Tailoring assistive systems for guiding and monitoring an individual in daily living activities is a complex task. This paper presents ALI, an assistive system combining a formal possibilistic argumentation system and an informal model of human activity: the Cultural-Historic Activity Theory, facilitating the delivery of tailored advices to a human actor. We follow an activity-centric approach, taking into consideration the human’s motives, goals and prioritized actions. ALI tracks a person in order to I) determine what activities were performed (...) over a period of time (activity recognition tracking), and II) send personalized notifications suggesting the most suitable activities to perform (decision-making monitoring). The ALI system was evaluated in a formative pilot study related to promote social activities and physical exercise. (shrink)

The view that voluntary active euthanasia and physician-assisted suicide should be made available for terminal patients only is typically warranted by reference to the risks that the procedures are seen to involve. Though they would appear to involve similar risks, the commonly endorsed end-of-life practices referred to as passive euthanasia are available also for non-terminal patients. In this article, I assess whether there is good reason to believe that the risks in question would be bigger in the case of voluntary (...) active euthanasia and physician-assisted suicide than in that of passive euthanasia. I propose that there is not. On that basis, I suggest that limiting access to voluntary active euthanasia and physician-assisted suicide to terminal patients only is not consistent with accepting the existing practices of passive euthanasia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Active Euthanasia and Assisted SuicidePat Milmoe McCarrick (bio)Although the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in its 1983 report, Deciding to Forego Life-Sustaining Treatment, described the words and terms "euthanasia," "right to die," and "death with dignity" as slogans or code words—"empty rhetoric," (I, p. 24), the literature reviewed for this Scope Note continues to use these terms. Therefore, to (...) discuss the termination of a patient's life by a physician at the patient's request, the phrase active euthanasia is used, and the supplying of a means by a physician whereby a patient can end his or her life is referred to as assisted suicide.Euthanasia, either as the "good death" from classical Greek or "mercy killing" to end unbearable suffering in the dying, has long been a topic of interest in western civilization (III, Brody 1989). In recent years, public awareness of this discussion about control over the time of one's death has been informed by a series of well-publicized events. They include the November 1991 rejection by a vote of 54 percent to 46 percent of the Washington state Initiative 119, which would have allowed the option of requesting one's physician to "aid-in-dying" for adult patients in a "medically terminal condition" (V, Gross 1991); two medical journal articles describing physician's actions in helping bring death to two patients (V, Anonymous 1988; V, Quill 1991); Dr. Jack Kevorkian's assistance in the suicide of three women (V, Belkin 1990; V, Wilkerson 1991); and the best seller status of a how-to book on committing suicide with opiates obtained from a physician (III, Humphry 1991).For the most part, material included in the annotated bibliography in Scope Note 18 has been chosen from works published in the four years since "It's Over, Debbie" (V, Anonymous 1988) appeared in early January 1988 in the Journal of the American Medical Association.Dr. Edmund D. Pellegrino (V, 1991, pp. 3118-19) presented opposing views about active voluntary euthanasia as follows:Those who favor voluntary euthanasia argue that it is a beneficent and compassionate act; it respects autonomy by preserving the patient's control of the manner, method, [End Page 79] and timing of death; it takes the matter outside the reach of "medical power" (accessed in this Scope Note's bibliography at V, Fletcher 1973; V, Nowell-Smith 1989) and scrupulosity; and it prevents the injustice that allows some patients to choose death by refusal of life-support measures, while denying others the right to do so by active euthanasia....The opponents of active euthanasia argue that it undermines the value of, and respect for, all human life (V, Kass 1989; V, Coyle 1990; V, Singer 1990). They fear that guidelines cannot avoid sliding down the "slippery slope" to involuntary euthanasia and selective devaluation of the lives of the most vulnerable among us.... If euthanasia is legal, it is predicted that patients will feel subtle pressure to conform so as to relieve the economic and emotional burdens they impose on family and friends.Euthanasia, its opponents further argue, is socially destructive: it undermines trust in physicians, desensitizes society to killing, and imperils the ground already gained in legitimating passive euthanasia(IV, Wolf 1989).Physicians were not particularly involved with a patient's death until after World War II when participation grew in proportion to the growth of technology. Since the complex, life-sustaining equipment that could forestall death was located in a hospital, death itself became almost completely medicalized (V, Dagi 1991). For terminally ill persons who would like to die a painless death, either by their own hand or with assistance, physicians have almost a monopoly on obtaining strong drugs for distribution to patients (V, Abrams 1990).Active euthanasia for human beings is not legalized anywhere in the world (V, VonDrehle 1991). It is classified as homicide or murder in all fifty states and in Great Britain, Canada, Australia, and the Phillippines (V, Nerland 1989). Twentysix states in the United States prohibit assisted suicide by statute (V, Rosenblum 1990).In 1969 in the Netherlands, a physician named Jan Hendrik van... (shrink)

In this essay I defend the following two claims: first, given appropriate circumstances, neither voluntary active euthanasia, nor assisting someone to commit suicide, is in any way morally wrong; secondly, there should be no laws prohibiting such actions, in the relevant cases. -/- The discussion is organized as follows. In the first section, I set out some preliminary concepts and distinctions. Then, in sections two and three, I offer two arguments in support of the thesis that assisted suicide and voluntary (...) active euthanasia are not morally wrong. Finally, in section four, I ask whether there is any reason for thinking that, even if, as I have argued, voluntary active euthanasia and assisted suicide are not morally wrong, they should, nevertheless, not be legally permitted, and I argue that this is not the case. (shrink)

The chapter focuses on cases of assisted suicide and voluntary euthanasia in relation to the rarely discussed notion of indirect paternalism. Indirect paternalism involves not just a paternalistic intervener and a person whose welfare is supposed to be protected, but also another party, whom I call “assistant.” Indirect paternalism interferes with an assistant in order to prevent harm to another person. I will introduce a strategy that paternalists can pursue to justify indirect paternalism. It specifically targets an element (...) of assistance cases, namely the fact that people do not necessarily have a justified claim or entitlement to demand such assistance. To prevent people from providing assistance seems normatively different from preventing a person to do something to herself by her own means. I critically discuss arguments from the goals of medicine and from the conscientious objection. These aspects are not deemed decisive when considering the case of indirect paternalistic intervention. Finally, I argue against the rationale of indirect paternalism by showing that there are at least two situations where it does not succeed. One such situation that undermines the justification of indirect paternalism is present when the offered service is itself harmless, another pertinent situation consists of a person necessarily requiring assistance to be really free. At least in some cases, these very conditions are given when contemplating assistance to die. (shrink)

In this article, a new adaptive data-driven strategy for voice activity detection using empirical mode decomposition is proposed. Speech data are decomposed using an a posteriori, adaptive, data-driven EMD in the time domain to yield a set of physically meaningful intrinsic mode functions. Each IMF preserves the nonlinear and nonstationary property of the speech utterance. Among a set of IMFs, the IMF that contains source information dominantly called characteristic IMF can be identified and extracted by designing a zero-frequency filter-assisted peaking (...) resonator. The detected CIMF is used to compute energy using short-term processing. Choosing proper threshold, voiced regions in speech utterances are detected using frame energy. The proposed framework has been studied on both clean speech utterance and noisy speech utterance. The proposed method is used for voice activity detection in the presence of white noise and shows encouraging result in the presence of white noise up to 0 dB. (shrink)

The supervisor of the activities of a system user should benefit from the knowledge contained in the event logs of the user. They allow the monitoring of the sequential and parallel user activities. To make event logs more accessible to the supervisor, we suggest a process mining approach, including first the design of an understanding model of the activities of a system user. The model design is based on the relationships between the event logs and the (...) class='Hi'>activities of a system user. An intervention model completes the understanding model to assist the supervisor. The intervention model enables an action of the supervisor on the critical activities, and the detection of anomalies. The models are automatically designed with a model-driven engineering approach. An experiment on a smart home system illustrates this tooled design, where the supervisor is a medical or paramedical staff member. (shrink)

The present study aims to explore the efficacy of educational interventions implemented in primary schools within the Kingdom of Saudi Arabia. Specifically, it seeks to examine the viewpoints of principals, assistant principals, and teachers regarding the effectiveness of these activities. By employing a mixed-methods approach, this study utilizes descriptive statistics, analysis of variance (ANOVA), and regression analysis to thoroughly investigate the intricacies associated with educational practices. The results of the study revealed differences in the perceived effectiveness among various (...) groups of stakeholders and regional discrepancies. Principals, in their capacity as educational leaders, demonstrate the highest mean scores, underscoring their crucial role in shaping the overall school culture. The significance of context in educational effectiveness is highlighted by regional variations, which are in line with the overarching objectives stated in Vision 2030. The regression analysis demonstrates a positive correlation between participant roles and perceived effectiveness, underscoring the importance of inclusive leadership. In its entirety, this study provides valuable insights that are essential for customizing educational methodologies to suit regional requirements, promoting cooperation, and improving the quality of primary education in Saudi Arabia. (shrink)

This paper gives an overview of pro-active meeting assistants, what they are and when they can be useful. We explain how to develop such assistants with respect to requirement definitions and elaborate on a set of Wizard of Oz experiments, aiming to find out in which form a meeting assistant should operate to be accepted by participants, and whether the meeting effectiveness and efficiency can be improved by an assistant at all. This paper gives an overview of pro-active (...) meeting assistants, what they are and when they can be useful. We explain how to develop such assistants with respect to requirement definitions and elaborate on a set of Wizard of Oz experiments, aiming to find out in which form a meeting assistant should operate to be accepted by participants, and whether the meeting effectiveness and efficiency can be improved by an assistant at all. (shrink)

This booklet on Active Assisted Living (AAL) technologies has been created as part of the GoodBrother COST Action, which has run from 2020 to 2024. COST Actions are European research programs that promote collaboration across borders, uniting researchers, professionals, and institutions to address key societal challenges. GoodBrother focused on ethical and privacy concerns surrounding video and audio monitoring in care settings. The aim was to ensure that while AAL technologies help older adults and vulnerable individuals, their privacy and data protection (...) rights remain a top priority. This booklet is designed to guide you through the role that AAL technologies play in improving the quality of life for older adults, caregivers, and people with disabilities. AAL technologies offer tools for those facing cognitive or physical challenges. They can enhance independence, assist with daily routines, and promote a safer living environment. However, the rise of these technologies also brings important questions about data protection and user autonomy. (shrink)

In the debate surrounding the morality and legality of the practices of physician-assisted death and euthanasia, a common logical argument regularly employed against these practices is the “slippery slope argument.” One formulation of this argument claims that acceptance of physician-assisted death will eventually lead down a “slippery slope” into acceptance of active euthanasia, including its voluntary, non-voluntary, and/or involuntary forms, through psychological and social processes that warp a society’s values and moral perspective of a practice over an extended period of (...) time. This formulation is known as the psychological slippery slope argument. This paper analyzes the psychological slippery slope argument as it is applied to the practice of physician-assisted death, and utilizing recent empirical evidence from various nations around the world that practice physician-assisted death and/or euthanasia, the paper argues that employing the psychological slippery slope argument against physician-assisted death is logically fallacious, this kind of slippery slope is unfounded in practice, and thus the psychological slippery slope argument is insufficient on its own to justify continued legal prohibition of physician-assisted death. (shrink)

Those who defend physician‐assisted suicide often seek to distinguish it from active euthanasia, but in fact, the two acts face the same objections. Both can lead to abuse, both implicate the physician in the death of a patient, and both violate whatever objections there are to killing. Their moral similarity derives from the similar roles of the physician.

No laws or official guidelines govern medical assistance for dying in Japan. However, over the past several years, cases of assisted suicide or voluntary euthanasia, rarely disclosed until recently, have occurred in close succession. Inspired by these events, ethical, legal, and social debates on a patient’s right to die have arisen in Japan, as it has in many other countries. Several surveys of Japanese people’s attitudes towards voluntary assisted dying suggest that a certain number of Japanese prefer active euthanasia. Against (...) this background, it is important to discuss voluntary assisted dying cases in Japan and the Japanese views on them and to consider their implications. We review three recent Japanese voluntary assisted dying cases and discuss the various objections to voluntary assisted dying that have been published in response to these in various media outlets. Our counterarguments include the double suffering of people who are unable to give up their desire to die, individuality of death, variability of culture, problem of being an annoyance to (burden on) others, a slippery slope argument supporting voluntary assisted dying, and unfair claims about responsibility and excessive burden on people who are unable to give up their desire to die. We also point out the psychocultural and social problems in Japanese society that these objections reflect, and argue that voluntary assisted dying can be ethically acceptable under certain conditions. We conclude that Japanese society must change in order to enable those who sincerely wish to die to do so in a better way. (shrink)

Guidelines provided by the Director of Public Prosecutions suggest that anyone assisting another to commit suicide in England and Wales, or elsewhere, will not be prosecuted provided there are no self-seeking motives and no active encouragement. This reflects the position in Switzerland. There, however, no difference is made between assistance and inducement. In addition, the Swiss approach makes it possible to establish organisations to assist the suicides of both their citizens and foreign visitors. It should not be assumed that this (...) approach is without controversy in Switzerland. Proposals for reform continue to be debated there, not least because of the concern about some of the actual practices of certain end-of-life organisations. It is likely that a few English citizens will continue to avail themselves of these services in Switzerland if they cannot find the help they require here. This paper explores the legitimacy of the current restrictive position adopted towards assisted suicide in England. It argues that the provisions within the guidelines prohibiting organisations that assist suicides, leaves some without the help they need. While legislative decriminalisation of assisted suicide and the establishment of state-sponsored suicide centres would represent the most permissive regime, this paper proposes that this would be a step too far. The preference here is for decriminalisation but adopting a ‘middle way’ between the two extremes: the more permissive approach provided by the ‘Swiss model’ is one that could be employed here, albeit within a more robust regulatory regime. (shrink)

The goal of this article is to better understand the diffusion of environmentally preferable manufacturing technology (as distinct from pollution control technology) in small-and medium-sized firms (SMEs) and the influence of technical assistance programs on the diffusion of these technologies. The authors draw their insights from the printing industry, a sector where small firms predominate. They find that smaller firms lag slightly in the adoption of environmental technologies. With regard to technical assistance, they find that printers identify suppliers and other (...) industry sources as more useful than government in providing information that leads to active exploration of new environmental technologies. In addition, in comparison to larger firms, smaller firms reported to be less familiar with government-sponsored programs and perceived some of the programs to be less useful. They point to several ways in which regulatory agencies are experimenting to make government sponsored programs more effective. (shrink)

Feminist research on community care and ‘informal carers’ identified this as a women's issue but failed to address the interests and experiences of older and disabled women – those who received ‘care’ One consequence is that such feminist research has implicitly, and sometimes explicitly, undermined disabled women's rights to a home, children and personal relationships. Using qualitative research, the article highlights the actual experience of women whose physical impairment means that they need help with daily living activities, looking at (...) the different circumstances in which such help is received. The disability movement's concept of ‘independent living’ raises particular issues for disabled women. ‘Independent living’ is about having choice and control over the assistance needed, rather than necessarily doing everything for yourself. However, gender inequalities may also inhibit the choice and control that women have in their lives. Assistance can be given within a personal relationship as an expression of love, but disabled women may also experience abusive, restrictive or exploitative relationships. Public services do not generally provide assistance in a way which enables a woman to have choice and control in her life, or even to carry out child-caring or homemaking tasks. The research on the various ways of receiving personal assistance found that those women who were able to purchase their own help were most likely to be living independently, in the sense of exerting choice and control in their lives. Feminist research can help to create a space for disabled women's absent voices, and add to the pressure for change in the way that personal assistance needs are met. This is a human and civil rights issue which has a key impact on the control that disabled women have over their lives. (shrink)

This paper discusses physician-assisted suicide and voluntary active euthanasia, supplies a short history and argues in favour of permitting both once rigid criteria have been set and the cases retro-reviewed. I suggest that among these criteria should be that VAE should only be permitted with one more necessary criterion: that VAE should only be allowed when physician assisted suicide is not a possible option. If the patient is able to ingest and absorb the medication there is no reason why VAE (...) should be permitted. A brief history of VAE and PAS is given and some of the arguments which have been given are analyzed. The Principle of the Double Effect is briefly discussed and why, in my opinion, it is not a valid principle is briefly discussed. (shrink)

We propose an AI-assisted design concept exploration tool, the “Character Space Construction”. Concept designers explore and articulate the target product aesthetics and semantics in language, which is expressed using “Design Concept Phrases”, that is, compound adjective phrases, and contrasting terms that convey what are not their target design concepts. Designers often utilize this dichotomy technique to communicate the nature of their aesthetic and semantic design concepts with stakeholders, especially in an early design development phase. The CSC assists this designers' cognitive (...) activity by constructing a “Character Space”, which is a semantic quadrant system, in a structured manner. A CS created by designers with the assistance of the CSC enables them to discern and explain their design concepts in contrast with opposing terms. These terms in a CS are retrieved and combined in the CSC by using a knowledge graph. The CSC presents terms and phrases as lists of candidates to users from which users will choose in order to define the target design concept, which is then visualized in a CS. The participants in our experiment, who were in the “arts and design” profession, were given two conditions under which to create DCPs and explain them. One group created and explained the DCPs with the assistance of the proposed CSC, and the other did the same task without this assistance, given the freedom to use any publicly available web search tools instead. The result showed that the group assisted by the CSC indicated their tasks were supported significantly better, especially in exploration, as measured by the Creativity Support Index. (shrink)

Assistive Device Art derives from the integration of Assistive Technology and Art, involving the mediation of sensorimotor functions and perception from both, psychophysical methods and conceptual mechanics of sensory embodiment. This paper describes the concept of ADA and its origins by observing the phenomena that surround the aesthetics of prosthesis-related art. It also analyzes one case study, the Echolocation Headphones, relating its provenience and performance to this new conceptual and psychophysical approach of tool design. This ADA tool is designed to (...) aid human echolocation. They facilitate the experience of sonic vision, as a way of reflecting and learning about the construct of our spatial perception. Echolocation Headphones are a pair of opaque goggles which disable the participant’s vision. This device emits a focused sound beam which activates the space with directional acoustic reflection, giving the user the ability to navigate and perceive space through audition. The directional properties of parametric sound provide the participant a focal echo, similar to the focal point of vision. This study analyzes the effectiveness of this wearable sensory extension for aiding auditory spatial location in three experiments; optimal sound type and distance for object location, perceptual resolution by just noticeable difference, and goal-directed spatial navigation for open pathway detection, all conducted at the Virtual Reality Lab of the University of Tsukuba, Japan. The Echolocation Headphones have been designed for a diverse participant base. They have both the potential to aid auditory spatial perception for the visually impaired and to train sighted individuals in gaining human echolocation abilities. Furthermore, this Assistive Device artwork instigates participants to contemplate on the plasticity of their sensorimotor architecture. (shrink)

In brief compass, I will touch on three of the central ethical and public policy issues that divide those who are opposed to physician-assisted dying from those who are supportive of this practice. These are: the moral distinction between actively hastening death and passively allowing to die; how to interpret the Hippocratic tradition in medicine with respect to physician-assisted death; and whether physician-assisted suicide can be effectively regulated. I shall summarize the arguments pro and con with respect to each issue, (...) and also indicate my own position. (shrink)

The traditional Christian focus concerning dying is on repentance, not dignity. The goal of a traditional Christian death is not a pleasing, final chapter to life, but union with God: holiness. The pursuit of holiness requires putting on Christ and accepting His cross. In contrast, post-traditional Christian and secular concerns with self-determination, control, dignity, and self-esteem make physician-assisted suicide and voluntary active euthanasia plausible moral choices. Such is not the case within the context of the traditional Christian experience of God, (...) which throughout its 2000 years has sternly condemned suicide and assisted suicide. The wrongness of such actions cannot adequately be appreciated outside the experience of that Christian life. Traditional Christian appreciations of death involve an epistemology and metaphysics of values in discordance with those of secular morality. This difference in the appreciation of the meaning of dying and death, as well as in the appreciation of the moral significance of suicide, discloses a new battle in the culture wars separating traditional Christian morality from that of the surrounding society. (shrink)

David Shaw presents a new argument to support the old claim that there is not a significant moral difference between killing and letting die and, by implication, between active and passive euthanasia. He concludes that doctors should not make a distinction between them. However, whether or not killing and letting die are morally equivalent is not as important a question as he suggests. One can justify legal distinctions on non-moral grounds. One might oppose physician- assisted suicide and active euthanasia when (...) performed by doctors on patients whether or not one is in favour of the legalisation of assisted suicide and active euthanasia. Furthermore, one can consider particular actions to be contrary to appropriate professional conduct even in the absence of legal and ethical objections to them. Someone who wants to die might want only a doctor to kill him or to help him to kill himself. However, we are not entitled to everything that we want in life or death. A doctor cannot always fittingly provide all that a patient wants or needs. It is appropriate that doctors provide their expert advice with regard to the performance of active euthanasia but they can and should do so while, qua doctors, they remain hors de combat. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Experiencing Assistive Technology:A Pragmatist Inflection for Occupational TherapyNate Whelan-Jacksonshortly after i wake up, I put braces on my legs. I wear them throughout the day. Often, I don't notice them. If I'm walking on a flat surface, they often fade into the background of my consciousness. I make allowances without thinking about how they structure my gait and the space they take up. Rarely, I misjudge this, and occasionally (...) fall. In those moments, their presence is apparent, coming to the foreground of my experience as a problem, something I need to accommodate as I collapse. When they need to be repaired, I notice them all of the time. As a user of assistive technology, the way in which I experience the technology can swing from regarding them as part of my body, to an external tool, to an object in my environment. This experience is fluid, weaving moments where a sense of my embodiment includes the devices with moments where they are alien to me. Even when they are alien to me, I use them successfully (most of the time). Reading reports of the experiences of other users of assistive equipment, especially prosthetics, I do not seem to be alone in experiencing this fluidity with respect to these devices. These experiences raise questions for me. Is "successful use" sufficient as a goal as I learn and re-learn how to walk with them? Often, I prefer the experience of braces as part of myself: How might that be cultivated? Perhaps the fluidity of encountering them at times as tools and at times as part of myself is a strength, one that I might reasonably seek to develop. How might education or therapy accommodate and prepare for this feature of experience with assistive technology?Phenomenological analyses of symptoms of "phantom limbs," use of prosthetics, and even of physical impairment more generally, highlight the fluidity of disability experience, emphasizing the experience of having to continually revise ways of navigating our environments. For many disabled people, this precarious character of experience might demand that we learn to use new [End Page 60] assistive technologies. This education often takes place in the context of occupational therapy (hereafter OT), a form of therapeutic intervention using "occupations," or purposive tasks, to facilitate independence. In this process, persons might not just learn to make use of a technology or perform a task, but also to experience the technology in a variety of ways—for instance, as an obstacle, as a tool, or as a part of their bodies. Thus, OT becomes not only a locus for developing new modes of coping and performing daily tasks, but a site at which relationships to assistive technologies come to the foreground.Those relationships, in various theoretical models underlying OT, are often analyzed in terms of task performance, and different elements modified in order to complete a given occupation. A person might make changes in their own habits of moving (for instance, learning to move their legs a certain way to facilitate walking), the environment (e.g., modify furniture or a configuration of a room), or some combination thereof. However, some experiences of disability call into question features of popular models underlying OT, like the person-environment-occupation model. In particular, features of the situation, like the equipment, can occupy multiple roles, or even change roles, from person to environment or vice versa, within the context of performing daily tasks. I suggest that John Dewey's work on education and analysis of habits with relationship to a creature's broader environment provide a useful framework for articulating models of experiencing assistive technologies that appreciate their fluidity within experiences of disability. This model offers a helpful orientation for OT, one that offers an expansive account of the potential "ends" of OT, from re-molding habits to complete tasks to supporting plasticity in an individual's relationship to different elements of the model itself.Occupational TherapyBroadly, occupational therapy fosters independence through a number of means. Occupational therapists can aid in re-training how to perform everyday activities, construct exercises to strengthen or re-habituate new uses of muscles, make recommendations for changing features of home or... (shrink)

Discussions in Germany regarding appropriate end-of-life decision-making have been heavily influenced by the liberalization of access to physician-assisted suicide and voluntary active euthanasia in the Netherlands and Belgium. These discussions disclose conflicting moral views regarding the propriety of physician-assisted suicide and euthanasia, threatening conflicts within not only the medical profession, but also the mainline churches in Germany, whose membership now entertains views regarding end-of-life decision-making at odds with traditional Christian doctrine. On the surface, there appears to be a broad consensus (...) supporting the hospice movement and condemning physician-assisted suicide and euthanasia. The German Supreme Court has held that treatment decisions should, in absence of known patients’ wishes, be made in light of commonly shared values, unless these violate the principle of “in dubio pro vita”. The Roman Catholic church and the Evangelical Lutheran church in Germany have developed an advance directive for treatment choices at the end of life, while condemning physician-assisted suicide and euthanasia. This stance is in tension with the strong emerging support for physician-assisted suicide and euthanasia, a development that promises to open up foundational disagreements within mainline German Christianity regarding the appropriate approach to intentionally terminating human life. (shrink)

Ethics and ethical behaviour are the fundamental pillars of a civilised society. The focus on ethical behaviour is indispensable in certain fields such as medicine, finance, or law. In fact, ethics gets precedence with anything that would include, affect, transform, or influence upon individuals, communities or any living creatures. Many institutions within Europe have set up their own committees to focus on or approve activities that have ethical impact. In contrast, lesser-developed countries are trying to set up these committees (...) to govern their academia and research. As the first European consortium established to assist academic integrity, European Network for Academic Integrity, we felt the importance of guiding those institutions and communities that are trying to conduct research with ethical principles. We have established an ethical advisory working group within ENAI with the aim to promote ethics within curriculum, research and institutional policies. We are constantly researching available data on this subject and committed to help the academia to convey and conduct ethical behaviour. Upon preliminary review and discussion, the group found a disparity in understanding, practice and teaching approaches to ethical applications of research projects among peers. Therefore, this short paper preliminarily aims to critically review the available information on ethics, the history behind establishing ethical principles and its international guidelines to govern research.The paper is based on the workshop conducted in the 5th International conference Plagiarism across Europe and Beyond, in Mykolas Romeris University, Lithuania in 2019. During the workshop, we have detailed a) basic needs of an ethical committee within an institution; b) a typical ethical approval process ; and c) the ways to obtain informed consent with some examples. These are summarised in this paper with some example comparisons of ethical approval processes from different universities. We believe this paper will provide guidelines on preparing and training both researchers and research students in appropriately upholding ethical practices through ethical approval processes. (shrink)

Abstract.In Canada, food assistance is provided through a widespread network of extra-governmental, community-based, charitable programs, popularly termed “food banks”. Most of the food they distribute has been donated by food producers, processors, and retailers or collected through appeals to the public. Some industry donations are of market quality, but many donations are “surplus” food that cannot be retailed. Drawing on insights from an ethnographic study of food bank work in southern Ontario, we examined how the structure and function of food (...) banks operate to facilitate the distribution of foods not marketed through the retail system. Our findings indicate that the handling of industry donations of unsaleable products is a labor-intensive activity, made possible by the surfeit of unpaid labor in food banks, the neediness of food bank clients, and clients’ lack of rights in this system. The marshalling of volunteer labor to serve a corporate need might be construed as a “win-win” situation because the work of salvaging edible foodstuffs from among industry “surplus” helps to “feed the hungry” while also diminishing the amount of refuse deposited in landfill sites, sparing corporations disposal costs and landfill tipping fees, and helping them forge an image of good corporate citizenship. However, the reliance of food banks on industry donations means that food assistance becomes defined as that which the corporate sector cannot retail. Moreover, the intertwining of food bank work with corporate needs may function to further entrench this ad hoc secondary food system and mitigate against initiatives to develop more effective responses to problems of hunger and food insecurity in our communities. (shrink)

This chapter contains sections titled: Important Concepts and Distinctions and Alternative Views A Brief Defense of Assisted Suicide and Voluntary Active Euthanasia Arguments for the View that Voluntary Active Euthanasia is Morally Wrong Should Assisted Suicide and Voluntary Active Euthanasia be Legal?

Background Medical Assistance in Dying in Canada came into effect in 2016 with the passing of Bill C-14. As patient interest and requests for MAID continue to evolve in Canada, it is important to understand the attitudes of future providers and the factors that may influence their participation. Attitudes towards physician hastened death in general and the specific provision of MAID are unknown among Canadian residents. This study examined residents’ attitudes towards PHD and MAID, and identified factors that may influence (...) their decision to participate in PHD and provide MAID. Methods A cross-sectional survey was adapted from prior established surveys on MAID to reflect the Canadian setting. All Canadian family medicine programs were invited to participate. The survey was distributed between December 2016 and April 2017. Analysis of the results included descriptive statistics to characterize the survey participants and multivariable logistic regressions to identify factors that may influence residents’ attitudes towards PHD and MAID. Results Overall, 247 residents from 6 family medicine training programs in Canada participated. While residents were most willing to participate in treatment withdrawal, active participation in PHD and MAID by prescription of a lethal drug and lethal injection were less acceptable. Logistic regressions identified religion as a consistent and significant factor impacting residents’ willingness to participate in PHD and MAID. Residents who were not strictly practicing a religion were more likely to be willing to participate in PHD and MAID. Increased clinical exposure to death and dying crudely correlated with increased willingness to participate in PHD and MAID, but when examined in multivariable models, only a few activities had a statistically significant association. Other significant factors included the residents’ sex and location of training. Conclusions Residents are hesitant to provide MAID themselves, with religious faith being a major factor impacting their decision. (shrink)

Kant’s notion of autonomy is not only a central concept in pure moral philosophy; it is also a key organizing concept in applied moral philosophy. Across the whole spectrum of human endeavors, there are helping relationships wherein some helpers (e.g., doctors, teachers, social workers, advisors, managers, or organizers) try to help their counterparts (e.g., patients, students, clients, workers, and so forth) to help themselves. But there is a fundamental “helping self-help conundrum” in the very idea of helpers giving external assistance (...) to others to become more autonomous, i.e., to become independent of external assistance. This conundrum makes genuine autonomy-enhancing help very subtle, difficult, and scarce. There is, however, a golden thread in applied moral philosophy running from Socrates, Stoics, and Augustine down to modern philosophers such as John Dewey, Leonard Nelson, David Hawkins, and Gilbert Ryle. This tradition appreciates the limitations highlighted by the fundamental conundrum and which argues that genuine help must be indirect to create the preconditions and catalyze the processes of the others taking an active and constructive role in helping themselves. The analysis also highlights the “yin and yang” of unhelpful help as social engineering (yang) and “rapacious benevolence” (yin). Iven Illich in particular developed a general critique of the “helping profession,” with their professional cartels always finding more “needs” and “disabilities” that need to attended to, that thereby generate more learned disabilities and disabling help. (shrink)

Medical assistance in dying (MAID) legislation in Canada followed much deliberation after the Supreme Court of Canada’s ruling inCarterv.Canada. Included in this deliberation was the Special Joint Committee on Physician Assisted Dying’s recommendation to extend MAID legislation beyond the inclusion of adults to mature minors. Children's agency is a construct advanced within childhood studies literature which entails eliciting children’s voices in order to recognise children as active participants in constructing their own childhoods. Using this framework, we consider the possible extension (...) of MAID legislation to most minors. We highlight important questions regarding how insights from children’s voices could be mobilised in the life or death context of MAID. We conclude that children’s voices have the potential to help determine their eligibility for MAID; however, incorporating children's voices in the context of MAID requires careful consideration due to the complexity of voice. (shrink)

It is commonly accepted that voluntary active euthanasia and physician-assisted suicide can be allowed, if at all, only in the cases of patients whose conditions are incurable. Yet, there are different understandings of when a patient’s condition is incurable. In this article, I consider two understandings of the notion of an incurable condition that can be found in the recent debate on physician-assisted dying. According to one of them, a condition is incurable when it is known that there is no (...) cure for it. According to the other, a condition is incurable when no cure is known to exist for it. I propose two criteria for assessing the conceptions and maintain that, in light of the criteria, the latter is more plausible than the former. (shrink)

Music is the carrier through which human beings express their emotions. It can clean up their hearts and seek emotional resonance. The combination of music and artificial intelligence, when music meets artificial intelligence, the mathematical logic part of data and algorithm replaces the image thinking, resulting in automatic music production. The basic principle of music creation is to use artificial intelligence technology to conduct in-depth training on a large number of songs, and then build a database. Then, within a certain (...) period of time, extract a segment from several songs, and then decompose it to form a new melody. The automatic music production is the collision of music and technology. With the flying of code and notes, it creates a different kind of beauty. Music culture is a new field of music application. With its refreshing audio-visual effect, it has made people have a new understanding of music and has become a hot topic in current mass cultural activities. The sound quality characteristics of music culture programs determine the characteristics of simple, fast and efficient design. However, the current audio and video design still stays in the traditional audio and video form design, with low design efficiency, long cycle, high cost and high requirements for designers. In view of the fact that the traditional audio and video design mode in China's music and cultural programs cannot meet the needs of performance programs at present, this paper proposes a design scheme of audio and visual effects of music and cultural programs with intelligent devices as the core, and develops a complete set of audio and visual effects aided design system on this basis. (shrink)

Assisted dying (AD) has not been legalized despite a number of presentations to parliament. It is necessary for doctors who support AD to justify themselves in the context of repeated legislative failure. This article describes the author's personal approach to the problem, one that prioritizes respect for autonomy above legal or societal objections. It is argued that for debilitated patients, the preservation of autonomy depends on a doctor's empathy and willingness to advocate. This sequence can be interrupted by externally and (...) internally imposed barriers. External factors include indiscriminate respect for the law and society's institutions, an inaccurate perception of the balance of risks to society and insufficient compensation for the dying person's inability to mount a sustained challenge. Internal brakes to advocacy such as elevation of personal morality above the needs of patients, attenuation of the therapeutic relationship in cases of moral complexity and the temptation to abdicate the role of physician are also explored. It is concluded that if AD could in theory be of benefit to a patient, but cannot be achieved due to its illegality, doctors have a duty to actively represent their demands as they would for other forms of treatment. (shrink)

The risks associated with the techniques of medically assisted procreation (MAP) rapidly became well-known, and in such a short space of time that no biomedical domain remained untouched by the great deal of thinking and the expression of a multitude of opinions it provoked. MAP is evolving between two poles: quality/misuse (even violation) and evidence/fantasy. The ethics will be evoked in the clinical reality from which they spring and where their justification lies. The three objects common to these ethics, the (...) oocyte, the embryo and the child, are illustrated in this context. MAP has as its corollary access to the oocyte, the fertilization of which will take place in vitro. Access to the embryo, on the other hand, enables the clinician, for the purposes of diagnosis [preimplantation genetic diagnosis (PGD), predictive medicine], or even soon for therapeutic purposes (gene therapy) to draw close to a boundary, to trespass beyond which may be seen by humanity to threaten its very origins and integrity: the alienation of the human genome. For the infertile couple, the missing child may take on a dimension of which they would have been unaware, had they not been forced to express their desire. The burden of the imaginary child may, in this way, become a heavier load to bear when, after such desire, he comes into being. MAP puts the goal of normalisation within reach and, in doing so, accentuates the risk of the burden of the attributed representation of the child. On the one hand, MAP offers a tremendous diagnostic and therapeutic potential, while on the other it opens the door to excess and delirium. In this melting pot, ethics, catalysed by this new source of problematics, has discovered a favourite area in which to define and redefine itself. We propose the intervention of ethics on three different levels. Before the elaboration of the law: on first reflection, ethics may influence the responsibilities of the legislator, by taking care that the law does not obscure the biomedical and socioeconomic contexts of MAP and, thereby, also include other related and complementary aspects dealing with the same subject. The secondary discussion of ethics should influence the application of legal protection, by taking into account the rapid technological and social development of MAP, there too, by discussing the whole, rather than the details which will obscure the object. The ethical reflection of the clinician, who is aware of these difficulties, is guided by elements that are specific to his position as a doctor. The cohesion of the team around the clinician and the ethics specialist enables us to develop consensual clinical ethics that are transmissible and therefore teachable. This complex role can, in our view, only be acted out directly in the clinical situation, where the constant, direct relationship with the object of the reflection and the treatment allows ethics to take into account the contingencies of medical practice: we invite the ethics specialist to take part in our clinical activity on a daily basis. (shrink)

In this article, I shall present three arguments for thc pcrmissibility 0f physician-assisted suicide (PAS), and then examine several objections 0f 21 "K21nti2m" and non-Kantian nature against them. These are really 0bjcctions against certain types of suicide. I shall focus 0n active PAS (eg., when 21 patient takes 21 lethal drug given by E1 physician, in which case both thc physician and patient are active). I shall assume the patient is 21 competent, responsible, rational agent, who gives his being in (...) physical discomfort (pain, nausea, ctc.) as thc reason for intending his death. I am assuming, therefore, thc pain while 21 sourcc of suffering docs not undermine his rational agency in 21 way that threatens responsibility for choice.] Current legal proposals for permitting PAS focus 0n procedures.. (shrink)

Active labor-market policies have developed significantly over the past two decades across Organization for Economic Cooperation and Development countries, with substantial cross-national differences in terms of both extent and overall orientation. The objective of this article is to account for cross-national variation in this policy field. It starts by reviewing existing scholarship concerning political, institutional, and ideational determinants of ALMPs. It then argues that ALMP is too broad a category to be used without further specification, and it develops a typology (...) of four different types of ALMPs: incentive reinforcement, employment assistance, occupation, and human capital investment. These are discussed and examined through ALMP expenditure profiles in selected countries. The article uses this typology to analyze ALMP trajectories in six Western European countries and shows that the role of this instrument changes dramatically over time. It concludes that there is little regularity in the political determinants of ALMPs. In contrast, it finds strong institutional and ideational effects, nested in the interaction between the changing economic context and existing labor-market policies. (shrink)

Euthanasia and physician assisted-suicide are terms used to describe the process in which a doctor of a sick or disabled individual engages in an activity which directly or indirectly leads to their death. This behavior is engaged by the healthcare provider based on their humanistic desire to end suffering and pain. The psychiatrist's involvement may be requested in several distinct situations including evaluation of patient capacity when an appeal for euthanasia is requested on grounds of terminal somatic illness or when (...) the patient is requesting euthanasia due to mental suffering. We compare attitudes of 49 psychiatrists towards euthanasia and assisted suicide with a group of 54 other physicians by means of a questionnaire describing different patients, who either requested physician-assisted suicide or in whom euthanasia as a treatment option was considered, followed by a set of questions relating to euthanasia implementation. When controlled for religious practice, psychiatrists expressed more conservative views regarding euthanasia than did physicians from other medical specialties. Similarly female physicians and orthodox physicians indicated more conservative views. Differences may be due to factors inherent in subspecialty education. We suggest that in light of the unique complexity and context of patient euthanasia requests, based on their training and professional expertise psychiatrists are well suited to take a prominent role in evaluating such requests to die and making a decision as to the relative importance of competing variables. (shrink)

Since the 1970s, new therapeutic practices, involving the interaction between humans and dolphins - Tursiops truncatus in particular, have developed. Such practices are known as dolphin-assisted therapies (DAT), a specific case of a more heterogeneous set of experiences with dolphins called dolphin-assisted activities (DAA): these include programmes of dolphin watching and swimming in high seas, as well as shows in dolphinariums and marine parks. DAT has grown rapidly as a highly attractive form of therapy, due to the well-liked animals (...) used in an aquatic, and often exotic, environment. This kind of co-therapy seems to testify the enchantement that dolphins - in myths and chronicles often reported in rescue at sea, perceived as especially charismatic - exert on people; the human attempt of bonding with them, possibly in response to the need of building a human-animal bodily intersubjectivity. (shrink)

As a practicing clinical ethicist at a major teaching hospital, I found it reassuring to learn that ethics consultation activity has increased overall. However, it was disheartening to see tha...

Until recently, physician assisted suicide was dealt with on the same basis as active voluntary euthanasia in the Netherlands. Over the last years, several cases relating to assistance in suicide of mental patients did raise specific issues, not addressed so far in the debate on euthanasia. One of these cases resulted in a Supreme Court decision. The paper summarizes this decision and comments on it from a legal point of view.

ABSTRACTPerhaps no American state has seen more legal activity on assisting suicide than Michigan, but despite legislation, a study Commission, several legal cases and a state Supreme Court ruling, the state seems much further from a humane resolution of the question than when the activities of Dr. Jack Kevorkian began in June of 1990. This note summarizes major legal events over a twelve‐month period , which included jury acquittal of Dr. Kevorkian, the inconclusive report of the Michigan Commission on (...) Death and Dying, the failure of the state legislature to enact legislation to replace the expired absolute but temporary prohibition, and the decision of the Michigan Supreme Court in Mich v. Kevorkian declaring assisting suicide a common law felony and ruling that in certain circumstances a person assisting suicide can be prosecuted for murder. The Commission's model decriminalization proposal and the bills subsequently introduced in the legislature , as well as the decision of the Supreme Court, are discussed. Certain puzzling features of the latter, especially with regard to the kind of causation that can turn helping another commit suicide into murder, are noted. (shrink)

Hidalgo1 argues that, contrary to widespread belief, active recruitment of health workers ‘generally refrains from enabling harm or facilitating wrongdoing’. In this commentary, I argue that the case is not yet convincing. There are a number of problems with the argument, only some of which I can sketch here. These include: Hidalgo gives an insufficient account of the relevant harms that are inflicted when healthcare workers emigrate. Relatedly, he does not take account of the underlying causes of migration and what (...) might assist in remedying the situation. He thus fails to catalogue a wide range of losses that are born when health workers emigrate from developing countries and fails to appreciate how his recommendations undermine some of the constructive initiatives that might assist poor, developing countries. Hidalgo misrepresents the situation in developing countries, incorrectly describing government funding of tertiary education as some kind of gift, rather than an investment in creating important human capital to provide for citizens’ needs, which can mean that fair returns on investment are quite justified. With the correct descriptions in place, the grounding for various duties to reciprocate is rendered secure. There are some important problems with the empirical studies cited such that they do not provide support for Hidalgo's argument.I begin with the case for . There are large disparities in life prospects between developing and developed countries. Indeed, this wide disparity is one of the main reasons healthcare workers want to leave in the first place. If that is the main reason healthcare workers seek to exit, it is not insignificant what would address the causal, underlying problems. How do we promote prosperity in developing countries? A lively debate on this topic flourishes. However, one factor that has widespread support from all sides of the debate is that the quality of …. (shrink)