" Journal of the American Medical Association "Walton has made a successful attempt to write about medical concerns without ever leaving the layperson to ...

Title: Medicine, Morals, and the LawPublisher: Gower Pub CoISBN: 0566005336Author: Sheila McLean and Gerry MaherTitle: Reproductive EthicsPublisher: Prentice HallISBN: 0137739044Author: Michael BaylesTitle: Ethics of Withdrawal of Life-Support SystemsPublisher: Praeger PaperbackISBN: 0275927105Author: Douglas N. Walton.

A number of influential reports on influenza pandemic preparedness include recommendations for extra-autonomous decisions to withdraw mechanical ventilation from some patients, who might still benefit from this technology, when demand for ventilators exceeds supply. An unintended implication of recommendations for nonvoluntary and involuntary termination of life support is that it make pandemic preparedness plans vulnerable to patients’ claims for assisted suicide and active euthanasia. Supporters of nonvoluntary passive euthanasia need to articulate why it is both morally different and (...) morally superior to voluntary active euthanasia if they do not wish to invite expansion of end-of-life options during health system catastrophe. (shrink)

Arrhythmias are irregular heartbeats that may be life-threatening. Proper monitoring and the right care at the right time are necessary to keep the heart healthy. Monitoring electrocardiogram patterns on continuous monitoring devices is time-consuming. An intense manual inspection by caregivers is not an option. In addition, such an inspection could result in errors and inter-variability. This article proposes an automated ECG beat classification method based on deep neural networks to aid in the detection of cardiac arrhythmias. The data collected (...) by an Internet of Things enabled ECG monitoring device are transferred to a server. They are analysed by a deep learning model, and the results are shared with the primary caregiver. The proposed model is trained using the MIT-BIH ECG arrhythmia database to classify into four classes: normal beat, left bundle branch block beat, right bundle branch block beat, and premature ventricular contraction. The received data are sampled with an overlapping sliding window and divided into an 80:20 ratio for training and testing, with tenfold cross-validation. The proposed method achieves higher accuracy with a simple model without any preprocessing when compared with previous works. For the train and test sets, we achieved accuracy rates of 99.09 and 99.03%, respectively. A precision, recall, and F1 scores of 0.99 is obtained. The proposed model achieves its goal of developing a simple and accurate ECG monitoring system with improved performance. This simple and efficient deep learning approach for heartbeat classification could be applied in real-time telehealth monitoring systems. (shrink)

Artificial intelligence-based clinical decision support systems have a potential to improve clinical practice, but they may have a negative impact on the physician-patient dialogue, because of the control problem. Physician-patient dialogue depends on human qualities such as compassion, trust, and empathy, which are shared by both parties. These qualities are necessary for the parties to reach a shared understanding -the merging of horizons- about clinical decisions. The patient attends the clinical encounter not only with a malfunctioning body, but (...) also with an ‘unhomelike’ experience of illness that is related to a world of values and meanings, a life-world. Making wise individual decisions in accordance with the patient’s life-world requires not only scientific analysis of causal relationships, but also listening with empathy to the patient’s concerns. For a decision to be made, clinical information should be interpreted considering the patient’s life-world. This side of clinical practice is not a job for computers, and they cannot be final decision-makers. On the other hand, in the control problem users blindly accept system output because of over-reliance, rather than evaluating it with their own judgement. This means over-reliant parties leave their place in the dialogue to the system. In this case, the dialogue may be disrupted and mutual trust may be lost. Therefore, it is necessary to design decision support systems to avoid the control problem and to limit their use when this is not possible, in order to protect the physician-patient dialogue. (shrink)

The question which is never entirely resolved is: what is life? Biology, claims to stand for the study of life and living things, yet we would say that it cannot make a thoroughly clear distinction between living and non living, except in some very obvious cases. There are textbook definitions, of course, based on certain notable properties such as the ability to metabolize or reproduce, but these are arbitrary. If we are familiar with the characteristics of a particular (...) animal or plant, we know enough to be able to pronounce that it is dead when certain internal and external behaviours are no longer evident. Even this has difficulties - such as revealed in the arguments about whether to switch off a human life support system or not. When you find a squishy object on the seashore, can you be sure if it is alive or dead - or never living? The same dilemma confronts medical scientists and microbiologists trying to decide, for example, whether viruses are living, or quasi living, or intermittently living, or what. (shrink)

Life is a relationship among various kinds of agents interacting at different scales in ways that are multifarious, complex, and emergent. Life is always a part of an ecological embedding in communities of interaction, which in turn structure and influence how life evolves. Evolution is essential for understanding life and biodiversity. Henri Bergson's Creative Evolution suggests a way of examining “tendencies” without “teleology.” In this paper I reexamine that work in light of recent concepts in evolutionary (...) ecology, and explore how agential aspects of life are essential for understanding how emergence provides a basis for a process-based metaphysics of life. In support of this project, I will explore how the major transitions of life on Earth have proceeded through increasing levels of cooperation among agents (e.g., mitochondria in animal cells forming a mutualistic relationship), which have allowed further emergences and complexity to evolve. This complexity always, however, emerges in the context of ecological relationships and a nonteleological evolutionary process. Yet, while nonteleological, the progression of life thus far on this planet seems to hold the promise of certain tendencies that seem inherent in life itself. (shrink)

This paper considers questions about continuity and discontinuity between life and mind. It begins by examining such questions from the perspective of the free energy principle (FEP). The FEP is becoming increasingly influential in neuroscience and cognitive science. It says that organisms act to maintain themselves in their expected biological and cognitive states, and that they can do so only by minimizing their free energy given that the long-term average of free energy is entropy. The paper then argues that (...) there is no singular interpretation of the FEP for thinking about the relation between life and mind. Some FEP formulations express what we call an independence view of life and mind. One independence view is a cognitivist view of the FEP. It turns on information processing with semantic content, thus restricting the range of systems capable of exhibiting mentality. Other independence views exemplify what we call an overly generous non-cognitivist view of the FEP, and these appear to go in the opposite direction. That is, they imply that mentality is nearly everywhere. The paper proceeds to argue that non-cognitivist FEP, and its implications for thinking about the relation between life and mind, can be usefully constrained by key ideas in recent enactive approaches to cognitive science. We conclude that the most compelling account of the relationship between life and mind treats them as strongly continuous, and that this continuity is based on particular concepts of life (autopoiesis and adaptivity) and mind (basic and non-semantic). (shrink)

Prevention and control of chronic conditions are global healthcare challenges. Patient self-management has been deemed essential for treating chronic conditions and improving the quality of patient life. However, the current Japanese system for supporting patient self-management of chronic conditions has received little ethical assessment. The first aim of this article is to provide an ethical analysis of current Japanese support for self-management of chronic conditions with reference to international discussions concerning self-management, developed mainly in western societies such as (...) Europe, the United States. The second aim is to clarify the challenges faced by Japanese biomedical ethics concerning selfmanagement support by focusing on the ethical concepts of quality of life and autonomy. This article identifies the following two challenges: [1] dispelling conceptual confusion concerning basic ethical concepts such as quality of life and autonomy, and [2] exploring the conceptual relationship between these ethical concepts, as they relate to providing support for chronically ill patients. By addressing these challenges and constructing a theoretical basis for radical change in support mechanisms, bioethics in Japan could contribute to efforts to construct a comprehensive support system for patients with chronic conditions, which organize variety kinds of supports, such as medical professional supports, supports from patient’s groups, local community supports, familial supports, support in patients’ workplace, and supports for patients’ family members as well. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future (...) class='Hi'>systems will need to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

Taking steps to build a more dementia‐friendly society is essential for addressing the needs of people experiencing dementia. Initiatives that improve the quality of life for those living with dementia are needed to lessen controllable factors that can negatively influence how people envision a future trajectory of dementia for themselves. Programs that provide better funding and better coordination for care support would lessen caregiver burden and make it more possible to imagine more people being able to live what (...) they might consider a “good life” with dementia. Specific proposals, such as payment for dementia care managers and new systems to support high‐quality, symptom‐based palliative care beyond the hospice benefit of only six months, would improve and reframe how many people in the United States experience a dementia illness. Such changes should be incorporated into discussions about improving and respecting preferences in the later stages of dementia. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future (...) class='Hi'>systems will need to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

The life sciences have evoked long-standing philosophical debates on a system view of life versus a reductionist view that reduces the complexity of life-forms to parts-based entities that can be described purely mechanistically. This paper examines how current scientific advances in the life sciences can contribute to an anti-reductionist concept of life. It does so by looking at synthetic biology, a discipline within the life sciences that has an ambiguous relationship to this debate. While (...) the field’s engineering approach to life could be considered a manifestation of a reductionist view of life, it also builds on a more holistic, systems view of life. This paper analyses recent scientific practices taking place within synthetic biology that seem to challenge the reductionist view of life. After analyzing the main anti-reductionist philosophical accounts of life, I ask how synthetic biology practices can support these accounts of life by considering living systems as processual, collaborative, and cognitive, and life versus nonlife on a more gradual scale. This empirically informed paper contributes to the literature by drawing observations about the concept of life by connecting the following: the reductionist view in the life sciences, the different anti-reductionist metaphysical stances in the philosophy of biology, and the emerging practices in synthetic biology. The paper concludes that synthetic biology can support anti-reductionist views of life in the philosophy of biology. (shrink)

An attempt by one of the leading political scientists to "extricate from the total political reality those aspects that can be considered the fundamental processes or activities without which no political life in society could continue." The conceptual framework for a "more complex structure of a theory" is developed around the concepts of demand, support, stress, and input-output. Easton explicitly rejects the discussion of political theory in terms of what he calls political philosophy, but the work is nevertheless (...) of interest to philosophers who have the stamina and interest to wade through a long and over-drawn discussion of the nature of political life.—K. A. M. (shrink)

Background: The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses’ involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation (...) generated a certain reluctance of a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. Objective: To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Research design: Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Participants and research context: Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse’s experience in exercising autonomy relating to end-of-life decision-making. Ethical considerations: Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. Findings: The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Conclusion: Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude that inserts them into the decision-making process. (shrink)

"The cases are presented in a concise and interesting manner... highlights the emerging consciousness of the importance of the contractual arrangement between physician and patient... " --Journal of the American Medical Association "The cases presented are interesting ones, and the commentaries are uniformly lucid.... Highly recommended... " --Religious Studies Review "Cohen contributes a well-selected collection of cases and commentaries which are presented in a crisp style... it is likely to have a real impact." --Ethics Twenty-six reports based on actual cases (...) with expert commentary that illuminate the ethical, medical, legal, and psychological contours of dilemmas surrounding termination of treatment decisions. Cases involve patients, families, physicians, nurses, lawyers, and health care administrators. A companion volume to the Hastings Center's Guidelines. See Guidelines for ad quotes when advertising both books. (shrink)

Finding meaning in our lives is a central tenet to the human experience and a core contributor to mental health. Individuals tend to actively seek the sources of meaning in their lives or consciously enact efforts to create or “craft” meaning in different life domains. These overall “Life Crafting” behaviors refer to the conscious efforts individuals exert to create meaning in their lives through cognitively framing how they view life, seeking social support systems to manage (...) life challenges, and actively seeking challenges to facilitate personal growth. Specifically, these behaviors are actioned to better align life goals, personal needs, values, and capabilities. However, no psychological assessment instrument currently exists to measure overall life crafting. As such, the purpose of this paper was twofold: to conceptualize life crafting and to develop, validate and evaluate a robust measure of overall life crafting. A mixed-method, multi-study research design was employed. First, nine participants were interviewed to determine the methods or techniques used to craft meaningful life experiences. These methods/techniques were used as indicators to create an initial item pool which was then reviewed by a panel of experts to ensure face validity. Second, in Study 1, the factorial structure of the instrument was explored by gathering data from a convenience sample, with the results showing support for a three-factor structure of life crafting, consisting of cognitive crafting, seeking social support, and seeking challenges. Finally, in Study 2, the aim was to confirm the factorial structure of the Life Crafting scale and to determine its level of internal consistency, partial measurement invariance across genders, and criterion validity [meaning in life, mental health, work engagement, and job burnout ]. The results supported a second-order factorial model of Life Crafting, which comprised of three first-order factors. Therefore, the Life Crafting Scale can be used as a valid and reliable instrument to measure- and track the effectiveness of life crafting interventions. (shrink)

To the extent that classical, neoclassical, and Marxist political economy have traditionally ignored the problem of economic scale and valorized economic growth, all three have much to learn from ecological economics. Its most important contribution is the argument that the human economy is a subsystem of the finite earth’s natural life-support system. Implied in this argument is a new metric of economic health, the life-value rather than the money-value of that which economies produce and distribute.

While the list of 17 Sustainable Development Goals proposed by the United Nations’ Open Working Group comprises a catalog of highly important post-2015 development priorities, one of the key issue that has not received the attention it deserves is the need to safeguard the Earth's life-support system. Over the course of the past decades, we have concentrated much more on socioeconomic development rather than on environmental sustainability while putting a number of the Earth's systems at risk, and (...) with it poverty eradication and sustainable development. There is thus a need to put the spotlight on global environmental change and to take account of the insights from the latest Earth system science and its implications for the future of global development and global ethics. The ongoing debate on the post-2015 SDGs offers an important occasion for this endeavor. Going beyond the current proposal of the Open Working Group and building on the planetary boundaries or guard rails framework, the SDGs.. (shrink)

The process of condensation of an amorphous solid into a rigid matrix can often trap molecules in reversible binding sites. Exchange of the same molecular species with such sites is known to be sensitive to small chemical differences and to distinguish between enantiomers. In addition to their usefulness in chromatographic processes, such materials can separate, by solid phase extraction, specific compounds from complex mixtures. Furthermore, the trapped molecules can have their reactions guided and catalytically changed. The combination of this spontaneously (...) formed system of templates and catalytic sites may support a type of replication cycle, and suggests some pathways from simple chemistry toward the complexities of biology. © 2005 Wiley Periodicals, Inc. Complexity 11: 30–35, 2005 -/- . (shrink)

The pandemic of COVID-19 has arrested the life of 7.8 million people living on this earth. However, some people are more vulnerable to the risk of this deadly virus. The frailty of senior citizens put them at the top of this list. The past 6 months have not only presented a threat to their physical health but to mental health also. Although lockdown was necessary to check the spread of the coronavirus it culminated in an exponential rise in the (...) problems of loneliness, anxiety, fear, helplessness, and depression. The present paper reviews the role of social networking sites, apps, and other digital platforms in saving and enriching the lives of the elderly, especially those who spent the lockdown alone and were devoid of a regular support system due to unavailability of transport and administrative restrictions on the movement of people. It also analyzes the efficiency of the virtual world in reducing their anxiety of being alone by connecting them with others and also make them feel empowered. The review is based on the online data collected about the insurgence in the percentage of elderly people using such platforms, recent studies analyzing the effects of the COVID 19 pandemic on senior citizens. Besides this personal telephonic discussions were conducted with some elderly people who spent their lockdown alone in their homes. The study was primarily focused on three objectives. Firstly it attempts to understand the ways in which senior citizens made use of social networking sites and various digital platforms for managing life better. Secondly, it analyses the process of adopting technology, and finally, it examined the width and depth of the impact technology created in their life and also the permanence of this change. The analysis clearly suggests an increase in the digital life of elderly people. The process moved in distinct stages from utter confusion to relative ease in using technology, thereby significantly reducing the loneliness, and bringing relatively stable change in the way they lead their life. (shrink)

Earth’s life-support system is facing megaproblems of sustainability. One important way of how these problems can be addressed is through innovation. This paper argues that responsible innovation that contributes to sustainable development consists of three dimensions: innovations avoid harming people and the planet, innovations ‘do good’ by offering new products, services, or technologies that foster SD, and global governance schemes are in place that facilitate innovations that avoid harm and ‘do good.’ The paper discusses global governance schemes based (...) on deliberation as a means to foster such responsible innovation. These schemes can provide voluntary soft-law regulations that complement and extend national and international hard-law regulations and facilitate collective innovation that contributes to SD goals. The article addresses the facilitative role of governments and international organizations in overcoming problems of deliberation and offers illustrative examples of such governance schemes. (shrink)

Les enfants polyhandicapés ont des besoins de soutien intenses et complexes. Souvent, ils sont dans des établissements spécialisés, avec peu d’opportunités d’apprentissage, menant une vie passive et isolée. Pour améliorer leur qualité de vie, leurs activités et leur inclusion, en particulier l’éducation inclusive, nous avons développé et expérimenté, dans le cadre du projet Européen Enablin+, une formation continue interprofessionnelle. En 2015-2017, nous avons organisé 64 cours pilotes et ateliers de formation sur 41 sujets dans huit pays européens, suivis d’un cours (...) de formation des formateurs. Sur la base d’une évaluation qualitative par les participants, nous pouvons faire les recommandations suivantes: à côté de la formation de compétences spécifiques à la profession, une formation continue devrait en premier lieu travailler à sensibiliser à la faisabilité et à la nécessité de l’inclusion aussi pour les enfants de grande dépendance. Tous les niveaux hiérarchiques du personnel, ainsi que les familles devraient être impliqués. Bien qu’enracinée dans les cadres conceptuels modernes du handicap (inclusion, qualité de vie, droits, capacités), cette formation devrait offrir un véritable apprentissage interprofessionnel basé sur des cas, une “gestion de cas” centrée sur la personne et la famille, un apprentissage réflexif sur les systèmes de croyances et les pratiques concernant activités inclusives et participation. Les formats de cours doivent être adaptés aux circonstances locales afin de permettre la participation de l’ensemble du personnel. (shrink)

The work of Dan Brock and Helga Kuhse is typical of the current stream of thought rejecting the validity of sanctity of life appeals to instill objective inviolable worth in human life regardless of the quality of life of the patient. The context of a person's life is supremely important. In their systems life can have high value, yet the value of life can be outweighed by the force of other disvalues. The notion (...) of quality of life has increasingly come to signify the measurement of the worth of a person's life itself. Having a life equals personal life. Any objectivity to life resides in 'personal', 'biographical', or 'creative' life, not mere biological life. Personal life represents the minimal threshold for any objective worth. In responding to this challenge, John Finnis has argued extensively that life is an intrinsic good – a basic human good. Following from our grasp of human life as a basic incommensurable good, it cannot be practically reasonable both to affirm that (a) 'human life is a basic human good', and (b) that 'human life qua human life can be intentionally acted against to its destruction'. Yet, if the good of human life can be considered self-evident, the self-evidence of the basic human good qua good does not mean that dialectical reasoning cannot be engaged in to indirectly support the practical reasonableness of respecting the good of human life in the deliberative choices that persons make concerning their actions. It is to the use of such dialectical reasoning, supportive of the status of human life as such a basic human good, that the article is primarily concerned to draw out and articulate. (shrink)

Social anxiety disorders (SAD) are among the most prevalent mental disorders (lifetime prevalence: 7–12%), with high impact on the life of an affected social system and its individual social system members. We developed a manualized disorder-specific integrative systemic and family therapy (ISFT) for SAD, and evaluated its feasibility in a pilot randomized controlled trial (RCT). The ISFT is inspired by Helm Stierlin’s concept of related individuation developed during the early 1980s, which has since continued to be refined. It integrates (...) solution-focused language, social network diagnostics, and genogram work, as well as resource- and problem orientation for both case conceptualization and therapy planning. Post-Milan symptom prescription to fluidize the presented symptoms is one of the core interventions in the ISFT. Theoretically, the IFST is grounded in radical constructivism and “Cybern-Ethics,” multi-directional partiality, and a both/and attitude toward a disorder-specific vs. non-disorder-specific therapy approach. SAD is understood from the viewpoint of social systems theory, especially in adaptation to a socio-psycho-biological explanatory model of social anxiety. In a prospective multicenter, assessor-blind pilot RCT, we included 38 clients with SAD (ICD F40.1; Liebowitz Social Anxiety Scale, LSAS-SR > 30): 18 patients participated in the ISFT, and 20 patients in Cognitive Behavioral Therapy (CBT; age:M = 36 years,SD = 14). Within-group, simple-effect intention-to-treat analyses showed significant reduction in social anxiety (LSAS-SR; ISFT:d = 1.67; CBT:d = 1.04), while intention-to-treat mixed-design ANOVA demonstrated the advantage of ISFT (d = 0.81). Per-protocol analyses supported these results. The remission rate based on blind diagnosticians’ ratings was good to satisfactory (Structured Clinical Interview, SCID; 78% in ST, 45% in CBT,p = 0.083); this has yet to be verified in a subsequent confirmatory RCT. The article will present the ISFT rationale and manual, including a special focus on multi-person settings, and the central findings from our pilot RCT. (shrink)

When posing the question "is artificial life possible?", our immediate answer is that on the one hand : of course it is - people make it, and indeed very interesting and even breathtaking structures have already been constructed, such as `aminats', self-reproducing patterns and the other things, we have seen already. In this sense we are forced to take artificial life as a fact (at least as a fact about a new branch of research), nearly in the same (...) way that the philosopher Kant took the theoretical physics of his days, Newtonian physics, as a matter of fact, and then asked: What are the conditions of possibility for this kind of theoretical science? On the other hand: The situation differs from Kant's. Artificial Life does not confront us with an analogy of theoretical mechanics within the field of biology. We face a curious situation: It is not obvious to the majority of biologists that Artificial Life is possible at all, at least in the purely computational sense of `software life'. Probably, most biologists would never call these artificial constructs `living'. Why not? Because the intuitive notions of life and living systems within biology implies, among other things, that living beings are a result of a long, ongoing evolutionary process that have created autonomous organisms, single-celled and multi-celled, that are highly organized, open (non-equilibrium), material thermodynamic systems based on metabolism and some kind of genetic information supported by macromolecules, that only metaphorically resemble a computer program. It is not that.. (shrink)

This conceptual paper argues that change makers, here called transformation stewards, attempting to catalyze transformational change need three core skillsets specific to stewarding transformative change, and further argues that mindfulness practices can potentially enhance these capacities. One skillset is reflexive systems-based awareness and understanding. Another includes capacities for fostering what gives life in complexly wicked social-ecological systems. A third is having capacity for and willingness to steward whole system change, rather than lead it in the conventional sense, (...) which is made necessary because of the nature of organizing transformation stewards in complex, life-oriented systems. Tentative evidence from the literature supports the idea that a combination of experience and mindfulness practices of various sorts can enhance these capabilities. (shrink)

Complex Systems Biology approaches are here considered from the viewpoint of Robert Rosen’s (M,R)-systems, Relational Biology and Quantum theory, as well as from the standpoint of computer modeling. Realizability and Entailment of (M,R)-systems are two key aspects that relate the abstract, mathematical world of organizational structure introduced by Rosen to the various physicochemical structures of complex biological systems. Their importance for understanding biological function and life itself, as well as for designing new strategies for treating (...) diseases such as cancers, is pointed out. The roles played by multiple metastable states in the “continuous uphill flow of Life” supported through internal bioenergetic processes that are coupled to essential inflows are also discussed in relation to dynamic realizations of (M,R)-systems. Furthermore, the roles played by the underlying, many-valued, quantum logics and symbolic computations for ultra-complex biological systems are also briefly discussed. (shrink)

This article addresses the use of computer-assisted career guidance systems (CACGS) in career interventions. Major CACGS developed in the past decades were based on the trait-factor or person-environment fit approaches in their conceptualization and design. The strengths and limitations of these CACGS in addressing the career development needs of individuals are discussed. The Career Construction Theory (CCT) is a promising paradigm to guide the development of new generations of CACGS. The narrative tradition, career adaptability model, and life-design interventions (...) of CCT offer rich conceptual and practical applications that could expand the scope and breadth of career exploration and identity construction through using CACGS. A digital system developed in Hong Kong called Infinity is a case-in-point of a CACGS where users could learn about career planning, engage in self and career construction through using the quantitative and qualitative assessment applications and gamified tools, take career planning actions over time, and communicate with their social supportive systems. Initial findings suggested that users of the system reported lesser decision-making difficulties, higher levels of decision clarity, and better understanding of what is career planning than non-users. Users from high academic achievement schools reported higher levels of career adaptability than their counterparts in schools of similar academic background. Users from low achievement schools reported higher intention to pursue government-supported universities than non-users from schools of similar background. Research and practice implications in schools and organizational settings are discussed. (shrink)

This book offers an in-depth analysis of the wide range of issues surrounding "passive euthanasia" and "allow-to-die" decisions. The author develops a comprehensive conceptual model that is highly useful for assessing and dealing with real-life situations. He presents an informative historical overview, an evaluation of the clinical settings in which treatment abatement takes place, and an insightful discussion of relevant legal aspects. The result is a clearly articulated ethical analysis that is medically realistic, philosophically sound, and legally viable.

Through her stories and mine, my sister and I allow the outside world to see the ways in which we grapple with a critical health incident along her journey of living with lupus. Lupus is a chronic, autoimmune disease that is difficult to recognize and to diagnose. The ambiguous nature of the disease creates considerable confusion for the ill person as well as her support system. Using an illness narrative, I analyze a real life event linked to chronic (...) illness, invisibility, living loss, liminality and family—and more specifically, to social support within the sibling relationship. (shrink)

After initially emerging in China, the coronavirus (COVID-19) outbreak has advanced rapidly. The World Health Organization (WHO) has recently declared it a pandemic, with Europe becoming its new epicentre. Italy has so far been the most severely hit European country and demand for critical care in the northern region currently exceeds its supply. This raises significant ethical concerns, among which is the allocation of scarce resources. Professionals are considering the prioritisation of patients most likely to survive over those with remote (...) chances, and this news has triggered an intense debate about the right of every individual to access healthcare. The proposed analysis suggests that the national emergency framework in which prioritisation criteria are currently enforced should not lead us to perceive scarce resources allocation as something new. From an ethical perspective, the novelty of the current emergency is not grounded in the devastating effects of scarce resources allocation, which is rife in recent and present clinical practice. Rather, it has to do with the extraordinarily high number of people who find themselves personally affected by the implications of scarce resources allocation and who suddenly realise that the principle of ‘equals should be treated equally’ may no longer be applicable. Along with the need to allocate appropriate additional financial resources to support the healthcare system, and thus to mitigate the scarcity of resources, the analysis insists on the relevance of a medical ethics perspective that does not place the burden of care and choice solely on physicians. (shrink)

U.G. Krishnamurti famously described enlightenment as a neurobiological state of being with no religious, psychological or mystical implications. He did not lecture, did not set up organizations, held no gatherings and professed to have no message for mankind. Known as the 'anti-guru', the 'raging sage' and the 'thinker who shuns thought', U.G. spent his life destroying accepted beliefs in science, god, mind, soul, religion, love and relationships-all the props man uses to live life. Having taken away all (...) class='Hi'>support systems from those who came to him, he refused to replace them with those of his own, always insisting that each must find his own truth. And when U.G. knew that it was time for him to go, he refused all attempts to prolong life with medical help. He let nature, and his body, take its course. On the afternoon of 22 March 2007, U.G. Krishnamurti passed away in Vallecrosia, Italy. A bare, intensely personal account of a bedside vigil with the dying, A Taste of Life records the final days that well-known film-maker Mahesh Bhatt spent with U.G. Krishnamurti. It narrates how, in death, U.G. shows the author and us a way to live life. Book jacket. (shrink)

This book attempts to provide an ethical foundation with which to address the question, 'Should we spread life beyond Earth?' It examines the material conditions of the solar system, the limits of consciousness, the limits of society, and the long term possibilities of sending human life out into the universe. The author delineates the ethical criteria of sentient life and considers justifications of space travel for the purpose of human expansion. Duemler gives special attention to the utilitarian (...) explanation which concludes that if life did [gnyad throughout the solar system, or even the galaxy, then this would serve to increase the amount of sentient life and, if life in the new world is a balanced positive, is therefore a positive event. Three main issues, drawing upon both science and philosophy, fall at the center of the discussion: supporting evidence not based on questionable dogma nor requiring huge intuitive leaps of faith; it must square with natural selection and have biological plausibility; and it must have inherent value, not requiring underlying conditions for a judgement to pass. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt to (...) capture a comprehensive overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

This analysis maps the deepening global crisis and the principles of its resolution by life-value analysis and method. Received theories of economics and justice and modern rights doctrines are shown to have no ground in life value and to be incapable of recognizing universal life goods and the rising threats to them. In response to this system failure at theoretical and operational levels, the unifying nature and measure of life value are defined to provide the long-missing (...) basis for understanding the common interest, human rights and social justice—that is, the universal life necessities of humanity across cultures and the evolving civil commons infrastructures to ensure them. In contrast, the treaty-imposed corporate rights system miscalled “globalization” is structured to predate life means and support systems at all levels with no accountability beyond itself. Only the logic of life value, human rights and life-protective law, it is concluded, can comprehend or govern this inherently life-blind and cumulatively eco-genocidal regime. (shrink)

AI systems are bringing an augmentation of human capabilities to shape the world. They may also drag a replacement of human conscience in large chunks of life. AI systems can be designed to leave moral control in human hands, to obstruct or diminish that moral control, or even to prevent it, replacing human morality with pre-packaged or developed ‘solutions’ by the ‘intelligent’ machine itself. Artificial Intelligent systems (AIS) are increasingly being used in multiple applications and receiving (...) more attention from the public and private organisations. The purpose of this article is to offer a mapping of the technological architectures that support AIS, under the specific focus of the moral agency. Through a literature research and reflection process, the following areas are covered: a brief introduction and review of the literature on the topic of moral agency; an analysis using the BDI logic model (Bratman 1987); an elemental review of artificial ‘reasoning’ architectures in AIS; the influence of the data input and the data quality; AI systems’ positioning in decision support and decision making scenarios; and finally, some conclusions are offered about regarding the potential loss of moral control by humans due to AIS. This article contributes to the field of Ethics and Artificial Intelligence by providing a discussion for developers and researchers to understand how and under what circumstances the ‘human subject’ may, totally or partially, lose moral control and ownership over AI technologies. The topic is relevant because AIS often are not single machines but complex networks of machines that feed information and decisions into each other and to human operators. The detailed traceability of input-process-output at each node of the network is essential for it to remain within the field of moral agency. Moral agency is then at the basis of our system of legal responsibility, and social approval is unlikely to be obtained for entrusting important functions to complex systems under which no moral agency can be identified. (shrink)

In an April 2023 article in JAMA Pediatrics, ‘Life Support System for the Fetonate and the Ethics of Speculation’, authors De Bie, Flake and Feudtner critique bioethicists for practising what they call ‘speculative ethics’. The authors refer to a 2017 article that they published on the Extra-uterine Environment of Neonatal Development (EXTEND) system. This system was able to keep fetonatal (newborn, but in a fetal physiological state) lambs alive outside of the parent lamb’s womb for 4 weeks. The (...) article has been accessed almost 300 000 times and received significant media attention. It also resulted in an explosion in the bioethics literature about ‘the ethics of the artificial womb’. However, the authors bemoan, these ethics discussions focused largely on unrealistic use cases of the new technology—from elective shortening of pregnancies to complete ectogenesis. The authors dubbed these discussions as ‘a technically and developmentally naive, yet sensationally speculative, pipe dream’. The use case of the EXTEND technology that is most realistic involves supporting extremely premature newborns (23–24 weeks). Other probable uses include supporting infants in later gestational ages (25–28 weeks) with pathological conditions, potentially allowing for surgeries or other therapeutics to be delivered without imposing risks on pregnant patients. To …. (shrink)

Patient report of functioning is one component of the neurocognitive exam following traumatic brain injury, and standardized patient-reported outcomes measures are useful to track outcomes during rehabilitation. The Traumatic Brain Injury Quality of Life measurement system is a TBI-specific extension of the PROMIS and Neuro-QoL measurement systems that includes 20 item banks across physical, emotional, social, and cognitive domains. Previous research has evaluated the responsiveness of the TBI-QOL measures in community-dwelling individuals and found clinically important change over a (...) 6-month assessment interval in a sample of individuals who were on average 5 years post-injury. In the present study, we report on the responsiveness of the TBI-QOL Cognition–General Concerns and Executive Function item bank scores and the Cognitive Health Composite scores in a recently injured sample over a 1-year study period. Data from 128 participants with complicated mild, moderate, or severe TBI within the previous 6 months were evaluated. The majority of the sample was male, white, and non-Hispanic. The participants were 18–92 years of age and were first evaluated from 0 to 5 months post-injury. Eighty participants completed the 1-year follow-up assessment. Results show acceptable standard response mean values for all measures and minimal detectable change values ranging from 8.2 to 8.8 T-score points for Cognition–General Concerns and Executive Functioning measures. Anchor rating analysis revealed that changes in scores on the Executive Function item bank and the Cognitive Health Composite were meaningfully associated with participant-reported changes in the areas of attention, multitasking, and memory. Evaluation of change score differences by a variety of clinical indicators demonstrated a small but significant difference in the three TBI-QOL change scores by TBI injury severity grouping. These results support the responsiveness of the TBI-QOL cognition measures in newly injured individuals and provides information on the minimal important differences for the TBI-QOL cognition measures, which can be used for score interpretation by clinicians and researchers seeking patient-reported outcome measures of self-reported cognitive QOL after TBI. (shrink)

This study employs bibliometric and thematic analysis to evaluate the growing body of research on subjective well-being and quality of life during the COVID-19 pandemic. The findings underscore the pandemic’s profound impacts on global health, evidenced by a notable increase in studies addressing mental health and quality of life, fostered by international scientific collaboration. Keyword analysis reveals critical themes, including the pandemic’s influence on mental health, physical activity, and social support systems. This research provides valuable insights (...) into the long-term consequences of the pandemic and highlights adaptive strategies for managing future crises. By identifying key trends and research gaps, the study serves as an essential resource for academics, policymakers, and public health practitioners, offering a roadmap for future investigations. (shrink)

In the 1787 Transcendental Deduction of the Categories Kant indicates the only possible ways by which one can account for a necessary agreement of experience with the concepts of its objects (B166), using analogies between modes of explanation and biological theories about the origin of life. He endorses epigenesis as a model for his system of pure reason (B167). This paper examines various interpretive claims about the meaning of this theory of generation and its significance for Kant’s philosophy (Section (...) 1), showing that, after his Critical shift in perspective, in 1775/77 Kant already combined preformed elements and their purposively oriented formation by natural forces (Section 2). Contrary to the standard view, Kant’s theory of race appears to constitute the background to assess Blumenbach’s later (1799/1781) shift to epigenesis after supporting Haller’s preformism (Section 3). In Section 4, I argue that the ground of affinity between epigenesis and formal idealism rests in tracing the first origin of these conformities: externala posterioriclimate conditions and predisposed germs and dispositions within the generative power of the human body; and externala posterioriexperience and spontaneousa prioriconcepts of its objects, within pure sensory intuiting and pure thinking. In both cases the external empirical conditions would function as occasioning propelling factors affecting internal pre-established forms of generation. (shrink)

Kindergarten teachers’ professional commitment affects their emotional input and turnover intention, and it is affected by the spiritual and material factors of teachers’ families, kindergartens, and society. Therefore, this study aimed to investigate the mediating effect of the dimensions of subjective well-being in the relationship between social support and professional commitment. The study is grounded in human ecology theory and social exchange theory. We surveyed 778 kindergarten teachers from different educational systems in Guangdong Province in China. We used (...) the “Appreciative Social Support” and “Subjective Well-being” Scales and the “Professional Commitment Questionnaire.” The results showed that the four variables of social support, positive affect, life satisfaction, and professional commitment of kindergarten teachers were significantly and positively correlated with each other: social support positively predicted positive affect and life satisfaction, positive affect and life satisfaction positively predicted professional commitment, and social support indirectly influenced professional commitment through the parallel and chain path of positive affect and life satisfaction. This represents a compound multiple mediating effects on professional commitment. (shrink)

The Covid-19 pandemic has put a strain on the health system, as well as the social, economic, and cultural ones at the Global level. After the pandemic, the risk is that the process of inclusion of persons with disabilities is grinding to a halt. But the chance is to find new ideas. This paper will define a brief but significant framework of principles that should be taken into consideration in order to support strategies of inclusion of people with disabilities (...) in the fields of health care and cultural life, especially through the research. (shrink)

In Social Life and Moral Judgment, author and philosopher Antony Flew examines the social problems induced by the mature welfare state. Welfare states make ever-increasing financial demands on their citizenry, yet the evidence clearly supports that such demands are not sustainable. In this superlative collection of thematic essays, Flew investigates and explains why this is so, and calls for a return to individual responsibility. The first essay establishes the philosophical basis for his argument. "Is Human Sociobiology Possible?" answers its (...) titular question in the negative, asserting that we are all members of a peculiar type of creature that can, and therefore must, be responsible for whatever choices between various courses of action or inaction that are open to us as individuals. In other essays, Flew shows how state welfare systems inevitably corrupt and demoralize their citizens by encouraging ever-more people to apply for welfare entitlements and reducing the incentives to avoid or escape the conditions warranting those entitlements. He investigates the origins of this new kind of welfare entitlement, and shows how very different what politicians and public sector employees produce is from what these people claim to be producing. Flew shows that the drive for "social" justice appears to require that the justly acquired income and wealth of all citizens should be progressively taxed away or supplemented by the state so that the eventual result is more, though never perfect, equality. This objective, he asserts, must be radically distinguished from old-fashioned, without prefix or suffix, justice. It was this type of justice Adam Smith referred to when he famously said that it is a virtue "of which the observance is not left to the freedom of our wills" but "which may be extorted by force." Flew question the aims of those who would discredit wealth creators and wealth-creating investment, showing that these are the same people who promote the rising "progressive" taxation needed to finance expenditure in the growing welfare state. Social Life and Moral Judgment is a timely critique, one that will be appreciated at a point in history when governments on both sides of the Atlantic have begun to describe spending on state health, social, education, and welfare services as investments, instead of mechanisms to achieve social justice. (shrink)