In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 487 Although this reviewer would have appreciated a fuller expression of the dialectical interdependency and synthetic elements holding between Fichte and Schelling than Schurr actually developed, his study is nevertheless an orderly and well-documented presentation of their fundamental views. The study can serve as a solid and professional introduction to the postKantian phase of German Idealism, and it most certainly deserves translation into English. LAWRENCES. STEPELEVICH Villanova (...) University Die Konstitution der Jl'sthetik in Wilhelm Diltheys Philosophie. By Michael Heinen. Abhandlungen zur Philosophie, Psychologie und P~dagogik, no. 100. (Bonn: Bouvier, 1974. Pp. 220) Michael Heinen's book draws attention to Dilthey's interest in the original dimension of art experience. That interest has been the traditional stock in the trade of philosophers since the ancient Greeks, and most crucially since the subjectivization of the aesthetic sphere in the speculative thought of Kant and German idealism. But the point is that there is a gap between those philosophers who speculated about perception, aesthetic pleasure, and the enjoyment of the senses, and who tried to justify those speculations through wide-ranging inquiries into the order of the world and its understanding through our ego and its potentialities--betweenthem and Dilthey, who knows that this age-old enthusiasm for metaphysical and epistemological inquiries has become obsolete. The earlier display of erudition may be vast and awe inspiring. But in Dilthey's mind an interest in those inquiries is no longer foremost. Commendable as all of them may be, they approach the world of the work of art and its experience from the outside, in an independent, self-sufficient, and almost autonomous manner, without facing up to the horizon of the world in which an artistic work is rooted. This horizon of the world emerges as the leitmotif of Heinen's book. Heinen reminds the reader that those who create are immersed in this horizon. The conditions under which they work, the tools they have, the methods they use, the materials that are available to them, the ideas they have in mind--all this can be traced back to the world which surrounds them. Moreover, they belong to an historical world. They are oriented toward a past they remember, a future they anticipate; and all they think, or feel, or will, stands in an historical context, long before they are conscious of themselves in this respect. Heinen rightly points out that this creates a problem not only for the analysis of the artistic expression but for the field of hermeneutics, for the method of understanding this expression. It is not so much something that is understood in its meaning by referring to an ego, or a system of cognitive faculties. It emerges from the socio-historical world; and we must place it back in the same horizon from which it emerges. Heinen agrees with Dilthey that we always find ourselves within the whole of life; and when understanding something--a work of art or any other historical object--we have to do it within the full context of life to which we belong. It is an objectification of life that we have to understand from life itself. This may help to explain why a work of art is more than an object created by an artist through his inspiration and the unconscious production of his genius. From his Hegelian perspective Heinen tells us that whenever an artist is involved in the creation of something he is dependent upon the world in which he lives and upon a dialectic between himself and the horizon of life. Heinen expressly defends the probability of this dialectic in a chapter on the presuppositions of Dilthey's aesthetics (pp. 134-162). He studies Dilthey's attempt to discover a methodological basis for the human sciences. He calls attention to the remarkable sequence of sketches in which Dilthey distinguishes between Geisteswissenschaften and Naturwissenschaften, between human sciences that, in one way or another, deal with historical and other manifestations of 488 HISTORY OF PHILOSOPHY life and inner experience, and natural sciences that deal with phenomena, with objects of nature. Dilthey is profoundly conscious and frank in announcing that the human sciences also treat phenomena or objects. But... (shrink)

The form of an action has a strong influence on the interaction between humans. According to their mood, people may perform the same gesture in different ways, such as gently or rudely. These aspects of social communication are named vitality forms by Daniel Stern, represent a mean to establish a direct and immediate connection with others. Indeed, the expression of different vitality forms enables us to communicate our affective states and at the same time the perception of these vitality forms (...) enables people around us to understand how we feel in that moment. In the last years of research, different fMRI studies have been carried out to investigate the neural correlates of vitality forms recognition and execution. Moreover, recent psychophysics studies conducted from our research group have demonstrated the presence of an affective contagion effect, during which vitality forms expressed by an agent affect the action perception and the motor response of the receiver. This means that vitality forms expressed by others can influence our mood positively or negatively, modulating as consequence our behavior. Note that vitality forms pervade our lives in a continuous manner and thus they are not expressed and perceived only during social interactions. For example, when we observe an artistic representation at the theatre, the dynamic postures of dancers, together with an alternation of acceleration and deceleration in their movements, communicate to us different affective states. Also when we are in a museum in front of a painting, lines, colors and shapes used by the artist can elicit in us different sensations and modify our attitude. In this view, with the aim to extend the concept of vitality forms from neuroscience and psychology to other disciplines of study, we dedicate part of this review to discuss how art, in all its forms, can be considered a pure expression of vitality forms. (shrink)

In this article I will address the issue of the embodiment of computing systems from the point of view distinctive of the so-called Unconventional Computation, focusing on the paradigm known as Morphological Computation. As a first step, I will contextualize Morphological Computation within the disciplinary field of Embodied Artificial Intelligence: broadly conceived, Embodied Artificial Intelligence may be characterized as embracing both conventional and unconventional approaches to the artificial emulation of natural intelligence. Morphological Computation stands out from other paradigms of unconventional (...) Embodied Artificial Intelligence in that it discloses a new, closer kind of connection between embodiment and computation. I will further my investigation by briefly reviewing the state-of-the-art in Morphological Computation: attention will be given to a very recent trend, whose core concept is that of “organic reconfigurability”. In this direction, as a final step, two advanced cases of study of organic or living morphological computers will be presented and discussed. The prospect is to shed some light on our title question: what progress has been made in understanding the embodiment of computing systems? (shrink)

_Riassunto_: Il concetto di modello corporeo è un’acquisizione relativamente recente della neuropsicologia. Studiosi attivi in questo ambito di ricerca interpretano il concetto di modello corporeo come facente riferimento ad un modello interno, una rappresentazione cognitiva delle proprietà anatomiche, volumetriche e posturali del corpo umano. È stato dimostrato come il modello corporeo fornisca un _background_ cognitivo stabile a processi d’integrazione dell’informazione multisensoriale riferita al corpo proprio. In questo senso, si ritiene che esso concorra a generare una forma elementare di autocoscienza corporea, (...) il cosiddetto sé corporeo minimale. Il presente contributo intende fornire un’aggiornata rassegna tematica sul modello corporeo trattato contestualmente alla teoria neuropsicologica del sé corporeo minimale. A tale scopo, saranno discussi studi teorici di rilievo che condividono una comune base sperimentale: le _Illusioni della Proprietà Corporea_ (IPC). Attenzione verrà riservata anche alle principali ricadute che un tale lavoro di sistematizzazione teorica ha recentemente conosciuto in psicopatologia, filosofia della neuroscienza e neurofilosofia. Saranno infine segnalati alcuni problemi aperti nella contemporanea ricerca sul modello corporeo. _Parole chiave_: Neuropsicologia; Modello corporeo; Sé corporeo minimo; Illusioni della proprietà corporea _The body model and the neuropsychological theory of the minimal bodily self. A thematic revie _ _Abstract_: The body model is a relatively new concept developed by neuropsychologists that refers to an internal model or cognitive representation of the anatomical, volumetric, and structural aspects of the human body. The body model has been shown to provide a stable cognitive background for body-related multisensory integration, thereby contributing to the formation of an elementary kind of corporeal self-consciousness, the so-called minimal bodily self. Here, I provide an updated thematic review of research on the body model in the context of the neuropsychological theory of the minimal bodily self. It examines theoretical studies based on experiments on _Body Ownership Illusions_ (BOI) and the important implications this work has for psychopathology, the philosophy of neuroscience and neurophilosophy. Finally, it points to some unanswered questions in contemporary research on the body model. _Keywords_: Neuropsychology;_ _Body Model; Minimal Bodily Self; Body Ownership Illusions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 53-64 [Access article in PDF] Incentives for Providing Organs Patricia Milmoe McCarrick and Martina Darragh After a contentious debate at its 2002 annual meeting, the American Medical Association's House of Delegates voted to endorse the opinion of its Council on Ethical and Judicial Affairs that the impact of financial incentives on organ donation should be studied (Josefson 2002). The shortage of (...) organs for transplantation has been an ongoing problem for more than 20 years. In June1981, Representative Philip Crane (R-IL) introduced legislation in the U.S. House of Representatives proposing a $25,000 income tax deduction and a $25,000 estate tax exclusion for donating an organ (Tax Incentives 1981). Still the National Organ Transplant Act enacted in October 1984 prohibited the offering of any "valuable consideration" in return for organs (United States 1984).The developments of a legal market for tissues in the United States and a black market for organs around the world have raised the question of whether donation without compensation is the only ethically viable option. Some critics of the current system claim reliance on donation actually promotes a black market in organs (Kaserman and Barnett 2002, p. 38; Palmer 1999, p. 36). In addition, a new set of compensation issues has arisen as living kidney donor transplantations begin to rival those performed with cadaveric organs (United States 2001).As a result, current suggestions for incentives go far beyond the traditional death benefit payment to include such ideas as medals of honor for donors, reimbursement for funeral expenses, exchange programs for organ donation, and special medical insurance for living organ donors. Numerous bills introduced into the 107th Congress have proposed such incentives (Delmonico et al. 2002.) In October 2002, the U.S. Department of Health and Human Services awarded $5.2 million in grants to study both clinical and behavioral interventions for increasing organ donations that do not involve incentives. The inspiration for some of the funded proposals comes from the successes of Spain's social services and the United Kingdom's clinical administration of organ procurement programs (Robeznieks 2002). [End Page 53]With a nod to evidence-based medicine, the underlying concern expressed in much of the current literature is that no idea for increasing the supply of organs should be discounted before it is studied. This bibliography provides a short introduction to the range of opinions expressed on the issue of incentives for providing organs.al-Mousawi, M.; Samhan, M.; al-Mezairee I.; Razzak, M.A.; and Khawari, F. Cadaver Organ Procurement in Kuwait. Transplantation Proceedings 31 (8): 3375-76, 1999.The authors describe a protocol that significantly increased cadaveric organ donation and credit it with fostering the expansion of an organ sharing program among the Arab Gulf states. Developed by Kuwaiti neurologists and anesthetists after a continuing education course on transplantation, the protocol places a special emphasis on the role of local transplant coordinators who facilitate the investigation of brain death cases by neurologists.Arnold, Robert; Bartlett, Steven; Bernat, James; et al. [Ethics Committee of the American Society of Transplant Surgeons] Financial Incentives for Cadaver Organ Donation: an Ethical Reappraisal. Transplantation 73 (8): 1361-67, 27 April 2002.To prepare for proposed studies of financial incentives for organ donation, the American Society of Transplant Surgeons convened a panel to develop a methodology for evaluating the ethics of such research. Comprised of organ procurement organization executives, physicians, surgeons, and ethicists, the panel generated a list of nine criteria for use in judging any incentives proposal. While opposed to direct payment or tax incentives for organ donation, a majority of the members support funeral expense reimbursement or charitable contributions as incentives that would not violate or undermine the ideal of altruism.Cameron, J. Stewart, and Hoffenberg, Raymond. The Ethics of Organ Transplantation Reconsidered: Paid Organ Donation and the Use of Executed Prisoners as Donors. Kidney International 55 (2): 724-32, February 1999.After reviewing arguments for and against payment for organ procurement, the authors apply these arguments to the specific case of obtaining organs from executed... (shrink)

Neuroethics entails investigations of neurocognitive mechanisms of morality and ethics; and studies and address of the ethical issues spawned by the use of neuroscience and its technologies to investigate cognition, emotion and actions. These two principal emphases, or what have been called “traditions” of neuroethics both mirror traditional bioethical discussions (such as debates about the safety of technological and pharmaceutical advances and ethical implications of new scientific and technological discoveries), and engage discourse about neuroscientific investigations of (proto-moral and moral) cognition, (...) emotions and behaviors, and what such findings may mean for human beliefs and conduct - from the individual to the political levels. (shrink)

An effectiveness assessment on ASCT in locally advanced and metastatic breast cancer identified serious ethical issues associated with this intervention. Our objective was to systematically review these aspects by means of a literature analysis. We chose the reflexive Socratic approach as the review method using Hofmann's question list, conducted a comprehensive literature search in biomedical, psychological and ethics bibliographic databases and screened the resulting hits in a 2-step selection process. Relevant arguments were assembled from the included articles, and (...) were assessed and assigned to the question list. Hofmann's questions were addressed by synthesizing these arguments. Of the identified 879 documents 102 included arguments related to one or more questions from Hofmann's question list. The most important ethical issues were the implementation of ASCT in clinical practice on the basis of phase-II trials in the 1990s and the publication of falsified data in the first randomized controlled trials (Bezwoda fraud), which caused significant negative effects on recruiting patients for further clinical trials and the doctor-patient relationship. Recent meta-analyses report a marginal effect in prolonging disease-free survival, accompanied by severe harms, including death. ASCT in breast cancer remains a stigmatized technology. Reported health-related-quality-of-life data are often at high risk of bias in favor of the survivors. Furthermore little attention has been paid to those patients who were dying. The questions were addressed in different degrees of completeness. All arguments were assignable to the questions. The central ethical dimensions of ASCT could be discussed by reviewing the published literature. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Managed Health Care: New Ethical Issues for All*Martina Darragh (bio) and Pat Milmoe McCarrick (bio)Changes in the way that health care is perceived, delivered, and financed have occurred rapidly in a relatively short time span. The 50-year period since World War II encompasses enormous growth in medical technology, soaring health care costs, and significant fragmentation of the two-party patient- physician relationship. This relationship first grew to include the (...) third-party payer, the health insurance industry, and now “with great speed and relatively little public awareness, a significant change has occurred in the way some decisions are made about a patient’s medical care” (III, Institute of Medicine 1989).The new means of providing health care bring an increasing number of parties into clinical decision-making processes. With this change, ethical issues that once concerned only health care professionals, the physician or the nurse, have expanded to include the patient and the groups who “manage” care—e.g., health maintenance organizations (HMOs), preferred provider organizations (PPOs), point of service groups (POSs), independent practice associations (IPAs), insurance reviewers, hospital administrators, institutional managers, and, the most recent players, purchasers of group health care who base their decisions on competitive pricing.The term “managed care” refers to a variety of continually adapting and developing arrangements that involve four groups. These groups, which have been labeled by the world of business, not health, are the “consumer” (once the patient), the “provider” (the physician and other health care professionals), the “insurer” (the reimburser for any care), and the “purchaser of care” or the primary buyer of health services (the large employer organization). Capitation is a common way to pay for health services in managed care systems. A certain dollar amount is negotiated for health services for a specified number of patients whether the care is delivered or not; the provider shares with the [End Page 189] insurer any financial risk for the actual cost of care (III, Centers for Disease Control 1995).When the Clinton administration’s health care reform movement failed to gain support in the U.S. Congress, the use of managed care to control rising health care costs accelerated. The literature on managed care and its effect on the patient-physician relationship reflects this shift. During the era of health care reform, “debate centered on how managed care could control costs, on the use of technology and patient satisfaction, [and] on access and barriers to care” (IV, Emanuel and Dubler 1995). When managed care organizations began contracting with physicians to provide health care services subject to the plans’ provisions, these plans became agents in clinical decision making on a wide-spread basis. HMO enrollment grew to 51 million persons by 1994 (III, Centers for Disease Control 1995). This “corporatization” of health care has sparked a plethora of articles about the effects of the marketplace on the physician’s ability to do what is best for the patient, and on the patient’s ability to trust the physician to do so.Many authors make it clear that managed care itself is not the problem, but rather the development of for-profit managed care plans by “corporate conglomerates with billions of dollars in assets that compensate their executives as grandly as basketball players” (V, Kassirer 1995) “in a marketplace that is largely unregulated” (I, Zoloth-Dorfman and Rubin 1995). “Some, mostly older plans that were created when cost containment was an unexpected benefit rather than their central purpose, deliver high-quality care economically. Unfortunately, others cut costs by recruiting the healthiest patients, excluding the sickest, rationing care by making it inconvenient to obtain, and denying care by a variety of mechanisms” (V, Kassirer 1995).These cost-containment features now play an intimate role in clinical practice. When a managed care plan contracts with a physician, the doctor becomes a “double agent” with contractual obligations to the plan to provide a preset amount of services and professional responsibilities to each patient to authorize necessary treatment (V, Angell 1993). This duality can undermine the physician’s fiduciary responsibility to the patient wherein the physician “has power over the affairs of [the patient]...and is required by law to act on that person’s... (shrink)

Does the most common response given by participants presented with Tversky and Kahneman’s famous taxi cab problem amount to a violation of Bayes’ theorem? In other words, do they fall victim to so-called base-rate fallacy? In the present paper, following an earlier suggestion by Crupi and Girotto, we will identify the logical arguments underlying both the original diagnosis of irrationality in this reasoning task under uncertainty and a number of objections that have been raised against such a diagnosis. This will (...) enable us to show firstly that, contrary to the dismissive arguments recently put forward by Elqayam and Evans, empirical evidence turns out to be quite useful in addressing questions of this kind. Therefore, it can make a significant contribution to moving the base-rate fallacy controversy forward. Secondly, the available empirical evidence (though limited and sometimes inconclusive) seems to support the charge of irrationality levelled against the majority of participants presented with the taxi cab problem, and hence suggests that base-rate neglect is a real fallacy − that is the conclusion of our analysis. (shrink)

ABSTRACT This article examines Olympe de Gouges’ demands for the rights of woman in her famous but still understudied work Les droits de la femme. A La Reine [1791]. Particular emphasis is put on analysing how she combines her demand for equality with her conception of sexual difference. The article consists of three parts. The first part gives a brief overview of the demands for the equality of the sexes as they were presented in seventeenth-century France and critically reacted upon (...) in eighteenth-century France, not least by Jean-Jacques Rousseau in his defence of sexual difference. The second and third parts focus on Gouges’ argumentation. First, by analysing how she argues for women’s active citizenship by criticising the exclusion of women from the public sphere, but without questioning sexual difference as such; and second, by discussing how she redefines the famous slogan of the French Revolution; liberty, equality, fraternity. The conclusion argues that rather than being caught in a paradox of equality and difference, as has been claimed by Joan W. Scott, Gouges did successfully combine the two concepts, even if her interpretation of their relation was excluded from the canon of political theory. (shrink)

Globally, parents and children in same-sex parent families are impacted by many laws related to the parental sexual orientation. These laws vary considerably from one country to another, ranging from full legal recognition to criminalization. The psychological consequences of living in an ambiguous or hostile legal climate likely interfere with parental health, family functioning, and child development. However, a systematic evidence synthesis of the pertinent literature and its placement within a broader psychological model are currently lacking. The aims of this (...) review were thus (1) to systematically review qualitative and quantitative evidence on the impact of sexual orientation laws on same-sex parent families in key domains and (2) to place these findings within a broader model informed by minority stress and family theories. Our review was preregistered and conducted in line with PRISMA guidelines. We searched for qualitative, quantitative, and mixed methods studies on the impact of sexual orientation laws on target outcomes (parental health, family functioning, child outcomes) via systematic database search (PubMed, Scopus, Web of Science) and forward-backward searches. Fifty-five studies published between 1999 and 2020 were eligible for inclusion and were synthesized using a data-based convergent synthesis design. Thirteen descriptive and three overarching analytical themes were identified through thematic synthesis. Linking our findings with minority stress and family theories, we propose a novel legal vulnerability model for same-sex parent families. The model posits that legal vulnerability constitutes an increased risk for parental and child health as well as family functioning through individual and shared pathways between family members. Additionally, the model introduces counteractions that families engage in on the personal, familial, and systemic level to mitigate the impact of legal vulnerability, as well as moderators on the contextual, familial, couple, and individual level that modulate this impact. Implications for research and clinical practice are discussed. (shrink)

In Europe the elderly population is projected to increase from 18.5% (93.9 million) in 2014 to 28.7% (149.1 million) by 2080. In the USA it is estimated that by the year 2030 more than 20% of the population will be aged 65 years or over. This specific population is at high risk of unrecognised or untreated psychiatric illnesses and suicide. It is well known that completed suicide rate increases with age in both men and women. Although elderly people attempt suicide (...) less often than other age groups, they show a higher completion rate. Generally the methods chosen by elderly are more lethal, the intent is more serious, they are more determined and they show fewer warning sign than the younger population. A recent systematic review and meta-analysis of psychosocial intervention following self-harm in adults found that cognitive behavioural therapy was the most effective in these patients. Unfortunately there have been few reported trials of other potentially effective interventions. Because the scientific literature on psychosocial suicide prevention interventions in the elderly is still scant we decided to conduct a mini-review in order to take stock of the situation. Studies were identified through electronic searches of the Cochrane library, MEDLINE, Scopus and Web of Science databases. PRISMA guidelines were followed and only 7 articles met the inclusion criteria. No firm conclusions can be drawn about this topic because there is still little data and studies used inconsistent outcome measures and designs. Nonetheless, the existing data suggests that psychosocial interventions are promising. (shrink)

There is a rapid growth in published knowledge about different aspects of age and aging. While this is highly welcome, it becomes increasingly difficult to keep up even with the main insights provided by this literature. Our review thus aims to provide a compact overview of current social science research in three major domains of older people’s life: health, families, and work. Moreover, we briefly discuss some theoretical issues and introduce the Survey of Health, Ageing, and Retirement in Europe (...) (SHARE). The research findings discussed here demonstrate both the challenges and opportunities lying ahead of us as life expectancy is increasing steadily and as the proportion of older people in our societies will grow further. More generally, we find a great value of life course and cross-nationally comparative perspectives in aging research. We conclude with an outlook on perspectives for future studies in this field. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

The mortality rate of patients affected with oral squamous cell carcinoma has been stable in recent decades due to several factors, especially diagnostic delay, which is often associated with a late stage diagnosis and poor prognosis. The aims of this paper were to: analyze diagnostic delay in OSCC and to discuss the various psychological factors of patients with OSCC, with particular attention to the patient’s fear of receiving news regarding their health; and the professional dynamics related to the decision-making processes (...) in cases of suspected OSCC. A preliminary review of literature focusing on OSCC diagnostic delay was performed. Seven articles were included with the diagnostic delay ranging from 45 days to approximately 6 months. Patients’ fears and, to a lesser degree, the concerns of dentists, were found to be still poorly investigated. On the basis of the authors’ professional experience, the development of oral lesions of unknown origin may generate different behaviors in the decision-making processes by patients and clinicians, and fear may play a key role in the distinct steps of this process. It is crucial to increase awareness and inform patients about the onset of OSCC, and contemporaneously encourage experimental studies on patients’ fear and professional behaviors with respect to communication regarding OSCC. (shrink)

Frailty is an age-related dynamic status, characterised by a reduced resistance to stressors due to the cumulative decline of multiple physiological systems. Several researches have highlighted a relationship between physical frailty and cognitive decline; however, the role of specific cognitive domains has not been deeply clarified yet. Current studies have hypothesised that physical frailty and neuropsychological deficits may share systemic inflammation and increased oxidative stress in different neurodegenerative disorders, such as Alzheimer’s and Parkinson’s disease. However, the role of the executive (...) dysfunction should be investigated in a more detailed way using a multidimensional approach. With this aim, we conducted a review of the literature on the few experimental articles published to discuss the existence of a relationship between frailty and cognitive impairment in neurocognitive disorders, particularly focusing on the domain of executive dysfunction. The data suggest that physical frailty and cognitive decline, especially executive dysfunction, are two aspects strongly linked in mild and major neurocognitive disorders due to Alzheimer's and Parkinson's disease. In light of this, a new framework linking ageing, cognitive decline, and neurodegenerative diseases is needed. In order to analyse the effects that ageing processes have on neural decline and neurocognitive disease, and to identify relevant groups of users and patients, future longitudinal studies should adopt a multidimensional approach, in the field of primary prevention and in the continuum from mild to major neurocognitive disorder. (shrink)

Using the volume of her works and correspondence recently edited by K. Herrmann, I assess the significance of Grete Hermann's work.

In lieu of an abstract, here is a brief excerpt of the content:Organizational Ethics and Health Care: Expanding Bioethics to the Institutional Arena **Laura Jane Bishop (bio), M. Nichelle Cherry (bio), and Martina Darragh* (bio)In 1995, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) expanded its patient rights standards to include requirements for assuring that hospital business practices would be ethical. Renamed “Patient Rights and Organization Ethics,” these standards are based on the realization that a hospital’s obligation to (...) its patients is derived from two relationships: the patient-provider relationship governed by “clinical ethics,” and the customer-supplier relationship governed by “business ethics.” “[This] boundary between ‘clinical’ ethics and ‘business’ ethics is not clear and in many cases is nonexistent. While marketing and admission practices are seen as issues related to ‘business’ ethics, they can lead to unneeded admissions or demand for unneeded services, both of which can unnecessarily expose the patient to the risk of side effects or complications. Likewise, underutilization of needed services is likely to lead to less than optimal health outcomes” (I. Schyve 1996, p. 17). “These new standards arose out of well-publicized concerns about abuses in which patients were admitted to hospitals unnecessarily and were discharged or transferred only after their insurance expired” (I. Schyve 1996, pp. 15–16).These abuses also sparked eloquent protests against threats to patient well-being and to the nature of the patient-provider relationship in the bioethics literature. The fiduciary responsibility of the provider to inform and to protect the patient was fragmented by insurer business practices such as gag clauses and economic credentialing of providers (VII. Scope Note 31, 1996). The background role that the institution plays, though poorly articulated historically, has been brought sharply into focus by the explosive growth of the managed practice of medicine. The context of medical ethics is no longer limited to the resolution of individual cases, but instead encompasses the adoption of institutional structures to protect and promote patient welfare (IV. Emanuel 1995, p. 335). In this new configuration, the institution and the providers are co-fiduciaries for populations [End Page 189] of patients, and the medicine that is practiced is “appropriately economically disciplined.” The expression “My patient always comes first” is no longer “... intellectually serious or morally responsible.” But, “... to be sure, both conceptually and in practice, being an economically disciplined fiduciary professional or institution is ethically unstable.... The task is to identify the boundaries outside of which institutional policy and behavior will not count as an ethically defensible form of being... [a] fiduciary.” (IV. McCullough 1997, pp. 143–44). This process of delimiting and enforcing boundaries requires the development of “... a language for talking about the ethical values of the organization. If such a language does not exist, discussions about ethics become cumbersome and unlikely to occur” (IV. Cleveland Clinic Foundation 1998, p. 2).As with bioethics generally, the literature addressing organizational ethics is multidisciplinary. JCAHO’s compliance guide for its revised standards, Ethical Issues and Patient Rights, draws on a wealth of ideas from both clinical ethics and business ethics. This is often an awkward alliance. “Because the study of organizational ethics is in its infancy compared to other areas of healthcare ethics, discussions about it often seem like hot air with no palpable payoff” (I. Boyle 1998, p. 2). The fact that “... there is an ancient history that reflects widespread doubt about the moral probity of business” (II. Frederick 1995, p. 209) does not help. To begin, “Aristotle had rude things to say about business” (II. Jackson 1998, p. 401). A brief review of introductions to several of the business ethics textbooks cited in this bibliography reveals that a rebuttal of “business ethics as an oxymoron” is the standard opening paragraph. This stigma is unfounded, and “increased stability” has characterized the state of business ethics literature during the 1990s (II. Beauchamp and Bowie 1997, p. ix). Significant attention has been given to elaborating two often overlapping theories—stakeholder and social contractarian.Originating in the 1960s as a pun on “stockholder,” proponents of stakeholder theory claim that a corporation’s fiduciary responsibility extends beyond increasing its profitability to protecting the rights of individuals or groups affected by its actions. Popular as a strategic planning tool in the... (shrink)

Changes in the shape and structural organization of the cell nucleus occur during many fundamental processes including development, differentiation and aging. In many of these processes, the cell responds to physical forces by altering gene expression within the nucleus. How the nucleus itself senses and responds to such mechanical cues is not well understood. In addition to these external forces, epigenetic modifications of chromatin structure inside the nucleus could also alter its physical properties. To achieve a better understanding, we need (...) to elucidate the relationship between nuclear structure and material properties. Recently, new approaches have been developed to systematically investigate nuclear mechanical properties. These experiments provide important new insights into the disease mechanism of a growing class of tissue‐specific disorders termed ‘nuclear envelopathies’. Here we review our current understanding of what determines the shape and mechanical properties of the cell nucleus. BioEssays 30:226–236, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Historical analysis and policy making often require counterfactual thought experiments that isolate hypothesized causes from a vast array of historical possibilities. However, a core precept of Jervis's “systems thinking” is that causes are so interconnected that the historian can only with great difficulty imagine causation by subtracting all variables but one. Prediction, according to Jervis, is even more problematic: The more sensitive an event is to initial conditions (e.g., butterfly effects), the harder it is to derive accurate forecasts. Nevertheless, if (...) awareness of system effects can help forecasters better calibrate their probability estimates of whether or not certain events will come to pass, systems thinkers who are pessimistic about prediction are diluting their confidence too much. The challenge is a meta-cognitive one: thinking systematically about when to engage in systems thinking; and weighing the costs and benefits of using simple or complex heuristics in policy environments that can shift suddenly from quiescence to turbulence. (shrink)

Background The rapidly growing quantity of health data presents researchers with ample opportunity for innovation. At the same time, exploitation of the value of Big Data poses various ethical challenges that must be addressed in order to fulfil the requirements of responsible research and innovation (Gerke et al. 2020 ; Howe III and Elenberg 2020 ). Data sovereignty and its principles of self-determination and informed consent are central goals in this endeavor. However, their consistent implementation has enormous consequences for the (...) collection and processing of data in practice, especially given the complexity and growth of data in healthcare, which implies that artificial intelligence (AI) will increasingly be applied in the field due to its potential to unlock relevant, but previously hidden, information from the growing number of data (Jiang et al. 2017 ). Consequently, there is a need for ethically sound guidelines to help determine how data sovereignty and informed consent can be implemented in clinical research. Methods Using the method of a narrative literature review combined with a design thinking approach, this paper aims to contribute to the literature by answering the following research question: What are the practical requirements for the thorough implementation of data sovereignty and informed consent in healthcare? Results We show that privacy-preserving technologies, human-centered usability and interaction design, explainable and trustworthy AI, user acceptance and trust, patient involvement, and effective legislation are key requirements for data sovereignty and self-determination in clinical research. We outline the implications for the development of IT solutions in the German healthcare system. (shrink)

BackgroundBiobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people’s (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures.MethodsWe designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was disseminated (...) via the Young Person’s Advisory Group North England (YPAGne) and participating CYP’s secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer.ResultsOne hundred two CYP completed the survey. Most were between 16–18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73).Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: ‘altruism’, ‘potential benefits outweigh individual risk’, 'frugality', and ‘(in)convenience’.Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: ‘altruism’, ‘body integrity’ and ‘sample frugality’. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80).ConclusionProspective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible. (shrink)

The two books discussed here make important contributions to our understanding of the role of spacetime concepts in physical theories and how that understanding has changed during the evolution of physics. Both emphasize what can be called a ‘dynamical’ account, according to which geometric structures should be understood in terms of their roles in the laws governing matter and force. I explore how the books contribute to such a project; while generally sympathetic, I offer criticisms of some historical claims concerning (...) Newton, and argue that the dynamical account does not undercut ontological issues as the books claim. *Received January 2009; revised March 2009. †To contact the author, please write to: Department of Philosophy, 1423 University Hall MC 267, University of Illinois at Chicago, 601 S. Morgan Street, Chicago, IL 60607; e‐mail: [email protected]. (shrink)