0.04 to 0.03.Conclusions: There was an increase of bioethical publications in the Medline database. The topics in bioethics literature have an important time variation. Some factors were suggested to explain this variation: current legal cases, resolution of the issue, saturation of a discussion and epidemiologic importance. (shrink)

ObjectiveTo further delineate risk and resilience factors contributing to trajectories of mental health symptoms experienced by college students through the pandemic.Participantsn = 183 college students.MethodsLinear mixed models examined time effects on depression and anxiety. Propensity-matched subgroups exhibiting “increased” versus “low and stable” depression symptoms from before to after the pandemic-onset were compared on pre-pandemic demographic and psychological factors and COVID-related experiences and coping strategies.ResultsStudents experienced worsening of mental health symptoms throughout the pandemic, particularly during Fall 2020 compared with Fall 2019. (...) The propensity-matched subgroup exhibiting relative resilience reported less alcohol use prior to the pandemic, greater use of active coping strategies, and less of an impact on their college progress.ConclusionsResults point to several potential targets of screening and intervention to decrease residual impacts of the pandemic. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

Evolutionary developmental biology (evo-devo) has undergone dramatic transformations since its emergence as a distinct discipline. This paper aims to highlight the scope, power, and future promise of evo-devo to transform and unify diverse aspects of biology. We articulate key questions at the core of eleven biological disciplines—from Evolution, Development, Paleontology, and Neurobiology to Cellular and Molecular Biology, Quantitative Genetics, Human Diseases, Ecology, Agriculture and Science Education, and lastly, Evolutionary Developmental Biology itself—and discuss why evo-devo is uniquely situated to substantially improve (...) our ability to find meaningful answers to these fundamental questions. We posit that the tools, concepts, and ways of thinking developed by evo-devo have profound potential to advance, integrate, and unify biological sciences as well as inform policy decisions and illuminate science education. We look to the next generation of evolutionary developmental biologists to help shape this process as we confront the scientific challenges of the 21st century. (shrink)

Artificial social intelligence (ASI) agents have great potential to aid the success of individuals, human–human teams, and human–artificial intelligence teams. To develop helpful ASI agents, we created an urban search and rescue task environment in Minecraft to evaluate ASI agents’ ability to infer participants’ knowledge training conditions and predict participants’ next victim type to be rescued. We evaluated ASI agents’ capabilities in three ways: (a) comparison to ground truth—the actual knowledge training condition and participant actions; (b) comparison among different ASI (...) agents; and (c) comparison to a human observer criterion, whose accuracy served as a reference point. The human observers and the ASI agents used video data and timestamped event messages from the testbed, respectively, to make inferences about the same participants and topic (knowledge training condition) and the same instances of participant actions (rescue of victims). Overall, ASI agents performed better than human observers in inferring knowledge training conditions and predicting actions. Refining the human criterion can guide the design and evaluation of ASI agents for complex task environments and team composition. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.4 (2001) 391-400 [Access article in PDF] Bioethics Inside the Beltway A Shooting on Capitol Hill: "The Ruby Satellite System," Mental Illness, and Failure of the American Legal System Peter J. Cohen On 24 July 1998, Russell Eugene Weston, Jr., stormed the United States Capitol, forced his way through a security checkpoint, bypassed a metal detector, and entered the office complex of Representative (...) Tom DeLay (R-TX), the House Majority Whip (Weil 1998). During this period of terror, he shot and killed two officers of the Capitol Police and seriously wounded another as they attempted to end his foray. 1 Weston was severely wounded by several Capital police officers and taken into custody. After being treated for his injuries, he was incarcerated in the District of Columbia. 2On 5 May 1999, Weston was transferred to the Federal Correctional Institute in Butner, North Carolina (United States v. Weston, 69 F. Supp. 2d 99 (D.D.C. 1999), 103), where he remains to this day. He has neither been brought to trial nor received appropriate psychiatric therapy, but continues to be warehoused "in solitary confinement under constant observation... in a psychotic state (United States v. Weston, 255 F.3d 873; LEXIS 16851 (U.S. App. 2001b), 3-4 [LEXIS]). I will briefly detail the legal events responsible for this mad situation and suggest alternative actions that should have been taken at the very onset of the case. Early Chronology Although overtly the crime appeared to be senseless and without any conceivable motivation, Weston believed that his acts were justified and necessary. The story he told to the court-appointed forensic psychiatrist, Sally C. Johnson, M.D., 3 was that while working for NASA in the early 1980s, he had developed a "Ruby Satellite System," a powerful machine that could reverse time. With access to this system, nothing was permanent--the user could simply reverse time and exit from the current scene. However, the "System" was now controlled by cannibals who were developing and spreading "Black Heva," the deadliest disease known to [End Page 391] humankind, similar to HIV or the plague. It resulted from human corpses rotting and turning black. Time was running out, and Weston believed he had to return to override the "Ruby Satellite System" in the Capitol so that he could stem the spread of "Black Heva" and prevent world calamity. He believed that if he were tried, convicted, and even executed, he could simply time reverse himself, place himself in a safe within the Capitol, and subsequently resume his life at whatever point he chose (United States v. Weston, 206 F.3d 9 (D.C. Cir. 2000), 19-20).On 22 April 1999, the district court accepted Dr. Johnson's diagnosis that Weston suffered from paranoid schizophrenia, the symptoms of which were so severe that he would be incapable of understanding the proceedings against him and of assisting in his own defense. On this basis, the court had no difficulty in finding him incompetent to stand trial (U.S. v. Weston 1999, 102).At Weston's initial hearing, Dr. Johnson had testified that medication would be efficacious in treating Weston's delusions: [T]he standard of care in someone suffering from this type of symptom picture would be to treat them with medication.... [T]here is a good likelihood that he'll have a positive response, positive in the sense that his symptoms will diminish in response to treatment.... The potential benefits to treating the defendant far outweigh the risks.... (U.S. v. Weston 1999, 108) The defense presented no expert testimony refuting Dr. Johnson's presentation. The district court then ordered that Weston begin receiving medication in order to render him nondangerous and competent for trial (U.S. v. Weston 1999, 108-9). The Problem Weston refused to be medicated! 4 He has continued to claim that the administration of antipsychotic drugs against his will would violate his Fifth Amendment due process liberty interest in avoiding unwanted bodily intrusion and implicated... (shrink)

Washington, D.C.’s City Council has recently taken the first step towards legalizing the use of “medical marijuana” in accordance with the provisions of the Legalization of Marijuana for Medical Treatment Initiative of 1998. This action was not overruled by the United States Congress within the 30-day deadline imposed by the District of Columbia’s Home Rule Statute. The Council is now crafting regulations that will govern the therapeutic and palliative use of this drug with the goal of avoiding some of the (...) problems faced by the other states that have legalized medical marijuana; however, the proposed rules do not establish criteria for legitimate medical practice when medical marijuana is recommended. If the enabling regulations are passed by the D.C. Council and not rejected by the Congress, the District of Columbia will join over onequarter of the states in legalizing medical marijuana. On the other hand, if the D.C. Council fails to act favorably on the final regulations, then the effective legalization of medical marijuana will die and not be reconsidered until next year. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

Edwin J. Delattre, Character and Cops: Ethics in Policing Washington, D.C.: American Enterprise Institute for Public Policy Research, 1989, xviii + 247 pp.

Abe and his friend Sol are out for a walk together in a part of town they haven't been in before. Passing a Christian church, they notice a curious sign in front that says "$1,000 to anyone who will convert." "I wonder what that's about," says Abe. "I think I'll go in and have a look. I'll be back in a minute; just wait for me." Sol sits on the sidewalk bench and waits patiently for nearly half an hour. Finally, (...) Abe reappears. "Well," asks Sol, "what are they up to? Who are they trying to convert? Why do they care? Did you get the $1,000?" Indignantly Abe replies, "Money. That's all you people care about." Ted Cohen thinks that's not a bad joke. But he also doesn't think it's an easy joke. For a listener or reader to laugh at Abe's conversion, a complicated set of conditions must be met. First, a listener has to recognize that Abe and Sol are Jewish names. Second, that listener has to be familiar with the widespread idea that Jews are more interested in money than anything else. And finally, the listener needs to know this information in advance of the joke, and without anyone telling him or her. Jokes, in short, are complicated transactions in which communities are forged, intimacy is offered, and otherwise offensive stereotypes and cliches lose their sting—at least sometimes. _Jokes_ is a book of jokes and a book about them. Cohen loves a good laugh, but as a philosopher, he is also interested in how jokes work, why they work, and when they don't. The delight at the end of a joke is the result of a complex set of conditions and processes, and Cohen takes us through these conditions in a philosophical exploration of humor. He considers questions of audience, selection of joke topics, the ethnic character of jokes, and their morality, all with plenty of examples that will make you either chuckle or wince. _Jokes:_ more humorous than other philosophy books, more philosophical than other humor books. "Befitting its subject, this study of jokes is... light, funny, and thought-provoking.... [T]he method fits the material, allowing the author to pepper the book with a diversity of jokes without flattening their humor as a steamroller theory might. Such a book is only as good as its jokes, and most of his are good.... [E]ntertainment and ideas in one gossamer package."—_Kirkus Reviews_ "One of the many triumphs of Ted Cohen's Jokes-apart from the not incidental fact that the jokes are so good that he doesn't bother to compete with them-is that it never tries to sound more profound than the jokes it tells.... [H]e makes you feel he is doing an unusual kind of philosophy. As though he has managed to turn J. L. Austin into one of the Marx Brothers.... Reading Jokes makes you feel that being genial is the most profound thing we ever do-which is something jokes also make us feel-and that doing philosophy is as natural as being amused."—Adam Phillips, _London Review of Books_ "[A] lucid and jargon-free study of the remarkable fact that we divert each other with stories meant to make us laugh.... An illuminating study, replete with killer jokes."—Kevin McCardle, _The Herald_ "Cohen is an ardent joke-maker, keen to offer us a glimpse of how jokes are crafted and to have us dwell rather longer on their effects."—Barry C. Smith, _Times Literary Supplement_ "Because Ted Cohen loves jokes, we come to appreciate them more, and perhaps think further about the quality of good humor and the appropriateness of laughter in our lives."—Steve Carlson, _Christian Science Monitor_. (shrink)