Background: Previous research shows that pediatricians inconsistently utilize the ethics consultation service (ECS). Methods: Pediatricians in two suburban, Midwestern academic hospitals were asked to reflect on their ethics training and utilization of ECS via an anonymous, electronic survey distributed in 2017 and 2018, and analyzed in 2018. Participants reported their clinical experience, exposure to formal and informal ethics training, use of formal and informal ethics consultations, and potential barriers to formal consultation. Results: Less experienced pediatricians were more likely to utilize (...) formal ethics consultation and more likely to have formal ethics training. The most commonly reported reasons not to pursue formal ECS consultation were inconvenience and self-reported expertise in pediatric ethics. Conclusions: These results inform ongoing discussions about ethics consultation among pediatricians and the role of formal ethics training in both undergraduate and graduate medical education. (shrink)

The first issue of Artificial Intelligence and Law journal was published in 1992. This paper provides commentaries on nine significant papers drawn from the Journal’s second decade. Four of the papers relate to reasoning with legal cases, introducing contextual considerations, predicting outcomes on the basis of natural language descriptions of the cases, comparing different ways of representing cases, and formalising precedential reasoning. One introduces a method of analysing arguments that was to become very widely used in AI and Law, namely (...) argumentation schemes. Two relate to ontologies for the representation of legal concepts and two take advantage of the increasing availability of legal corpora in this decade, to automate document summarisation and for the mining of arguments. (shrink)

In this paper we explore the connections between ethics and decision theory. In particular, we consider the question of whether decision theory carries with it a bias towards consequentialist ethical theories. We argue that there are plausible versions of the other ethical theories that can be accommodated by “standard” decision theory, but there are also variations of these ethical theories that are less easily accommodated. So while “standard” decision theory is not exclusively consequentialist, it is not necessarily ethically neutral. Moreover, (...) even if our decision-theoretic models get the right answers vis-`a-vis morally correct action, the question remains as to whether the motivation for the non-consequentialist theories and the psychological processes of the agents who subscribe to those ethical theories are lost or poorly represented in the resulting models. (shrink)

Disproportional morbidity and mortality experienced by ethnic minorities in the UK have been highlighted by the COVID-19 pandemic. The ‘Black Lives Matter’ movement has exposed structural racism’s contribution to these health inequities. ‘Cultural Safety’, an antiracist, decolonising and educational innovation originating in New Zealand, has been adopted in Australia. Cultural Safety aims to dismantle barriers faced by colonised Indigenous peoples in mainstream healthcare by addressing systemic racism.This paper explores what it means to be ‘culturally safe’. The ways in which New (...) Zealand and Australia are incorporating Cultural Safety into educating healthcare professionals and in day-to-day practice in medicine are highlighted. We consider the ‘nuts and bolts’ of translating Cultural Safety into the UK to reduce racism within healthcare. Listening to the voices of black, Asian and minority ethnic National Health Service (NHS) consumers, education in reflexivity, both personal and organisational within the NHS are key. By listening to Indigenous colonised peoples, the ex-Empire may find solutions to health inequity. A decolonising feedback loop is required; however, we should take care not to culturally appropriate this valuable reverse innovation. (shrink)

Research consent processes must provide potential participants with the necessary information to help them decide if they wish to join a study. On the Oxford ‘A’ Research Ethics Committee we’ve found that current research proposals mostly provide adequate detail (even if not in an easily comprehensible format), but often fail to support decision making, a view supported by published evidence. In a previous paper, we described how consent might be structured, and here we develop the concept of an Information and (...) Decision Aid (IDA) that can support decision making and be used to guide the dialogue between researcher and potential participant. Our proposal requires limited changes to current processes or paperwork and would provide an easily accessible document for others that the potential participant might approach for advice. It could later be integrated with the Informed Consent Form to ensure all matters of concern to the individual participant have been addressed before consent is formally signed off. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

Metacognition – the ability to represent, monitor and control ongoing cognitive processes – helps us perform many tasks, both when acting alone and when working with others. While metacognition is adaptive, and found in other animals, we should not assume that all human forms of metacognition are gene-based adaptations. Instead, some forms may have a social origin, including the discrimination, interpretation, and broadcasting of metacognitive representations. There is evidence that each of these abilities depends on cultural learning and therefore that (...) cultural selectionmight shape humanmetacognition. The cultural origins hypothesis is a plausible and testable alternative that directs us towards a substantial new programme of research. (shrink)

Apologies are an important part of moral life and a method by which someone can satisfy their reparative obligations. At the same time, apologies can be used both as a shield to protect the person apologizing and as a weapon against the person to whom the apology is owed. In this paper we unpack both claims. We defend two principles one should employ to try to avoid such bad outcomes: (1) Apologies must be one-sided and nontransactional, and (2) the wrongdoer (...) must be willing to pay what they owe. We argue that these principles require the wrongdoer’s emotional vulnerability. Furthermore, we argue that the duty to be vulnerable in issuing apologies helps to make sense of why apologizing well is so difficult and why members of privileged groups might be especially prone to apologizing badly. (shrink)

Working memory capacity (WMC) refers to the ability to maintain information in short–term memory while attending to the immediate environment, and has been associated with emotional states. Yet, research on the link between WMC and emotion in naturalistic settings is growing and inconsistencies have been observed. In the current study (N = 109), we directly replicated the procedures of a prior experience sampling study (Garrison & Schmeichel, 2022), which found that higher WMC attenuates the relationship between stressful events in daily (...) life and negative affect. We measured WMC in the laboratory and then measured the occurrence of stressful events, momentary emotional states, and coping responses to stress several times a day for six days. Higher WMC was associated with reduced momentary negative emotion, but this relationship did not depend on the occurrence of a stressful event. Exploratory analyses found that higher WMC was associated with a greater likelihood of planning as a coping response to stress and greater number of coping strategies reported per stressful event. However, coping did not mediate the link between WMC and momentary negative emotion. Our results contribute to the robustness and ecological validity of the link between WMC and reduced negative emotion in daily life. (shrink)

While we are familiar with socialist and fascist aesthetics, liberalism is not usually thought to permit a political role for literature. Nussbaum has attempted to fill this lacuna. She sketches a “liberal aesthetics” by linking three aspects of literature to her normative proposal. The representation of suffering is connected to the capability approach; the presentation of ethical dilemmas to political liberalism; and the reaction of pity to legal and political judgment. Literature is thus hoped to contribute to the stability of (...) liberal democracies. For over 25 years, individual works by Nussbaum on the value of literature have been critiqued on aesthetic grounds: for not dealing with form, for denying the polyphony of texts, for having a limited conception of readerly identification, and for using an elitist and generically limited selection of material. As of yet, no criticisms have, however, considered the full oeuvre of Nussbaum’s defense of literature, and none have examined this aspect of her work in light of her political philosophy. By placing the aesthetic and political aspects of Nussbaum’s work in conversation, this article investigates the proposed relationship between literature and liberalism. It argues that each component of Nussbaum’s liberal aesthetics contains a political danger: foreclosing discussion of intergenerational responsibility; obscuring questions about which doctrines are permissible in the public sphere; and encouraging stereotypes of marginalized people. Literature, understood like this, may risk exacerbating present tensions within liberalism, rather than bolstering its stability. (shrink)

We apply the distinction between parameter independence and outcome independence to the linear and nonlinear models of a recent nonrelativistic theory of continuous state vector reduction. We show that in the nonlinear model there is a set of realizations of the stochastic process that drives the state vector reduction for which parameter independence is violated for parallel spin components in the EPR-Bohm setup. Such a set has an appreciable probability of occurrence (≈ 1/2). On the other hand, the linear model (...) exhibits only extremely small parameter dependence effects. We investigate some specific features of the models and we recall that, as has been pointed out recently, if one wants to be able to speak of definite outcomes (or equivalently of possessed objective elements of reality) at finite times, one has to slightly change the criteria for their attribution to physical systems. The concluding section is devoted to a detailed discussion of the difficulties which one meets when one tries to take, as a starting point for the formulation of a relativistic theory, a nonrelativistic scheme which exhibits parameter dependence. Here we derive a theorem which identifies the precise sense in which the occurrence of parameter dependence forbids a genuinely relativistic generalization. Finally we show how the appreciable parameter dependence of the nonlinear model gives rise to problems with relativity, while the extremely weak parameter dependence of the linear model does not give rise to any difficulty, provided one takes into account the appropriate criteria for the attribution of definite outcomes. (shrink)

In their scoping review of the literature on artificial womb technology (AWT), De Bie et al. report that “complete ectogenesis has been hailed as an alternative to abortion,” (De Bie et al. 2023, 7...

Background: Ethics in nursing care are traditionally discussed in terms of moral norms or principles. When taking an ontological approach to ethics, ethics is about ethos. Ethos involves both an internal and an external side of ethics. Considering ethics and health from an ontological perspective can provide a different understanding of ethics and health in caring and nursing. Aim and research question: The aim of this study is to deepen the ontological understanding of ethics and health in caring and nursing. (...) The research question is as follows: What is the ontology of health and ethics in caring and nursing? Research design: The study follows a hermeneutical design inspired by Gadamer. Participants and research context: essays about ethics and health were gathered from PhD students in nursing and caring sciences. Ethical considerations: The research follows Responsible conduct of research guidelines provided by the Finnish Advisory Board on Research Integrity. Findings: An ethos with the values of freedom and responsibility seem to ontologically be important for ethics and health. These values allow a movement between the internal and the external sides of ethics that is important for health. Discussion: The ethos of freedom and responsibility that is essential for ethics and health can provide the current ethical debate a new starting point that previous research asks for. Conclusion: Ontologically, an ethos of freedom and responsibility is essential for ethics and health in nursing and caring. (shrink)

Acute aerobic exercise has been shown to improve fine motor skills and alter activation of the motor cortex. The intensity of exercise may influence M1 activation, and further impact whole-body motor skill performance. The aims of the current study were to compare a whole-body motor skill via a piano task following moderate-intensity training and high-intensity interval training, and to determine if M1 activation is linked to any such changes in performance. Nine subjects, aged 18 ± 1 years completed a control, (...) MIT, and HIIT trial followed by administration of a piano performance task. M1 activation was evaluated by measuring oxyhemoglobin and hemoglobin difference changes during post-exercise piano performance using functional near-infrared spectroscopy. The results indicate that piano performance scores were higher after the MIT trial, but not HIIT trial, compared to the control trial. A negative relationship was detected between heart rate during HIIT and post-HIIT piano scores. M1 activation was significantly increased after the HIIT trial. M1 activation was also positively associated with piano performance when exercise trials and all trials were combined. We found that acute moderate-intensity exercise led to an improvement in complex motor skill performance while higher-intensity exercise increased M1 activation. These results demonstrate that moderate-intensity exercise can prime the nervous system for the acquisition of whole-body motor skills, suggesting that similar exercise protocols may be effective in improving the outcomes of other motor tasks performed during regular routines of daily life. In addition, it appears that improvements in motor task performance may be driven by M1 activation. Our findings provide new mechanistic insight into the complex relationship between exercise intensity, M1 activation, and whole-body motor skill performance. (shrink)

This study examines the influence of women in business using a sample of firms on Fortune's “100 Best Companies to Work For” list and is an extension of Bernardi et al.'s work. We use the data from Bernardi et al. to determine whether a higher representation of women on a board signals an increased commitment of a firm to a quality environment and employment characteristics necessary to establish the firm on Fortune's “100 Best Companies to Work For” list. Our findings (...) include a significant increase in the number of female directors on Fortune 500 companies between 1977 and 2001. The initial analysis of the 27 firms appearing on both Fortune's “100 Best Companies to Work For” list and the Fortune 500 in 2001 indicates a positive correlation between the number of female directors and a company's appearance on the “100 Best Companies to Work For” list. (shrink)

Ladyman, Presnell, and Short proposed a model of the implementation of logical operations by physical processes in order to clarify the exact statement of Landauer's Principle, and then offered a new proof of the latter based on the construction of a thermodynamic cycle, arguing that if Landauer's Principle were false it would be possible to harness a machine that violated it to produce a violation of the second law of thermodynamics. In a recent paper in this journal, John Norton directly (...) challenges the consistency of that proof. In the present paper we defend the proof given by Ladyman et al. against his critique. In particular, contrary to what Norton claims, we argue that the processes used in the proof cannot be used to construct a cycle that enacts erasure in a thermodynamically reversible way, and that he does not show that the processes used in the proof violate the Second Law of Thermodynamics. (shrink)

Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)

Conscious experiences involve subjective qualities, such as colours, sounds, smells and emotions. In this Perspective, we argue that these subjective qualities can be understood in terms of their similarity to other experiences. This account highlights the role of memory in conscious experience, even for simple percepts. How an experience feels depends on implicit memory of the relationships between different perceptual representations within the brain. With more complex experiences such as emotions, explicit memories are also recruited. We draw inspiration from work (...) in machine learning as well as the cognitive neuroscience of learning and decision making to make our case and discuss how the account could be tested in future experiments. The resulting findings might help to reveal the functions of subjective experience and inform current theoretical debates on consciousness. (shrink)

We examine the concept of personhood in relation to people living with dementia and implications for the humanity of care, drawing on a body of ethnographic work. Much debate has searched for an adequate account of the person for these purposes. Broad contrasts can be made between accounts focusing on cognition and mental faculties, and accounts focusing on embodied and relational aspects of the person. Some have suggested the concept of the person is critical for good care; others suggest the (...) vexed debates mean that the concept should be abandoned. We argue instead that the competing accounts illuminate the very tensions in personhood which are manifest for all of us, but especially for people living with dementia, and argue that our account has explanatory power in shedding light on how precisely dehumanisation and constraints on agency may arise for people living with dementia, and for staff, within an institutional context. (shrink)

Authorship is commonly used as the basis for the measurement of research productivity. It influences career progression and rewards, making it a valued commodity in a competitive scientific environment. To better understand authorship practices amongst collaborative teams, this study surveyed authors on collaborative journal articles published between 2011 and 2015. Of the 8364 respondents, 1408 responded to the final open-ended question, which solicited additional comments or remarks regarding the fair distribution of authorship in research teams. This paper presents the analysis (...) of these comments, categorized into four main themes: (1) disagreements, (2) questionable behavior, (3) external influences regarding authorship, and (4) values promoted by researchers. Results suggest that some respondents find ways to effectively manage disagreements in a collegial fashion. Conversely, others explain how distribution of authorship can become a “blood sport” or a “horror story” which can negatively affect researchers’ wellbeing, scientific productivity and integrity. Researchers fear authorship discussions and often try to avoid openly discussing the situation which can strain team interactions. Unethical conduct is more likely to result from deceit, favoritism, and questionable mentorship and may become more egregious when there is constant bullying and discrimination. Although values of collegiality, transparency and fairness were promoted by researchers, rank and need for success often overpowered ethical decision-making. This research provides new insight into contextual specificities related to fair authorship distribution that can be instrumental in developing applicable training tools to identify, prevent, and mitigate authorship disagreement. (shrink)

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. (...) Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors. (shrink)

The volume relates the controversy concerning competing knowledge claims to truth.

Everybody negotiates. But not everybody negotiates ethically. One driver of unethical negotiation behavior is power. Yet, we still haven’t discovered the principalmoderating and mediating influences between power and ethical negotiation behavior. In this pair of experimental studies we’re interested in finding out how resilience and moral identity affect an individual’s ethical behavior in both simple and complex negotiations when primed for power.

Research has shown that paternal involvement positively impacts on child health and development. We aimed to develop a conceptual model of dimensions of fatherhood, identify and categorise methods used for linking fathers with their children in administrative data, and map these methods onto the dimensions of fatherhood. We carried out a systematic scoping review to create a conceptual framework of paternal involvement and identify studies exploring the impact of paternal exposures on child health and development outcomes using administrative data. We (...) identified four methods that have been used globally to link fathers and children in administrative data based on family or household identifiers using address data, identifiable information about the father on the child's birth registration, health claims data, and Personal Identification Numbers. We did not identify direct measures of paternal involvement but mapping linkage methods to the framework highlighted possible proxies. The addition of paternal National Health Service numbers to birth notifications presents a way forward in the advancement of fatherhood research using administrative data sources. (shrink)