Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate ethics consultation.Objective: To provide (...) an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)

_Huangdi Neijing_ is a classic medical text of ancient China. Composed of two sections, _Suwen_ and _Lingshu_, the book is filled with enduring wisdom and insight and is still consulted by doctors today. This translation is based largely on Li Zhongzi's concise 1642 edition, titled _Neijing Zhiyao_, and continues the centuries-long effort to annotate the text, especially in light of modern developments in medicine. Instead of "explaining a classic with a classic," this edition adds commentaries and emendations that enhance the (...) theoretical core of _Huangdi Neijing_, illuminating a seminal work of Chinese medicine that covers much more than the basic principles of yin-yang and the five elements. (shrink)

Information processing in neural systems can be described and analyzed at multiple spatiotemporal scales. Generally, information at lower levels is more fine-grained but can be coarse-grained at higher levels. However, only information processed at specific scales of coarse-graining appears to be available for conscious awareness. We do not have direct experience of information available at the scale of individual neurons, which is noisy and highly stochastic. Neither do we have experience of more macro-scale interactions, such as interpersonal communications. Neurophysiological evidence (...) suggests that conscious experiences co-vary with information encoded in coarse-grained neural states such as the firing pattern of a population of neurons. In this article, we introduce a new informational theory of consciousness: Information Closure Theory of Consciousness (ICT). We hypothesize that conscious processes are processes which form non-trivial informational closure (NTIC) with respect to the environment at certain coarse-grained scales. This hypothesis implies that conscious experience is confined due to informational closure from conscious processing to other coarse-grained scales. Information Closure Theory of Consciousness (ICT) proposes new quantitative definitions of both conscious content and conscious level. With the parsimonious definitions and a hypothesize, ICT provides explanations and predictions of various phenomena associated with consciousness. The implications of ICT naturally reconcile issues in many existing theories of consciousness and provides explanations for many of our intuitions about consciousness. Most importantly, ICT demonstrates that information can be the common language between consciousness and physical reality. (shrink)

Classification is one of the distinctive features of Paralympic sport. Despite the existence of classification rules and a well-defined classification process, some Paralympic athletes intentionally misrepresent their abilities to classifiers in order to be allocated to a lower performing competition class, in which they secure an unfair advantage over other athletes. Such deception undermines the integrity of the competition by exploiting a vulnerability in the classification process. Such manipulation is hard to mitigate and harder still to prove that an athlete (...) had; intentionally misrepresented their abilities or; failed for innocent reasons to make maximum efforts during the classification or; had acted under coercive pressure from others in their entourage or environment. These challenges are compounded in the case of Paralympic athletes that have an intellectual impairment or who are accompanied by a parent/guardian who acts as a proxy, rendering evaluations as to responsibility even more complex. This article presents a conceptual analyses of intentional misrepresentation of abilities in Paralympic sport, and the differentiation of responsibility for offence thereupon, as stipulated in the draft of the International Standard for Intentional Misrepresentation, accompanying the new 2025 Athlete Classification Code (IPC, Citation2024). Drawing on philosophical and legal analysis we (i) set out existing shortcomings associated with Paralympic classification; (ii) articulate the range of potential intentional misrepresentational acts with respect to classification manipulation; and (iii) articulate the range of negative effects on the integrity of Paralympic sport. (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)

Objectives: To study the attitudes of both medical and non-medical students towards the do-not-resuscitate decision in a university in Hong Kong, and the factors affecting their attitudes.Methods: A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.Results: A total of 766 students participated in the study. There were statistically (...) significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient’s own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.Conclusions: Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient’s own wish as most important in DNR decisions. Family wishes were considered less important than the patient’s own wishes. (shrink)

The US neutrino community gathered at the Workshop on the Intermediate Neutrino Program at Brookhaven National Laboratory February 4-6, 2015 to explore opportunities in neutrino physics over the next five to ten years. Scientists from particle, astroparticle and nuclear physics participated in the workshop. The workshop examined promising opportunities for neutrino physics in the intermediate term, including possible new small to mid-scale experiments, US contributions to large experiments, upgrades to existing experiments, R&D plans and theory. The workshop was organized into (...) two sets of parallel working group sessions, divided by physics topics and technology. Physics working groups covered topics on Sterile Neutrinos, Neutrino Mixing, Neutrino Interactions, Neutrino Properties and Astrophysical Neutrinos. Technology sessions were organized into Theory, Short-Baseline Accelerator Neutrinos, Reactor Neutrinos, Detector R&D and Source, Cyclotron and Meson Decay at Rest sessions.This report summarizes discussion and conclusions from the workshop. (shrink)

To read, to read a book, is, like all the other really human occupations, a Utopian task. I call “utopian” every action whose initial intention cannot be fulfilled in the development of its activity and which has to be satisfied with approximations essentially contradictory to the purpose which had started it. Thus “to read” begins by signifying the project of understanding a text fully. Now this is impossible. It is only possible with a great effort to extract a more or (...) less important portion of what the text has tried to say, communicate, make known; but there will always remain an “illegible” residue. It is, on the other hand, probable that, while we are making this effort, we may read, at the same time, into the text; that is, we may understand things which the author has not “meant” to say, and, nevertheless, he has “said” them; he has presented them to us involuntarily—even more, against his professed purpose. This twofold condition of speech, so strange and antithetical, appears in two principles of my “Axioms for a New Philology,” which are as follows:1.Every utterance is deficient—it says less than it wishes to say.2.Every utterance is exuberant—it conveys more than it plans. (shrink)

Pain is not a primitive sensory event but rather a complexperception and a process by which a person interacts with theinternal and external environments, constructs meaning, andengages in action. Because folk beliefs are central to meaning,folk concepts of pain play multiple causal roles in a painpatient's interaction with health care providers and others.In every case, the notion of pain is linked to a goal-directedbehavior that is useful to the person. The wide variation inconcepts of pain across individuals suffering with painunderscores (...) the richness and complexity of the pain experience.In some cases involving chronic pain, the patient may form amaladaptive cluster of behaviors around the concept of pain.Patient beliefs and expectations are an important part of manychronic pain syndromes, and patients can benefit fromintervention directed at revising the individual's folk model of pain. Memetics offers a framework for identifying the memesthat patients hold and determining whether patient memes fitor clash with provider memes. (shrink)