Calls for the “translation” of research from bench to bedside are increasingly demanding. What is translation, and why does it matter? We sketch the recent history of outcome-oriented translational research in the United States, with a particular focus on the Roadmap Initiative of the National Institutes of Health (Bethesda, MD). Our main example of contemporary translational research is stem cell research, which has superseded genomics as the translational object of choice. We explore the nature of and obstacles to translational research (...) and assess the ethical and biomedical challenges of embracing a translational ethos. (shrink)

Calls for the “translation” of research from bench to bedside are increasingly demanding. What is translation, and why does it matter? We sketch the recent history of outcome-oriented translational research in the United States, with a particular focus on the Roadmap Initiative of the National Institutes of Health. Our main example of contemporary translational research is stem cell research, which has superseded genomics as the translational object of choice. We explore the nature of and obstacles to translational research and assess (...) the ethical and biomedical challenges of embracing a translational ethos. (shrink)

Giorgio Agamben is accused of political passivity, but this article argues that he sees the potential for resistance in modes of being inactive and unproductive, in study, play and profanity, which alone can escape the binary oppositions through which modern power operates, most notably the attempt to separate useful from useless life. He finds the resources for this model in very diverse locations, including the poetry of the troubadours, medieval thought about angels and medieval monastic movements. Agamben argues that such (...) texts retain philosophical potential which is revealed precisely by modern crises of subjectivity, economy and community. Agamben’s The End of the Poem is read here as containing early elements of a mode of resistance that informs the new paradigms for human life and practice developed in his The Kingdom and the Glory and The Highest Poverty, where the revolutionary potential of past cultures emerges fully. (shrink)

What is it like to live with the label “Disability?” NIB editorial staff and narrative symposium editors, Jeffery Bishop and Naomi Sunderland developed a call for stories, which was sent to several list serves, shared with the 1000 Voices Project community and posted on Narrative Inquiry in Bioethics ’ website. The request for personal stories from people who identify with the label “disabled” asked them to: consider how the label “disability” interacts with other aspects of their life in health (...) care settings; does the term “disability” reflect their actual embodied experiences of impairment or does it fail to do justice to their particular experience of impairment; describe the kind of experiences that are possible because of the impairment(s); discuss how the label has affected their “authentic voice”; and many other concepts about what effects the label has on their lives. These authors share deeply personal experiences that will help readers understand their world, challenges, and joys. Thirteen stories are found in the print version of the journal and an additional five supplemental stories are published online only through Project MUSE. The stories are complemented by four commentary articles by Elizabeth R. Schiltz; Lorna Hallahan; Nicole Matthews, Kathleen Ellem, and Lesley Chenoweth; and Jeffery Bishop, Rachelle Barina, and Devan Stahl. These scholars come from the disciplines of law, social work, media studies, medicine, and bioethics from Australia and the United States. Together, the symposium’s storytellers and commentators offer striking and informative insights into the everydayness of living with disabilities. (shrink)

One of the core problems with engineering ethics education is perceptual. Although ethics is meant to be a central component of today’s engineering curriculum, it is often perceived as a marginal requirement that must be fulfilled. In addition, there is a mismatch between faculty and student perceptions of ethics. While faculty aim to communicate the nuances and complexity of engineering ethics, students perceive ethics as laws, rules, and codes that must be memorized. This paper provides some historical context to better (...) understand these perceptual differences, and suggests that curriculum constraints are important contributing factors. Drawing on the growing scholarship of student engagement approaches to pedagogy, the paper explores how students can be empowered to effect change in the broader engineering curriculum through engineering ethics. The paper describes a student engagement approach to pedagogy that includes students as active participants in curriculum design—a role that enables them to critically reflect about why ethics is a requirement. Including students in the process of curriculum design leads students to reframe ethics as an integrative tool with the capacity to bring together different engineering departments and build bridges to non-engineering fields. This paper argues that students can and should play an active and important role in relocating ethics from the periphery to the core of the engineering curriculum. (shrink)

Throughout the twentieth century calls to modernize natural history motivated a range of responses. It was unclear how research in natural history museums would participate in the significant technological and conceptual changes that were occurring in the life sciences. By the 1960s, the Museum of Vertebrate Zoology at the University of California, Berkeley, was among the few university-based natural history museums that were able to maintain their specimen collections and support active research. The MVZ therefore provides a window to the (...) modernization of natural history. This paper concentrates on the directorial transitions that occurred at the MVZ between 1965 and 1971. During this period, the MVZ had four directors: Alden H. Miller (Director 1940–1965), an ornithologist; Aldo Starker Leopold (Acting Director 1965–1966), a conservationist and wildlife biologist; Oliver P. Pearson (Director 1966–1971), a physiologist and mammalogist; and David B. Wake (Director 1971–1998), a morphologist, developmental biologist, and herpetologist. The paper explores how a diversity of overlapping modernization strategies, including hiring new faculty, building infrastructure to study live animals, establishing new kinds of collections, and building modern laboratories combined to maintain collections at the MVZ’s core. The paper examines the tensions between the different modernization strategies to inform an analysis of how and why some changes were institutionalized while others were short-lived. By exploring the modernization of collections-based research, this paper emphasizes the importance of collections in the transformation of the life sciences. (shrink)

Early in his career Thomas Hunt Morgan was interested in embryology and dedicated his research to studying organisms that could regenerate. Widely regarded as a regeneration expert, Morgan was invited to deliver a series of lectures on the topic that he developed into a book, Regeneration. In addition to presenting experimental work that he had conducted and supervised, Morgan also synthesized and critiqued a great deal of work by his peers and predecessors. This essay probes into the history of regeneration (...) studies by looking in depth at Regeneration and evaluating Morgan’s contribution. Although famous for his work with fruit fly genetics, studying Regeneration illuminates Morgan’s earlier scientific approach which emphasized the importance of studying a diversity of organisms. Surveying a broad range of regenerative phenomena allowed Morgan to institute a standard scientific terminology that continues to inform regeneration studies today. Most importantly, Morgan argued that regeneration was a fundamental aspect of the growth process and therefore should be accounted for within developmental theory. Establishing important similarities between regeneration and development allowed Morgan to make the case that regeneration could act as a model of development. The nature of the relationship between embryogenesis and regeneration remains an active area of research. (shrink)

It is widely accepted that translational research practitioners need to acquire special skills and knowledge that will enable them to anticipate, analyze, and manage a range of ethical issues. While there is a small but growing literature that addresses the ethics of translational research, there is a dearth of scholarship regarding how this might apply to engineers. In this paper we examine engineers as key translators and argue that they are well positioned to ask transformative ethical questions. Asking engineers to (...) both broaden and deepen their consideration of ethics in their work, however, requires a shift in the way ethics is often portrayed and perceived in science and engineering communities. Rather than interpreting ethics as a roadblock to the success of translational research, we suggest that engineers should be encouraged to ask questions about the socio-ethical dimensions of their work. This requires expanding the conceptual framework of engineering beyond its traditional focus on “how” and “what” questions to also include “why” and “who” questions to facilitate the gathering of normative, socially-situated information. Empowering engineers to ask “why” and “who” questions should spur the development of technologies and practices that contribute to improving health outcomes. (shrink)

Emotions are often portrayed as subjective judgments that pose a threat to rationality and morality, but there is a growing literature across many disciplines that emphasizes the centrality of emotion to moral reasoning. For engineers, however, being rational usually means sequestering emotions that might bias analyses—good reasoning is tied to quantitative data, math, and science. This paper brings a new pedagogical perspective that strengthens the case for incorporating emotions into engineering ethics. Building on the widely established success of active and (...) collaborative learning environments, in particular the problem-based learning (PBL) philosophy and methodology, the paper articulates new strategies for incorporating emotion into engineering ethics education. An ethics education pilot study is analyzed to explore how PBL can engage students’ emotions. Evidence suggests that PBL empowers students to cultivate value for engineering ethics and social responsibility, and in doing so, redefine the societal role of the engineer. Taking students’ emotions seriously in engineering ethics offers an effective strategy to meaningfully engage students in ethical learning. (shrink)

Despite the known positive effects of acute exercise on cognition, the effects of a competitive team sport match are unknown. In a randomized crossover design, 20 female and 17 male field hockey players completed a battery of cognitive tests prior to, at half-time, and immediately following a competitive match ; with effect sizes presented as raw ES from mixed effect models. Blood samples were collected prior to and following the match and control trial, and analyzed for adrenaline, noradrenaline, brain derived (...) neurotrophic factor, cathepsin B, and cortisol. The match improved response times for a simple perception task at full-time and response times on the complex executive function task improved at half-time. Working memory declined at full-time on the match. The change in working memory was negatively correlated with increases in cortisol, as was the change in simple perception response time and the change in noradrenaline concentration. This study is the first to highlight the effects a competitive hockey match can have on cognition. These findings have implications for performance optimization, as understanding the influence on specific cognitive domains across a match allows for the investigation into strategies to improve these aspects. (shrink)

Schistosomes are parasitic blood flukes, responsible for significant human disease in tropical and developing nations. Here we review information on the organization of the cytoskeleton and associated motor proteins of schistosomes, with particular reference to the organization of the syncytial tegument, a unique cellular adaptation of these and other neodermatan flatworms. Extensive EST databases show that the molecular constituents of the cytoskeleton and associated molecular systems are likely to be similar to those of other eukaryotes, although there are potentially some (...) molecules unique to schistosomes and platyhelminths. The biology of some components, particular those contributing to host–parasite interactions as well as chemotherapy and immunotherapy are discussed. Unresolved questions in relation to the structure and function of the tegument relate to dynamic organization of the syncytial layer. BioEssays 26:752–765, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

“ The Origins of Genome Architecture ” by Michael Lynch (2007) may not immediately sound like a book that someone interested in the philosophy of biology would grab off the shelf. But there are three important reasons why you should read this book. Firstly, if you want to understand biological evolution, you should have at least a passing familiarity with evolutionary change at the level of the genome. This is not to say that everyone interested in evolution should be a (...) geneticist or a bioinformatician, but that a working knowledge of genetic change is an essential part of the intellectual toolkit of modern evolutionary biology, even if your primary focus is the evolution of behaviour or the diversity of communities. Secondly, this book provides excellent examples of another important tool in the biologist’s intellectual toolkit, but one that is rarely explained or illustrated to such an extent: null (or neutral) models. The role null models play in testing hypotheses in evolution is a central focus of this book. Thirdly, as an accomplished work of advocacy for a strictly microevolutionary view of evolution, this book provides grist for the mill for the important debate about whether population genetic processes are the sine qua non of evolutionary explanations. (shrink)

Is Rabinowitz seriously suggesting that his “rules” of reading are equally applicable to the analysis of British and American forms of popular writing and their readerships between 1920 and the 1960s? Is he seriously suggesting that Gone with the Wind, for example, would be “read” in the same way and for the same meanings in the southern states, the northern states, in Yorkshire and London? In this particular case the issue of cultural reproduction is also crucial—the complex relations between the (...) book and film “texts” and readerships for both. Is the book now read “through” the film and the mythos of Hollywood? Can the novel’s “history” of the Civil War and the period of Reconstruction be seen in relation to experience of the Depression on the one hand and to dominant historical discourses of the period privileged within American educational institutions on the other?2Or, if we take a British example like A. J. Cronin, whose work was regarded as both “serious” and “popular” in the late 1930s, what happens to Rabinowitz’s distinction? Clearly, Cronin’s fiction is not “acceptable” in the literary canon but his example illustrates the weakness of any critical analysis of the popular rooted in “literary” assumptions. Very important questions are raised by the commercial success of The Citadel, not among “the people” in any generalized sense but among specific constituencies of professional, middle-class readerships in both New Deal American and in Britain during a period of history remarkable for the regrouping of the forces of social-democratic consensus politics—an alliance between “sympathetic” fractions of the professional middle class and “the people” which culminated eventually in the postwar Labour party election victory. Thus readers are not only readers, and the processes of reading—especially perhaps of popular fiction—are not reducible to abstract rules which exclude all considerations of cultural=political institutions and discourses. 2. This example is partly indebted to discussion with Greg Gaut and Jane P. Tompkins during a University of Minnesota Conference, “On the Social Edge” . Derek Longhurst is principal lecturer and course leader in communication studies at Sunderland Polytechnic and general editor of the forthcoming series Culture and Popular Fiction. His publications include chapters in Re-Reading English and An Introduction to Contemporary Cultural Studies. He is currently working on a book about the political thriller. (shrink)

Anderson (philosophy, U. of Sunderland, England) presents an exegetical, restorative, and critical account of French philosopher Ricoeur's early work on human will, seeing in it a dual-aspect perspective of people that helps make sense of his later complex writings. Emphasizes the important impact of Kant on his original thinking. (Editor's note: this review corrects a misleading one appearing in the December 1993 issue.) Paper edition (837-0), $19.95. Annotation copyright by Book News, Inc., Portland, OR.

The American idealist movement started in St. Louis, Missouri in 1858, becoming more influential as women joined and influenced its development. Susan Elizabeth Blow was well known as an educator and pedagogical theorist who founded the first public kindergarten program in America (1873-1884). Anna C. Brackett was a feminist and pedagogical theorist and the first female principal of a secondary school (St. Louis Normal School, 1863-72). Grace C. Bibb was a feminist literary critic and the first female dean at the (...) University of Missouri, Columbia (1878-84). American idealism took on a new form in the 1880s with the founding of the Concord School of Philosophy in Massachusetts. Ellen M. Mitchell participated in the movement in both St. Louis and Concord. She was one of the first women to teach philosophy at a co-educational college (University of Denver, 1890-92). Lucia Ames Mead, Marietta Kies, and Eliza Sunderland joined the movement in Concord. Lucia Ames Mead became a chief pacifist theorist in the early twentieth century. Kies and Sunderland were among the first women to earn the Ph.D. in philosophy (University of Michigan, 1891, 1892). Kies wrote on political altruism and shared with Mitchell the distinction of teaching at a coeducational institution (Butler College, 1896-99). These were the first American women as a group to plunge into philosophy proper, bridging those years between the amateur, paraprofessional and professional academic philosopher. Dorothy Rogers's new book at last gives them the attention they deserve. America's First Women Philosophers is indexed in H.W. Wilson's Essay and General Literature Index. (shrink)

This article identifies the author of an anonymous 1751 pamphlet and a group of associated letters to The Gentleman's Magazine as one Thomas Daniel, a customs officer at Sunderland and amateur philosopher. It explores the form of immaterialism Daniel presented, in relation to the views of Malebranche, Newton, Berkeley, Arthur Collier, and Jonathan Edwards.

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. 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[xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. 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This short paper is based on a presentation delivered by four young people from Sunderland Children Services—Amy, Claire, Jordan and Glen (supported by Grace Roddam, Young People's Training and Development Mentor, and Dave Laverick, Workforce Development Consultant)—at the ‘Learning Professional Wisdom: Courage and Compassion’ Ethics and Social Welfare conference, which took place on 15 May 2009 at St Mary's College, Durham University, UK. The conference was organized by the newly formed Ethics and Social Welfare network, with support from the (...) Social Work and Policy Subject Centre (SWAP), Durham University and Ethics & Social Welfare journal. The conference focused on the contested nature of ‘moral character’ in professional education, whether this can be learnt and developed and how it links with judgements about ‘suitability for practice’. The four young people, drawing on their specific experiences of the looked after system, provided a valuable contribution which will assist understanding of what is meant by the term ‘ethical practitioner’ and the values and attributes they believe practitioners should have in order to fulfil their ethical obligations. (shrink)

We report a magnetization, magnetostriction, electrical resistivity, specific heat and neutron scattering study of a UNi 2/3 Rh 1/3 Al single crystal, a solid solution of an antiferromagnet UNiAl and a ferromagnet URhAl. The huge uniaxial magnetic anisotropy confining the principal magnetic response to the c axis in the parent compounds persists also for the solid solution. The magnetization curve at 1.6 K has a pronounced S shape with an inflection at 12 T. The temperature dependence of magnetic susceptibility exhibits (...) a maximum around 10 K and is magnetic history dependent at lower temperatures where the resistivity increases linearly with decreasing temperature. The low-temperature „ anomaly is removed in a magnetic field applied along c , which yields a large negative magnetoresistance amounting to m 46 z in 14 T . The C/T values exhibit a minimum around 12 K and below 8 K they become nearly constant , which is strongly affected by magnetic fields. Neutron scattering data confirm a non-magnetic ground state of UNi 2/3 Rh 1/3 Al. The bulk properties at low temperatures are tentatively attributed to the freezing of U magnetic moments with antiferromagnetic correlations. The additional intensities detected on top of nuclear reflections in neutron diffraction in a magnetic field applied along c are found to be proportional to the field-induced magnetization, which reflects field-induced ferromagnetic coupling of U magnetic moments. This scenario is corroborated also by finding low-temperature magnetostriction data that also scale with the square of magnetization. (shrink)

The paper proves that a historical method in Marxism is not identified to a dialectical method. The logic of history and the logic of its analysis in Marxism do not always coincide. The Logical coincides with the Historical only in eternity as it actually occurs in the works by G.V.F. Hegel. Eternity which has already witnessed everything does not know history any more. In the same way, history also begins there where the eternity comes to an end. Therefore, artificial identification (...) of the Logical with the Historical in Marxism led sometimes to actual mistakes. It is no wonder that it has always caused discussions in Marxism. They are mainly explained by the fact that the deductive, abstract-to-concrete method in which the “General” appears before the “Concrete” is an anti-historical method in its Nature. In real human history the “General” which is generalization of many “Concrete” could not appear before the latter in any way. For this reason, the real historical materialism needs an inductive method of knowledge. Only in that case historical materialism will cease to remain the soviet “histmat” and becomes the real form of a new world outlook. The author is of the opinion that the Party spirit of the Soviet philosophy promoted preservation of the anomalies mentioned in Marxism. The open discussion could help to find valid but not inherited from Hegel relation of historical and logical methods in Marxism. (shrink)