Purpose Although surrogate decision-making is prevalent in intensive care units and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. Subjects and methods We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death. We developed and applied a (...) coding framework to identify normative statements by clinicians regarding what considerations should guide surrogates’ decisions, including whether clinicians explained one or more of Buchanan and Brock’s three standard principles of SDM to family members. Results Clinicians made at least one statement about how to perform the surrogate role in 24 conferences ). We observed three general types of normative guidance provided to surrogates, with some conferences containing more than one type of guidance: counselling about one or more standard principles of SDM ; counselling surrogates to make decisions centred on the patient as a person, without specifying how to accomplish that ; and counselling surrogates to make decisions based on the family’s values. Conclusions Clinicians did not provide normative guidance about the surrogate role in two-thirds of family conferences for incapacitated patients at high risk for death. When they did, clinicians’ guidance was often incomplete and sometimes conflicted with standard principles of SDM. Future work is needed to understand whether providing explicit guidance on how to perform the surrogate role improves decision-making or mitigates surrogates’ psychological distress. (shrink)

Objective: Even when critically ill patients are almost certain to die from their illnesses, there is generally an element of prognostic uncertainty. Little is known about how physicians handle this uncertainty in conversations with surrogate decision makers. We sought to evaluate whether and how physicians discuss prognostic uncertainty with surrogate decision makers of patients who are highly likely, but not certain, to die. Design: We audiotaped and transcribed discussions between clinicians and surrogate decision makers at two major California teaching hospitals (...) from 2006 through 2008. Physicians completed a questionnaire addressing their prognostic estimates for patients' survival to hospital discharge. Participants: We included physicians and surrogates of 12 incapacitated, critically ill patients. Measurements: We analyzed transcripts of discussions in which physicians' estimates of patients' chances of hospital survival were 1% to 5%; we coded whether physicians disclosed the prognostic uncertainty and, if so, how they conveyed that death was highly likely but not certain. Results: Physicians' estimates of short-term survival were 1% to 5% for 12 of the 70 patients enrolled in the original study. In 8 of 12 cases, physicians conveyed prognostic uncertainty by using probabilistic language or by an explicit mention of uncertainty. In four cases, physicians made at least one statement that either implied or was ambiguous about whether death was certain. Conclusion: We observed variability in how physicians handle prognostic uncertainty in their discussions with surrogates of patients who are highly likely, but not certain, to die, including some circumstances in which physicians stated or implied that death was certain. (shrink)

The aim of this chapter is to address the role of memory in past-life convictions. Although it is commonly accepted in the modern media - and popular western culture more generally - that people believe they have lived before because the memory contains detailed verifiable facts, little is known about how people actually reason about the veracity of their previous existence. To our knowledge, the current project is the most extensive research that probes the role of memory in past life (...) convictions. More specifically, we explore two questions. First, to what extent does memory lead to past-life belief, and is this conviction based on external validation or via the episodic sense of personal identity contained in the memory? Second, what is the conception of self on which one's current self is taken to be the same as the past-life self? -/- In what follows, we propose that memory plays an important role in convincing people that they have lived before. Fundamentally, this memory is episodic insofar as it represents the event as happened to the encoder. This memory contrasts with semantic memory - memory of facts...Further, we contend that it is the episodic sense of personal identity (rather than external validation) that typically contributes to the belief in a past life. Finally, we argue that the conception of self implicated in past-life belief is the non-trait conception. Of course, this fits naturally with the idea that the belief in a past life issues partly from the episodic sense of identity, since it is the non-trait conception of self that is implicated in the episodic sense of identity... -/- Our proposal in this chapter can be construed as a psychological extension of Reid's point in the context of past-life belief. People assume that they are the same person as someone in earlier times, despite large variations in the traits between those individuals, and they think this partly because of the testimony of their episodic memory. If our account is correct, then it makes the belief in a past life less bizarre, at least psychologically. For we are suggesting that the episodic sense of personal identity that led to your conviction that you existed at the time of your sixteenth birthday celebrations some decades ago, is also involved in other people's convictions that they existed 200 years ago. This proposal is also situated in recent cognitive approaches to the study of religion and religious experiences, which suggests that extraordinary convictions are often underpinned by the ordinary processes of social cognition (e.g. see Barrett 2000; Barrett 2007; Boyer 2001; Lawson and McCauley 1990; for reincarnation, see White Forthcoming-a,-b). (shrink)

We examine the ethical, social, and regulatory barriers that may hinder research on therapeutic potential of certain controversial controlled substances like marijuana, heroin, or ketamine. Hazards for individuals and society and potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of these substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may, however, limit research on their considerable therapeutic potential. We review (...) the surprisingly sparse literature and address the particular ethical concerns pertinent to research with illicit and addictive substances, such as undue inducement, informed consent, therapeutic misconception, and risk to participants, researchers, and institutions. We consider the perspectives of key research stakeholders and explore whether they may be infected with bias. We conclude by proposing an empirical research agenda to provide an evidentiary basis for ethical reasoning. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has motivated medical ethicists and several task forces to revisit or issue new guidelines on allocating scarce medical resources. Such guidelines are relevant for the allocation of scarce therapeutics and vaccines and for allocation of ICU beds, ventilators, and other life-sustaining treatments or potentially scarce interventions. Principles underlying these guidelines, like saving the most lives, mitigating disparities, reciprocity to those who assume additional risk (eg, essential workers and clinical trial participants), and equal access may (...) compete with one another. We propose the use of a “categorized priority system” (also known as a “reserve system”) as an improvement over existing allocation methods, particularly because it may be able to achieve disparity mitigation better than other methods. (shrink)

In the United States, people may donate organs and tissues to a family member, friend, or anyone whose specific need becomes known to them. For example, in late 2003 dozens of people came forward to donate a kidney to a professional basketball player known to them only through his sports performances. People may also donate a kidney to no one in particular through a process known as nondirected donation. In nondirected donation, people donate a kidney to the organ allocation system (...) rather than to anyone known to them personally. There are limits, though, to generosity. People are usually not allowed to donate to groups of people, no matter the contours of the group, whether white, black, Catholic or Presbyterian, third-time liver recipient, and so on. As the agency that oversees national transplantation policy, the United Network for Organs Sharing does not allow this sort of restricted donation, though it appears that some regional Organ Procurement Organizations occasionally bend the rules when donors insist that their organs go to children or to first-time recipients. Those ad hoc arrangements are, however, the exception to the rule. (shrink)

Few figures of the Middle Ages command the attention of so many modern disciplines as Robert Grosseteste (c. 1170-1253). Theology, Philosophy, History, and Science are all areas which his life and thought continue to have significance and to inspire re-interpretation. Accompanied by a series of original commentaries, this new edition of Grosseteste's work, with English translation, draws together the perspectives of modern scientists and medieval specialists. Volume I of a six volume series, Knowing and Speaking presents two of the (...) earliest of Grosseteste's works, the treatises On the Liberal Arts and On the Generation of Sounds. These are accompanied by a significant Middle English treatise on the Seven Liberal Arts whose anonymous fifteenth-century author translated and excerpted passages from Grosseteste's treatises in a re-imagining of their structure and function.0Each work is treated separately within the volume, which is constructed in three parts. On the Liberal Arts sets Grosseteste's thoughts on the arts subjects and emphasises moral concerns about the purpose of learning. On the Generation of Sounds builds on the theories and statements of On the Liberal Arts in connection to the production of sound, elaborating the earlier position, relating the generation of sounds to human vocal and speech production. (shrink)

The sounds of the college campus raise important questions of participation, identity, privilege, disability, and marginalization. During the 2019–2020 academic year, three university instructors from distinct disciplines (music, history, and political science) and a student research assistant (history) used sound as a method for inquiring into contested and erased sites on the campus of Western Carolina University, a regional comprehensive university located in the southeastern United States. The project came to be called Sonic Histories. Paid student volunteers were led on (...) a soundwalk and completed three online questionnaires that engaged questions of race and belonging on campus. This study presents findings on how students experience and interpret contested and erased sites through sounds heard and imagined. Sonic Histories explores two central questions. Historically, whose voices have been included and whose have been excluded on college campuses? How can sound promote awareness of racialized spaces and, in turn, achieve social engagement? The authors challenge the triumphant narrative of campus histories, which highlights racial reconciliation and progress while eliding the ways predominantly white campuses still exclude minorities. By re-centering minority voices in campus spaces, the authors explore the systemic exclusion of minorities that has occurred on college campuses across the country. At a time when places of higher education are refining and developing their commitment to diversity and inclusivity—while assessing their past in honest ways—the Sonic Histories project builds upon ongoing initiatives to position the college campus as a scholarly community that lives up to its democratic ideals of inclusion. (shrink)

A longitudinal study of 308 white -collar U.S. employees revealed that feelings of hope and gratitude increase concern for corporate social responsibility. In particular, employees with stronger hope and gratitude were found to have a greater sense of responsibility toward employee and societal issues; interestingly, employee hope and gratitude did not affect sense of responsibility toward economic and safety/quality issues. These findings offer an extension of research by Giacalone, Paul, and Jurkiewicz.

Bioethics conjures images of dramatic healthcare challenges, yet everyday clinical ethics issues unfold regularly. Without sufficient ethical awareness and a relevant working skillset, clinicians can feel ill-equipped to respond to the ethical dimensions of everyday care. Bioethicists were interviewed to identify the essential skills associated with everyday clinical ethics and to identify educational case scenarios to illustrate everyday clinical ethics. Individual, semi-structured interviews were conducted with a convenience sample of bioethicists. Bioethicists were asked: (1) What are the essential skills required (...) for everyday clinical ethics? And (2) What are potential educational case scenarios to illustrate and teach everyday clinical ethics? Participant interviews were analyzed using qualitative content analysis. Twenty-five (25) bioethicists completed interviews (64% female; mean 14.76 years bioethics experience; 80% white). Five categories of general skills and three categories of ethics-specific skills essential for everyday clinical ethics were identified. General skills included: (1) Awareness of Core Values and Self-Reflective Capacity; (2) Perspective-Taking and Empathic Presence; (3) Communication and Relational Skills; (4) Cultural Humility and Respect; and (5) Organizational Understanding and Know-How. Ethics-specific skills included: (1) Ethical Awareness; (2) Ethical Knowledge and Literacy; and (3) Ethical Analysis and Interaction. Collectively, these skills comprise a Toolbox of Everyday Clinical Ethics Skills. Educational case scenarios were identified to promote everyday ethics. Bioethicists identified skills essential to everyday clinical ethics. Educational case scenarios were identified for the purpose of promoting proficiency in this domain. Future research could explore the impact of integrating educational case scenarios on clinicians’ ethical competencies. (shrink)

Aworkshop was held August 26–28, 2015, by the Earth- Life Science Institute (ELSI) Origins Network (EON, see Appendix I) at the Tokyo Institute of Technology. This meeting gathered a diverse group of around 40 scholars researching the origins of life (OoL) from various perspectives with the intent to find common ground, identify key questions and investigations for progress, and guide EON by suggesting a roadmap of activities. Specific challenges that the attendees were encouraged to address included the following: What key (...) questions, ideas, and investigations should the OoL research community address in the near and long term? How can this community better organize itself and prioritize its efforts? What roles can particular subfields play, and what can ELSI and EON do to facilitate research progress? (See also Appendix II.) The present document is a product of that workshop; a white paper that serves as a record of the discussion that took place and a guide and stimulus to the solution of the most urgent and important issues in the study of the OoL. This paper is not intended to be comprehensive or a balanced representation of the opinions of the entire OoL research community. It is intended to present a number of important position statements that contain many aspirational goals and suggestions as to how progress can be made in understanding the OoL. The key role played in the field by current societies and recurring meetings over the past many decades is fully acknowledged, including the International Society for the Study of the Origin of Life (ISSOL) and its official journal Origins of Life and Evolution of Biospheres, as well as the International Society for Artificial Life (ISAL). (shrink)

Since its inception in 2010, the Network for Public Health Law has aligned with federal, state, tribal, and local public health practitioners to assess how law can promote and protect the public’s health. In 2013, Network authors illustrated major trends in public health laws and policies emanating from an internal assessment of thousands of requests for technical assistance nationally. More recently, the Robert Wood Johnson Foundation has invited the Network and other partners to consider new ideas and strategies toward (...) building a “culture of health.” Per Figure 1, RWJF’s conception of a culture of health emphasizes key action areas essential to the promotion of health across all sectors and diverse populations. (shrink)

Arthur W. H. Adkins's writings have sparked debates among a wide range of scholars over the nature of ancient Greek ethics and its relevance to modern times. Demonstrating the breadth of his influence, the essays in this volume reveal how leading classicists, philosophers, legal theorists, and scholars of religion have incorporated Adkins's thought into their own diverse research. The timely subjects addressed by the contributors include the relation between literature and moral understanding, moral and nonmoral values, and the contemporary meaning (...) of ancient Greek ethics. The volume also includes an essay from the late Adkins himself illustrating his methodology in an analysis of the "Speech of Lysias" in Plato's _Phaedrus_. _The Greeks and Us_ will interest all those concerned with how ancient moral values do or do not differ from our own. Contributors include Arthur W. H. Adkins, Stephanie Nelson, Martha C. Nussbaum, Paul Schollmeier, James Boyd White, Bernard Williams, and Lee Yearley. Commentaries by Wendy Doniger, Charles M. Gray, David Grene, Robert B. Louden, Richard Posner, and Candace Vogler. (shrink)

I shared Raanan Gillon’s1 surprise at Robert Veatch’s criticism of the white coat ceremonies,2 and I think that the points raised by Veatch were quite adequately countered by Gillon’s response. The provocative points raised by Veatch do stimulate some valuable critical thinking about the process, although I think Veatch was carried away a bit by hyperbole. To label the drama of the ceremony as “ominous” goes a bit far by any criterion.I should like to describe an oath taking (...) initiation ceremony in use at the Ben Gurion University Faculty of Health Sciences for almost three decades, its history, features, current practice, and conclusions. I believe that Veatch’s specific objections are addressed by our process and merit consideration by other institutions as well.When the medical school was founded in 1974 the then dean , Professor Moshe Prywes, met with the just entering class several weeks before the onset of the academic year during a summer preliminary orientation period . Professor Prywes, an imaginative, charismatic innovator with a flair for public relations and the dramatic, suggested to the entering class that they take the physician’s oath during the first weeks of the academic year, coinciding with their first exposure to patients . He explained that he wanted the students to regard themselves as already bearing responsibilities and duties, and not just rights. He saw them as “change agents” working to upgrade the medical care and the health of the patients and community, right from the first days of their schooling.I had just arrived in Israel as a new immigrant to assume the foundation professorship of medicine, coming from …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Recuperation of the Theory-Death of the Avant-GardeRobert Radin (bio)Paul Mann. The Theory-Death of the Avant-Garde. Bloomington: Indiana UP, 1991.It is difficult to respond to an essay that so thoroughly lays bare (and thereby challenges) what it is we do when we respond to another writer’s writing. I find it hard to begin, caught somewhere in that terminal state between speech and silence, that moment Beckett captures at the (...) end of the The Unnamable: “I can’t go on, I’ll go on.” Should I follow every word I write with “[sic],” at once quote myself and distance myself from what I have just written, indicate that I am aware of what it is I’m doing even as I’m doing it? I’ll go on.The fact that Paul Mann’s The Theory-Death of the Avant-Garde has received relatively little critical response since its publication in 1991 may in fact be a measure of its success. Nevertheless, this lack of response seems worthy of attention, given that Mann devotes so much of his essay to making the point that art’s (and theory’s) raison d’être is to generate further discourse, to keep the discursive economy going, however resistant to dominant culture that art or theory may appear to be.After repeatedly, painstakingly pointing out the status of his own essay in the discursive economy he describes—the discourse of the avant-garde—Mann anticipates the likely response to his work:It is not difficult to imagine whatever little response this essay is liable to. For the most part dismissals of what will be taken as its nihilism, its cynicism, its defeatism, its adherence to this or that dubious theory, its outmoded obsession with recuperation. But the essay was not written for those who reject an insistence on recuperation only in order to conceal from themselves the extent of their own recuperation.[141]And further on in the same passage: “it [the essay] was also written precisely so that it could be dismissed” [141]. Mann, to varying degrees, has correctly diagnosed the critical reception of his work thus far. When the essay is dismissed in reviews it is because it is seen as both passé and nihilistic. Even in one of the favorable reviews of Mann’s essay the question of nihilism arises. It is this “specter of nihilism” that I want to take up here—after first reviewing some of the more salient features of Mann’s argument—as I think it is a response most readers will have to struggle through (as Mann correctly points out), and it might tell us something about the larger discursive economy of which The Theory-Death of the Avant-Garde is now a part. That Mann’s position is seen as outmoded is less of an issue for me. It may be that his essay was already “old” by the time it was published, [End Page 41] his position already dismissable under the aegis of other names: Baudrillard, Barthes, Derrida. But that his essay is no longer new, that his position has exhausted its discursive currency, only further makes his point: in the discourse of the avant-garde, and in the discursive economy generally, the new supersedes all other values. More important, Mann’s position in particular must exhaust itself quickly if the discursive economy is to continue to thrive.In The Pleasure of the Text Roland Barthes delineates what he calls the “versus myth”:Art seems compromised, historically, socially. Whence the effort on the part of the artist himself to destroy it.... Unfortunately, this destruction is always inadequate; either it occurs outside the art, but thereby becomes impertinent, or else it consents to remain within the practice of the art, but quickly exposes itself to recuperation (the avant-garde is that restive language which is going to be recuperated). The awkwardness of this alternative is the consequence of the fact that destruction of discourse is not a dialectic term but a semantic term: it docilely takes its place within the great semiological “versus” myth (white versus black); whence the destruction of art is doomed to only paradoxical formulae... (shrink)

Abstract:This essay argues for lyric as an anthropomorphic pattern of thought which shapes our readings of poetry and Earth. Theorizing what I call "lyric geology," the essay foregrounds two critical conjunctions: (1) the historical co-emergence of the normative lyric subject and the human species as geologic agent; and (2) the anthropomorphic genealogy of literary criticism called "lyricization" as it dovetails with Sylvia Wynter's account of the "over-representation" of colonial man as "the human itself." Reading across a seemingly eclectic archive—Charles Lyell, (...) Robert Knox, Richard Owen, and a maroon known in the Mauritian imperial archive as Simon—I show how the colonial anthropos as self-consciously theorized in and across the nineteenth century materially effectuates on a planetary scale the very racialized anthropomorphosis fallaciously naturalized as lyric. So understood, man's generic "over-representation" and lyric are co-constitutive projects. Together, they proliferate a human fantasy whose flat speciesism at once reproduces and effaces white supremacist violence and colonial dispossession. (shrink)

"Simone Weil's bibliography": pages [181]-194. Includes index. Introduction / George Abbott White -- The jagged edge / Michele Murray -- Simone Weil's mind / Robert Coles -- The life and death of Simone Weil / J.M. Cameron -- Simone Weil, last things / Michele Murray -- Simone Weil's Iliad / Michael K. Ferber -- Notes on Simone Weil's Iliad / Joseph H. Summers -- Patriotism and The need for roots / Conor Cruise O'Brien -- Marxism-Leninism and the language (...) of Politics magazine / Staughton Lynd -- Simone Weil's work experiences / George Abbott White. (shrink)

High-level perception--”the process of making sense of complex data at an abstract, conceptual level--”is fundamental to human cognition. Through high-level perception, chaotic environmen- tal stimuli are organized into the mental representations that are used throughout cognitive pro- cessing. Much work in traditional artificial intelligence has ignored the process of high-level perception, by starting with hand-coded representations. In this paper, we argue that this dis- missal of perceptual processes leads to distorted models of human cognition. We examine some existing artificial-intelligence models--”notably (...) BACON, a model of scientific discovery, and the Structure-Mapping Engine, a model of analogical thought--”and argue that these are flawed pre- cisely because they downplay the role of high-level perception. Further, we argue that perceptu- al processes cannot be separated from other cognitive processes even in principle, and therefore that traditional artificial-intelligence models cannot be defended by supposing the existence of a --œrepresentation module--� that supplies representations ready-made. Finally, we describe a model of high-level perception and analogical thought in which perceptual processing is integrated with analogical mapping, leading to the flexible build-up of representations appropriate to a given context. (shrink)

Mindreading (or folk psychology, Theory of Mind, mentalizing) is the capacity to represent and reason about others’ mental states. The Simulation Theory (ST) is one of the main approaches to mindreading. ST draws on the common-sense idea that we represent and reason about others’ mental states by putting ourselves in their shoes. More precisely, we typically arrive at representing others’ mental states by simulating their mental states in our own mind. This entry offers a detailed analysis of ST, considers theoretical (...) arguments and empirical data in favour of and against it, discusses its philosophical implications, and illustrates some alternatives to it. (shrink)

Individual differences in the mere willingness to think analytically has been shown to predict religious disbelief. Recently, however, it has been argued that analytic thinkers are not actually less religious; rather, the putative association may be a result of religiosity typically being measured after analytic thinking (an order effect). In light of this possibility, we report four studies in which a negative correlation between religious belief and performance on analytic thinking measures is found when religious belief is measured in a (...) separate session. We also performed a meta-analysis on all previously published studies on the topic along with our four new studies (N = 15,078, k = 31), focusing specifically on the association between performance on the Cognitive Reflection Test (the most widely used individual difference measure of analytic thinking) and religious belief. This meta-analysis revealed an overall negative correlation (r) of -.18, 95% CI [-.21, -.16]. Although this correlation is modest, self-identified atheists (N = 133) scored 18.7% higher than religiously affiliated individuals (N = 597) on a composite measure of analytic thinking administered across our four new studies (d = .72). Our results indicate that the association between analytic thinking and religious disbelief is not caused by a simple order effect. There is good evidence that atheists and agnostics are more reflective than religious believers. (shrink)

MMA fighting in a competition is not necessarily wrong and is often, as far as we can tell, permissible. Our argument has two premises. First, if an act does not infringe on anyone’s moral right or violate another side-constraint, then it is morally permissible. Second, MMA-violence does not infringe on anyone’s moral right or violate another side-constraint. The first premise rested on two assumptions. First, if a person does a wrong act, then he wrongs someone. Second, if one person wrongs (...) a second, then the first infringes on the second’s right. We then looked at Nicholas Dixon’s powerful Kantian argument that MMA fighting is wrong. (shrink)

: We argue that healthy people should be allowed to sell one of their kidneys while they are alive—that the current prohibition on payment for kidneys ought to be overturned. Our argument has three parts. First, we argue that the moral basis for the current policy on live kidney donations and on the sale of other kinds of tissue implies that we ought to legalize the sale of kidneys. Second, we address the objection that the sale of kidneys is intrinsically (...) wrong because it violates the Kantian duty of respect for humanity. Third, we address a range of consequentialist objections based on the idea that kidney sales will be exploitative. Throughout the paper, we argue only that it ought to be legal for an individual to receive payment for a kidney. We do not argue that it ought to be legal for an individual to buy a kidney. (shrink)

Bhatia-Lin and associates (2019) consider ethical and regulatory issues when social media platforms are used to track and locate research subjects who were recruited during hospitalization. They me...

About 1000 references to books, journal articles, government publications, reports, and bibliographies. Topical arrangement under headings such as History of medical ethics, Behavior control, and Truth-telling in medicine. Entries include bibliographical information and occasional brief annotations. Author index.

Responsibility is impossible because there is no responsibility-maker and there needs to be one if people are morally responsible. The two most plausible candidates, psychology and decision, fail. A person is not responsible for an unchosen psychology or a psychology that was chosen when the person is not responsible for the choice. This can be seen in intuitions about instantly-created and manipulated people. This result is further supported by the notion that, in general, the right, the good, and virtue rest (...) on the exercise of a capacity rather than the capacity itself. It is also supported by the notion that negligence is not a responsibility-maker. ​ A person is not responsible for a choice that does not reflect his psychology or that does reflect it when he is not responsible for the psychology. This can be seen by considering intuitions regarding acts that are unconnected or arbitrarily connected to a person’s psychology. It can also be seen intuitions about acts that result from a manipulated psychology. The problem with choice as a foundation can be further seen in that an infinite or self-created person would not be responsible despite these superhuman choice-related features. (shrink)

For more than sixty years, surgeons have used bioethical strategies to promote patient self‐determination, many of these now collectively described as “informed consent.” Yet the core framework—understanding, risks, benefits, and alternatives—fails to support patients in deliberation about treatment. We find that surgeons translate this framework into an overly complicated technical explanation of disease and treatment and an overly simplified narrative that surgery will “fix” the problem. They omit critical information about the goals and downsides of surgery and present untenable options (...) as a matter of patient choice. We propose a novel framework called “better conversations.” Herein, surgeons provide context about clinical norms, establish the goals of surgery, and comprehensively delineate the downsides of surgery to generate a deliberative space for patients to consider whether surgery is right for them. This paradigm shift meets the standards for informed consent, supports deliberation, and allows patients to anticipate and prepare for the experience of treatment. (shrink)

Book reviewed in this article: The New Health Care For Profit: Doctors and Hospitals in a Competitive Environment. Edited by Bradford H. Gray The Healing Mission and the Business Ethic. By Robert M. Cunningham The Medical Industrial Complex. By Stanley Wohl.

This article presents a review of reverse correlation in neurophysiology. We discuss the basis of reverse correlation in linear transducers and in spiking neurons. The application of reverse correlation to measure the receptive fields of visual neurons using white noise and m‐sequences, and classical findings about spatial and color processing in the cortex resulting from such measurements, are emphasized. Finally, we describe new developments in reverse correlation, including “sub‐space” and categorical reverse‐correlation. Recent results obtained by applying such methods in (...) the orientation, spatial‐frequency and Fourier domains have revealed the importance of cortical inhibition in the establishment of sharp tuning selectivity in single neurons. (shrink)