Is there ever any reason for a doctor to lie to a patient? In this paper, we critically review the literature on lying to patients and challenge the common notion that while lying is unacceptable, a related entity--'benevolent deception' is defensible. Further, we outline a rare circumstance when treating psychotic patients where lying to the patient is justified. This circumstance is illustrated by a clinical vignette.

BackgroundClinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies (...) and revised it. This paper presents the Euro-MCD 2.0 and describes the revision process.MethodsThe revision process comprised an iterative dialogue among the authors as Euro-MCD-project team, including empirical findings from six Euro-MCD field-studies and input from European experts in CES and theory. Empirical findings contained perceptions and experiences of MCD outcomes among healthcare professionals who participated in MCDs in various settings in Norway, Sweden and the Netherlands. Theoretical viewpoints on CES, literature on goals of CES and MCD and ethics theory guided the interpretation of the empirical findings and final selection of MCD outcomes.ResultsThe Euro-MCD 2.0 Instrument includes three domains: Moral Competence, Moral Teamwork and Moral Action. Moral Competence consists of items about moral sensitivity, analytical skills and virtuous attitude. Moral Teamwork includes open dialogue and supportive relationships and Moral Action refers to moral decision-making and responsible care. During the revision process, we made decisions about adding and reformulating items as well as decreasing the number from 26 to 15 items. We also altered the sentence structure of items to assess the current status of outcomes (e.g. ‘now’) instead of an assumed improvement over time (e.g. ‘better’) and we omitted the question about perceived importance.ConclusionsThe Euro-MCD 2.0 is shorter, less complex and more strongly substantiated by an integration of empirical findings, theoretical reflections and dialogues with participants and experts. Use of the Euro-MCD 2.0 will facilitate evaluation of MCD and can thereby monitor and foster implementation and quality of MCD. The Euro-MCD 2.0 will strengthen future research on evaluation of outcomes of MCD. (shrink)

Atualmente, biotecnologias são empregadas na forma de protocolos a fim de sincronizar o crescimento folicular e a ovulação, bem como permitir que vacas atuem como receptoras de embriões visando melhorar o potencial genético do rebanho. O objetivo desse estudo foi avaliar o efeito da utilização de implantes intravaginais de progesterona de 1º, 2º e 3º uso no protocolo de transferência de embriões em tempo fixo (TETF) sobre a taxa de prenhez em receptoras girolandas. O experimento ocorreu em uma fazenda localizada (...) no município de São Sebastião do Maranhão (MG). Foram utilizadas 74 vacas submetidas aos seguintes protocolos: No dia 0 (D0) administrou-se 2 ml de 17β-Estradiol e progesterona e foi colocado o implante intravaginal de progesterona. Estes implantes foram colocados de forma aleatória, sendo de 1° uso (grupo 1; n=15), 2° (grupo 2; n=24) ou 3° (grupo 3; n=35).No D8, os implantes foram retirados e administrou-se 2 ml PGF2α; 1,5 ml de eCG e 1 ml de 17β-Estradiol e progesterona. A inovulação dos embriões in vitroo correu no D (16) para todas as vacas que apresentaram um corpo lúteo. As variáveis qualitativas (prenhe ou não prenhe) foram comparadas em tabelas de contingência e analisadas pelo teste de qui-quadrado a 5% de probabilidade. Neste estudo não houve diferença estatística entre os grupos protocolados em relação ao aproveitamento como receptoras: 1º uso (53,3%), 2º (79,2%) e 3º (68,65). Ademais, observou-se uma taxa de prenhez entre os grupos de 37,5% para o 1º uso, 42,1% para o 2º e 33,3% para o 3º (P>0,05). Dentre as vantagens ao reaproveitamento dos implantes multiusos destaca-se a redução dos custos dos protocolos hormonais, já que a progesterona é o hormônio mais oneroso, desta forma, a maximização do uso reduz o valor final do protocolo sem prejuízos a taxa de prenhez. (shrink)

Any theory of information needs to comply with what we call the implementation, formalization, and representation constraints. These constraints are justified by basic considerations concerning scientific modelling and methodology. In the first part of this paper, we argue that the implementation and formalization constraints cannot be satisfied because the relation between Shannon information and IIT must be clarified. In the second part of the paper, we focus on the representation constraint. We argue that IIT cannot succeed in satisfying this constraint (...) for semantic contents without offering models for concepts, conceptual roles, and context sensitivity. In the final part of the paper, further complications are raised with respect to the distinction between consciousness and attention, which apply more specifically to the representation constraint. We conclude with some recommendations as to how IIT may succeed in solving these problems, highlighting the advantages and enormous potential of IIT as a scientific theory. (shrink)

Cambridge’deki büyük akademik cemaatin sakinleri olan bizler bir araya geldik ve hoşgörü ve onun egemen politik iklim içerisindeki yeri hakkında dostça ama ateşli bir tartışma yürüttük. Okuyucu, bizim nerelerde aynı düşüncede olmadığımızı bulmakta hiçbir zorluk çekmeyecektir. Diğer taraftan, farklı başlangıç noktalarından ve farklı yollardan hareketle yaklaşık olarak aynı yere ulaştık. Her birimiz için, egemen hoşgörü kuramı ve pratiğinin, incelendiği takdirde, korkunç politik gerçekleri gizlemeye yarayan bir maske olduğu ortaya çıktı. Kızgınlığın tonu makaleden makaleye keskin bir şekilde artmakta; belki de boş (...) yere, okuyucuların bu noktaya getiren akıl yürütmeyi takip edeceklerini umuyoruz. Nihayetinde bu kızgınlık hem kafa hem de kalpte ikamet etmektedir…. (shrink)

We performed an EEG graph analysis on data from 31 typical readers (22.27 ± 2.53 y/o) and 24 dyslexics (22.99 ± 2.29 y/o), recorded while they were engaged in an audiovisual task and during resting-state. The task simulates reading acquisition as participants learned new letter-sound mappings via feedback. EEG data was filtered for the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–13 Hz), and beta (13–30 Hz) bands. We computed the Phase Lag Index (PLI) to provide an estimate of the (...) functional connectivity between all pairs of electrodes per band. Then, networks were constructed using a Minimum Spanning Tree (MST), a unique sub-graph connecting all nodes (electrodes) without loops, aimed at minimizing bias in between groups and conditions comparisons. Both groups showed a comparable accuracy increase during task blocks, indicating that they correctly learned the new associations. The EEG results revealed lower task-specific theta connectivity, and lower theta degree correlation over both rest and task recordings, indicating less network integration in dyslexics compared to typical readers. This pattern suggests a role of theta oscillations in dyslexia and may reflect differences in task engagement between the groups, although robust correlations between MST metrics and performance indices were lacking. (shrink)

Attentional bias has been suggested to contribute to the persistence of substance use behavior. However, the empirical evidence for its proposed role in addiction is inconsistent. This might be due to the inability of commonly used measures to differentiate between attentional engagement and attentional disengagement. Attesting to the importance of differentiating between both components of AB, a recent study using the odd-one-out task showed that substance use was differentially related to engagement and disengagement bias. However, the AB measures derived from (...) the OOOT showed insufficient reliability to be used as a solid measure of individual differences. Therefore, the current study aimed to improve the reliability of the AB measures derived from the OOOT by using more distinct contrast stimuli, adding practice trials, increasing the number of trials, and by having participants perform the task in an alcohol-relevant context. We contrasted the original OOOT with the adapted OOOT and assessed AB in low- and high-drinking individuals. Participants were 245 undergraduate students who typically tend to drink either low or high amounts of alcohol. In one condition, AB was measured with the original OOOT in a typical laboratory context, whereas in the other condition, AB was measured with the OOOT-adapt in a bar context. The OOOT-adapt showed superior internal consistency, especially for the high-drinking group. Further, specifically the OOOT-adapt differentiated between low- and high-drinking participants showing that high drinkers engaged faster with alcohol cues than did low drinkers. Thus, the OOOT-adapt was found to be a promising candidate to reliably index AB in the context of alcohol use. The OOOT-adapt further showed superior criterion validity as it could differentiate between low- and high-drinking individuals, thereby adding to the evidence that AB might be involved in substance use behavior. (shrink)

In this paper I identify a tension between the two sets of works by Kuhn regarding the genesis of the “new historiography” of science. In the first, it could be said that the change from the traditional to the new historiography is strictly endogenous. In the second, the change is predominantly exogenous. To address this question, I draw on a text that is considered to be less important among Kuhn’s works, but which, as shall be argued, allows some contact between (...) Kuhn’s two approaches via Koyré. I seek to point out and differentiate the roles of Koyré and Kuhn – from Kuhn’s point of view – in the development of the historiography of science and, as a complement, present some reflections regarding the justification of the new historiography. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

Both these developments would have surprised Berkeley. He would have found it paradoxical that the vulgar should have rejected his vulgar immaterialism as paradoxical, since he of course believed himself to be on their side in the matter, and characterised his own philosophy as a.

Ethics support services like Moral Case Deliberation intend to support healthcare professionals in ethically difficult situations. To assess outcomes of MCD, the Euro-MCD Instrument has been developed. Field studies to test this instrument are needed and have been conducted, examining important outcomes before MCD participation and experienced outcomes. The current study aimed to describe how participants’ perceive the importance of MCD outcomes after MCD; compare these perceptions with those before MCD participation; and test the factor structure of these outcomes. Swedish, (...) Norwegian and Dutch healthcare professionals rated the importance of outcomes in the Euro-MCD Instrument after four and eight MCDs. Ratings were compared with those before MCD participation using paired and independent samples t-tests. The factor structure was tested using exploratory factor analyses. After 4 and 8 MCDs, 443 respectively 247 respondents completed the instrument. More than 69% rated all MCD outcomes as ‘quite’ or ‘very’ important, especially outcomes from Enhanced Collaboration, Improved Moral Reflexivity and Improved Moral Attitude. Significant differences for 16 outcomes regarding ratings before and after MCD participation were not considered meaningful. Factor analyses suggested three categories, which seemingly resemble the domains Improved Moral Reflexivity, Enhanced Collaboration and a combination of Improved Moral Attitude and Enhanced Emotional Support. After participation in MCDs, respondents confirmed the importance of outcomes in the Euro-MCD Instrument. The question on perceived importance and the categorization of outcomes need reconsideration. The revised instrument will be presented elsewhere, based on all field studies and theoretical reflections. (shrink)

Las reflexiones recogidas en este volumen constituyeron, en su mayor parte, el contenido del Seminario de Semántica celebrado en la Universidad de Oviedo, y uno de los textos ("Léxico y cognición: ¿hay términos de base?") formó parte del programa de conferencias de Año Europeo de las Lenguas. Conforme al espíritu de esas jornadas centradas en la pluralidad lingüística, esta publicación se hace simultáneamente en dos lenguas: español y francés. Aunque se tomen como referencia aspectos concretos de dos lenguas concretas, la (...) española y la francesa, los problemas que aquí se suscitan son de índole general, ya que afectan, y de manera crucial, a todas las lenguas. (shrink)

Since the Global Financial Crisis, a surge of interest in the use of finance as a tool to address social and economic problems suggests the potential for a generational shift in how the finance industry operates and is perceived. J. C. de Swaan seeks to channel the forces of well-intentioned finance professionals to improve finance from within and help restore its focus on serving society. Drawing from inspiring individuals in the field, de Swaan proposes a framework for pursuing a viable (...) career in finance while benefiting society and upholding humanistic values. In doing so, he challenges traditional concepts of success in the industry. This will also engage readers outside of finance who are concerned about the industry's impact on society. (shrink)

Despite the importance of the “historiographical revolution” in Kuhn’s work, he did not carry out a specific study about it. Without a systematic investigation into it, he even affirms that the “old” historiography of science (OHS) is unhistorical, suggesting its summary disqualification in the face of his “new historiography” of science (NHS). My wider project, of which this paper is a part, is to better discuss the issue of the justification of the NHS. In this paper, I discuss the justification (...) (and the genesis) of the OHS, focusing on Condorcet and Comte and resorting especially to Koyré. This will allow us to understand that the relation between the OHS and the NHS is a new instance of inter-theoretical incommensurability. And, indeed, that the NHS is not stricto senso a new historiography. It is the same historiography used for other disciplines (art, philosophy), which in the twentieth century begins to be applied to science as well. (shrink)