The author comments on the article “The neurobiology of addiction: Implications for voluntary control of behavior,‘ by S. E. Hyman. The author agrees with Hyman that debate persists whether addiction is a brain disease or a moral condition. The author states that Hyman has not fully answered the question of when addicted persons are responsible for what they do. The author also suggests that addiction is a brain disease and therapy can improve the symptoms of this life-threatening syndrome. Accession Number: (...) 24077918; Authors: Cohen, Peter J. 1; Email Address: [email protected]; Affiliations: 1: Georgetown University Law Center; Subject: EDITORIALS; Subject: ADDICTIONS; Subject: BRAIN -- Diseases; Subject: SYNDROMES; Subject: HYMAN, S. E.; Number of Pages: 3p. (shrink)

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)

Adaptive training adjusts a training task with the goal of improving learning outcomes. Adaptive training has been shown to improve human performance in attention, working memory capacity, and motor control tasks. Additionally, correlations have been observed between neural EEG spectral features (4–13 Hz) and the performance of some cognitive tasks. This relationship suggests some EEG features may be useful in adaptive training regimens. Here, we anticipated that adding a neural measure into a behavioral-based adaptive training system would improve human performance (...) on a subsequent transfer task. We designed, developed, and conducted a between-subjects study of 44 participants comparing three training regimens: Single Item Fixed Difficulty (SIFD), Behaviorally Adaptive Training (BAT), and Combined Adaptive Training (CAT) using both behavioral and EEG measures. Results showed a statistically significant transfer task performance advantage of the CAT-based system relative to SIFD and BAT systems of 6 and 9 percentage points, respectively. Our research shows a promising pathway for designing closed-loop BCI systems based on both users' behavioral performance and neural signals for augmenting human performance. (shrink)

The mental illness of substance dependence or addiction is responsible for major economic, social, and personal costs. If we are to elucidate its etiology, understand its mechanisms, and eventually bring it under control, scientific investigation is essential. Research in animals and humans has enhanced our understanding of this disease through examination of genetic, neurophysiological, biochemical, and behavioral factors. But because animals cannot verbalize their subjective responses to drugs and because significant symptoms of addiction cannot be observed in non-drug-dependent humans, it (...) is not surprising that certain investigations of substance dependence have required the participation of addicted or substance-dependent humans. (shrink)

Increasingly, clinical research is evaluated on the quality of its statistical analysis. Traditionally, statistical analyses in clinical research have been carried out from a ‘frequentist’ perspective. The presence of an alternative paradigm – the Bayesian paradigm – has been relatively unknown in clinical research until recently. There is currently a growing interest in the use of Bayesian statistics in health care research. This is due both to a growing realization of the limitations of frequentist methods and to the ability of (...) Bayesian methods explicitly to incorporate prior expert knowledge and belief into the analyses. This is in contrast to frequentist methods, where prior experience and beliefs tend to be incorporated into the analyses in an ad hoc fashion. This paper outlines the frequentist and Bayesian paradigms. Acute myocardial infarction mortality data are then analysed from both a Bayesian and a frequentist perspective. In some analyses, the two methods are seen to produce comparable results; in others, they produce different results. It is noted that in this example, there are clinically relevant questions that are more easily addressed from a Bayesian perspective. Finally, areas in clinical research where Bayesian ideas are increasingly common are highlighted. (shrink)

The theme of Aesthetics in Present Future concerns the new chances the arts have and the deep changes they are undergoing, due to the new media, and the digital world in which we are growingly immersed. That this world is to be understood from an aesthetic point of view, become clear if we think of how much of what we produce, and observe and study is offered through images in particular and perceptual means in general.

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)

Although the official retirement age for Malaysia is 60 years, a significant number of academia opt to retire early. The number of early retirement applicants increases on a yearly basis. Exploring the factors that influence academia to retire early is essential, particularly with the upcoming retirement of baby boomers. This study aims to investigate the influence of gender as a moderating factor in the association between early retirement intentions (ERI) and several factors, including financial security, health conditions, workload, and a (...) lack of IT skills, within the context of teachers. Out of a total of 180 questionnaires sent, 126 teachers responded to the given questionnaire. The selection of teachers has been done randomly around the Klang Valley and the questionnaire has been distributed using the Stratified Random Sampling Method. PLS-SEM v4 has been used to analyse the collected data. The results show that health conditions and a lack of IT skills are important influences on early retirement decisions. This study sheds light on the complexities of early retirement decisions among teachers and highlights the importance of addressing health and IT skill-related issues to better retain and manage experienced educators in the Klang Valley, ultimately contributing to achieving sustainable existence in the region. By understanding the factors influencing early retirement intentions, educational institutions and policymakers should take proactive measures to create a supportive work environment that fosters teacher retention. (shrink)

Clinics and hospitals around the globe are offering stem cell treatments to persons with serious conditions for whom no effective therapies are available in their home countries. Many of these treatments, which are touted as cures for such conditions as Parkinson's and Alzheimer's Diseases, multiple sclerosis, and spinal cord injuries, have not gone through clinical trials that establish their safety and efficacy. Indeed, it is unclear whether some of them even utilize stem cells. State regulation of these therapies tends to (...) be weak or nonexistent in some of the countries in which they are offered. This puts those who believe they must travel abroad for stem cell treatments at risk of injury from procedures that .. (shrink)

The attempts to mitigate the unprecedented health, economic, and social disruptions caused by the COVID-19 pandemic are largely dependent on establishing compliance to behavioral guidelines and rules that reduce the risk of infection. Here, by conducting an online survey that tested participants’ knowledge about the disease and measured demographic, attitudinal, and cognitive variables, we identify predictors of self-reported social distancing and hygiene behavior. To investigate the cognitive processes underlying health-prevention behavior in the pandemic, we co-opted the dual-process model of thinking (...) to measure participants’ propensities for automatic and intuitive thinking vs. controlled and reflective thinking. Self-reports of 17 precautionary behaviors, including regular hand washing, social distancing, and wearing a face mask, served as a dependent measure. The results of hierarchical regressions showed that age, risk-taking propensity, and concern about the pandemic predicted adoption of precautionary behavior. Variance in cognitive processes also predicted precautionary behavior: participants with higher scores for controlled thinking (measured with the Cognitive Reflection Test) reported less adherence to specific guidelines, as did respondents with a poor understanding of the infection and transmission mechanism of the COVID-19 virus. The predictive power of this model was comparable to an approach (Theory of Planned Behavior) based on attitudes to health behavior. Given these results, we propose the inclusion of measures of cognitive reflection and mental model variables in predictive models of compliance, and future studies of precautionary behavior to establish how cognitive variables are linked with people’s information processing and social norms. (shrink)

Persons with serious and disabling medical conditions have traveled abroad in search of stem cell treatments in recent years. However, weak or nonexistent oversight systems in some countries provide insufficient patient protections against unproven stem cell treatments, raising concerns about exposure to harm and exploitation. The present article, the first of two, describes and analyzes stem cell tourism in Russia and India and addresses several scientific/medical, ethical, and policy issues raised by the provision of unproven stem cell-based treatments within them. (...) The distinction between treatment based on proven clinical research and "innovative treatment" is addressed and the authors conclude that the innovations at issue constitute neither. Regulatory measures need to be developed or strengthened in accord with internationally accepted standards in such countries to protect those seeking stem cell treatments. (shrink)

_Objective:_ The aim of the current study was to investigate associations, unique and interactive, between mothers’ and children’s histories of childhood sexual abuse (CSA) and children’s psychiatric outcomes using an intergenerational perspective. Further, we were particularly interested in examining whether maternal reflective functioning about their own trauma (T-RF) was associated with a lower likelihood of children’s abuse exposure (among children of CSA-exposed mothers). _Methods:_ One hundred and eleven children ( M age = 9.53 years; 43 sexual abuse victims) and their (...) mothers ( M age = 37.99; 63 sexual abuse victims) participated in this study. Mothers completed the Parent Development Interview (PDI), which yielded assessments of RF regarding their own experiences of abuse, and also reported on their children’s internalizing and externalizing symptoms. _Results:_ Children of CSA-exposed mothers were more likely to have experienced CSA. A key result was that among CSA-exposed mothers, higher maternal T-RF regarding their own abuse was associated with lower likelihood of child CSA-exposure. Mothers’ and children’s CSA histories predicted children’s internalizing and externalizing symptoms, such that CSA exposure for mother or child was associated with greater symptomatology in children. _Conclusion:_ The findings show that the presence of either maternal or child CSA is associated with more child psychological difficulties. Importantly in terms of identifying potential protective factors, maternal T-RF is associated with lower likelihood of CSA exposure in children of CSA-exposed mothers. We discuss these findings in the context of the need for treatments focusing on increasing T-RF in mothers and children in the context of abuse to facilitate adaptation and reduce the intergenerational risk. (shrink)

Robust ex vivo expansion of umbilical cord blood (UCB) derived hematopoietic stem and progenitor cells (HSPCs) should enable the widespread use of UCB as a source of cells to treat hematologic and immune diseases. Novel approaches for HSPC expansion have recently been developed, setting the stage for the production of blood stem cell derived products that fulfill our current best known criteria of clinical relevance. Translating these technologies into clinical use requires bioengineering strategies to overcome challenges of scale‐up, reproducibility, and (...) product quality assurance. Clinical‐scale implementation should also define criteria and targets for cost‐effective cell manufacturing. As production strategies become more effective, new opportunities in the therapeutic use of ex vivo expanded hematopoietic cell products will emerge. Herein we examine key technological milestones that need to be met in order to move ex vivo expanded HSPC therapies from the bench‐top to the bedside in a robust and reliable manner. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

Artificial intelligence (AI)-based digital phenotyping, including computational speech analysis, increasingly allows for the collection of diagnostically relevant information from an ever-expanding number of sources. Such information usually assesses human behaviour, which is a consequence of the nervous system, and so digital phenotyping may be particularly helpful in diagnosing neurological illnesses such as Alzheimer’s disease. As illustrated by the use of computational speech analysis of Alzheimer’s disease, however, neurological illness also introduces ethical considerations beyond commonly recognised concerns regarding machine learning and (...) data collection in everyday environments. Individuals’ decision-making capacity cannot be assumed. Understanding of analytical results will likely be limited even as the personal significance of those results is both highly sensitive and personal. In a traditional clinical evaluation, there is an opportunity to ensure that information is relayed in a way that is highly customised to the individual’s ability to understand results and make decisions, and privacy is closely protected. Can any such assurance be offered as digital phenotyping technology continues to advance? AI-supported digital phenotyping offers great promise in neurocognitive disorders such as Alzheimer’s disease, but it also poses ethical challenges. We outline some of these risks as well as strategies for risk mitigation. (shrink)

Three experiments examined the effects of interactive visualizations and spatial abilities on a task requiring participants to infer and draw cross sections of a three‐dimensional (3D) object. The experiments manipulated whether participants could interactively control a virtual 3D visualization of the object while performing the task, and compared participants who were allowed interactive control of the visualization to those who were not allowed control. In Experiment 1, interactivity produced better performance than passive viewing, but the advantage of interactivity disappeared in (...) Experiment 2 when visual input for the two conditions in a yoked design was equalized. In Experiments 2 and 3, differences in how interactive participants manipulated the visualization were large and related to performance. In Experiment 3, non‐interactive participants who watched optimal movements of the display performed as well as interactive participants who manipulated the visualization effectively and better than interactive participants who manipulated the visualization ineffectively. Spatial ability made an independent contribution to performance on the spatial reasoning task, but did not predict patterns of interactive behavior. These experiments indicate that providing participants with active control of a computer visualization does not necessarily enhance task performance, whereas seeing the most task‐relevant information does, and this is true regardless of whether the task‐relevant information is obtained actively or passively. (shrink)

This paper represents an attempt to better understand the educational expectations of Japanese university students. Eighty students were asked to indicate whether or not they felt there was some relationship between 24 English words. The results were then added and entered into a table where the number at each intersection of words represented the total number of students that felt there relationship between those two words. This table was then analyzed using Multidimensional Scaling to produce a two dimension plot representing (...) the relationship between these 24 words. Since the distance between the words the plot represents the level of similarity, a study of the result gives some insight into the educational expectations of these students. A description of the data collection and analysis, as well as, one possible interpretation of the results is included. (shrink)

Section I argues, against Peter Mew, that, since people create nothing ex nihilo, everything now privately owned incorporates something that once was not, and that this has important consequences for distributive justice. Section II defends the ?diachronic? approach to distributive justice against Mew's charge that it is ?otiose?, and section III claims that beliefs about distributive justice have a big effect on political conflict in the real world. Section IV enters a few disagreements with Mew's account of the political (...) ?quiescence? of the Western proletariat. Section V relieves the tension between the Marxist commitment to the advancement of productive power and the Marxist commitment to those at whose expense that advancement occurs. (shrink)

People who judge that a wrongdoer’s behaviour is determined are disposed, in certain cases, to judge that the wrongdoer cannot be responsible for his behaviour. Some try to explain this phenomenon by arguing that people are intuitive incompatibilists about determinism and moral responsibility. However, Peter Strawson argues that we excuse determined wrongdoers because judging that someone is determined puts us into a psychological state – ‘the objective stance’ – which prevents us from holding them responsible, not because we think (...) that determined wrongdoers cannot be responsible. Two studies were completed to test the claim that the objective stance prevents us from judging wrongdoers responsible. Implicit association measures revealed that participants primed in the objective stance appraised a wrongdoer more positively, but as no less blameworthy, than those neutrally primed. These findings raise doubts about Strawson’s explanation of our tendency to excuse determined wrongdoers. (shrink)