BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Predictable somatosensory feedback leads to a reduction in tactile sensitivity. This phenomenon, called tactile suppression, relies on a mechanism that uses an efference copy of motor commands to help select relevant aspects of incoming sensory signals. We investigated whether tactile suppression is modulated by the task-relevancy of the predicted consequences of movement and the intensity of related somatosensory feedback signals. Participants reached to a target region in the air in front of a screen; visual or tactile feedback indicated the reach (...) was successful. Furthermore, tactile feedback intensity varied across two groups of participants. We measured tactile suppression by comparing detection thresholds for a probing vibration applied to the finger either early or late during reach and at rest. As expected, we found an overall decrease in late-reach suppression, as no touch was involved at the end of the reach. We observed an increase in the degree of tactile suppression when strong tactile feedback was given at the end of the reach, compared to when weak tactile feedback or visual feedback was given. Our results suggest that the extent of tactile suppression can be adapted to different demands of somatosensory processing. Downregulation of this mechanism is invoked only when the consequences of missing a weak movement sequence are severe for the task. The decisive factor for the presence of tactile suppression seems not to be the predicted action effect as such, but the need to detect and process anticipated feedback signals occurring during movement. (shrink)

There is the world of ideas and the world of practice; the French are often for sup pressing the one and the English the other; but neither is to be suppressed. -Matthew Arnold The Function of Criticism at the Present Time From its inception, bioethics has confronted the need to reconcile theory and practice. At first the confrontation was purely intellectual, as writers on ethical theory (within phi losophy, theology, or other humanistic disciplines) turned their attention to topics from the (...) world of medical practice. Recently the confrontation has grown more intense. The ap pointment of clinical ethicists in hospitals and other health care settings is an accelerating trend in North America. Concomitantly, those institutions involved in training peo ple in clinical ethics have added organized exposure to the world of practice, in the form of placement requirements, to the normal academic course load. In common with other dis ciplines, bioethics has begun to see clinical training as a con dition of didactic theory and apprenticeship. (shrink)

An animal confronts numerous challenges when constructing an optimal navigational route. Spatial representations used for path optimization are likely constrained by critical environmental factors that dictate which neural systems control navigation. Multiple coding schemes depend upon their ecological relevance for a particular species, particularly when dealing with the third, or vertical, dimension of space.

Research ethics committees—animal ethics committees for animal-based research and institutional research boards for human subjects—have a key role in research governance, but there has been little study of the factors influencing their effectiveness. The objectives of this study were to examine how the effectiveness of a research ethics committee is influenced by committee composition and dynamics, recruitment of members, workload, participation level and member turnover. As a model, 28 members of AECs at four universities in western Canada were interviewed. Committees (...) were selected to represent variation in the number and type of protocols reviewed, and participants were selected to include different types of committee members. We found that a bias towards institutional or scientific interests may result from a preponderance of institutional and scientist members, an intimidating atmosphere for community members and other minority members, recruitment of community members who are affiliated with the institution and members joining for reasons other than to fulfil the committee mandate. Thoroughness of protocol review may be influenced by heavy workloads, type of review process and lack of full committee participation. These results, together with results from the literature on research ethics committees, suggested potential ways to improve the effectiveness of research ethics committees. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

Blumenthal-Barby et al. (2022) list several areas of philosophy that may contribute to bioethics. Missing from their list and explicit discussion is the philosophy of disability. Whereas mainstream...

People crossing the border into the United States or Canada may find their electronic devices subject to search. Border agents can require travelers to unlock their devices, and then browse through...

There is little question that neuroethics can be enriched by closer engagement with Buddhism. One key concern is how to minimize risks of moral imperialism and appropriation while doing so. This co...

Anglo-American approaches to Aristotelian metaphysics have been deeply influenced by the reconstructions of the “Oxford analysts,” most notably of the late G. E. L. Owen. In Owen’s seminal articles, Aristotle emerges—like the later Plato of G. Ryle and J. L.Ackrill—as a primitive exponent of analytical methodologies. The principles of Aristotelian metaphysics—being, unity, identity, essence, accident—are reconstructed by Owen as foundational concepts implicit in ordinary linguistic practices. Metaphysics is, in effect, reduced to a form of logic, focused on the clarification of (...) the conceptual apparatus of ordinary language. (shrink)

Within the field of causal inference, it is desirable to learn the structure of causal relationships holding between a system of variables from the correlations that these variables exhibit; a sub-problem of which is to certify whether or not a given causal hypothesis is compatible with the observed correlations. A particularly challenging setting for assessing causal compatibility is in the presence of partial information; i.e. when some of the variables are hidden/latent. This paper introduces the possible worlds framework as a (...) method for deciding causal compatibility in this difficult setting. We define a graphical object called a possible worlds diagram, which compactly depicts the set of all possible observations. From this construction, we demonstrate explicitly, using several examples, how to prove causal incompatibility. In fact, we use these constructions to prove causal incompatibility where no other techniques have been able to. Moreover, we prove that the possible worlds framework can be adapted to provide a complete solution to the possibilistic causal compatibility problem. Even more, we also discuss how to exploit graphical symmetries and cross-world consistency constraints in order to implement a hierarchy of necessary compatibility tests that we prove converges to sufficiency. (shrink)

Analysis of sites of newly integrated DNA in cellular genomes is important to several fields, but methods for analyzing and visualizing these datasets are still under development. Here, we describe tools for data analysis and visualization that take as input integration site data from our INSPIIRED pipeline. Paired-end sequencing allows inference of the numbers of transduced cells as well as the distributions of integration sites in target genomes. We present interactive heatmaps that allow comparison of distributions of integration sites to (...) genomic features and that support numerous user-defined statistical tests. To summarize integration site data from human gene therapy samples, we developed a reproducible report format that catalogs sample population structure, longitudinal dynamics, and integration frequency near cancer-associated genes. We also introduce a novel summary statistic, the UC50, which provides a single number summarizing possible clonal expansion. Using these tools, we characterize ongoing longitudinal characterization of a patient from the first trial to treat severe combined immunodeficiency-X1, showing successful reconstitution for 15 years accompanied by persistence of a cell clone with an integration site near the cancer-associated gene CCND2. Software is available at https://github.com/BushmanLab/INSPIIRED. (shrink)

Background. The events of 9/11 and the October 2002 National Intelligence Estimate on Iraq's Continuing Programs for Weapons of Mass Destruction precipitated fundamental changes within the US Intelligence Community. As part of the reform, analytic tradecraft standards were revised and codified into a policy document – Intelligence Community Directive (ICD) 203 – and an analytic ombudsman was appointed in the newly created Office for the Director of National Intelligence to ensure compliance across the intelligence community. In this paper we investigate (...) the untested assumption that the ICD203 criteria can facilitate reliable evaluations of analytic products. Method. Fifteen independent raters used a rubric based on the ICD203 criteria to assess the quality of reasoning of 64 analytical reports generated in response to hypothetical intelligence problems. We calculated the intra-class correlation coefficients for single and group-aggregated assessments. Results. Despite general training and rater calibration, the reliability of individual assessments was poor. However, aggregate ratings showed good to excellent reliability. Conclusions. Given that real problems will be more difficult and complex than our hypothetical case studies, we advise that groups of at least three raters are required to obtain reliable quality control procedures for intelligence products. Our study sets limits on assessment reliability and provides a basis for further evaluation of the predictive validity of intelligence reports generated in compliance with the tradecraft standards. (shrink)

We comment on the proposition “that lower temperatures and especially greater seasonal variation in temperature call for individuals and societies to adopt … a greater degree of self-control” (Van Lange et al., sect. 3, para. 4) for which we cannot find empirical support in a large data set with data-driven analyses. After providing greater nuance in our theoretical review, we suggest that Van Lange et al. revisit their model with an eye toward the social determinants of self-control.

A method now popular for fixing the scopes of arguments involves a covert movement operation, named QR (for Quantifier Rule) by Robert May. May envisioned QR as a kind of adjunction operation, attaching the arguments so affected to phrases dominating that argument. From the surface representation in (1a), for instance, QR can fashion the representations in (1b) and (1c) by adjoining the object and/or subject argument to IP. (1) a. [IP Someone [VP loves everyone ]]. b. [IP everyone1 [IP someone (...) [VP loves t1 ]]]. c. [IP someone2 [IP everyone1 [IP t2 [VP loves t1 ]]]] As the representations in (1a,b) suggest, QR has syntactic consequences rather like those displayed by Topicalization, the process that derives (2b) from (2a). (shrink)

A priori reflection, common sense and intuition have proved unreliable sources of information about the world outside of us. So the justification for a theory of the categories must derive from the empirical support of the scientific theories whose descriptions it unifies and clarifies. We don’t have reliable information about the de re modal profiles of external things either because the overwhelming proportion of our knowledge of the external world is theoretical—knowledge by description rather than knowledge by acquaintance. This undermines (...) the traditional idea that to be an object of category C is to be an object with such- and-such characteristic possibilities of combination. But this is no loss because de re modal thought lacks utility for creatures like us. (shrink)

First published by Texte zur Kunst and as part of the Whitney Biennial, we present Fraser's essays together express a something like claustrophobia. As the artworldmarket has become dominated by the speculative economic activities that fueled the current extreme income distribution inequalities globally, can a critique exist that is not already paying into these exploitative practices?

One of the interests in the Gapping construction is the headache it causes for those trying to get constituency structure right. On the assumption that Gapping, like other processes of sentence grammar, respects constituency, it is very hard to deliver the right constituents in cases such as (1). (1) a. Some consider him honest and others consider him pleasant. b. The faculty brought scotch to the party and the students brought beer to the party. c. The girls occasionally ate peanuts (...) and the boys occasionally ate breath mints. (Understand the material in strikeouts to be Gapped.) Everything else tells us that the Gapped strings in (1) should not form a constituent which excludes the material left behind. Yet, the fact that only when the verb Gaps may the other material too suggests just the opposite. That is, if we deny that the verb forms a constituent with the other material, and let Gapping apply to each of the elided constituents independently, we would have no way to express this dependency. If we let Gapping only elide constituents that house the verb, on the other hand, it follows. (shrink)

This paper looks at an approach to Principle C in which the disjoint reference effect triggered by definite description arises because there is a preference for using bound pronouns in those cases. Philippe Schlenker has linked this approach to the idea that the NP part of a definite description should be the most minimal in content relative to a certain communicative goal. On a popular view about what the syntax and semantics of a personal pronoun is, that should have the (...) effect of favoring a pronoun over a definite description. This paper shows how that can be made the source of “Vehicle Change,” an effect in ellipsis contexts in which definite descriptions seem to behave like pronouns. It requires, however, a way of distinguishing bound pronouns from non-bound pronouns, and the paper makes a proposal about how these two kinds of pronouns can be distinguished in the way needed. (shrink)

The Mohist Canons are a set of brief statements on a variety of philosophical and other topics by anonymous members of the Mohist school , an influential philosophical, social, and religious movement of China's Warring States period (479-221 B.C.). [1] Written and compiled most likely between the late 4th and mid 3rd century B.C., the Canons are often referred to as the “later Mohist” or “Neo-Mohist” canons, since they seem chronologically later than the bulk of the Mohist writings, most of (...) which are probably from the mid-5th to the late 4th century. The.. (shrink)