ObjectivesThe purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records.MethodsPregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses. Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic (...) models were evaluated for the associations between substance use and each birth outcome.ResultsThe average maternal age was 30 years, 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance u... (shrink)

Using an approach developed in the context of human bioethics, we argue that chimpanzees in research can be regarded as vulnerable subjects. This vulnerability is primarily due to communication barriers and situational factors—confinement and dependency—that make chimpanzees particularly susceptible to risks of harm and exploitation in experimental settings. In human research, individuals who are deemed vulnerable are accorded special protections. Using conceptual and moral resources developed in the context of research with vulnerable humans, we show how chimpanzees warrant additional safeguards (...) against harm and exploitation paralleling those for human subjects. These safeguards should include empowering third parties to act as surrogate decision makers for chimpanzees, ensuring participant “assent,” and avoiding recruitment of animal subjects based merely on convenience. (shrink)

There is an intriguing recent effort to develop a valid cosmological argument on the basis of quite minimal assumptions.1 Indeed, the basis of the new cosmological argument is so slight that it is likely to make even a conscientious theist suspicious – to say nothing of our vigilant atheists. In Section 1 we present the background assumptions and central premises of the new cosmological argument. We are sympathetic to the conclusion that there necessarily exists an intelligent and powerful creator of (...) the actual universe, but we show in Section 2 that the new cosmological argument cannot establish this claim. Specifically, we show by reductio ad absurdum that the new argument is unsound, and that every plausibly modified version of the argument is also unsound.2 We close our discussion with a diagnosis of what went wrong in the new cosmological argument. Our conclusion is that this intriguing new argument promises considerably more than it can show. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

In this entry we provide a critical review of recent work on the nature and ethics of blame, including issues of moral standing.

Clinical trials for acute conditions such as myocardial infarction and stroke pose challenges related to informed consent due to time limitations, stress, and severe illness. Consent processes shou...

This is the first chapter to our edited collection of essays on the nature and ethics of blame. In this chapter we introduce the reader to contemporary discussions about blame and its relationship to other issues (e.g. free will and moral responsibility), and we situate the essays in this volume with respect to those discussions.

Blame is usually discussed in the context of the free will problem, but recently moral philosophers have begun to examine it on its own terms. If, as many suppose, free will is to be understood as the control relevant to moral responsibility, and moral responsibility is to be understood in terms of whether blame is appropriate, then an independent inquiry into the nature and ethics of blame will be essential to solving (and, perhaps, even fully understanding) the free will problem. (...) In this article we first survey and categorize recent accounts of the nature of blame – is it action, belief, emotion, desire, or something else? – and then we look at several proposed requirements on appropriate blame that look beyond the transgressor himself, considerations that will form part of a full account of the ethics of blame. (shrink)

A growing body of literature has examined managers’ use of restorative practices in the workplace. However, little is currently known about why managers use restorative practices as opposed to alternative responses. We employed a qualitative interview technique to develop an inductive model of managers’ restorative versus punitive response in the context of employee wrongdoing. The findings reveal a set of key motivating and moderating influences on the manager’s decision to respond to wrongdoing in a restorative versus punitive manner. The findings (...) also suggest that managers’ personal needs and perceived duties in the aftermath of employee wrongdoing are generally more consistent with restorative responses than punishment responses, which helps explain managers’ use of restorative workplace practices. (shrink)

No one has written more insightfully on the promises and perils of human agency than Gary Watson, who has spent a career thinking about issues such as moral responsibility, blame, free will, addiction, and psychopathy. This special edition of OSAR pays tribute to Watson's work by taking up and extending themes from his pioneering essays.

BackgroundInformed consent forms are intended to facilitate research enrollment decisions. However, the technical language in institutional templates can be unfamiliar and confusing for decision-makers. Standardized language describing financial implications of participation, namely compensation for injury and costs of care associated with participating, can be complex and could be a deterrent for potential participants. This standardized language may also be misleading in the context of comparative effectiveness trials of standard care interventions, in which costs and risk of injury associated with participating (...) may not differ from regular medical care. In addition, the revised U.S. Common Rule contains a new requirement to present key information upfront; the impact of how this requirement is operationalized on comprehension and likelihood of enrollment for a given study is unknown.MethodsTwo online surveys assessed the impact of (1) changes to compensation for injury language (standard vs. tailored language form) and (2) changes to the key information page (using the tailored compensation language form with standard key information vs. modified key information vs. modified key information plus financial information) on both likelihood of enrollment in and understanding of a hypothetical comparative effectiveness trial.ResultsLikelihood of enrolling was not observed to be different between the standard and tailored language forms in Study 1 (73 vs. 75%; p = 0.6); however, the tailored language group had a higher frequency of understanding the compensation for injury process specific to the trial (25 vs. 51%; p < 0.0001). Modifications to the key information sheet in Study 2 did not affect likelihood of enrolling (88 vs. 85 vs. 85%; p = 0.6); however, understanding of randomization differed by form (44 vs. 59 vs. 46%; p = 0.002).ConclusionsThese findings suggest that refining consent forms to clarify key information and tailoring compensation for injury language to the nature of the study, especially in the context of comparative effectiveness trials, may help to improve study comprehension but may not impact enrollment. (shrink)

Unconscious processes are mental states that occur in the absence of subjective awareness. We offer a focused historical survey of the robust debate about the nature of unconscious mental processing, from ancient and medieval theories that allow for bodily functions without subjective awareness to the 20th century acceptance of autonomous unconscious processing. The background introduction culminates with the rise of cognitive science in the latter half of the 20th century, as dual systems theories claimed that the mind had two forms (...) of processing: an unconscious system that is associative, fast, and automatic and a conscious system that performs sequential, deliberative, and slow mental functions. More recently, the “cognitive unconscious” has been discovered to perform most if not all cognitive functions including higher-level cognitive processing, such as addition and subtraction. Despite a rich history of experimental methods and findings, recent criticisms are forcing scientists to reexamine these advancements. We are optimistic that the field will develop novel techniques that answer these criticisms, including measures for studying subjective reports in the absence of subjective awareness of the content of the unconscious state and the act of reporting. (shrink)

Volume 20, Issue 8, August 2020, Page W12-W13.

What is it to blame someone, and when are would-be blamers in a position to do so? What function does blame serve in our lives, and is it a valuable way of relating to one another? The essays in this volume explore answers to these and related questions.

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)

Explanations of the violence perpetrated by the Khmer Rouge between 1975 and 1979 in Cambodia often conflate two events: the far-ranging and self-destructive violence within the revolutionary Party, which led to the deaths of tens of thousands of cadres, and the larger genocidal destruction of so-called “counter-revolutionary” classes and ethnic minorities. The exterminationist violence inflicted within the Khmer Rouge organization itself is perplexing, for its shape and sequence cannot be explained by theories of mass violence in the current literatures on (...) genocide or state terror. Our aim in this article is twofold. First, we show how key features of a theory of limitless, exterminationist, and ultimately self-destructive violence are contained within G.W.F. Hegel’s obscure analysis of the Terror of the French Revolution. Second, this Hegelian theory of exterminationist violence with a particular model of modern consciousness at its heart, can account for the transformation of typical forms of r.. (shrink)

As in the transmigration of souls after death in the Pythagorean myth that Socrates recounts in the Phaedo, for G.W.F. Hegel, in the Philosophy of Right, individuals are also 'reborn' out of their original nature into a 'second nature'. This article asks whether the Hegelian transmigration aims at their becoming nothing higher than that 'race of tame and social creatures . . . bees perhaps, wasps, or ants' which the Pythagorean myth relates is the fate of those who 'practiced popular (...) and social goodness . . . but devoid of philosophy and intelligence'. Through an analysis of duty, virtue, rectitude, custom and habit, this article argues that Hegel's account of the nature of fully ethical self-consciousness contains within it a robust, practical knowledge that resists the 'bees problem', shifts the focus of criticism from the truncation of human possibilities to the vitality of life, and ultimately furnishes resources that can secure the latter -- all without abandoning conventionality as the ethical horizon. (shrink)

J. Phys. A, to appear, quant-ph/0506173.

in Stochastic Processes, Physics and Geometry II, edited by S. Albeverio, U. Cattaneo, D. Merlini (World Scientific, Singapore, 1995) pp. 221-232.

New natural lawyers--notably Grisez, Finnis, and George--have written much on civil marriage's moral boundaries and grounds, but with slight influence. The peripheral place of the new natural law theory (NNLT) results from the marital grounds they suggest and the exclusionary moral conclusions they draw from them. However, I argue a more authentic and attractive NNLT account of marriage is recoverable through overlooked resources within the theory itself: friendship and moral self-constitution. This reconstructed account allows us to identify the relation between (...) marriage and human flourishing and the morality of same-sex marriage without making marriage infinitely plastic. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

Ruchkin et al. ascribe a pivotal role to long-term memory representations and binding within working memory. Here we focus on the interaction of working memory and long-term memory in supporting on-line representations of experience available to guide on-going processing, and we distinguish the role of frontal-lobe systems from what the hippocampus contributes to relational long-term memory binding.

This article explores Hegel’s Philosophy of Right as a work on education that responds to two democratic ideals: the ideal of individual integrity, which demands that individuals come to know the principles that animate them of their own accord, and the ideal of collectivism, which demands that individuals be at home in a shared world. While the great political works of Plato and Rousseau fasten on one of these ideals at the expense of the other, I show that Hegel’s political (...) philosophy accepts both. The result is what I call the paradox of democratic education. Hegel solves this paradox through a three-fold pedagogical strategy which speaks to the transformational possibilities of institutions as well as more directly to the needs of the “ironic consciousness.” This strategy reveals a Hegel who calls on us to strengthen our commitment to a democratic polity through a deeper conception of the requirements of democratic education. (shrink)

Although O'Regan & Noë (O&N) claim that the world may serve as the viewers' external visual memory, findings from the field of memory research have demonstrated the existence of internal visual representations. These representations are stored in the viewer's brain, contain information regarding visual objects and their relations, guide subsequent exploration of the visual world and promote change detection.

The aim of this study was to analyze the association between physical activity and eating habits during the COVID-19 pandemic among Brazilian adults. A sample of 1,929 participants answered an online survey, however 1,874 were included in the analysis. The impact of the COVID-19 pandemic on eating habits was assessed inquiring about participants' intake of fruits, vegetables, fried foods, and sweets during the pandemic. Physical activity was assessed by asking participants about their weekly frequency, intensity and number of minutes/hours engaging (...) in structured physical activities per week. Participants were then stratified into categories based on moderate-to-vigorous intensity and into active or inactive. Increased sweets consumption was the most commonly reported change to eating habits, followed by an increase in the consumption of vegetables, fruits, and fried foods. Physical activity practice was related to lower consumption of fried foods and sweets. A cluster analysis revealed subjects with higher the level of physical activity was more likely to follow a healthy diet. Thus, physical activity was positively associated with healthier eating habits. Health authorities must recommend regular physical as a strategy to improve overall health during the COVID-19 pandemic. Future studies should address the physical activity interventions to improve health status during a pandemic. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (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.