There are currently two legally established criteria for death: the irreversible cessation of circulation and respiration and the irreversible cessation of neurologic function. Recently, there have been technological developments that could undermine the irreversibility requirement. In this paper, I focus both on whether death should be identified as an irreversible state and on the proper scope of irreversibility in the biological definition of death. In this paper, I tackle the distinction between the commonsense definition of death and the biological definition (...) of death to show that even the commonsense concept of death is specified by biological facts. Resting on this argument, I argue that any definition of death is a posteriori. Thus, irreversibility is part of any definition of death because the actual phenomenon of death is irreversible. In addition, I show that the proper domain of irreversibility in a definition of death is circumscribed by physical possibilities and that irreversibility in the definition of death refers to current possibilities for the reversal of relevant biological processes. I conclude that, despite recent technological advancements, death is still irreversible. (shrink)

Health care providers are expected both to relieve pain and to provide anticipatory guidance regarding how much a procedure is going to hurt. Fulfilling those expectations is complicated by the cognitive modulation of pain perception. Warning people to expect pain or setting expectations for pain relief not only influences their subjective experience, but it also alters how nociceptive stimuli are processed throughout the sensory and discriminative pathways in the brain. In light of this, I reconsider the characterization of placebo analgesia (...) as pharmacologically inert and the use of it as deceptive. I show that placebo analgesia exploits the same physical mechanisms as proven analgesics and argue that it should be utilized to relieve pain. Additionally, I describe factors to help identify situations in which clinicians have the obligation to disclose the potential for pain coupled with ways of mitigating the risk of high-intensity pain by setting positive expectations. (shrink)

To cause pain, it is not enough to deliver a dose of noxious stimulation. Pain requires the interaction of sensory processing, emotion, and cognition. In this paper, I focus on the role of cognition in the felt intensity of pain. I provide evidence for the cognitive modulation of pain. In particular, I show that attention and expectation can influence the experience of pain intensity. I also consider the mechanisms that underlie the cognitive effects on pain. I show that all the (...) proposed mechanisms of pain modulation affirm the view that cognition impacts the sensory and discriminative aspects of pain. I conclude that pain perception is a cognitively penetrated phenomenon. (shrink)

Neuroethics is an emerging interdisciplinary field with unsettled boundaries. Many of the ethical issues within the purview of neuroethics could be described as resulting from the clash between the scientific perspective on concepts such as free will, personal identity, consciousness, etc., and the putatively commonsense conceptions of those terms. The assumption that undergirds the framing of the conflict between these two approaches is that advances in neuroscience, psychiatry, and psychology can be used to explain phenomena covered by commonsense concepts and (...) in some cases undermine them entirely. This book is focused on the examination of the particular relationship between developments in neuroscience and commonsense moral concepts. Common sense, I argue, has been misinterpreted as a static, either foundational or degenerative, basis of our morality, when it is an ever shifting repository of theories from many domains. Within this discussion, I focus on the application of neuroscience to human beings, i.e., the ethics of neuroscience. But I also cover issues within the purview of the neuroscience of ethics, and attempt to address the infiltration of neuroscientific knowledge into everyday parlance and the impact of that on our commonsense morality and psychology. (shrink)

Scientific inquiry has revealed that pain is a complex and heterogonous phenomenon that is neither localized to a circumscribed region in the brain nor realized by a unique neurological mechanism. This discovery has inspired the application of a new version of eliminativism–scientific eliminativism–to pain. Based on this view, pain is not a natural kind and should be eliminated from scientific theorizing. Scientific eliminativism applied to pain is purportedly distinct from eliminative materialism because the former does not require elimination of the (...) term ‘pain’ from its quotidian uses in folk psychology. In this paper, I challenge the distinction between scientific eliminativism and eliminative materialism and argue that the two versions of eliminativism make the same claims. I argue further that endorsement of scientific eliminativism for pain leads to elimination of the category of pain from folk psychology. To avoid this outcome, I formulate a proposal that obviates the need for eliminativism in any domain. (shrink)

In 1959 two French neurologists, Pierre Mollaret and Maurice Goullon, coined the term coma dépassé to designate a state beyond coma. In this state, patients are not only permanently unconscious; they lack the endogenous drive to breathe, as well as brainstem reflexes, indicating that most of their brain has ceased to function. Although legally recognized in many countries as a criterion for death, brain death has not been universally accepted by bioethicists, by the medical community, or by the public. I (...) this paper, I defend brain death as a biological concept. I challenge two assumptions in the brain death literature that have shaped the debate and have stood in the way of an argument for brain death as biological. First, I challenge the dualism established in the debate between the body and the brain. Second, I contest the emphasis on consciousness, which prevents the inclusion of psychological phenomena into a biological criterion of death. I propose that the term organism should apply both to the functioning of the body and the brain. I argue that the cessation of the organism as a whole should take into account three elements of integrated function. Those three elements are: 1) the loss of integrated bodily function; 2) the loss of psychophysical integration required for processing of external stimuli and those required for behavior; and, 3) the loss of integrated psychological function, such as memory, learning, attention, and so forth. The loss of those three elements of integrated function is death. (shrink)

Pain is considered an immediately conscious sensation. If one has a pain, one knows it, and one knows it incorrigibly; these features qualify pain as a paradigmatic mental phenomenon. In everyday p...

The web is being loaded daily with a huge volume of data, mainly unstructured textual data, which increases the need for information extraction and NLP systems significantly. Named-entity recognition task is a key step towards efficiently understanding text data and saving time and effort. Being a widely used language globally, English is taking over most of the research conducted in this field, especially in the biomedical domain. Unlike other languages, Arabic suffers from lack of resources. This work presents a BERT-based (...) model to identify biomedical named entities in the Arabic text data that investigates the effectiveness of pretraining a monolingual BERT model with a small-scale biomedical dataset on enhancing the model understanding of Arabic biomedical text. The model performance was compared with two state-of-the-art models, and it outperformed both models with 85% F1-score. (shrink)

Upon entering the examination room, Caitlyn encounters a woman sitting alone and in distress. Caitlyn introduces herself as the hospital ethicist and tells the woman, Mrs. Dennis, that her aim is to help her reach a decision about whether to perform an autopsy on her recently deceased husband. Mrs. Dennis begins the encounter by telling the ethicist that she has to decide quickly, but that she is very torn about what to do. Mrs. Dennis adds, “My sons disagree about the (...) autopsy.” As a standardized patient, a specialized actor, the woman playing Mrs. Dennis has already delivered the same opening lines several times to different learners practicing their clinical ethics consultation skills. An SP encounter is a simulated patient encounter used for educational purposes that requires the standardization of verbal and behavioral responses. In the encounter, the simulator, or “patient,” uses a scripted medical history to enable the learner to employ a certain skill, say, the ability to perform a neurological exam. The use of standardized patients in the evaluation of clinical skills has become a staple in medical education. To tackle the challenge of teaching clinical ethics consultation skills, we have incorporated SP encounters into the curriculum of the Bioethics Program of The Union Graduate College and the Icahn School of Medicine at Mount Sinai. SP encounters are incorporated into one of our onsite classes, the Onsite Clinical Ethics Practicum, and they are part of the capstone examination, which all of our graduates must complete successfully. The inclusion of simulated encounters into the curriculum is one way in which we equip our students with the core competencies specified by the American Society for Bioethics and Humanities Task Force for clinical ethicists. (shrink)

Unrepresented patients are individuals who lack decision makingcapacity and have no family or friends to make medical decisions for them. This population is growing in number in the United States, particularly within emergency and intensive care settings. While some bioethical discussion has taken place in response to the question of who ought to make decisions for these patients, the issue of how surrogate medical decisions ought to be made for this population remains unexplored. In this paper, we argue that standard (...) applications of surrogate decision making principles in health care are not well suited to many unrepresented patients with long-term mental health diagnosis. We argue that when applied to this population, the substituted judgment standard, designed to preserve patient preferences and values, may lead to the exclusion of their preferences. We argue further that the application of the best interest standard runs the risk of leading to harmful cases of overtreatment or undertreatment. We offer an alternative interpretation of the best interest principle that is better able to promote the well-being of unrepresented patients, especially for those who lack capacity because of mental disorders. This alternative is based on the practices and principles of harm reduction and includes three components: emphasis on considering the expressed preferences of unrepresented patients, a focus on reducing harm as well as the delivery of clinical benefits, and a recognition of the importance of promoting trust. (shrink)

The use of brain technology that contributes to psychological changes has spurred a debate about personal identity. Some argue that neurotechnology does not undermine personal continuity (Levy, 2011) while others argue that it does (Kreitmair, 2019; Schechtman, 2010). To make these assessments, commentators fail to identify psychological changes that cause personal discontinuity. In this paper, I present a view that identifies personal continuity with the maintenance of a self-concept. I argue that a concept of self requires the ability to self-ascribe (...) physical and psychological features and that the diachronic self emerges with self-ascriptions of features that require endurance over time. I maintain that an adequate concept of self does not depend on the maintenance of any particular combination of self-ascriptions and that it can be maintained despite even significant changes in psychological or physical traits. Finally, I apply the self-concept view to identify changes that can result in discontinuity of self. (shrink)

Making decisions for incapacitated patients has been a perennial problem in bioethics. Surrogate decision-makers are sometimes expected to use substituted judgment to make such decisions. Applying...

This chapter will address the axiological objection to cognitive enhancement, which is that the use of cognitive enhancers reduces the value of cognitive achievement. In a recent defense of cognitive enhancement, Carter and Pritchard (2019) utilize the extended mind hypothesis to argue that cognitive enhancers do not compromise knowledge acquisition. In this chapter, it will be demonstrated that the reliance on the extended mind hypothesis leaves some cognitive enhancers vulnerable to the axiological objection. To expand the scope of the argument, (...) it will be shown that criteria for cognitive integration are applicable even to enhancers that cause changes to cognition internal to the human organism. This chapter will begin with a description of several cognitive enhancers and with the identification of the type of cognitive process they purportedly improve. It will then be demonstrated that even when those improvements are internal, they need not affect cognitive character and do not compromise cognitive agency. (shrink)

Loss of personal identity in dementia can raise a number of ethical considerations, including the applicability of advance directives and the validity of patient preferences that seem incongruous with a previous history of values. In this chapter, we first endorse the self-concept view as the most appropriate approach to personal continuity in healthcare. We briefly describe two different types of dementia, Alzheimer’s dementia (AD) and behavioral-variant frontotemporal dementia (bv-FTD). We identify elements considered important for the continuation of a self-concept, including (...) continuation of memories, consistency in personality traits and personal preferences, and continued endorsement of certain moral tenets. We show that, depending on which element is considered most important for personal identity, continuity of a self-concept for individuals with distinct types of dementia will be affected and assessed differently. Utilizing a variety of empirical evidence, we argue that persistence of memory, personality traits, and preferences are not the most important for the maintenance of personal identity. Instead, as studies aimed to capture the folk-psychological view of personal continuity demonstrate, judgements about continuity depend primarily on the persistent commitment to widely shared moral beliefs. Because of that, we argue that individuals with bv-FTD are more likely to lose their sense of self than individuals whose dementia primarily affects memory, such as Alzheimer’s disease. We end the chapter by showing how the importance of moral beliefs for continuity of self can be used to provide guidance to health-care professionals when considering changes in preference by individuals with dementia. (shrink)

In explaining human psychology and behavior, a dichotomy is often established between scientific explanations in neuroscience or neurology, and explanations that rely on psychological or social fac...

The established two tracks of neuroenhancement, moral and cognitive enhancements, rest on the characterization of commonsense morality as a set of static psychological dispositions. In this paper, I challenge this way of describing commonsense morality. I draw a parallel between commonsense psychology and commonsense morality, and I propose that the right way to characterize commonsense morality is as an empirically evaluable theory, with a structure similar to a scientific theory. I argue further that psychological dispositions to react in certain ways (...) require the tacit endorsement of a commonsense moral theory. By adopting this view, I argue that the way to change our psychological dispositions is by changing the background theory that produces them. I conclude that when commonsense morality is construed as an empirically evaluable theory, the cleft between the abilities that support scientific progress and the abilities that promote moral progress closes and it becomes evident that the way to promote both types of advancements is through cognitive enhancement. (shrink)

Introduction Nursing shortages and turnover pose significant challenges for health organizations worldwide, driven by various organizational and individual factors. Ethical climate has emerged as a critical aspect influencing nurses' well-being and retention within healthcare settings, reflecting organizational practices with moral implications. Understanding the relationship between ethical climate and turnover intention among nurses is paramount for practitioners, managers, and policymakers. Aim This review aimed to examine evidence and synthesize findings from prior studies on the association between ethical climate and turnover intention (...) among nurses and identify key variables influencing its dynamics. Methods A scoping review methodology was employed, encompassing studies retrieved up to February 2024 from major scientific databases, including PUBMED/MEDLINE, WEB OF SCIENCE, SCOPUS, and SCIENCE DIRECT. This study was conducted following ethical considerations and sound scientific guidelines. Results Sixteen articles meeting the inclusion criteria were identified. Overall, a significant association between ethical climate and turnover intention was observed, with theoretical underpinnings demonstrated. Key variables frequently linked to both ethical climate and turnover intention included organizational commitment, job satisfaction, and moral distress, while organizational commitment, organizational cynicism, and organizational trust emerged as mediators. Conclusion Despite demonstrating a clear association, results underscore the necessity for replication studies, qualitative and longitudinal approaches, and standardized measurement. Enhancing the ethical climate through regular assessments, education, and interprofessional collaboration can improve retention. Future research should focus on theory building, ethical management and leadership, associated factors analysis, and intervention studies to develop comprehensive models and effective strategies for improving the ethical climate and reducing nurse turnover. (shrink)

Selon Gilles-Gaston Granger, la différence entre la logique et les mathématiques est une différence de degré. De la logique des propositions aux mathématiques en passant par le calcul des prédicats et le reste des calculs logiques, la forme perd en pureté et le contenu gagne progressivement en épaisseur. Du degré zéro de l’opposition d’une forme à un contenu au niveau de la logique propositionnelle aux formes logico-mathématiques productrices de « contenus formels », le calcul s’enrichit en propriétés d’individuation au détriment (...) de ses propriétés méta-logiques. Granger ne prétend pas avoir fondé par là un véritable critère de logicité. Toujours est-il qu’il part d’un nombre de présupposés explicitement établis lui servant de point d’appui pour démarquer la logique des mathématiques. En revenant sur ces présupposés, nous voudrions montrer, comme l’a reconnu Pascal Engel précédemment, qu’ils ne sont pas exempts d’ambiguïtés, tant par leurs ramifications philosophiques que par les difficultés techniques qu’ils suscitent. Néanmoins, et à la différence d’Engel, nous n’irons pas jusqu’à dire que la conception grangérienne constitue, malgré ses ambiguïtés, un critère de logicité. (shrink)

More than 5 billion people in the world own a smartphone. More than half of these have been used to collect and process health-related data. As such, the existing volume of potentially exploitable health data is unprecedentedly large and growing rapidly. Mobile health applications (apps) on smartphones are some of the worst offenders and are increasingly being used for gathering and exchanging significant amounts of personal health data from the public. This data is often utilized for health research purposes and (...) for algorithm training. While there are advantages to utilizing this data for expanding health knowledge, there are associated risks for the users of these apps, such as privacy concerns and the protection of their data. Consequently, gaining a deeper comprehension of how apps collect and crowdsource data is crucial. To explore how apps are crowdsourcing data and to identify potential ethical, legal, and social issues (ELSI), we conducted an examination of the Apple App Store and the Google Play Store in North America and Europe to identify apps that could potentially gather health data through crowdsourcing. Subsequently, we analyzed their privacy policies, terms of use, and other related documentation to gain insights into the utilization of users’ data and the possibility of repurposing it for research or algorithm training purposes. More specifically, we reviewed privacy policies to identify clauses pertaining to the following key categories: research, data sharing, privacy/confidentiality, commercialization, and return of findings. Based on the results of these app search, we developed an App Atlas that presents apps which crowdsource data for research or algorithm training. We identified 46 apps available in the European and Canadian markets that either openly crowdsource health data for research or algorithm training or retain the legal or technical capability to do so. This app search showed an overall lack of consistency and transparency in privacy policies that poses challenges to user comprehensibility, trust, and informed consent. A significant proportion of applications presented contradictions or exhibited considerable ambiguity. For instance, the vast majority of privacy policies in the App Atlas contain ambiguous or contradictory language regarding the sharing of users’ data with third parties. This raises a number of ethico-legal concerns which will require further academic and policy attention to ensure a balance between protecting individual interests and maximizing the scientific utility of crowdsourced data. This article represents a key first step in better understanding these concerns and bringing attention to this important issue. (shrink)

Recenze seznamuje s knihou Philosophy of Mind: An Introduction, jejímž autorem je Timothy John Bayne. Recenze je zaměřena na obsah jednotlivých kapitol a celkové zhodnocení knihy. Cílem je seznámit čtenáře s klíčovými tématy, jimž se Bayne v knize věnuje, a s jeho argumentací. Klíčová slova: filosofie mysli, Timothy John Bayne, Philosophy of Mind: An Introduction.

It is one of the premises of eliminative materialism that commonsense psychology constitutes a theory. There is agreement that mental states can be construed as posited entities for the explanation and prediction of behavior. Disputes arise when it comes to the range of the commonsense theory of mental states. In chapter one, I review major arguments concerning the span and nature of folk psychology. In chapter two, relying on arguments by Quine and Sellars, I argue that the precise scope of (...) commonsense psychology cannot be determined because there are no resources to distinguish claims that are commonsense from all others. I use this conclusion to evaluate Churchland’s proposal that folk psychology should be eliminated in favor of a scientific theory. I argue that, although such an elimination is possible, it is unnecessary because commonsense psychology is in part informed by scientific theories. The properties that are usually attributed to mental states, on my view, are not common sense and would re-emerge even if we replaced our current theory with a scientific one. In chapter three, I examine how this affects eliminativist arguments, such as Churchland’s proposals for how to solve the emergence of the phenomenal character of sensations. I argue that it might be the case that some phenomenal properties are the result of endorsing a particular theory, but phenomenal character as such is a permanent feature of any theory about internal states. Addressing the problem of the incorrigibility of mental states, in chapter four, I challenge Rorty’s idea that such a property is the mark of the mental and can be attributed to our mental states based on our everyday usage of mental terms. The position asserted in the dissertation is compatible with the view that any theory can be revised, but doubts are expressed concerning the likelihood for a complete replacement of the current folk-psychological theory. Taking inspiration form Sellars, in chapter five, I argue that the establishment of a conceptual framework entails a wholistic jump from no concepts to a rudimentary framework. With this leap some properties are solidified and stand in the way of elimination. (shrink)

The purpose of this essay is to examine some of the ethical concerns raised regarding the use of neuroenhancers. Authors such as Fukuyama and Sandel argue that medical intervention should be limited to treatment of disease, and that enhancement should be outside of the scope of medicine. This commentary will examine the distinction between treatment and enhancement. I shall conclude that it is not a well-drawn distinction and should not be used to provide guidance with regards to the use of (...) psychopharmacological agents for the purpose of cognitive enhancement. I shall further examine whether concepts such as disability and normality could provide a criterion for determining whether enhancement is a permissible use of medical intervention. I conclude that as those concepts are contextually defined, they cannot be used to make principled arguments against enhancement. Finally, I shall review the charge that medicalization of cognitive performance enhancers is not morally permissible. I shall argue that medicalization might have both negative and positive consequences, and decisions about the moral permissibility of medicalization should be made on a case-by-case basis. (shrink)

Ovaj članak specificira mjesto Hipokratove zakletve u programu bioetičkog obrazovanja na profesionalnim fakultetima gdje se obrazuju budući medicinski i zdravstveni radnici. Predstavljena konceptualizacija sadržaja i opisana metodologija rada pokazuje kako se sadržaji curriculuma, kojima dominiraju povijesne činjenice, aktualiziraju uporabom znanja što su ih studenti usvojili ranije, te problematiziraju aktivnim uključenjem studenata u prikupljanju nove informacije relevantne za sadržaj, a onda koriste usvojeno znanje kako bi riješili konkretni bioetički predmet ili problem. Ponuđena aktivnost studenata i nastavnika ima svrhu pokazati suradnički odnos (...) između njih, te komunikaciju u kojoj studenti i nastavnici međusobno preuzimaju zadatke u realizaciji sadržaja curriculuma. (shrink)

ObjectiveTo examine body image perception and the associations of body dissatisfaction with socio-demographic and lifestyle factors among Saudi women attending fitness centers in Riyadh.MethodsSaudi females aged 16 years and older were recruited from 12 randomly selected fitness centers in Riyadh, using stratified clustered sampling technique. Height and weight were measured to calculate actual body mass index. A previously validated instrument was used to collect socio-demographic and lifestyle variables including physical activity, sedentary behaviors, sleep and dietary habits. Stunkard Figure Rating Scale (...) silhouettes were used to assess perceived and desired body shape.ResultsThe participants had a mean age of 29.2. The majority were not married, with no children and had college degrees. While 63% were overweight or obese, nearly 40% of women underestimated their perceived body shape. The majority of respondents were dissatisfied with their body shape including 68% of normal weight women. Females who had BD were significantly older, had higher BMI, reported more weight loss attempt and had expended less time in vigorous and total PA than those who were satisfied with their body shape. However, when adjusting for socio-demographic variables, logistic regression analysis revealed significant associations of BD with higher BMI, shorter membership duration of fitness club, and reduced dairy products and energy drinks consumption.ConclusionExcept for BMI and decreased dairy products and energy drinks consumption, many lifestyle behaviors did not associate with BD among Saudi females attending fitness centers. The findings can inform healthcare providers when intervention strategy is implicated for females with BD. Future studies should compare the associations of BD with lifestyle behaviors between males and females attending fitness centers and seeking weight loss. (shrink)

This paper aims at investigating the perceived difference between ethics and IT ethics in college students. The study mainly investigates whether university students in the Middle East and their counterpart in the USA hold the same ethical values both in a traditional context and in an IT context. The study also investigates possible differences in students’ ethics considering their level of study and whether they have prior business ethics knowledge or not. Furthermore, the study controls for possible self-others bias in (...) students’ responses to ethical issues by addressing some ethical issues where the respondent is the subject of the issue and other ethical issues where someone other than the respondent is the subject of the issue. Questionnaires were administered to university students in the USA and in several Middle East countries. A total of 401 usable questionnaires were returned. The study found that both the USA and the Middle East students have statistically significant lower ethical intention scores when addressing ethical issues in an IT context compared to traditional non-IT context. This pattern was consistent regardless of the students’ level of study and their prior knowledge of business ethics, and taking into consideration self-others bias. Additionally, it was found that graduate students have higher IT as well as non-IT ethical intentions compared to undergraduate students, however, it was found that the students’ prior business ethics knowledge did not affect the students’ ethical intention scores. Self-other bias was found to act in opposite directions for ethical issues in an IT context compared to ethical issues in a traditional context. For ethical issues within IT-context, students were less strict with themselves while they were stricter with others. For ethical issues within traditional non-IT context, students were stricter with themselves, while they were less strict with others. Finally, the study found that while students both in the USA and in the Middle East disagree with unethical IT as well as non-IT conducts, the degree to which they disagree with the unethical behavior significantly differ, where USA students were found to be significantly stricter with their disagreement. (shrink)

Endorsing the view that commonsense conceptions are shaped by scientific claims provides an explanation for why microbiota-gut-brain research might become incorporated into commonsense notions of health. But scientific claims also shape notions of personal identity, which accounts for why they can become entrenched in common sense even after they have been refuted by science.

Work purpose: to present and analyze pedagogical strategies and the communicational approach to definitions of bioethics, a mutual part of the bioethics contents being realized on the university studies of Dentistry, Organization, Planning and Management in Healthcare, and professional studies of Medical Radiology at the Medical School in Rijeka. Methods: the method of content analysis was used to research and present encyclopaedic and some authorial definitions of bioethics, with special emphasis on definitions of bioethics by authors – bioethicists from Croatia; (...) the method of pattern 1: included the curriculum of Medical Ethics and Bioethics and the Ethics of Healthcare, and researched standpoints of forty-five students educated in studies where bioethics courses are being realized. The pattern is specifically stratified because it: a) included students whose curriculum is being realized in shifts – intensive lectures in a duration of two weeks, and those whose lectures are being realized each week during one semester; b) different year of education . 2. The scale of assessment was used to research and obtain standpoints of students on the contents of the curriculum, methods of its performance, and the achieved level of communication among students and communication with the professor. Expected results: the presented method of work and results obtained by the scale of assessment should display the acceptability and successfulness of the presented pedagogicalmethodological means of work and point out to weaknesses and deficiencies, and finally conclude the extent to which the presented concept, and approaches to the actualization of the definitions of bioethics contribute to the realization of dialogue and communication in which students simultaneously experience the curriculum as necessary, useful, interesting, and one that may motivate them to think, exchange ideas and offer possible solutions. The scale of assessment should point out to different standpoints of students depending on the length of their study and commitment to a method of class realization. (shrink)