The effective collection and management of personal data of rapidly migrating populations is important for ensuring adequate healthcare and monitoring of a displaced peoples’ health status. With developments in ICT data sharing capabilities, electronic personal health records (ePHRs) are increasingly replacing less transportable paper records. ePHRs offer further advantages of improving accuracy and completeness of information and seem tailored for rapidly displaced and mobile populations. Various emerging initiatives in Europe are seeking to develop migrant‐centric ePHR responses. This paper highlights their (...) importance and benefits, but also identifies a number of significant ethical, legal and social issues (ELSI) and challenges to their design and implementation, regarding (1) the kind of information that should be stored, (2) who should have access to information, and (3) potential misuse of information. These challenges need to be urgently addressed to make possible the beneficial use of ePHRs for vulnerable migrants in Europe. (shrink)

The development of electronic personal health records by independent vendors and national health systems is understood to empower patients and create a new kind of consumerism in healthcare. With more personal health information at hand, active participation in the management of health and rational purchasing of healthcare services will be possible. Healthcare systems will also be able to contain costs and achieve sustainability. Based on a careful examination of the literature, we argue that many of the declared benefits of this (...) technology are rather unattainable. As the boundaries between the public and private healthcare sectors become blurred and as employers struggle to reduce health insurance expenses, this proclaimed ‘consumer empowerment in healthcare’ is an attempt to introduce a technology and a business model for centralising all relevant PHI to render them economic. We reflect on the consequences for the ‘empowered’ user and we suggest that this new market device has to separate and individually address sufficiently issues of privacy, confidentiality and security before it can claim a place in the digital healthcare ecosystem. (shrink)

During the Nazi regime (1933–1945), more than 300 000 psychiatric patients were killed. The well‐calculated killing of chronic mentally ‘ill’ patients was part of a huge biopolitical program of well‐established scientific, eugenic standards of the time. Among the medical personnel implicated in these assassinations were nurses, who carried out this program through their everyday practice. However, newer research raises suspicions that psychiatric patients were being assassinated before and after the Nazi regime, which, I hypothesize, implies that the motives for these (...) killings must be investigated within psychiatric practice itself. An investigation of the impact of the interplay between the notes left by nurses and those by psychiatrists illustrates the active role of the psychiatric medical record in the killing of these patients. Using theoretical insights from Michel Foucault and philosopher Giorgio Agamben and analyzing one part of a particularly rich patient file found in the Langenhorn Psychiatric Asylum in the city of Hamburg, I demonstrate the role of the record in both constructing and deconstructing patient subjectivities. De‐subjectifying patients condemned them to specific zones in the asylum within which they were reduced to their ‘bare life’‐ a precondition for their physical assassination. (shrink)

In consciousness studies, the first-person perspective, seen as a way to approach consciousness, is often seen as nothing but a variant of the third-person perspective. One of the most important advocates of this view is Dennett. However, as I show in critical interaction with Dennett’s view, the first-person perspective and the third-person perspective are different ways of asking questions about themes. What these questions are is determined by the purposes that we have when we ask them. Since our purposes are (...) different according to the perspective we take, each perspective has a set of leading questions of its own. This makes that the first-person perspective is an approach of consciousness that is substantially different from the third-person perspective, and that one cannot be reduced to the other. These perspectives are independent, although complementary approaches of the mind. (shrink)

Personal review record, as a form of personally identifiable information, refers to the past review information of a reviewer. The disclosure of reviewers’ personal information on electronic commerce websites has been found to substantially impact consumers’ perception regarding the credibility of online reviews. However, personal review record has received little attention in prior research. The current study investigated whether the disclosure of personal review record influenced consumers’ information processing and decision making by adopting event-related potentials measures, as ERPs allow for (...) a nuanced examination of the neural mechanisms that underlie cognitive processes. At the behavioral level, we found that the purchase rate was higher and that the reaction time was shorter when the review record was disclosed, indicating that the disclosed condition was more favorable to the participants. Moreover, ERPs data showed that the disclosed condition induced an attenuated N400 component and an increased LPP component relative to the undisclosed condition, suggesting that the former condition gave rise to less cognitive and emotional conflict and to more positive evaluations. Thus, by elucidating potential cognitive and neural underpinnings, this study demonstrates the positive impact of reviewers’ disclosure of personal review record on consumers’ purchase decisions. (shrink)

Introduction Understanding the views of the public is essential if generally acceptable policies are to be devised that balance research access to general practice patient records with protection of patients' privacy. However, few large studies have been conducted about public attitudes to research access to personal health information. Methods A mixed methods study was performed. Informed by focus groups and literature review, a questionnaire was designed which assessed attitudes to research access to personal health information and factors that influence these. (...) A postal survey was conducted of an electoral roll-based sample of the adult population of Ireland. Results Completed questionnaires were returned by 1575 (40.6%). Among the respondents, 67.5% were unwilling to allow GPs to decide when researchers could access identifiable personal health information. However, 89.5% said they would agree to ongoing consent arrangements, allowing the sharing by GPs of anonymous personal health information with researchers without the need for consent on a study-by-study basis. Increasing age (by each 10-year increment), being retired and primary level education only were significantly associated with an increased likelihood of agreeing that any personal health information could be shared on an ongoing basis: OR 1.39 (95% CI 1.18 to 1.63), 2.00 (95% CI 1.22 to 3.29) and 3.91 (95% CI 1.95 to 7.85), respectively. Conclusions Although survey data can be prone to response biases, this study suggests that prior consent agreements allowing the supply by GPs of anonymous personal health information to researchers may be widely supported, and that populations willing to opt in to such arrangements may be sufficiently representative to facilitate valid and robust consent-dependent observational research. (shrink)

Ibn Djuljul from Andalusia who wrote in the Western Islamic World and Nadīm from Baghdād who wrote in the Eastern Islamic World, give information about lots of physicians and translators in their books that contributed significantly to history of science. Both authors write their books at same time or very close time. Sometimes they offer similar information, but sometimes they provide different information. -/- One of the physicians whom Ibn Djuljul mentioned in his book, Māsarjawayh lived at the times of (...) Umayyads. Nadīm gives information about Māsarjīs who lived at the times of Abbāsids. However, in the course of centuries, some authors combined the knowledge about these two people by giving reference to Ibn Djuljul’s and Nadīm’s work and represented as the same person. Accordingly, most of the modern scholars mentioned the two authors as a substitute. -/- This paper wants to keep track of this confusion and wants to clarify whether Māsarjawayh who was mentioned by Ibn Djuljul and Māsarjīs who was told by Nadīm are the same person or not. (shrink)

Here is an account of the enlightenment experience and its consequences written by a trained philosopher and mathematician who is also a master of English prose.

The term “Electronic Health Records” means something different to each of the stakeholders in health care, but it always seems to carry a degree of emotional baggage. Increasingly, EHRs are advertized as a nearly unmitigated good that will transform medical care, improve safety and efficiency, allow better patient engagement, and open the door to an era of cheap, effective, timely, and patient-centered care. Indeed, for some EHR proponents the benefits of adopting them are so obvious that adoption has become an (...) end in itself. But for others — and especially for a number of skeptical practitioners and patients — EHR is a code word that portends the corporate transformation of health care delivery, the loss of patient privacy, the demand that patients bear more responsibility in health care, and the unreflective takeover of the health care system by people who do not understand medical care or how health care relationships unfold. (shrink)

Although recent years have seen an increase in professional learning communities, use of video and lesson study groups, most teachers still work and learn in isolation. What they know is personal and remains private; little opportunity exists for most teachers to develop shared knowledge or language. The scale of the teaching force, and the rapid turnover of new teachers, makes this lack of shared knowledge an acute problem. This paper explores the potential of records of practice for developing collective professional (...) knowledge about teaching and learning. We define and illustrate what we mean by records of practice and elaborate the meaning of the term collective professional knowledge. Three concrete examples of records of practice, originating in different contexts and times, are presented and their special features are analyzed and discussed. The paper clarifies that records are not in themselves professional knowledge, but constitute a valuable and unique resource for the study of practice and the generation of knowledge originating in and useful for practice. To illustrate varied approaches for studying practice, possible uses of records of practice for the generation of collective professional knowledge are described and analyzed. The paper concludes with questions about records of practice and their uses. (shrink)

Personalist thought offers fundamental perspectives which are able to shape the broader fields of philosophy, theology, and related areas of study. Familiarity with the scope of its recent developments is valuable not only for personalist scholars but also for those interested in non-materialist thought and especially the problems and questions of the person in various aspects. This work, bringing together papers from a 2019 conference, aims to serve these readerships. It will also provide an archival record of the state of (...) the field at this point in Western intellectual history. In terms of content, the work addresses four general themes: personalist thought as it is encountered in the writings of particular scholars; the place of personalism within broader philosophical thought; personalist engagement with major religious traditions; and the application of personalist modes of thinking to a range of real-world questions. The book is unique in that it brings together multiple strands of personalist thought, demonstrating its breadth and depth and its ability to engage in wider contemporary philosophical and cultural debates. (shrink)

Drug abuse has been and continues to be, a common social issue worldwide, yet the efficiency of widely adopted sweeping speech for anti-drug campaigns has proven inefficient. To provide students with a safe and efficient learning situation related to drug refusal skills, we used a novel approach rooted in a serious learning game and concept map during a brief extracurricular period to help students understand drugs and their negative effects. The proposed game-based situational learning system allowed all students to participate (...) simultaneously and individually in multiple scenarios of drug temptation posed by peers and classmates to practice responding and refusing drugs in school and community settings. Moreover, to explore whether different personality traits result in different anti-drug responses, we used a serious game to conduct an anti-drug experiment on 53 junior middle school students aged 13–15. Each participant’s decision-making process was recorded in the serious game as behavioral patterns for lag sequential analysis. The outcomes revealed seven behavioral patterns including differentiation, acceptance, effective and ineffective responses, effective and ineffective solution-seeking, and failure to refuse. The GSEQ which is a computer program for analyzing sequential observational data was used. The results indicated the following: Neuroticism was performed at a relatively low level under the guidance of a concept map. “Neuroticism” was associated with the lowest risk of accepting drugs. Students with “openness to experiences” were at high risk of accepting drugs. Almost all personality behavioral transition diagrams showed that failure to refuse drugs was followed by inefficient seeking of help and inefficient refusal. These findings provide reference points for designing adaptive anti-drug education programs. (shrink)

Musicians generally believe that memory differs from one person to the next. As a result, memorizing strategies that could be useful to almost everyone are not widely taught. We describe how an 18-years old piano student (Grade 7, ABRSM), learned to memorize by recording her thoughts, a technique inspired by studies of how experienced soloists memorize. The student, who had previously ignored suggestions that she play from memory, decided to learn to memorize, selecting Schumann’s “Der Dichter Spricht” for this purpose. (...) Rather than explicitly teaching the student how to memorize, the teacher taught her to record her thoughts while playing by marking them on copies of the score, adapting an approach used previously in research with experienced performers. Over a 6½ week period, the student recorded her thoughts during practice (five times) and while performing from memory for the teacher (three times). The student also video-recorded 3 weeks of practice, three performances, and the reconstruction of the piece from memory after a 9½-weeks break. The thoughts that the student reported were prepared during practice, stable over time, and functioned as memory retrieval cues during reconstruction. This suggests that the student memorized in the same way as the more experienced musicians who have been studied previously and that teaching student musicians to record their thoughts may be an effective way to help them memorize. The speed and durability of her memorization surprised the student, inspiring her to perform in public and to use the same technique for new pieces. (shrink)

This essay examines some ethical aspects of stalkingincidents in cyberspace. Particular attention is focused on the Amy Boyer/Liam Youens case of cyberstalking, which has raised a number of controversial ethical questions. We limit our analysis to three issues involving this particular case. First, we suggest that the privacy of stalking victims is threatened because of the unrestricted access to on-linepersonal information, including on-line public records, currently available to stalkers. Second, we consider issues involving moral responsibility and legal liability for Internet (...) service providers (ISPs) when stalking crimesoccur in their `space' on the Internet. Finally, we examine issues of moral responsibility for ordinary Internet users to determine whether they are obligated to inform persons whom they discover to be the targets of cyberstalkers. (shrink)

The unsustainable growth in U.S. health care costs is in large part attributable to the rising costs of pharmaceuticals and medical devices and to unnecessary medical procedures. This fact has led health reform advocates and policymakers to place considerable hope in the idea that increased government support for research on the comparative effectiveness of medical treatments will eventually help to reduce health care expenses by informing patients, health care providers, and payers about which treatments for common conditions are effective and (...) which are not. Comparative effectiveness research has shown in some cases that expensive but commonly used treatments are significantly less effective than relatively inexpensive alternatives. Critics warn, however, that CER will homogenize patient care, limit patient choices, and lead to improper health care rationing and even to the denial of lifesaving treatments. (shrink)

BackgroundThe current paper follows up on the results of an exploratory quantitative analysis that compared the publication and citation records of men and women researchers affiliated with the Faculty of Computing and Engineering at Dublin City University in Ireland. Quantitative analysis of publications between 2013 and 2018 showed that women researchers had fewer publications, received fewer citations per person, and participated less often in international collaborations. Given the significance of publications for pursuing an academic career, we used qualitative methods to (...) understand these differences and explore factors that, according to women researchers, have contributed to this disparity.MethodsSixteen women researchers from DCU’s Faculty of Computing and Engineering were interviewed using a semi-structured questionnaire. Once interviews were transcribed and anonymised, they were coded by both authors in two rounds using an inductive approach.ResultsInterviewed women believed that their opportunities for research engagement and research funding, collaborations, publications and promotions are negatively impacted by gender roles, implicit gender biases, their own high professional standards, family responsibilities, nationality and negative perceptions of their expertise and accomplishments.ConclusionsOur study has found that women in DCU’s Faculty of Computing and Engineering face challenges that, according to those interviewed, negatively affect their engagement in various research activities, and, therefore, have contributed to their lower publication record. We suggest that while affirmative programmes aiming to correct disparities are necessary, they are more likely to improve organisational culture if they are implemented in parallel with bottom-up initiatives that engage all parties, including men researchers and non-academic partners, to inform and sensitise them about the significance of gender equity. (shrink)

The question addressed here is whether evidence concerning defendants' past criminal records should be introduced at their trials because such evidence reveals their character and thus reveals whether they are the kinds of persons likely to have committed the crimes with which they are currently charged. I strongly caution against the introduction of such evidence for a number of reasons. First, the link between defendants' past criminal records and claims about their standing dispositions to think and act is tenuous, at (...) best. Second, noncharacter, or trace, evidence should have primacy in determining the guilt or innocence of defendants. Third, character evidence will vary in its freshness and specificity. Other things being equal, only relatively fresh and specific character evidence has probative value. Moreover, such evidence will have greater probative value in criminal cases where the issue before the court is whether a crime has been committed than in cases where the issue is whether it was the defendant who committed the crime. Finally, we might be more sanguine about the introduction of fresh and specific character evidence under conditions likely to work against its misuse or misinterpretation. However, the relevant conditions may not often be satisfied in the real world of criminal trials and defendants. (shrink)

Confidentiality of health information is increasingly relevant in the era of electronic medical records. We discuss the case of a hospitalized patient who requested a neurology consultation for an episode he described as an “LSD-like” (Lysergic acid diethylamide) flashback. The patient expressed concern that the episode was a residual effect of past drug use, but subsequently requested that his drug use not be documented. Involved in a custody battle, he feared that if his records were released to the court he (...) could lose custody of his children. Ethical concerns arose with regards to the physician’s competing obligations with a duty to record information accurately and honestly, respect patient autonomy, and maintain patient confidentiality. We discuss the decision of the team to document the patient’s drug use by arguing that the obligation to maintain confidentiality did not supersede the primary role of the medical record as a complete and accurate account, which cannot be altered at a patient’s behest. (shrink)

Personal medical information is now bought and sold on the open market. Companies use it to make hiring and firing decisions and to identify customers for new products. The justification for providing such access to medical information is that doing so benefits the public by securing public safety, controlling costs, and supporting medical research. And individuals have supposedly consented to it. But we can achieve the common goods while better protecting privacy by making institutional changes in the way information is (...) maintained and protected. (shrink)

A DIALOGUE on PERSONAL IDENTITY and IMMORTALITY This is a record of conversations of Gretchen We/rob, a teacher of philosophy at a small mid- western ...

Personal Health Monitoring (PHM) uses electronic devices which monitor and record health-related data outside a hospital, usually within the home. This paper examines the ethical issues raised by PHM. Eight themes describing the ethical implications of PHM are identified through a review of 68 academic articles concerning PHM. The identified themes include privacy, autonomy, obtrusiveness and visibility, stigma and identity, medicalisation, social isolation, delivery of care, and safety and technological need. The issues around each of these are discussed. The system (...) / lifeworld perspective of Habermas is applied to develop an understanding of the role of PHMs as mediators of communication between the institutional and the domestic environment. Furthermore, links are established between the ethical issues to demonstrate that the ethics of PHM involves a complex network of ethical interactions. The paper extends the discussion of the critical effect PHMs have on the patient’s identity and concludes that a holistic understanding of the ethical issues surrounding PHMs will help both researchers and practitioners in developing effective PHM implementations. (shrink)

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues (...) to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies. (shrink)

Increasingly, medical records are being stored in computer databases that allow for efficiencies in providing treatment and in the processing of clinical and financial services. Computerization of medical records has also diminished patient privacy and, in particular, has increased the potential for misuse, especially in the form of nonconsensual secondary use of personally identifiable records. Organizations that store and use medical records have had to establish security measures, prompted partially by an inconsistent patchwork of legal standards that vary from state (...) to state. There is widespread appreciation among policy makers regarding the need for legal reform. The Health Information and Portability Accountability Act of 1996 mandated that the Administration develop regulations regarding the control of medical records. The Administration has offered regulations from the Department of Health and Human Services. Survey data reveal what healthcare professionals who have access to sensitive medical records believe are the greatest threats to patients' privacy. The overlap between Administration proposals and the responses of healthcare professionals is striking. (shrink)

Some philosophers think that forgiveness should only be granted in response to the wrongdoer’s repentance, while others think that forgiveness can properly be given unconditionally. In this paper I show that both of these positions are partially correct. In redemptive forgiveness we wipe the wrong from the offender’s moral record. It is wrong to forgive redemptively in the absence of some atonement. Personal forgiveness, on the other hand, is granted when the victim overcomes inappropriate though humanly understandable feelings of hate (...) or vindictive anger towards the wrongdoer and comes to see them as deserving of a certain unconditional respect ’qua’ moral agent. Personal forgiveness is unconditionally admirable. (shrink)

While recently reading the 1914-1919 Congressional Record debates over woman suffrage, I was struck by the familiarity of the content. The concerns of the early 1900s mirror those of the early 2000s: concentration of wealth within a tiny percentage of the population, equal pay across sex and race lines, the risk of U.S. entanglement in foreign wars, food safety, workers' rights, potable water, taxation, and so on. I also was struck by the familiarity of the debate's form. Much like the (...) rebuttal speeches I was trained to deliver as an intercollegiate debater, the pro-suffrage speeches contain systematic, comprehensive, and specific refutation of anti-suffrage arguments.Yet, it took decades of activism outside of... (shrink)

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

How do we refer to people in everyday conversation? No matter the language or culture, we must choose from a range of options: full name ('Robert Smith'), reduced name ('Bob'), description ('tall guy'), kin term ('my son') etc. Our choices reflect how we know that person in context, and allow us to take a particular perspective on them. This book brings together a team of leading linguists, sociologists and anthropologists to show that there is more to person reference than meets (...) the eye. Drawing on video-recorded, everyday interactions in nine languages, it examines the fascinating ways in which we exploit person reference for social and cultural purposes, and reveals the underlying principles of person reference across cultures from the Americas to Asia to the South Pacific. Combining rich ethnographic detail with cross-linguistic generalizations, it will be welcomed by researchers and graduate students interested in the relationship between language and culture. (shrink)

In the present study we asked whether it is possible to decode personality traits from resting state EEG data. EEG was recorded from a large sample of subjects (n=289) who had answered questionnaires measuring personality trait scores of the 5 dimensions as well as the 10 subordinate aspects of the Big Five. Machine learning algorithms were used to build a classifier to predict each personality trait from power spectra of the resting state EEG data. The results indicate that the (...) five dimensions as well as their subordinate aspects could not be predicted from the resting state EEG data. Finally, to demonstrate that this result is not due to systematic algorithmic or implementation mistakes the same methods were used to successfully classify whether the subject had eyes open or closed. These results indicate that the extraction of personality traits from the power spectra of resting state EEG is extremely noisy, if possible at all. (shrink)

In this paper, I present an overview of personal and intimate technologies within a pedagogical context. I describe two courses that I have developed for Computation Arts at Concordia University: “Tangible Media and Physical Computing” and “Second Skin and Soft Wear.” Each course deals with different aspects of physical computing and tangible media in a Fine Arts context. In both courses, I introduce concepts of soft computation and intimate reactive artifacts as artworks. I emphasize the concept of memory (contrasting computer (...) memory and personal, interpretive memory), and explore how responsive or interactive objects can create a new medium for annotating architectural space and objects, for leaving traces of presence, and for recording personal histories. At the core of this pedagogical practice is a strong emphasis on engaging a vulnerable, personal approach to working with electronics and physical computation. To contextualize the teaching practice, I begin by presenting some of my own research projects developed at Extra Soft Labs (also known as XS Labs), then segue into a detailed discussion of these two classes, and conclude with a discussion of some student work. (shrink)

Persons with Parkinson’s disease are advised to use compensatory strategies such as external cues or cognitive movement strategies to overcome gait disturbances. It is suggested that external cues involve the processing of sensory stimulation, while cognitive-movement strategies use attention allocation. This study aimed to compare over time changes in attention allocation in PwP between prolonged walking with cognitive movement strategy and external cues; to compare the effect of cognitive movement strategies and external cues on gait parameters; and evaluate whether these (...) changes depend on cognitive function. Eleven PwP participated in a single-group pilot study. Participants walked for 10 min under each of three conditions: natural walking, using external cuing, using a cognitive movement strategy. Attention and gait variables were extracted from a single-channel electroencephalogram and accelerometers recordings, respectively. Attention allocation was assessed by the% of Brain Engagement Index signals within an attentive engagement range. Cognitive function was assessed using a neuropsychological battery. The walk was divided into 2-min time segments, and the results from each 2-min segment were used to determine the effects of time and condition. Associations between cognitive function and BEI signals were tested. Findings show that in the cognitive movement strategy condition, there was a reduction in the % of BEI signals within the attentive engagement range after the first 2 min of walking. Despite this reduction the BEI did not consistently differ from natural and metronome walking. Spatiotemporal gait variables were better in the cognitive movement strategy condition relative to the other conditions. Global cognitive and information processing scores were significantly associated with the BEI only when the cognitive movement strategy was applied. In conclusion, the study shows that a cognitive movement strategy has positive effects on gait variables but may impose a higher attentional load. Furthermore, when walking using a cognitive movement strategy, persons with higher cognitive function showed elevated attentive engagement. The findings support the idea that cognitive and attentional resources are required for cognitive movement strategies in PwP. Additionally, this study provides support for using single-channel EEG to explore mechanistic aspects of clinical interventions. (shrink)

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In (...) this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing. (shrink)

Background: Personal genomic testing (PGT) offers individuals genetic information about relationships, wellness, sporting ability, and health. PGT is increasingly accessible online, including in emerging markets such as Australia. Little is known about what consumers expect from these tests and whether their reflections on testing resonate with bioethics concepts such as autonomy. Methods: We report findings from focus groups and semi-structured interviews that explored attitudes to and experiences of PGT. Focus group participants had little experience with PGT, while interview participants had (...) undergone testing. Recordings were transcribed and analyzed using thematic analysis. Findings were critically interpreted with reference to bioethics scholarship on autonomy. Results: Fifty-six members of the public participated in seven focus groups, and 40 individuals were interviewed separately. Both groups valued the choice of PGT, and believed that it could motivate relevant actions. Focus group themes centered on the perceived value of choices, knowledge enabling action and knowledge about the self. Interview themes suggest that participants reflexively engage with their PGT information to make meaning, and that some appreciate its shortcomings. Critical interpretation of findings shows that while consumers of PGT are able to exercise a degree of autonomy in choosing, they may not be able to achieve a substantive conceptualization of autonomy, one that promotes alignment with higher-order desires. Conclusions: PGT consumers can critically reason about testing. However, they may uncritically accept test results, may not appreciate drawbacks of increased choice, or may overestimate the potential for information to motivate behavioral change. While consumers appear to be capable of substantive autonomy, they do so without ongoing support from companies. PGT companies promote a problematic (“default”) account of autonomy, reliant on empowerment rhetoric. This leaves consumers vulnerable to making decisions inconsistent with their higher-order desires. As PGT expands, claims about its power and value need to be carefully drawn. (shrink)

BackgroundConsenting for retrospective medical records-based research (MR) and leftover tissue-based research (TR) continues to be controversial. Our objective was to survey Saudis attending outpatient clinics at a tertiary care hospital on their personal preference and perceptions of norm and current practice in relation to consenting for MR and TR.MethodsWe surveyed 528 Saudis attending clinics at a tertiary care hospital in Saudi Arabia to explore their preferences and perceptions of norm and current practice. The respondents selected one of 7 options from (...) each of 6 questionnaires.ResultsRespondents' mean (SD) age was 33 (11) years, 42% were males, 56% were patients, 84% had ≥ secondary school education, and 10% had previously volunteered for research. Respectively, 40% and 49% perceived that the norm is to conduct MR and TR without consent and 38% and 37% with general or proposal-specific consent; the rest objected to such research. There was significant difference in the distribution of choices according to health status (patients vs. companions) for MR (adjusted Kruskal-Wallis test P = 0.03) but not to age group, gender, education level, or previous participation in research (unadjusted P = 0.02 - 0.59). The distributions of perceptions of current practice and norm were similar (unadjusted Marginal Homogeneity test P = 0.44 for MR and P = 0.89 for TR), whereas the distributions of preferences and perceptions of norm were different (adjusted P = 0.09 for MR and P = 0.02 for TR). The distributions of perceptions of norm, preferences, and perceptions of current practice for MR were significantly different from those of TR (adjusted P < 0.009 for all).ConclusionsWe conclude that: 1) there is a considerable diversity among Saudi views regarding consenting for retrospective research which may be related to health status, 2) the distribution of perceptions of norm was similar to the distribution of perceptions of current practice but different from that of preferences, and 3) MR and TR are perceived differently in regard to consenting. (shrink)

BackgroundHealth data holds great potential for improved treatments. Big data research and machine learning models have been shown to hold great promise for improved diagnostics and treatment planning. The potential is tied, however, to the availability of personal health data. In recent years, it has been argued that data from health records should be available for health research, and that individuals have a duty to make the data available for such research. A central point of debate is whether such secondary (...) use of health data requires informed consent.Main bodyIn response to recent writings this paper argues that a requirement of informed consent for health record research must be upheld. It does so by exploring different contrasting notions of the duty of easy rescue and arguing that none of them entail aperfectduty to participate in health record research. In part because the costs of participation cannot be limited to 1) the threat of privacy breaches, but includes 2) the risk of reduced trust and 3) suboptimal treatment, 4) stigmatization and 5) medicalisation, 6) further stratification of solidarity and 7) increased inequality in access to treatment and medicine. And finally, it defends the requirement of informed consent by arguing that the mere possibility of consent bias provides a rather weak reason for making research participation mandatory, and that there are strong, independent reasons for making.ConclusionArguments from the duty of easy rescue in combination with claims about little risk of harm and potential consent bias fail to establish not only aperfectduty to participate in health record research, but also that participation in such research should be mandatory. On the contrary, an analysis of these arguments indicates that the duty to participate in research is most adequately construed as animperfectduty, and reveals a number of strong reasons for insisting that participation in health records research is based on informed consent. (shrink)

It has been debated whether the so-called attention economy, in which the attention of agents is measured and sold, jeopardizes something of value. One strand of this discussion has focused on so-called attention rights, asking: should attention be legally protected, either by introducing novel rights or by extending the scope of pre-existing rights? In this paper, however, in order to further this discussion, we ask: How is attention already protected legally? In what situations does a person have the right to (...) attention under current law? -/- Unlike (Chomanski, Neuroethics 16:1–11, 2023), who discusses an overall right to attention, or (Puri, Rutgers Law Record 48:206–221, 2021), who discusses an overall right to attentional privacy, in this paper we focus on two types of situations in which a person’s attention is already protected by legal regulation. Sustained attention-requiring tasks can be jeopardized by distractions whereas attentiveness to certain kind of stimuli can be jeopardized by immersive stimuli. That is why distractions are regulated in situations where an agent has what we call a concentration right and immersive stimuli are regulated in situations where an agent has what we call a duty to be attentive. The further analysis of these situations provides an understanding of the legal means by which attention is already regulated, which can be helpful when thinking about how it should be regulated in the future. (shrink)

In this article, we tried to reveal the relationship between personality traits and escape behavior in traffic accidents. Different from common computer simulations, this study, for the first time, established a real database recording the escape behavior and personality traits of subjects when watching a first-person-view driving video with explosion. Then, we used a modeling method of general linear to establish a quantitative model of the influence of personality traits, explosion, and their interaction on escape behavior. In the model, we (...) introduced escape response time, escape time, escape direction, escape speed, escape trajectory, and other motion characteristics to study individual escape behavior in accidents. Through the analysis, we concluded several conclusions, including that high neurotic individuals tend to escape with shorter response time and slower speed by choosing doors far from the explosion source. These conclusions may provide some references for the effective escape of the crowd and the successful escape of the individual under traffic accidents. (shrink)

Virtual reality constitutes an alternative, effective, and increasingly utilized treatment option for people suffering from psychiatric and neurological illnesses. However, the currently available VR simulations provide a predetermined simulative framework that does not take into account the unique personality traits of each individual; this could result in inaccurate, extreme, or unpredictable responses driven by patients who may be overly exposed and in an abrupt manner to the predetermined stimuli, or result in indifferent, almost non-existing, reactions when the stimuli do not (...) affect the patients adequately and thus stronger stimuli are recommended. In this study, we present a VR system that can recognize the individual differences and readjust the VR scenarios during the simulation according to the treatment aims. To investigate and present this dynamically adaptive VR system we employ an Anxiety Disorder condition as a case study, namely arachnophobia. This system consists of distinct anxiety states, aiming to dynamically modify the VR environment in such a way that it can keep the individual within a controlled, and appropriate for the therapy needs, anxiety state, which will be called “desired states” for the study. This happens by adjusting the VR stimulus, in real-time, according to the electrophysiological responses of each individual. These electrophysiological responses are collected by an external electrodermal activity biosensor that serves as a tracker of physiological changes. Thirty-six diagnosed arachnophobic individuals participated in a one-session trial. Participants were divided into two groups, the Experimental Group which was exposed to the proposed real-time adaptive virtual simulation, and the Control Group which was exposed to a pre-recorded static virtual simulation as proposed in the literature. These results demonstrate the proposed system’s ability to continuously construct an updated and adapted virtual environment that keeps the users within the appropriately chosen state for approximately twice the time compared to the pre-recorded static virtual simulation. Thus, such a system can increase the efficiency of VR stimulations for the treatment of central nervous system dysfunctions, as it provides numerically more controlled sessions without unexpected variations. (shrink)

Personality signatures are sets of if-then rules describing how a given person would feel or act in a specific situation. These rules can be used as the major premise of a deductive argument, but they are mostly processed for social cognition purposes; and this common usage is likely to leak into the way they are processed in a deductive reasoning context. It is hypothesised that agreement with a Modus Ponens argument featuring a personality signature as its major premise is affected (...) by the reasoner's own propensity to display this personality signature. To test this prediction, Modus Ponens arguments were constructed from conditionally phrased items extracted from available personality scales. This allowed recording of (a) agreement with the conclusion of these arguments, and (b) the reasoner's propensity to display the personality signature, using as a proxy this reasoner's score on the personality scale without the items used in the argument. Three experiments ( N = 256, N = 318, N = 298) applied this procedure to Fairness, Responsive Joy, and Self-Control. These experiments yielded very comparable effects, establishing that a reasoner's propensity to display a given personality signature determines this reasoner's agreement with the conclusion of a Modus Ponens argument featuring the personality signature. (shrink)

A short definitive account of Keith Ward's theology, based on the philosophy of Personal Idealism. It records Ward's views about God, revelation, the kingdom of God, life after death, the incarnation, atonement, and Trinity. In summary, it is a concise and clear account of most central Christian doctrines, formed in the light of modern science and Idealist philosophy.

The structure, content, and orientation of the contemporary medical record inadequately reflect the appropriate influence of patients' rights and bioethics on health care. Most tellingly, the medical chart reveals a remarkable absence of attention to medical ethics, except in the case of crisis management. But medical ethics informs both crisis decision-making and virtually all clinical interventions. Indeed, clinical care embodies a complex array of choices influenced by individual and cultural values, themselves reflecting religious beliefs, personal histories, psychologies, and social mores. (...) But the typical medical chart, which records clinical descriptions, analyses, and rationales for treatment, rarely identifies or accounts for this value-laden dimension of care and thus both over-simplifies and distorts the depiction of a patient's illness and its treatment. To better reflect the complex moral domain of clinical care, and assist in organizing its complex structure, a systematic procedure is proposed here to evaluate the ethical status of every patient: As a routine part of the clinical evaluation, in a designated Ethical Concerns section of the medical record, an ?ethics work-uP? is designed to serve as a moral ?diagnostic? analogous to its scientific counterpart. Adapted to the needs of individual patients, such evaluations should identify ethical problems, coordinate related data, resources, and opinion, and define the rationale for choices made and actions pursued. In establishing improved integration of the ?epistemologies? of care and the ?ethics? of care, the goals of a more humane, patient-centered medicine may be better met. (shrink)

Hildegard of Bingen was one of the most remarkable women of her day. From early childhood she experienced religious visions, and at the age of eight she entered a cloistered religious life in the Benedictine monastery of Disibondenberg. Eventually she not only became abbess of the community, but presided over the establishment of an important new convent near Bingen. All but forgotten for hundreds of years, Hildegard was rediscovered in the 1980s and since then her visionary writings have been widely (...) read and studied. Even more surprisingly, music that she composed has been performed and recorded to great acclaim. She has come to be seen by some as a proto-feminist icon -- a woman of great accomplishments who made her own way in a man's world and exerted extraordinary influence over some of the most powerful figures of her time. Much of Hildegard's correspondence has been preserved. It reveals that for more than 30 years this cloistered nun was an unflinching adviser and correspondent to all levels of church and society, from popes and kings to ordinary lay persons, from Jerusalem to England. With the 2004 OUP publication of Volume III of Joseph Baird and Radd Ehrman's translation, the complete correspondence became available for the first time in English. For this new abridgement, Baird has selected 75 of the most interesting and revealing of the letters from Volumes I, II, and III. Freed from the organizational restraints of the Latin edition of the letters, he has arranged them in roughly chronological order and provided greatly expanded, accessibly written introductory notes that contextualize the letters and explain their significance. As a result, this fascinating collection serves as a kind of life in letters that makes an ideal introduction ot this exceptional woman, her world, and her work. This book is the first to give a thorough and definitive illlumination of the personal life of Hildegard of Bingen as viewed through the defining lens of her personal correspondence: her early, hesitant bid for recognition of her spiritual gifts; her courageous, and ultimately futile, fight to retain the companionship of her close personal friend and the poignant outcome of that struggle; her vehement defiance of the male hierarchy in her bid to establish her own communities under her personal governance; her impudent challenge to contemporary conservatives views by the dress and customs she established in her community; her paean of praise for the power of music; and her adamant refusal, even at the advanced age of eighty, to give in to the demands of the male authorities even in the face of excommunication. (shrink)

The American Recovery and Reinvestment Act of 2009 (ARRA) required healthcare providers in the United States to adopt and demonstrate meaningful use of electronic health records (EHRs) by January 1, 2014. In many ways, EHRs mark a notable improvement over paper medical records as they are more easily accessible and allow for electronic searching and sharing of medical history. However, as EHRs have become mandated by ARRA, many nurses now rely upon computers far more heavily during nurse–patient interactions, thereby decreasing (...) the level of direct interpersonal communication between the two. There is evidence that eye contact between nurses and patients positively affects patient satisfaction. Above and beyond the issue of patient satisfaction is the more basic ethical issue of respecting the patient as a person. The author argues that the templates used in electronic health systems have the possibility of eroding the respect for humanity that is the hallmark of nurse–patient relationships, as signalled by the American Nurses Association’s first principle in their Code of Ethics. Using concepts from philosophers Martin Heidegger and Emmanuel Levinas, the author provides guidance as to what an ethical interaction between nurse and patient should look like in an age of EHRs. (shrink)

When Taylor Swift's record label was sold in 2019, the six studio albums she recorded for them came under the control of a person with whom she has had years of bad blood: Kanye West's former manager Scooter Braun. But rather than move on, Swift chose to take the unprecedented step of re-recording duplicate versions of those albums. With all of the profits made from selling, streaming, and licensing these “Taylor's Versions” going directly to Swift, she could deprive Braun (...) of potentially hundreds of millions of dollars. The gambit has already paid off. The first two Taylor's Versions (of Fearless and Red) debuted at Number 1 on the Billboard charts and have sold over one million copies so far; and four more are still on the way. In this book, nine philosophers and one music producer explore the philosophical richness of Swift's project and the questions it raises: Are Swift's re-recordings new works of art or mere copies of the originals? Do the Taylor's Versions of the songs have the same meanings as the original versions, or do they now mean something different? Is her re-recording project genuinely artistic or merely commercial? Is Swift standing up for artists' rights or looking out for herself? Does the music industry exploit artists, and, if so, how should it be reformed? Together they show the philosophical dividends one of the most famous and acclaimed recording artists of her generation is capable of producing. For anyone interested in the complicated relationship between popular art and commerce this book is a must-read. (shrink)