La Consulta Ética Clínica es una actividad relativamente nueva en USA, como un servicio destinado a ayudar a pacientes individuales o grupos. Se describe la evolución histórica de la CEC desde su inicio en 1976. Entre otras funciones, la CEC presta un soporte moral y un “confort” psicológico a los profesionales de la salud en la toma de decisiones. Se describen los métodos operativos y de acceso a la CEC.

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

Background: Bioethics consultations are conducted in varied settings, including hospitals, universities, and other research institutions, but there is sparse information about bioethics consultations conducted in corporate settings such as pharmaceutical companies. The purpose of this article is to describe a bioethics consultation service at a pharmaceutical company, to report characteristics of consultations completed by the service over a 6-year period, and to share results of a consultation feedback survey. Methods: Data on the descriptive characteristics of bioethics consultations were collected from (...) 2008 to 2013 and analyzed in Excel 2007. Categorical data were analyzed via the pivot table function, and time-based variables were analyzed via formulas. The feedback survey was administered to consultation requesters from 2009 to 2012 and also analyzed in Excel 2007. Results: Over the 6-year period, 189 bioethics consultations were conducted. The number of consultations increased from five per year in 2008 to approximately one per week in 2013. During this time, the format of the consultation service was changed from a committee-only approach to a tiered approach (tailored to the needs of the case). The five most frequent topics were informed consent, early termination of a clinical trial, benefits and risks, human biological samples, and patient rights. The feedback survey results suggest the consultation service is well regarded overall and viewed as approachable, helpful, and responsive. Conclusions: Pharmaceutical bioethics consultation is a unique category of bioethics consultation that primarily focuses on pharmaceutical research and development but also touches on aspects of clinical ethics, business ethics, and organizational ethics. Results indicate there is a demand for a tiered bioethics consultation service within this pharmaceutical company and that advice was valued. This company's experience indicates that a bioethics consultation service raises awareness about bioethics, empowers employees to raise bioethical concerns, and helps them reason through challenging issues. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Biological evolution provides a creative fount of complex and subtle adaptations, often surprising the scientists who discover them. However, because evolution is an algorithmic process that transcends the substrate in which it occurs, evolution’s creativity is not limited to nature. Indeed, many researchers in the field of digital evolution have observed their evolving algorithms and organisms subverting their intentions, exposing unrecognized bugs in their code, producing unexpected adaptations, or exhibiting outcomes uncannily convergent with ones in nature. Such stories routinely reveal (...) creativity by evolution in these digital worlds, but they rarely fit into the standard scientific narrative. Instead they are often treated as mere obstacles to be overcome, rather than results that warrant study in their own right. The stories themselves are traded among researchers through oral tradition, but that mode of information transmission is inefficient and prone to error and outright loss. Moreover, the fact that these stories tend to be shared only among practitioners means that many natural scientists do not realize how interesting and lifelike digital organisms are and how natural their evolution can be. To our knowledge, no collection of such anecdotes has been published before. This paper is the crowd-sourced product of researchers in the fields of artificial life and evolutionary computation who have provided first-hand accounts of such cases. It thus serves as a written, fact-checked collection of scientifically important and even entertaining stories. In doing so we also present here substantial evidence that the existence and importance of evolutionary surprises extends beyond the natural world, and may indeed be a universal property of all complex evolving systems. (shrink)

Heterogeneity within MDD has hampered identification of biological markers (e.g., intermediate phenotypes, IPs) that might increase risk for the disorder or reflect closer links to the genes underlying the disease process. The newer characterizations of dimensions of MDD within Research Domain Criteria (RDoC) domains may align well with the goal of defining IPs. We compare a sample of 25 individuals with MDD compared to 29 age and education matched controls in multimodal assessment. The multimodal RDoC assessment included the primary IP (...) biomarker, positron emission tomography (PET) with a selective radiotracer for 5-HT1A ([11C]WAY-100635), as well as event-related functional MRI with a Go/No-go task targeting the Cognitive Control network, neuropsychological assessment of affective perception, negative memory bias and Cognitive Control domains. There was also an exploratory genetic analysis with the serotonin transporter (5-HTTLPR) and monamine oxidase A (MAO-A) genes. In regression analyses, lower 5-HT1A binding potential (BP) in the MDD group was related to diminished engagement of the Cognitive Control network, slowed resolution of interfering cognitive stimuli, one element of Cognitive Control. In contrast, higher/normative levels of 5-HT1A BP in MDD (only) was related to a substantial memory bias toward negative information, but intact resolution of interfering cognitive stimuli and greater engagement of Cognitive Control circuitry. The serotonin transporter risk allele was associated with lower 1a BP and the corresponding imaging and cognitive IPs in MDD. Lowered 5HT 1a BP was present in half of the MDD group relative to the control group. Lowered 5HT 1a BP may represent a subtype including decreased engagement of Cognitive Control network and impaired resolution of interfering cognitive stimuli. Future investigations might link lowered 1a BP to neurobiological pathways and markers, as well as probing subtype-specific treatment targets. (shrink)

The volume documents, and makes an original contribution to, an astonishing period in twentieth-century philosophy—the progress of Arne Naess's ecophilosophy from its inception to the present. It includes Naess's most crucial polemics with leading thinkers, drawn from sources as diverse as scholarly articles, correspondence, TV interviews and unpublished exchanges. The book testifies to the skeptical and self-correcting aspects of Naess's vision, which has deepened and broadened to include third world and feminist perspectives. Philosophical Dialogues is an essential addition to the (...) literature on environmental philosophy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Human Genome ProjectSharon J. Durfy (bio) and Amy E. Grotevant (bio)In recent years, scientists throughout the world have embarked upon a long-term biological investigation that promises to revolutionize the decisions people make about their lives and lifestyles, the way doctors practice medicine, how scientists study biology, and the way we think of ourselves as individuals and as a species. It is called the Human Genome Project, and its (...) ultimate goal is to map and determine the chemical sequence of the three billion nucleotide base pairs that comprise the human genome. The feat is expected to take about fifteen years (see General Surveys).These three billion base pairs include an estimated 50,000 to 100,000 genes. The rest of the genome—perhaps 95 percent of it—is nongenic sequences with unknown function, sometimes called "junk." Determining the order and organization of all this material has been likened to tearing six volumes of the Encyclopaedia Brittanica into pieces, then trying to put it all back together to read the information (Surveys: Hall 1990). The effort could be well worth it, many scientists say, because it is expected to yield major insights into many common and complex diseases, including cancer, cardiovascular disease, and Alzheimer's disease (Debate: Dulbecco 1986; Koshland 1989).The Human Genome Project is not without controversy, however (Debate: Davis 1990; Leder 1990; Rechsteiner 1990). Many scientists fear that funding for it will be diverted from other areas of research, rather than obtained from new funding sources. This has enlivened the debate about the relative value of "big" versus "small" science. Also, the value of undertaking a complete sequencing of the genome has been questioned, especially given the high proportion of non-genic sequences.Advocates of the effort converted many critics by making two alterations in the original plan. Plans were included to simultaneously determine the nucleotide sequence of the genomes of other organisms; this provides comparisons and points of reference for the human sequence (U.S.: NIH/DOE 1990). Second, in response to concerns about the high cost of developing technology to sequence the whole [End Page 347] genome, the focus moved from large-scale sequencing to mapping the genome, which would hasten the search for disease genes (U.S.: NIH/DOE 1990).The ideal map would be both genetic, locating DNA markers, or signposts, at closely spaced intervals along the chromosomes, and physical, indicating the exact distance between these markers (Map: McKusick 1991). Since 1973, Human Gene Mapping workshops (HGM) have been held at least every two years to locate, compare, and compile genetic markers. This information is published and is accessible through Genome Database at Johns Hopkins University (McKusick 1991). The most recent Human Genome Mapping workshop was held in August 1991, at which the Human Genome Organization (HUGO) began to assume increased responsibility for coordination of the international mapping effort (Surveys: Maddox 1991).Historical Background of the United States EffortThe first serious discussions about sequencing the entire human genome occurred at a workshop at the University of California at Santa Cruz in 1985 (U.S.: Sinsheimer 1989). A second workshop, organized by the U.S. Department of Energy (DOE) and held in March 1986, addressed the feasibility of an organized program (U.S.: DOE 1986). Shortly thereafter, DOE instituted its own genome project (U.S.: DOE 1987). Reports in early 1988 from both the National Research Council (NRC) of the National Academy of Sciences (NAS) and Congress' Office of Technology Assessment (OTA) (U.S.: NRC 1988; OTA 1988) served as catalysts, and in fiscal year 1988, the U.S. Congress officially launched the Human Genome Project by appropriating funds to both the Department of Energy and the National Institutes of Health (NIH).To avoid potential congressional "meddling" (U.S.: Roberts 1988), NIH and DOE drafted a memorandum of understanding for interagency coordination in October 1988 (U.S.: NIH/DOE 1990). The agencies then created both separate and joint committees, and working groups to administer the project. NIH established the Office of Human Genome Research in 1988 (directed by James D. Watson) to plan and coordinate NIH genome activities. That office has evolved into the National Center for Human Genome Research (NCHGR... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 33.3 (2000) 294-298 [Access article in PDF] Book Review Reclaiming Rhetorica: Women in the Rhetorical Tradition Listening to Their Voices: The Rhetorical Activities of Historical Women The Changing Tradition: Women in the History of Rhetoric Reclaiming Rhetorica: Women in the Rhetorical Tradition. Ed. Andrea A. Lunsford. Pittsburgh Series in Composition, Literacy, and Culture. Pittsburgh: U of Pittsburgh P, 1995. Pp. xiv + 354. $22.95 paperback; $59.95 (...) cloth. Listening to Their Voices: The Rhetorical Activities of Historical Women. Ed. Molly Meijer Wertheimer. University of South Carolina Series in Rhetoric/Communication. Columbia, SC: U of South Carolina P, 1997. Pp. xii + 408. NP. The Changing Tradition: Women in the History of Rhetoric. Ed. Christine Mason Sutherland and Rebecca Sutcliffe. Calgary, Alberta: U of Calgary P, 1999. Pp. 279. NP. These three books, all published within the last five years, are both reflections of and important contributions to the growing scholarship on women's roles in rhetorical history as theorists and as practitioners. Indeed, the titles listed in chronological order--Reclaiming Rhetorica, Listening to Their Voices, and The Changing Tradition--suggest the process of transformation that the study of rhetorical history has undergone in recent years. Both individually and together, these works are a healthful antidote to the rhetorical history most of us learned at our (male) professors' knees.The books share certain features. As edited volumes, they span rhetorical history, from its classical roots to modern feminist theories. Although some figures appear more than once in different volumes (e.g., Aspasia and Mary Astell), the constraints of brief chapters permit us only tantalizing glimpses of each woman and her activities. Like all edited collections, these books include a variety of viewpoints and voices. Despite the disparity that is inevitable in a collection of essays, the quality of the work in these volumes is uniformly high. The editors of all three collections have done a nice job of assuring that the contributors stay to the point and write well without sacrificing scholarly precision. For those seeking a simple history or detailed analysis of any particular figure or time, these books will not suffice. But for most readers who are unfamiliar with the full range [End Page 294] of women in rhetorical history, this reader among them, these volumes provide a delightful introduction to the resilience, creativity, and significance of women in our formerly unacknowledged rhetorical past.In her introduction to Reclaiming Rhetorica, Andrea Lunsford shares the intriguing history of the volume, which explains its eclecticism and its goals. Approached by students who wanted to explore the role of women in rhetorical history, Annette Kolodny offered a two-semester graduate seminar titled "Women Rhetoricians." For the class, the students did extensive archival recovery research, much of which is included in the published volume. Interestingly, the students were the ones who persisted in trying to bring their works, plus the other contributors' efforts, to publication. The resultant book is, then, as James J. Murphy says in his foreword, "not a history of women rhetoricians, or women orators, or women writers. It is, instead, a glimmer of possibilities, an array of glances,--an enthymeme."The essays range widely in time covered and in focus. For example, the first chapter is a consideration of Aspasia, who left no written record of her own. Her accomplishments and influence must, then, be constructed from references to her in the works of others. The authors, Susan Jarratt and Rory Ong, contend that both her gender and her non-Athenian roots played a role in the suppression of her memory. Returning to the theme of "dangerous femininity," the concluding chapter explores the work of a modern theorist, Julia Kristeva. In that chapter, Suzanne Clark demonstrates how Kristeva has challenged traditional notions of rhetoric and provides dialogism as an antidote to the constraints of earlier approaches to human interaction. The chapters between these two take a variety of directions. Mary Wollstonecraft's feminist dialogics stands alongside of the autobiographical The... (shrink)

An Enquiry into the Nature of Liberation: Bhaṭṭa Rāmakaṇṭha’s Paramokṣanirāsakārikāvṛtti, a Commentary on Sadyojyotiḥ’s Refutation of Twenty Conceptions of the Liberated State. Edited and translated by Alex Watson, Dominic Goodall, and S. L. P. Anjaneya Sarma. Collection Indologie, vol. 122. Pondicherry: Institut Français de Pondichéry, École française d’Extrême-Orient, 2013. Pp. 508. €38.