It is no longer possible to claim that the biological characteristics of the future adult are already determined at conception. After all, a zygote may develop into a hydatidiform mole rather than into a human being. The development of an individual human person is determined by genetically and nongenetically coded molecules within the embryo, together with the influence of the maternal environment. Consequently, it is an error to regard the zygote's chromosomal (and other) DNA as sufficient to determine the uniqueness (...) of the future individual. (shrink)

Chad A Witt, Ramsey R Hachem Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO, USA: The role of donor-specific antibodies to human leukocyte antigens and the burden of antibody-mediated rejection in lung transplantation remain enigmatic. Over the past several years, evidence has been emerging that humoral immunity plays an important role in the development of both acute and chronic lung allograft dysfunction. Multiple case reports and case series have identified (...) lung allograft recipients with clinical findings consistent with acute AMR. However, there is currently no widely accepted definition for AMR in lung transplantation, and this has been a significant barrier to furthering our understanding of this form of rejection. Nonetheless, the development of DSA after transplantation has consistently been identified as an independent risk factor for persistent and high-grade acute cellular rejection and CLAD. This has raised the possibility that chronic AMR may be a distinct phenotype of CLAD although evidence supporting this paradigm is still lacking. Additionally, antibodies to lung-restricted self-antigens have been associated with primary graft dysfunction early and the development of CLAD late after transplantation, and emerging evidence underscores significant interactions between autoimmunity and alloimmunity after transplantation. There is currently an active International Society for Heart and Lung Transplantation working group that is developing an operational definition for AMR in lung transplantation. This will be critical to improve our understanding of this form of rejection and conduct clinical trials to identify optimal treatment strategies. This review will summarize the literature on DSA and AMR in lung transplantation and discuss the impact of antibodies to self-antigens on lung allograft dysfunction. Keywords: antibody-mediated rejection, donor-specific antibodies, lung transplantation. (shrink)

In der folgenden Übersicht wird versucht, die wissenschaftstheoretischen Tätigkeiten in den Niederlanden, insbesondere auf den Gebieten der Logik und Grundlagenforschung, Philosophie der Naturwissenschaften, Philosophie der Geschichtswissenschaft und der Sozialwissenschaften zu skizzieren. In einer Schlußbetrachtung werden die allgemeinen methodologischen Fragestellungen und die daraus sich ergebenden neuen Möglichkeiten einer Wissenschaftstheorie erörtert.

R. S. Peters, C. A. Mace; VII—Emotions and the Category of Passivity, Proceedings of the Aristotelian Society, Volume 62, Issue 1, 1 June 1962, Pages 117–142, h.

This article presents the first results of a study of the decisions made by health professionals in South Australia concerning the management of death, dying, and euthanasia, and focuses on the findings concerning the attitudes and practices of medical practitioners. Mail-back, self-administered questionnaires were posted in August 1991 to a ten per cent sample of 494 medical practitioners in South Australia randomly selected from the list published by the Medical Board of South Australia. A total response rate of 68 per (...) cent was obtained, 60 per cent of which (298) were usable returns. It was found that forty-seven per cent had received requests from patients to hasten their deaths. Nineteen per cent had taken active steps which had brought about the death of a patient. Sixty-eight per cent thought that guidelines for withholding and withdrawal of treatment should be established. Forty-five per cent were in favour of legalisation of active euthanasia under certain circumstances. (shrink)

Neuroscientists are searching for the engram within the conceptual framework established by John Locke's theory of mind. This framework was elaborated before the development of information theory, before the development of information processing machines and the science of computation, before the discovery that molecules carry hereditary information, before the discovery of the codon code and the molecular machinery for editing the messages written in this code and translating it into transcription factors that mark abstract features of organic structure such as (...) anterior and distal. The search for the engram needs to abandon Locke's conceptual framework and work within a framework informed by these developments. The engram is the medium by which information extracted from past experience is transmitted to the computations that inform future behavior. The information-conveying symbols in the engram are rapidly generated in the course of computations, which implies that they are molecules. (shrink)

The argument of the Transcendental Deduction of the Categories in the Critique of Pure Reason is the deepest and most far-reaching in philosophy. In his new book, Robert Howell interprets main themes of the Deduction using ideas from contemporary philosophy and intensional logic, thereby providing a keener grasp of Kant's many subtleties than has hitherto been available. No other work pursues Kant's argument through every twist and turn with the careful, logically detailed attention maintained here. Surprising new accounts of apperception, (...) the concept of an object, the logical functions of thought, the role of the Metaphysical Deduction, and Kant's relations to his Aristotelian-Cartesian background are developed. Howell makes a precise contribution to the discussion of most of the disputed issues in the history of Deduction interpretation. Controversial in its conclusions, this book demands the attention of all who take seriously the task of understanding Kant's work and evaluating it dispassionately. (shrink)

_Sonoran Desert, Stuart Hameroff and Alwyn Scott awoke from their_ _siestas to take margaritas in the shade of a ramada. On a nearby_ _table, a tape recorder had accidentally been left on and the following_ _is an unedited transcript of their conversation._.

Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...) ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)

Error is protean, ubiquitous and crucial in scientific process. In this paper it is argued that understanding scientific process requires what is currently absent: an adaptable, context-sensitive functional role for error in science that naturally harnesses error identification and avoidance to positive, success-driven, science. This paper develops a new account of scientific process of this sort, error and success driving Self-Directed Anticipative Learning (SDAL) cycling, using a recent re-analysis of ape-language research as test example. The example shows the limitations of (...) other accounts of error, in particular Mayo’s (Error and the growth of experimental knowledge, 1996) error-statistical approach, and SDAL cycling shows how they can be fruitfully contextualised. (shrink)

Objective: To evaluate feasibility of the guidelines of the Groupe Francophone de Réanimation et Urgence Pédiatriques for limitation of treatments in the paediatric intensive care unit .Design: A 2-year prospective survey.Setting: A 12-bed PICU at the Hôpital Jeanne de Flandre, Lille, France.Patients: Were included when limitation of treatments was expected.Results: Of 967 children admitted, 55 were included with a 2-day median delay. They were younger than others , had a higher paediatric risk of mortality score , and a higher paediatric (...) overall performance category score at admission ; all p<0.002. 34 children died. A limitation decision was made without meeting for 7 children who died: 6 received do-not-resuscitate orders and 1 received withholding decision. Decision-making meetings were organised for 31 children, and the following decisions were made: 12 DNROs , 4 withholding , with 14 withdrawing and 1 continuing treatment . After limitation, 21 children died and 10 survived . 13 procedures were interrupted because of death and 11 because of clinical improvement . Parents’ opinions were obtained after 4 family conferences , 3 days after inclusion. The first meeting was planned for 6 days after inclusion and held on the 7th day after inclusion; 80% of parents were immediately informed of the decision, which was implemented after half a day.Conclusions: GFRUPs procedure was applicable in most cases. The main difficulties were anticipating the correct date for the meeting and involving nurses in the procedure. Children for whom the procedure was interrupted because of clinical improvement and who survived in poor condition without a formal decision pointed out the need for medical criteria for questioning, which should systematically lead to a formal decision-making process. (shrink)

Chalmers (2018) maintains that even if we understood every physical process in the brain we could still wonder why these processes give rise to conscious experience. The meta-problem is the challenge of explaining why we think this 'hard problem' exists. This response to the target paper endorses illusionist accounts of three 'problem intuitions' about consciousness: duality, presentation, and revelation. Subject–object duality is explained in terms of a clash between two compelling but contradictory convictions about consciousness. Phenomenal presence is understood in (...) relation to the configurational features of sensory experiences. And intuitions of revelation are explained as due to an unfounded belief in introspective ontological access. These illusionist analyses are used to bolster the case for physicalist realism rather than to support 'strong' illusionism. In addition to addressing the meta-problem they suggest a promising approach to the hard problem as wel. (shrink)

Hawthorne and Magidor's criticisms of the model of presupposition and assertion that I have used and defended are all based on a rejection of some transparency or introspection of assumptions about speaker presupposition. This response to those criticisms aims first to clarify, and then to defend, the required transparency assumptions. It is argued, first, that if the assumptions are properly understood, some prima facie problems for them do not apply, second, that rejecting the assumptions has intuitively implausible consequences, and third, (...) that the 'margin of error' argument against the principle of positive introspection has a false premiss. The paper concludes with a response to a criticism of what Hawthorne and Magidor call 'the uniformity principle' that is used in the model to explain some pragmatic phenomena. (shrink)