Medical assistance in dying (MAiD) in Canada is a complex, novel interprofessional practice governed by stringent legal criteria. Often, patients need assistance navigating the system, and MAiD providers/assessors struggle with the administrative challenges of MAiD. Resultantly, the role of the MAiD care coordinator has emerged across the country as a novel practice dedicated to supporting access to MAiD and ensuring compliance with regulatory requirements. However, variability in the roles and responsibilities of MAiD care coordinators across Canada has highlighted the need (...) for accountability and standardization for this practice. This manuscript constitutes a first attempt to describe this emerging role, through discussion of proposed standards of practice, as well as roles and responsibilities, and ethical duties of this emergent professional practice. We detail the core commitments of MAiD care coordinators to patients, providers/assessors and institutions involved in the MAiD process. We address the core competencies that inform the unique skillset required by MAiD care coordinators to facilitate high-quality care, while highlighting the moral and ethical considerations embedded in this work. To illustrate the complexity of the MAiD care coordinator role, case examples involving ethical dilemmas encountered in practice are included. Finally, a code of ethics is proposed to serve as a guide for appropriate professional practice and conduct. This manuscript is intended to illustrate the importance of transparency and accountability for this new role that provides service to vulnerable patients and families; this is especially critical as the ethical complexity of MAiD is likely to increase with future changes in legislation opening MAiD access to new populations. (shrink)

Ontological realism is a philosophical stance that provides a definitional framework for ontologies and is referred to by various applied ontologists. From a computer science perspective, ontologies are often associated with formal languages for the representation of ontologies like the Web Ontology Language (OWL). It has, however, not been made explicit how the realist framework is related to the representation formalism. We analyse how the representational units of OWL can be used for modelling realist ontologies. While OWL is sufficiently close (...) to the realist framework of ontologies to describe them, there are categories in OWL that are alien to realist ontologies or duplicate categories in realist ontologies. This clarification allows separating talk about ontologies in general from talk about their specific representation. (shrink)

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

Embodiment theories have proposed a reciprocal relationship between emotional state and bodily reactions. Besides large body postures, recent studies have found emotions to affect rather subtle bodily expressions, such as slumped or upright sitting posture. This study investigated back muscle activity as an indication of an effect of positive and negative emotions on the sitting position. The electromyography activity of six back muscles was recorded in 31 healthy subjects during exposure to positive and negative affective pictures. A resting period was (...) used as a control condition. Increased muscle activity patterns in the back were found during the exposure to negative emotional stimuli, which was mainly measured in the lumbar and thorax regions. The positive emotion condition caused no elevated activity. The findings show that negative emotions lead to increased differential muscle activity in the back and thus corroborate those of previous research that emotion affects subtle bodily expressions. (shrink)

BACKGROUND -/- The importance of ontologies in the biomedical domain is generally recognized. However, their quality is often too poor for large-scale use in critical applications, at least partially due to insufficient training of ontology developers. -/- OBJECTIVE -/- To show the efficacy of guideline-based ontology development training on the performance of ontology developers. The hypothesis was that students who received training on top-level ontologies and design patterns perform better than those who only received training in the basic principles of (...) formal ontology engineering. -/- METHODS -/- A curriculum was implemented based on a guideline for ontology design. A randomized controlled trial on the efficacy of this curriculum was performed with 24 students from bioinformatics and related fields. After joint training on the fundamentals of ontology development the students were randomly allocated to two groups. During the intervention, each group received training on different topics in ontology development. In the assessment phase, all students were asked to solve modeling problems on topics taught differentially in the intervention phase. Primary outcome was the similarity of the students’ ontology artefacts compared with gold standard ontologies developed by the authors before the experiment; secondary outcome was the intra-group similarity of group members’ ontologies. -/- RESULTS -/- The experiment showed no significant effect of the guideline-based training on the performance of ontology developers (a) the ontologies developed after specific training were only slightly but not significantly closer to the gold standard ontologies than the ontologies developed without prior specific training; (b) although significant differences for certain ontologies were detected, the intra-group similarity was not consistently influenced in one direction by the differential training. -/- CONCLUSION -/- Methodologically limited, this study cannot be interpreted as a general failure of a guideline-based approach to ontology development. Further research is needed to increase insight into whether specific development guidelines and practices in ontology design are effective. (shrink)

During the COVID-19 pandemic, universities had to shift from face-to-face to emergency remote education. Students were forced to study online, with limited access to facilities and less contact with peers and teachers, while at the same time being exposed to more autonomy. This study examined how students adapted to emergency remote learning, specifically focusing on students’ resource-management strategies using an individual differences approach. One thousand eight hundred university students completed a questionnaire on their resource-management strategies and indicators of successful adaptation (...) to emergency remote learning. On average, students reported being less able to regulate their attention, effort, and time and less motivated compared to the situation before the crisis started; they also reported investing more time and effort in their self-study. Using a k-means cluster analysis, we identified four adaptation profiles and labeled them according to the reported changes in their resource-management strategies: the overwhelmed, the surrenderers, the maintainers, and the adapters. Both the overwhelmed and surrenderers appeared to be less able to regulate their effort, attention, and time and reported to be less motivated to study than before the crisis. In contrast, the adapters appreciated the increased level of autonomy and were better able to self-regulate their learning. The resource-management strategies of the maintainers remained relatively stable. Students’ responses to open-answer questions on their educational experience, coded using a thematic analysis, were consistent with the quantitative profiles. Implications about how to support students in adapting to online learning are discussed. (shrink)

BackgroundAdverse childhood experiences can cause serious mental problems in adolescents and therefore may expected to be associated with higher use of psychosocial care, potentially varying by type of specific ACE. The aim of our study is to explore the association of the number of ACE and types of specific ACE with entering and using psychosocial care.MethodsWe used data from the Slovak Care4Youth cohort study, comprising 509 adolescents from 10 to 16 years old. We used logistic regression models adjusted for age, (...) gender, and family affluence to explore the associations of number and type of specific ACE with the use of psychosocial care.ResultsHaving three or more ACE as well as experiencing some specific ACE increased the likelihood of using psychosocial care. Regarding experience with the death of somebody else you love, we found a decreased likelihood of the use of psychosocial care.ConclusionExperiencing ACE above a certain threshold and parent-related ACE increase the likelihood of adolescent care use. (shrink)

Objectives: Medical decision support and other intelligent applications in the life sciences depend on increasing amounts of digital information. Knowledge bases as well as formal ontologies are being used to organize biomedical knowledge and data. However, these two kinds of artefacts are not always clearly distinguished. Whereas the popular RDF(S) standard provides an intuitive triple-based representation, it is semantically weak. Description logics based ontology languages like OWL-DL carry a clear-cut semantics, but they are computationally expensive, and they are often misinterpreted (...) to encode all kinds of statements, including those which are not ontological. Method: We distinguish four kinds of statements needed to comprehensively represent domain knowledge: universal statements, terminological statements, statements about particulars and contingent statements. We argue that the task of formal ontologies is solely to represent universal statements, while the non-ontological kinds of statements can nevertheless be connected with ontological representations. To illustrate these four types of representations, we use a running example from parasitology. Results: We finally formulate recommendations for semantically adequate ontologies that can efficiently be used as a stable framework for more context-dependent biomedical knowledge representation and reasoning applications like clinical decision support systems. (shrink)

BACKGROUND -/- The need for detailed description and modeling of cells drives the continuous generation of large and diverse datasets. Unfortunately, there exists no systematic and comprehensive way to organize these datasets and their information. CELDA (Cell: Expression, Localization, Development, Anatomy) is a novel ontology for the association of primary experimental data and derived knowledge to various types of cells of organisms. -/- RESULTS -/- CELDA is a structure that can help to categorize cell types based on species, anatomical localization, (...) subcellular structures, developmental stages and origin. It targets cells in vitro as well as in vivo. Instead of developing a novel ontology from scratch, we carefully designed CELDA in such a way that existing ontologies were integrated as much as possible, and only minimal extensions were performed to cover those classes and areas not present in any existing model. Currently, ten existing ontologies and models are linked to CELDA through the top-level ontology BioTop. Together with 15.439 newly created classes, CELDA contains more than 196.000 classes and 233.670 relationship axioms. CELDA is primarily used as a representational framework for modeling, analyzing and comparing cells within and across species in CellFinder, a web based data repository on cells (http://cellfinder.org). -/- CONCLUSIONS -/- CELDA can semantically link diverse types of information about cell types. It has been integrated within the research platform CellFinder, where it exemplarily relates cell types from liver and kidney during development on the one hand and anatomical locations in humans on the other, integrating information on all spatial and temporal stages. CELDA is available from the CellFinder website: http://cellfinder.org/about/ontology. (shrink)

Both unipolar and bipolar depression have been linked with impairments in executive functioning. In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as (...) blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions using structural equation modeling in adolescents and young adults with varying severity of mood symptoms. A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal. (shrink)

Ernst Cassirer (1874–1945) occupies a unique place in 20th-century philosophy. His view that human beings are not rational but symbolic animals and his famous dispute with Martin Heidegger at Davos in 1929 are compelling alternatives to the deadlock between 'analytic' and 'continental' approaches to philosophy. An astonishing polymath, Cassirer's work pays equal attention to mathematics and natural science but also art, language, myth, religion, technology, and history. However, until now the importance of his work has largely been overlooked. -/- In (...) this outstanding introduction Samantha Matherne examines and assesses the full span of Cassirer’s work. Beginning with an overview of his life and works she covers the following important topics: Cassirer’s neo-Kantian background; philosophy of mathematics and natural science, including Cassirer’s first systematic work, Substance and Function, and subsequent works, like Einstein’s Theory of Relativity; the problem of culture and the ground-breaking The Philosophy of Symbolic Forms; Cassirer’s ethical and political thought and his diagnosis of fascism in The Myth of the State; and Cassirer’s influence and legacy. -/- Including chapter summaries, suggestions for further reading, and a glossary of terms, this is an ideal introduction to Cassirer’s thought for anyone coming to his work for the first time. It is essential reading for students in philosophy as well as related disciplines such as intellectual history, art history, politics, and literature. (shrink)

""Catching Ourselves in the Act" is no less than an attempt to explain intelligence. Delightful how the author dismantles traditional views in.

Abstract25.6 Million people in the United States have Limited English Proficiency (LEP), defined as insufficient ability to read, write, or understand English. We will (1) Delineate the merits of approaching language as a social determinant of health, (2) highlight pertinent public health values and guidelines which are most relevant to the plight of populations with LEP and (3) Use the COVID-19 pandemic as an example of how a breakdown in public health ethics values created harm for populations and patients with (...) LEP. We define a framework to tease out public health responsibilities given some populations’ limited proficiency in a society’s predominant language. The American Public Health Association (APHA) public health ethics core values serve as a framework to interrogate current practices. We use the COVID-19 case to illustrate gaps between health policy and healthcare disparities experienced by populations with LEP. (shrink)

The authors consider the legal and ethical considerations of offering a time-limited trial of a potentially non-beneficial intervention in the setting of patient or surrogate requests to pursue aggressive treatment. The likelihood of an intervention’s success is rarely a zero-sum game, and an intervention’s risk-to-benefit ratio may be indiscernible without further information (often, a matter of time).

In _Biocultural Creatures_, Samantha Frost brings feminist and political theory together with findings in the life sciences to recuperate the category of the human for politics. Challenging the idea of human exceptionalism as well as other theories of subjectivity that rest on a distinction between biology and culture, Frost proposes that humans are biocultural creatures who quite literally are cultured within the material, social, and symbolic worlds they inhabit. Through discussions about carbon, the functions of cell membranes, the activity (...) of genes and proteins, the work of oxygen, and the passage of time, Frost recasts questions about the nature of matter, identity, and embodiment. In doing so, she elucidates the imbrication of the biological and cultural within the corporeal self. In remapping the relation of humans to their habitats and arriving at the idea that humans are biocultural creatures, Frost provides new theoretical resources for responding to political and environmental crises and for thinking about how to transform the ways we live. (shrink)

Foucault contra Habermas is an incisive examination of, and a comprehensive introduction to, the debate between Foucault and Habermas over the meaning of enlightenment and modernity. It reprises the key issues in the argument between critical theory and genealogy and is organised around three complementary themes: defining the context of the debate; examining the theoretical and conceptual tools used; and discussing the implications for politics and criticism. In a detailed reply to Habermas' Philosophical Discourse of Modernity, this volume explains the (...) difference between Habermas' philosophical practice and Foucault's between the analytics of truth and the politics of truth. Many of the most difficult arguments in the exchange are subject to a detailed critical analysis. This examination also includes discussion of the ethics of dialogue; the practice of criticism; the politics of recognition, and the function of civil society and democracy. (shrink)

In light of the central role scientific research plays in Merleau-Ponty’s phenomenology, the question has arisen whether his phenomenology involves some sort of commitment to naturalism or whether it is better understood along transcendental lines. In order to make headway on this issue, I focus specifically on Merleau-Ponty’s method and its relationship to Kant’s transcendental method. On the one hand, I argue that Merleau-Ponty rejects Kant’s method, the ‘method-without-which’, which seeks the a priori conditions of the possibility of experience. On (...) the other hand, I show that this does not amount to a methodological rejection of the transcendental altogether. To the contrary, I claim that Merleau-Ponty offers a new account of the transcendental and a priori that he takes to be the proper subject matter of his phenomenological method, the method of ‘radical reflection’. And I submit that this method has important affinities with aesthetic themes in Kant’s philosophy. (shrink)

In the Critique of Pure Reason, Kant describes schematism as a (A141/B180–1). While most commentators treat this as Kant's metaphorical way of saying schematism is something too obscure to explain, I argue that we should follow up Kant's clue and treat schematism literally as Kunst. By letting our interpretation of schematism be guided by Kant's theoretically exact ways of using the term Kunst in the Critique of Judgment we gain valuable insight into the nature of schematism, as well as its (...) connection to Kant's concerns in the third Critique. (shrink)

Scholars have recognized that contentious political action typically draws on relatively stable scripts for the enactment of claims making. But if such repertoires of political practice are generally reproduced over time, why and how do new modes of practice emerge? Employing a pragmatist perspective on social action, this article argues that change in political repertoires can be usefully understood as a result of situated political innovation—i.e., of the creative recombination of existing practices, through experimentation over time, by interacting political agents (...) for whom old repertoires were proving inadequate to the changing context of action. The utility of this approach is demonstrated by applying it to explain the historical emergence of a new set of populist mobilizing practices in early twentieth-century Peru. The results have implications for the study of political action and historical change. (shrink)

Biases and misunderstanding stemming from pre-training in Generative Pre-Trained Transformers are more likely for users of underrepresented English varieties, since the training dataset favors dominant Englishes (e.g., American English). We investigate (potential) bias in GPT-4 when it interacts with Trinidadian English Creole (TEC), a non-hegemonic English variety that partially overlaps with standardized English (SE) but still contains distinctive characteristics. (1) Comparable responses: we asked GPT-4 18 questions in TEC and SE and compared the content and detail of the responses. (2) (...) Accurate translation: we assessed how accurate and authentic 29 TEC and 34 SE translations were. (3) Language knowledge and attitudes: we asked what language the prompts were written in and categorized the responses and examined any language attitudes that were exhibited. Content and detail in prompts were comparable. The model was proficient at translating TEC pronouns and many grammatical categories. It was weaker at processing spelling and vocabulary items. In addition, it produced several inauthentic features. Only 39% of TEC-generated sentences were fully grammatical. While GPT-4 was perfect at identifying SE, it was 21% accurate at identifying TEC, which it sometimes classified as English with “errors” and “corrected”. GPT-4’s scope of use is limited for non-hegemonic English users. It is problematic that some of its analyses perpetuate bias against underrepresented Englishes. Increased research on lesser-documented Englishes is necessary and we anticipate that this problem affects dialects of other languages. We intend to partner with Trinidadian stakeholders to train GPT-4 in the future. (shrink)

In the Critique of the Power of Judgment, Kant offers a theory of artistic expression in which he claims that a work of art is a medium through which an artist expresses an ‘aesthetic idea’. While Kant’s theory of aesthetic ideas often receives rather restrictive interpretations, according to which aesthetic ideas can either present only moral concepts, or only moral concepts and purely rational concepts, in this article I offer an ‘inclusive interpretation’ of aesthetic ideas, according to which they can (...) present not only moral and purely rational concepts but also empirical concepts and emotions related to our ordinary experience. Although this latter class of experience-oriented aesthetic ideas has been neglected, I argue that recognizing the role it plays in Kant’s account is crucial for understanding his views not only of artistic production and our experience of art but also of the value he takes art to have for our ordinary experience of the world, others, and our own selves. What is more, insofar as the inclusive interpretation brings to light Kant’s acknowledgement of the close connection between experience and art, it reveals that his overall view of art is more plausible than is often thought, and recommends it as worthy of further consideration. (shrink)

Samantha Matherne defends a systematic interpretation of the philosopher Immanuel Kants theory of imagination. In contrast with more traditional theories of imagination, as a kind of fantasy that we exercise only in relation to objects that are not real or not present, Matherne argues that Kant theorizes imagination as something that we exercise just as much in relation to objects that are real and present. In short, she attributes to Kant a view of imagining as something that pervades our (...) lives. In order to bring out this pervasiveness, Matherne offers an account of what kind of mental capacity Kant takes imagination to be in general. She then explores Kants picture of how we exercise our imagination in perception, ordinary experience, the appreciation of beauty and sublimity, the production of art, the pursuit of happiness, and the pursuit of morality. However, she makes the case that Kants analysis of this wide range of phenomena is underwritten by a unified theory of what imagination is, as a remarkably flexible cognitive capacity that we can exercise in constrained and creative, playful and serious ways. (shrink)

Augustine of Hippo is notorious for arguing that evil is nothing more than a privation or lack of good. He also thinks that goodness is equivalent to existence and that there are degrees not only of goodness but also of existence. Critics have charged that such abstractions have no purchase in the concrete world of our experience. This article investigates what Augustine means by both goodness and existence in the illuminating context of his view that the world is a dependent (...) or derivative creation. It does so by showing how order (ordo) is a further correlate of both goodness and existence. Augustine points out the existence of two radically different realities: that which changes (creation) and that which is unchangeable (God the creator, identified as truth). For Augustine, the orderliness exhibited by the former constitutes both its dependence on the latter, and its goodness and existence: order is essentially an imitation of unchanging unity. This article therefore provides the framework for a more substantive and intelligible understanding of Augustine’s conception of evil, not only as lack but as disorder. More broadly, it shows that the idea of order is central to the metaphysics in which Augustine’s ethics is grounded. (shrink)

This article surveys recent feminist contributions to moral philosophy with an emphasis on those works which engage with debates within mainstream ethics. The article begins by examining a tension said to arise from the two criteria a theory must meet if it is to count as feminist moral theory: the women's experience requirement and the feminist conclusion requirement. Subsequent sections deal with feminist relational theories of rights, feminist work on responsibility and feminist contractarian approaches to ethics. A final section looks (...) at the application of some feminist moral theories to the problem of abortion. (shrink)

In contrast to those who trace civil society to “community” per se, Foucault is keen to locate this concept as it emerges at a particular moment in respect of specific exigencies of government. He suggests that civil society is a novel way of thinking about a problem, a particular problematization of government that emerges in the eighteenth century and which combines incommensurable conceptions of the subject as simultaneously a subject of right and of interests. This article takes up Foucault’s discussion (...) of the Scottish Enlightenment in The Birth of Biopolitics to trace the distinctiveness of his discussion of civil society, but also in order to suggest that we ought to pay closer attention to the tensions between commercial-civilizational and civic republican themes in the literature of the late eighteenth century than does Foucault. It is my tentative suggestion that Foucault’s account leaves out significant aspects of these debates that offer counter-valences to the dominant models of the subject available to contemporary political discourse. (shrink)

What standard or principle should guide decisionmaking concerning the permissibility of allowing children to be organ donors? For a long time, it has been widely assumed that the best interest of the child is the appropriate standard. But recently, several critics have charged that this standard fails to give due weight to the interests of the family and the intimate relationships that the family makes possible.1,2 This article reviews and rejects both the best-interest standard and the alternative standard recommended by (...) the critics. I then propose a new standard to help parents, healthcare professionals, and judges decide when it is and is not permissible for children to serve as organ donors. This new standard modifies and broadens the best-interest standard to allow it to account adequately for the contribution that intimate relationships make to the well-being of children. (shrink)

‘Serendipity’ is a category used to describe discoveries in science that occur at the intersection of chance and wisdom. In this paper, I argue for understanding serendipity in science as an emergent property of scientific discovery, describing an oblique relationship between the outcome of a discovery process and the intentions that drove it forward. The recognition of serendipity is correlated with an acknowledgment of the limits of expectations about potential sources of knowledge. I provide an analysis of serendipity in science (...) as a defense of this definition and its implications, drawing from theoretical and empirical research on experiences of serendipity as they occur in science and elsewhere. I focus on three interrelated features of serendipity in science. First, there are variations of serendipity. The process of serendipitous discovery can be complex. Second, a valuable outcome must be obtained before reflection upon the significance of the unexpected observation or event in respect to that outcome can take place. Therefore, serendipity is retrospectively categorized. Third, the primacy of epistemic expectations is elucidated. Finally, I place this analysis within discussions in philosophy of science regarding the impact of interpersonal competition upon the number and significance of scientific discoveries. Thus, the analysis of serendipity offered in this paper contributes to discussions about the social-epistemological aspects of scientific discovery and has normative implications for the structure of epistemically effective scientific communities. (shrink)