Our knowledge of the human brain and the influence of pharmacological substances on human mental functioning is expanding. This creates new possibilities to enhance personality and character traits. Psychopharmacological enhancers, as well as other enhancement technologies, raise moral questions concerning the boundary between clinical therapy and enhancement, risks and safety, coercion and justice. Other moral questions include the meaning and value of identity and authenticity, the role of happiness for a good life, or the perceived threats to humanity. Identity and (...) authenticity are central in the debate on psychopharmacological enhancers. In this paper, I first describe the concerns at issue here as extensively propounded by Carl Elliott. Next, I address David DeGrazia’s theory, which holds that there are no fundamental identity-related and authenticity-related arguments against enhancement technologies. I argue, however, that DeGrazia’s line of reasoning does not succeed in settling these concerns. His conception of identity does not seem able to account for the importance we attach to personal identity in␣cases where personal identity is changed through enhancement technology. Moreover, his conception of authenticity does not explain the reason why we find inauthentic values objectionable. A broader approach to authenticity can make sense of concerns about changes in personal identity by means of enhancement technologies. (shrink)

Informed decision-making (IDM) is considered an important ethical and legal requirement for population-based screening. Governments offering such screening have a duty to enable invitees to make informed decisions regarding participation. Various views exist on how to define and measure IDM in different screening programmes. In this paper we first address the question which components should be part of IDM in the context of cancer screening. Departing from two diverging interpretations of the value of autonomy—as a right and as an ideal—we (...) describe how this value is operationalized in the practice of informed consent in medicine and translate this to IDM in population-based cancer screening. Next, we specify components of IDM, which is voluntariness and the requirements of disclosure and understanding. We argue that whereas disclosure should contain all information considered relevant in order to enable authentic IDM, understanding of basic information is sufficient for a valid IDM. In the second part of the paper we apply the capability approach in order to argue for the responsibility of the government to warrant equal and real opportunities for invitees for IDM. We argue that additional conditions beyond mere provision of information are needed in order to do so. (shrink)

Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity—whether it should be considered primarily a medical condition or (...) more a psychosocial problem—seem to affect the specialists’ normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents’ feelings regarding both being able to influence their child’s health and their child being able to control their own condition, and the adolescents’ sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views—e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure—play an important role in the acceptability of bariatric surgery for childhood obesity. (shrink)

Background Massively parallel sequencing techniques, such as whole exome sequencing (WES) and whole genome sequencing (WGS), may reveal unsolicited findings (UFs) unrelated to the diagnostic aim. Such techniques are frequently used for diagnostic purposes in pediatric cases of developmental delay (DD). Yet policy guidelines for informed consent and return of UFs are not well equipped to address specific moral challenges that may arise in these children’s situations. Discussion In previous empirical studies conducted by our research group, we found that it (...) is sometimes uncertain how children with a DD will develop and whether they could come to possess capacities for autonomous decision-making in the future. Parents sometimes felt this brought them into a Catch-22 like situation when confronted with choices about UFs before undergoing WES in trio-analysis (both the parents’ and child’s DNA are sequenced). An important reason for choosing to consent to WES was to gain more insight into how their child might develop. However, to make responsible choices about receiving or declining knowledge of UFs, some idea of their child’s future development of autonomous capacities is needed. This undesirable Catch-22 situation was created by the specific policy configuration in which parents were required to make choices about UFs before being sequencing (trio-analysis). We argue that this finding is relevant for reconfiguring current policies for return of UFs for WES/WGS and propose guidelines that encompass two features. First, the informed consent process ought to be staged. Second, differing guidelines are required for withholding/disclosing a UF in cases of DD appropriate to the level of confidence there is about the child’s future developmental of autonomous capacities. Conclusion When combined with a dynamic consent procedure, these two features of our guidelines could help overcome significant moral challenges that present themselves in the situations of children undergoing genomic sequencing for clarifying a DD. (shrink)

Internet recruitment methods for research are rapidly evolving as technology and participant preferences do as well. This brings data security concerns, balanced with respect to persons for research participants. Internet recruitment research strategies are still important given the importance of creating private and accessible pathways for potentially marginalized populations or people experiencing stigmatized mental health conditions to participate in research. This manuscript describes the case of social media recruitment for a mental health and racism study in Fall 2022 that was (...) infiltrated by bots. We contextualize it in the context of data quality literature, with considerations for future directions including strategies for study design and management, and further research questions. (shrink)

Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese (...) parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks. (shrink)

The current article aims to provide an up-to-date synopsis of available techniques to study affect dynamics using intensive longitudinal data (ILD). We do so by introducing the following eight dichotomies that help elucidate what kind of data one has, what process aspects are of interest, and what research questions are being considered: (1) single- versus multiple-person data; (2) univariate versus multivariate models; (3) stationary versus nonstationary models; (4) linear versus nonlinear models; (5) discrete time versus continuous time models; (6) discrete (...) versus continuous variables; (7) time versus frequency domain; and (8) modeling the process versus computing descriptives. In addition, we discuss what we believe to be the most urging future challenges regarding the modeling of affect dynamics. (shrink)

Abstract. We argue that all human beings have a special type of dignity which is the basis for (1) the obligation all of us have not to kill them, (2) the obligation to take their well-being into account when we act, and (3) even the obligation to treat them as we would have them treat us, and indeed, that all human beings are equal in fundamental dignity. We give reasons to oppose the position that only some human beings, because of (...) their possession of certain characteristics in addition to their humanity (for example, an immediately exercisable capacity for self-consciousness, or for rational deliberation), have full moral worth. What distinguishes human beings from other animals, what makes human beings persons rather than things, is their rational nature, and human beings are rational creatures by virtue of possessing natural capacities for conceptual thought, deliberation, and free choice, that is, the natural capacity to shape their own lives. (shrink)

Prominent thinkers such as Jurgen Habermas and Michael Sandel are warning that biomedical enhancements will undermine fundamental political values. Yet whether biomedical enhancements will undermine such values depends on how biomedical enhancements will function, how they will be administered and to whom. Since only few enhancements are obtainable, it is difficult to tell whether these predictions are sound. Nevertheless, such warnings are extremely valuable. As a society we must, at the very least, be aware of developments that could have harmful (...) consequences. Indeed, if important values were to be jeopardized, we should take appropriate measures to protect them. This paper focuses on four central values: solidarity, personal responsibility, equality and autonomy. It delineates the conditions under which biomedical enhancements would undermine these values. It also details the circumstances under which these values would be unaffected by enhancements as well as those under which they would be promoted. Specifying these conditions is valuable; it would enable society to prepare appropriate ethical guidelines and policy responses in advance. (shrink)

It is well known that when resolution occurs in the stichic iambics and trochaics of tragedy word-end is not found between the two shorts so produced: w or, more accurately, that the first short of resolution must not be the last syllable of a polysyllabic word. Moreover, the syllables in resolution most often form part of the same word as the following short or anceps, e.g.: Ion 1143.

We show that arbitrary tautologies of Johansson’s minimal propositional logic are provable by “small” polynomial-size dag-like natural deductions in Prawitz’s system for minimal propositional logic. These “small” deductions arise from standard “large” tree-like inputs by horizontal dag-like compression that is obtained by merging distinct nodes labeled with identical formulas occurring in horizontal sections of deductions involved. The underlying geometric idea: if the height, h(∂), and the total number of distinct formulas, ϕ(∂), of a given tree-like deduction ∂ of a minimal (...) tautology ρ are both polynomial in the length of ρ, |ρ|, then the size of the horizontal dag-like compression ∂ᶜ is at most h(∂)×ϕ(∂), and hence polynomial in |ρ|. That minimal tautologies ρ are provable by tree-like natural deductions ∂ with |ρ|-polynomial h(∂) and ϕ(∂) follows via embedding from Hudelmaier’s result that there are analogous sequent calculus deductions of sequent ⇒ρ. The notion of dag-like provability involved is more sophisticated than Prawitz’s tree-like one and its complexity is not clear yet. Our approach nevertheless provides a convergent sequence of NP lower approximations of PSPACE-complete validity of minimal logic. (shrink)

The projection postulate, which prescribes “collapse of the state vector” upon measurement, is not an essential part of quantum mechanics. Rather it is only an optional discarding of certain branches of the state vector that are expected to be irrelevant for the purpose at hand. However, its use is hazardous, and there are examples of repeated measurements for which the conventional application of the projection postulate leads to incorrect results.

The attempt to derive (rather than assume) the statistical postulate of quantum theory from the many-universes interpretation of Everett and De Witt is analyzed The many-universes interpretation is found to be neither necessary nor sufficient for the task.

In The Souls of Black Folk, W.E.B. Du Bois introduces double consciousness as a result of racial prejudice and oppression. Explained as a state of confliction felt by black Americans, Du Bois presents double consciousness as integral to understanding the black experience. Later philosophers question the importance of double consciousness to current race discussions, but this paper contends that double consciousness provides valuable insights into black and white relations. To do this, I will utilize the modern slang term, “Oreo,” to (...) highlight how a perceived incompatibility between blacks and whites could prevent America from achieving a greater unity. (shrink)

At the beginning of the twentieth century, among the foundational schools of mathematics appeared ‘intuitionism’ by Dutchman L. E. J. Brouwer, who based arithmetic on the intuition of time and all mental constructions that could be made out of it. His pupil Arend Heyting was the first populariser of intuitionism, and he repeatedly emphasised that no philosophy was required to practise intuitionism so that such mathematics could be shared by anyone. Still, stimulated by invitations to humanistic conferences, he wrote a (...) series of notes, preserved in the State Archives, Haarlem, about solipsism. In them, he operated a series of theoretical reflections consisting of the stripping away of the patterns that are part of our consciousness and their subsequent progressive re-introduction, in order to understand the formation of our Self as distinct from the natural world and other humans. In 1996, following a stroke, neuroscientist Jill Bolte Taylor experienced the deprivation of certain abilities in her brain and their successive regaining. In her experience there are remarkable similarities with what Heyting had hypothesised about the formation of the self. The purpose of this article is to highlight them and point out how Heyting's theoretical construct was found to be embodied in the brain. (shrink)

The combination of breeding for increased production and the intensification of housing conditions have resulted in increased occurrence of behavioral, physiological, and immunological disorders. These disorders affect health and welfare of production animals negatively. For future livestock systems, it is important to consider how to manage and breed production animals. In this paper, we will focus on selective breeding of laying hens. Selective breeding should not only be defined in terms of production, but should also include traits related to animal (...) health and welfare. For this we like to introduce the concept of robustness. The concept of robustness includes individual traits of an animal that are relevant for health and welfare. Improving robustness by selective breeding will increase (or restore) the ability of animals to interact successfully with the environment and thereby to make them more able to adapt to an appropriate husbandry system. Application of robustness into a breeding goal will result in animals with improved health and welfare without affecting their integrity. Therefore, in order to be ethically acceptable, selective breeding in animal production should accept robustness as a breeding goal. (shrink)

Argument-places play an important role in our dealing with relations. However, that does not mean that argument-places should be taken as primitive entities. It is possible to give an account of ‘real’ relations in which argument-places play no role. But if argument-places are not basic, then what can we say about their identity? Can they, for example, be reconstructed in set theory with appropriate urelements? In this article, we show that for some relations, argument-places cannot be modeled in aneutralway in (...) V[A], the cumulative hierarchy with basic ingredients of the relation as urelements. We argue that a natural way to conceive of argument-places is to identify them with abstract, structureless points of a derivative structure exemplified by positional frames. In case the relation has symmetry, these points may be indiscernible. (shrink)