This paper examines one nascent entrepreneurial endeavour intended by Canada's Stem Cell Network to catalyze the commercialization of stem cell research: the creation of a company called "Aggregate Therapeutics". We argue that this initiative, in its current configuration, is likely to result in a breach of public trust owing to three inter-related concerns: conflicts of interest; corporate influence on the university research agenda; and the failure to provide some form of direct return for the public's substantial tax dollar investment. These (...) concerns are common to many efforts to commercialize academic science but are rendered particularly acute in this case given the therapeutic promise of stem cell research and the considerable number of resources related to stem cell research in Canada, which Aggregate Therapeutics is expected to pool. We do, however, believe that the company can be altered to guard against a violation of the public's trust, and so we present concrete modifications to its structure, which we contend should be given immediate consideration. (shrink)

This study employs a qualitative approach to investigate the factors influencing engagement in Irish employee wellbeing programmes. Two stages of data collection were conducted, involving 52 employees completing open-ended questionnaires in Stage 1 and 23 participants interviewed in Stage 2. Three themes emerged from the thematic analysis of the data: (1) communicating wellbeing initiatives; (2) creating and maintaining interest in wellbeing; and (3) challenges to employee wellbeing. The three themes and their subthemes provide qualitative evidence from employees on the barriers (...) to and drivers of workplace wellbeing initiative utilisation through the lenses of Resource utilisation Theory and Culture of Health. The findings underscore the importance of supportive environments and effective design in enhancing programme utilisation, along with the need to offer targeted initiatives addressing secondary and tertiary wellbeing issues. By addressing shortcomings in Irish workplaces, this research contributes to advancing the effectiveness and impact of workplace wellbeing initiatives at multiple levels: organisational, individual, and governmental. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

In the forty‐year history of U.S. bioethics commissions, these government‐sanctioned forums have often demonstrated their power to address pressing problems and to enable policy change. For example, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, established in 1974, left a legacy of reports that were translated into regulations and had an enormous practical impact. And the 1982 report Splicing Life, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and (...) Behavioral Research, became the basis for the National Institutes of Health's Recombinant DNA Advisory Committee as well as for the Food and Drug Administration's developing “Points to Consider” when contemplating the introduction of recombinant DNA into human beings. Some efforts of bioethics commissions, however, are not tightly connected to policy change or to outcomes directly linked to a specific report. While direct policy impact is indeed a useful metric for government bioethics commissions, it is not their only legitimate utility. For instance, bioethics commissions can also be incubators for deliberation on a hot topic, giving policy‐makers time to think through options while the political heat has some time to dissipate. Or a bioethics commission may stake out a position that enables a politician to take action while not necessarily following its recommendations. (shrink)

Objective Our objective was to evaluate whether those individuals with previous involvement with formal clinical ethics processes differ in their attitudes towards the resolution of prototypical clinical ethics cases than general health care professionals. We hypothesized that those individuals with previous participation in ethics consultation would have significantly different attitudes on the appropriate role of ethics committees in the assessment and resolution of clinical ethical dilemmas than those who have not. Methods We conducted a case-based survey of health care professionals (...) at six US hospitals. We administered the survey to health care professionals in a variety of clinical roles at each center and further sub-categorized these by respondents reporting or not reporting their membership on an ethics committee or participation as an ethics consultant/requestor of ethics consult services. Using the analysis of variance test, we present the variation in attitudes using a 5-point Likert scale with 95% confidence intervals and significance set at p ≤ 0.05. Results A total of 240 respondents completed the survey (response rate: 63.6%) from all six surveyed centers (128 respondents with involvement with ethics consultation, 112 respondents without). Health care professionals not previously involved with formal clinical ethics processes were less likely to view the ethics committee as having a role in resolving the presented clinical ethical dilemmas ( p = 0.01 for analysis of variance comparison). Conclusion In this multi-center survey study, health care providers without previous involvement with formal clinical ethics processes were less likely than those with previous involvement to support a role for ethics committees aiding in ethical case resolution. (shrink)

This case is part of a series of case studies used as an exercise within a program on research ethics education. The case involves research on genetic birth defects in a culturally distinct, closed religious community in which elders speak for the community. The case raises ethical issues of informed consent in such a setting; of collaboration with the community; of conflicts between the researchers’ responsibilities to the community as a whole and to individual subjects; of the impact of the (...) researcher’s findings on the practices and values of the community and issues regarding how the researchers share findings with subjects and how the findings are stored. (shrink)

Little research has explored the perceptions of military medical providers in the deployed environment and how their perceptions may change over time across an extended military conflict. To our knowledge, no studies have examined military medical providers’ opinions on readiness for their roles in the post-9/11 contingency operations. What has been published indicates that, during the height of Operation Iraqi Freedom, military medical providers often deployed with little notice and minimal formal training. The present report examines data obtained from multiple (...) cohorts of military medical providers (N = 321) deployed to Iraq between 2005 and 2009. Despite varying degrees of support from the U.S. public, our findings indicate that U.S. Air Force military medical providers’ support for the people of Iraq, their belief in the mission, and their ability to influence change did not vary with time. (shrink)

The COVID-19 pandemic will generate vexing ethical issues for the foreseeable future and many journals will be open to content that is relevant to our collective effort to meet this challenge. While the pandemic is clearly the critical issue of the moment, it’s important that other issues in medical ethics continue to be addressed as well. As can be seen in this issue, the Journal of Medical Ethics will uphold its commitment to publishing high quality papers on the full array (...) of medical ethics. At the same time, JME aims to be a premiere home for ground-breaking scholarship on the ethical issues raised by COVID-19. Toward this end, we have a number of papers that are freely available online and for which production has been fast-tracked.1–5 A challenge for authors who want to write about the pandemic is the rapidly evolving nature of the situation and the time it takes for journal content to be reviewed and published, even when fast-tracked. For that reason, all authors who would like to submit a paper on the pandemic can also submit a post to the JME blog prior to submitting a full paper to the journal. Those interested in writing for the JME blog should contact one of its editors, Hazem Zohny or Mike King. Over the last 3 weeks, 30 high-quality commentaries on the pandemic have been posted to the blog. These posts are circulated widely via the JME Twitter and Facebook feeds and have stimulated significant …. (shrink)

_24 and Philosophy_ is a book you just can't do without. It's all here, folks: the reason Presidents trust him; how Jack cuts through the lies and ambiguities; why he puts his life on the line for others; and how he knows which knee cap to blow out to get that all-important next lead. With the help of twenty "_24_ crazed" philosophers, you'll figure out what makes this guy tick, and much much more. A witty, but philosophical exploration of the (...) popular television series _24_, now in its sixth season Addresses pressing ethical issues relating to torture, terrorism and warfare Raises fascinating questions about knowledge, loyalty, and suspicion Explores in-depth the character and behaviour of Jack Bauer Written by philosophers who are all serious fans of the show. (shrink)

The editors of the _Journal of Medical Ethics_ support the call of the UK Health Alliance on Climate for urgent action to ensure that the current Conference of the Parties to the United Nations Framework Convention on Climate Change ‘finally delivers climate justice for Africa and vulnerable countries’. 1 As they note ‘Africa has suffered disproportionately although it has done little to cause the crisis’. The burden of climate change has thus far fallen disproportionately on Global South countries. The monsoon (...) in Pakistan this year killed over 1100 people and the public health implications of the flooding might affect the health of over 5 million people. 2 The South Asian monsoon impacts the lives of a billion people and the flooding associated with wet seasons is likely to occur eight times more frequently in future years than at present. 3 For many pacific islands such as Kiribati,... (shrink)

We sought to evaluate whether health care professionals’ viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals. The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and (...) case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals completed the survey. Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location. (shrink)

Introduction: There is significant overlap in the type of structural language impairments exhibited by children with autism spectrum disorder and children with attention deficit hyperactivity disorder. This similarity suggests that the cognitive impairment contributing to the structural language deficits in ASD and ADHD may be shared. Previous studies have speculated that procedural memory deficits may be the shared cognitive impairment. The procedural deficit hypothesis argues that language deficits can be explained by differences in the neural structures underlying the procedural memory (...) network. This hypothesis is based on the premise that the neural structures comprising the procedural network support language learning. In this study, we aimed to test the PDH in children with ASD, ADHD, and typical development.Methods: One hundred and sixty-three participants : 91 with ASD, 26 with ADHD, and 46 with TD, completed standardized measures of cognitive and language ability as well as structural magnetic resonance imaging. We compared the structural language abilities, the neural structures underlying the procedural memory network, and the relationship between structural language and neural structure across diagnostic groups.Results: Our analyses revealed that while the structural language abilities differed across ASD, ADHD, and TD groups, the thickness, area, and volume of the structures supporting the procedural memory network were not significantly different between diagnostic groups. Also, several neural structures were associated with structural language abilities across diagnostic groups. Only two of these structures, the inferior frontal gyrus, and the left superior parietal gyrus, are known to be linked to the procedural memory network.Conclusions: The inferior frontal gyrus and the left superior parietal gyrus, have well-established roles in language learning independent of their role as part of the procedural memory system. Other structures such as the caudate and cerebellum, with critical roles in the procedural memory network, were not associated with structural language abilities across diagnostic groups. It is unclear whether the procedural memory network plays a fundamental role in language learning in ASD, ADHD, and TD. (shrink)

Volume 20, Issue 7, July 2020, Page W17-W19.

Nietzsche's use of metaphor has been widely noted but rarely focused to explore specific images in great detail. A Nietzschean Bestiary gathers essays devoted to the most notorious and celebrated beasts in Nietzsche's work. The essays illustrate Nietzsche's ample use of animal imagery, and link it to the dual philosophical purposes of recovering and revivifying human animality, which plays a significant role in his call for de-deifying nature.

The increasing use of pharmacotherapy raises specific ethical concerns for psychologists working with vulnerable populations. Due to a shortage of trained specialists, professionals without training in mental health, such as primary care providers, are increasingly prescribing and monitoring psychotropic medications. Vulnerable populations face additional barriers to mental health treatment and are at heightened risk when these factors intersect. Hence, these patients experience unique barriers to receiving optimal psychopharmacological care and are differentially vulnerable to deleterious outcomes associated with misdiagnosis and overmedication. (...) Taken together, these factors fuel inequities in the access, quality, and utilization of mental health care. Psychologists working with these patients are ethically mandated to protect patients from harm and ensure equitable care across patient populations. Specifically, psychologists must respond to the dilemma of how to effectively treat patients within these vulnerable populations who have been misdiagnosed or poorly medicated while remaining within the bounds of their competence. This article recommends pathways to address these dilemmas through education, training, research, and advocacy. (shrink)

At the same time that social justice concerns are on the rise on college campuses, empathy levels among US college students are falling. Social injustice resulting from organizational decisions and actions causes profound and unnecessary human suffering, and research to understand antecedents to these decisions and actions lacks attention. Empathy represents a potential tool and critical skill for organizational decision-makers, with empirical evidence linking empathy to moral recognition of ethical situations and greater breadth of understanding of stakeholder impact and improved (...) financial success. This study explores the potential relationship between empathy and social justice, using a multifaceted operationalization of social justice, which includes management actions and social sympathies. Results broadly support the positive empathy and social justice relationship and suggest higher education interventions to develop empathy in college business students. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

What might a synaesthetic cinema look like? Or, better, what might it sound, smell, taste and feel like? This essay approaches David Lynch's Mulholland Drive as a means of thinking through conceptual but concrete descriptions of synaesthesia not as an artistic device, a metaphor, an historical trend, or a rare clinical condition, but as a way of being in space and time — and being in cinema — that is simultaneously abstract and very real. Lynch's film becomes, as well, an (...) opportunity to think about cinematic spectacle and ‘excess’ in sensorily specific ways. The hallucinatory sensual disjunctions that occur throughout the film reveal a double system of reference: vision and proprioception mutually informing and interrupting one another, in ways that recall Brian Massumi's discussion of topological architecture. Those moments of cinematic, sensory ‘excess’ are sensual reminders of the degree to which vision is entangled with other senses in the experience of cinema. (shrink)

Returning to John P. Reeder's 1978 essay on “Religious Ethics as a Field and Discipline,” this essay explores debates surrounding the original intentions for the Journal of Religious Ethics (JRE) and for the field of religious ethics, as these have played out over the decades among an influential group of scholars involved with the JRE since its inception: Arthur Dyck, Ronald Green, Stanley Hauerwas, and Jeffrey Stout. While the JRE and its founding mission are in need of ongoing critique (...) and transformation, we might well still affirm the journal's ongoing importance as a site for the negotiation of a commons, the identification of possibilities for shared life, imagined beyond exclusion and domination. (shrink)

EBONY PATTERSON, RUBEN MARTINEZ, LAURENT CRENSHAW, KARLA R. WILLIAMS, LARRY BROWN, TIFFANY HALL, KRISTEN M.J. HARRIS, MICHAEL SMITH, KHYLA CRAINE, NYAH CARMICHAEL, SHANNA DUBOSE, EBONY DAVIS, NICOLE BREWER, KARLA HARLIN, BRIAN HARRIS, KATRINA GIPSON, CANDICE B.N. REYNOLDS.

Does having an initially high level of justified confidence in a belief vindicate remaining steadfast in the face of disagreement? According to one prominent view in the literature, namely Jennifer Lackey's justificationist position, the answer is yes so long as one also has personal information that provides a symmetry-breaker. In this article, I raise a problem for the justificationist view. On the most straightforward reading of the justificationist position, personal information always provides a symmetry-breaker in a peer dispute over (...) a belief in which one has high justified confidence. However, this position is implausibly strong because it renders epistemically permissible a dogmatic attitude in a relevant set of peer disagreements. Alternatively, weaker readings of the view fail to provide a perspicuous account of when high justified confidence matters in a disagreement. (shrink)

Our fourteenth year of publication begins with an exceptional expansion of our sense of philosophy’s powers and resources. In our special featured article, Brian Schroeder’s groundbreaking essay, “...

Jennifer Hawkins (2024) offers two cases that challenge traditional accounts of decision-making capacity, according to which respect for a medical decision turns on an individual’s cognitive capacities at the time the decision is made (Hawkins 2024; Appelbaum and Grisso 1988). In each of her described cases (involving anorexia nervosa and grief, respectively), a patient makes a decision that—although instrumentally rational at the time—does not reflect the patient’s longer-term values due to being in a particular psychological state. Importantly, this state (...) does not impair the patient’s cognition, but rather predisposes them to make a decision that conflicts with their own broader values, beliefs, or desires. (shrink)

The first career retrospective of activist photographer Brian Weil, whose work and practice explored insular cultures. This book offers the first career retrospective of Brian Weil, an artist whose photographs pushed viewers into a deeply unsteadying engagement with insular communities and subcultures. A younger contemporary of such participant-observer photographers as Larry Clark and Nan Goldin, Weil took photographs that foreground the complex relationships between photographer and subject, and between photograph and viewer. Weil was a member of ACT UP (...) and the founder of New York City's first needle exchange, and his photographs became inextricably tied to his activist practice. His late work, an extensive series of portraits whose subjects bear witness to the emerging AIDS pandemic, is included here, along with selections from several earlier and concurrent projects: Sex, Miami Crime, Hasidim, and an extensive video project with members of nascent transgender support groups. This book commemorates a 2013 exhibition of Brian Weil's work at the Institute of Contemporary Art at the University of Pennsylvania and includes in-depth essays on Weil by Stamatina Gregory and Jennifer Burris, an interiew with the artist by Claudia Gould, and reprints of archival edited notes discussing crime and photographic evidence based on a series of interviews conducted by Sylvère Lotringer with filmmaker George Diaz in the 1980s. (shrink)

This article discusses Jennifer Hornsby's account of action in her *Actions*, together with Brian O'Shaughnessy's in *The Will*.

The paper proposes a minimal definition of dreaming in terms of immersive spatiotemporal hallucination (ISTH) occurring in sleep or during sleep–wake transitions and under the assumption of reportability. I take these conditions to be both necessary and sufficient for dreaming to arise. While empirical research results may, in the future, allow for an extension of the concept of dreaming beyond sleep and possibly even independently of reportability, ISTH is part of any possible extension of this definition and thus is a (...) constitutive condition of dreaming. I also argue that the proposed ISTH model of dreaming, in conjunction with considerations on the epistemic relationship between dreaming and dream reports, raises important questions about the extent to which dreams typically involve a detailed body representation—an assumption that plays an important role in philosophical work on dreaming. As a commonly accepted definition of dreaming is lacking in current dream research, the ISTH model, which integrates conceptual analysis and epistemological considerations with results from empirical research, is an important contribution to this field. By linking dreaming to felt presence, full-body illusions, and autoscopic phenomena such as out-of-body experiences in wakefulness and in the hypnagogic state, the ISTH model of dreaming also helps integrate dream research, both theoretically and experimentally, with the study of other altered states of consciousness involving hallucinations. It makes straightforward and investigable predictions by claiming that all of these experiences have amodal spatiotemporal hallucinations as their common denominator. Finally, it is theoretically relevant for the philosophical discussion on minimal phenomenal selfhood. (shrink)

What is common knowledge? According to the dominant iterative model, a group of people commonly knows that p if and only if they each individually know that p, and they furthermore each know that they each know that p, and so on to infinity. According to the integrative model proposed in this paper, a group commonly knows that p when its members are united in a state of mind of the type whose contents must be true. Epistemic integration within a (...) group is enabled by symmetrical signalling processes such as eye contact. In conversational dyads, symmetrical processing operates on pairs of signals produced by the two sides in a familiar format: speakers generate content for joint attention in main channel communication, and addressees evaluate that content in backchannel communication. Processes of reinforcement learning shape our pairwise signalling, driving the accumulation of common knowledge, both in response to extrinsic reward for coordinated action, and in response to the intrinsic reward of curiosity. Where the iterative model caps the epistemic performance of the group at the level of its weakest member, the integrative model of common knowledge shows how groups working together can outperform their strongest member working alone. (shrink)

Experiments in psychology and experimental philosophy suggest that judgments about actual causation are partially governed by norms: norm violations are more likely to be singled out as causes, while structurally analogous factors that obey the norms are unlikely to be singled out. The norm-sensitivity of causal judgment has, in turn, lent support to a normative analysis of causation itself. In this paper, I question whether the support stands. I articulate and examine two principal reasons support might be so derived. For (...) each, I argue that, in fact, a non-normative analysis is better supported. (shrink)

Are slurring statements, when applied to members of the slurred group, true, false, or a little bit of both? Intuitions are mixed. And investigating more truth-value judgments is unlikely to cure the stalemate we find ourselves in. Truth-value judgments are just not up to the task. In their place, I propose we look to judgments of lying instead. This change in focus provides a new and better tool for understanding the complex semantics and pragmatics of slurs. As I argue, it (...) also suggests that slurring statements encode, conventionally implicate and presuppose the same information as statements with the slur's neutral counterpart. I then briefly apply this style of argument to the semantics and pragmatics of evaluative language more generally. (shrink)

A promising development in the philosophy of causation analyzes actual causation using structural equation models, i.e., “causal models”. This paper carefully considers what it means for an interpreted model to be accurate of its target situation. These considerations show, first, that our existing understanding of accuracy is inadequate. Further, and more controversially, they show that any causal model analysis is committed to a kind of relativism – a view whereby causation is a three-part relation holding between a cause, an effect, (...) and something else. In particular, insofar as a causal model analysis construes causation mind-and-language independently, it must treat causation as relative to a specification of background possibilities – i.e., a ‘modal profile.’ Or, so I argue. (shrink)