Medical science at its core aims to preserve health and eliminate disease, but a common theme in scientific discovery is the application of findings in ways that were not the primary intent. The development of diagnostic modalities to predict the health of resulting children has been a fundamental aim underpinning research into prenatal and preimplantation diagnostic modalities; however, the knowledge gained has in some cases been utilized for nonmedical purposes. As an example, amniocentesis developed to determine whether the pregnancy is (...) chromosomally normal also provides information about the sex of the fetus, which normally does not affect health. The emerging gene‐editing technologies that could be used to repair mutated disease‐causing genes in an embryo will presumably also be able to be used to alter traits unrelated to disease. And yet, I will argue, the desire to preserve the mystery of reproduction remains a central value in humans’ quest to reproduce. This yearning to maintain the mysteries will likely temper the development of strategies to alter our genome and affect the genetic identities of our offspring. In my experience as an obstetrician and reproductive endocrinology and infertility subspecialist, people want to have, not the best possible baby, but rather their own baby. (shrink)

This article examines the historically embedded relations of three 19th-century phenomena in which the non-consuming body is constituted as a spectacle of admiration. These three phenomena, known as Fasting Women, Living Skeletons and Hunger Artists, all emerged and disappeared in Europe in the 18th and 19th centuries. Viewing the emergence and disappearance of the three phenomena as embedded in the historical crossroads of pre-modern and modern ethics, the article argues that each of these phenomena corresponds differently to the clash between (...) modern `rationality' and the pre-modern celebration of `miracles'. The article maintains that while Fasting Women epitomized that clash by becoming (a highly contested) spectacle of `the miraculous', the Living Skeletons transcended the clash by portraying a spectacle of liminal corporeality (the `living dead') and the Hunger Artists announced the dissolution of that very clash by performing a spectacle of `the controlled self'. Through a focus on the spectacle of fasting (i.e. the appeared, performed, `gazed at' act of fasting), a phenomenological typology of the three phenomena is outlined. I suggest that while Fasting Women and Living Skeletons embodied a spectacle of a lean body, which does not require suffering, the Hunger Artists embodied a spectacle of hunger centred on suffering and pain. The phenomenological `mapping' of these phenomena is then considered in the context of `performativity theory' and proposed as a frame of reference for a sociological study of anorexia nervosa. (shrink)

The relationship between adults and children in liberal democracies is based on two flawed assumptions that are widespread: first, that childhood is an impediment, a passing phase of impaired maturity; and second, that children benefit from the proliferation of rights ascribed to them. Social institutions, and particularly the education system, are correspondingly misconstrued. This article focuses on the combined effect of vulnerability and autonomy as they construct contemporary childhood. I conclude that adults' obligations rather than children's rights are the appropriate (...) social, political and educational basis for adult society's relations with children. (shrink)

Standardizing consultation processes is increasingly important as clinical ethics consultation becomes more utilized in and vital to medical practice. Solid organ transplant represents a relatively nascent field replete with complex ethical issues that, while explored, have not been systematically classified. In this paper, we offer a proposed taxonomy that divides issues of resource allocation from viable solutions to the issue of organ shortage in transplant and then further distinguishes between policy and bedside level issues. We then identify all transplant related (...) ethics consults performed at the Cleveland Clinic between 2008 and 2013 in order to identify how consultants conceptually framed their consultations by the domains they ascribe to the case. We code the CC domains to those in the Core Competencies for Healthcare Consultation Ethics in order to initiate a broader conversation regarding best practices in these highly complex cases. A discussion of the ethical issues underlying living donor and recipient related consults ensues. Finally, we suggest that the ethical domains prescribed in the Core Competencies provide a strong starting ground for a common intra-disciplinary language in the realm of formal CEC. (shrink)

When a nation declares war, it rarely takes time to define the concept. When a peace treaty is signed, governments and peoples assume that they know what to exp.

In the engaging and thought-provoking book The Gene Machine: How Genetic Technologies Are Changing the Way We Have Kids and the Kids We Have, Bonnie Rochman addresses the question of choice in human reproduction through the lens of knowledge. Asserting that the desire for knowledge is the central theme of modern-day reproduction, she asks, “Is genetic knowledge empowering or fear-inducing or both?” Yet the question at the heart of the book goes beyond knowledge. Rochman delves into whether genetic information is (...) actionable and then examines the corollary question of whether individuals should make decisions based on this data. Do parents want to choose the kinds of kids they have? Certainly, most parents would do what they could to prevent their child from having a painful, life-limiting disease. But that is the extreme. And while genetic technologies generally start by targeting the extreme, the inevitable byproduct is the ability to know about and affect the fringe. It is at the borders that the critical questions lie. Taking advantage of reproductive choices has potentially life-altering and permanent consequences not only for the chooser but also for the resulting child, the family unit, and society. (shrink)

Citizenship under Fire examines the relationship among civic education, the culture of war, and the quest for peace. Drawing on examples from Israel and the United States, Sigal Ben-Porath seeks to understand how ideas about citizenship change when a country is at war, and what educators can do to prevent some of the most harmful of these changes.Perhaps the most worrisome one, Ben-Porath contends, is a growing emphasis in schools and elsewhere on social conformity, on tendentious teaching of history, (...) and on drawing stark distinctions between them and us. As she writes, "The varying characteristics of citizenship in times of war and peace add up to a distinction between belligerent citizenship, which is typical of democracies in wartime, and the liberal democratic citizenship that is characteristic of more peaceful democracies."Ben-Porath examines how various theories of education--principally peace education, feminist education, and multicultural education--speak to the distinctive challenges of wartime. She argues that none of these theories are satisfactory on their own theoretical terms or would translate easily into practice. In the final chapter, she lays out her own alternative theory--"expansive education"--which she believes holds out more promise of widening the circles of participation in schools, extending the scope of permissible debate, and diversifying the questions asked about the opinions voiced. (shrink)

The diversity of contemporary democratic nations challenges scholars and educators to develop forms of education that would both recognize difference and develop a shared foundation for a functioning democracy. In this essay Sigal Ben-Porath develops the concept of shared fate as a theoretical and practical response to this challenge. Shared fate offers a viable alternative to current forms of citizenship education, one that develops a significant shared dimension while respecting deep differences within a political community. It is grounded in (...) the social and moral realities of civic life, and it seeks to weave the historical, political, and social ties among members of the nation into a form of affiliation that would sustain and expand their shared political project. Some particular educational contexts are considered through the lens of shared fate, including the resegregation of some schooling systems, linguistic diversity, and patriotic education. (shrink)

Democracies are calling on schools to respond to a rise in extremist ideologies and actions. In this article Sigal Ben-Porath situates the rise in extremism within the broader context of political polarization. She suggests that the latter is a more appropriate target for school intervention than the former. She further suggests that addressing polarization can result in a reduction in extremism, and that polarization can be addressed by refocusing the use of existing teaching and learning tools, rather than by (...) instituting new forms of intervention such as the Prevent strategy used in the UK. Tackling polarization through media literacy and the development of democratic habits can help rectify false beliefs, which contribute both to broad political polarization and to individuals' slide toward extremism. Focusing on strengthening knowledge as well as social ties can fortify individuals' and communities' resilience against extremism, as well as build bridges and connect people to a sense of shared fate across political divides. These practices are more effective and more justified than targeting individual students who are suspected of holding radical beliefs. (shrink)

In this essay, Ben-Porath begins from the assumption that just war theory should be extended to include a jus post bellum component. Postwar conduct should be significantly informed by a care ethics perspective, particularly its political aspects as developed by Joan Tronto and others. Care ethics should be extended to the international postwar arena with one significant amendment, namely, weakening the aim of ending dependence.

The paper examines when unilateral and bilateral pretence may be beneficial distinguishing between positive and negative externalities. Using a two-player single period game and defining altruism, selfishness and meanness as "sentimental continuity" it is shown how the optimal level of the pretended sentimentality is determined. The novelty of the model is that the optimal degree of altruism (meanness) depends on the extent of the positive (negative) externalities.

This paper deals about dualities for bounded prelinear Hilbert algebras. In particular, we give an Esakia-style duality between the algebraic category of bounded prelinear Hilbert algebras and a category of H-spaces whose morphisms are certain continuous p-morphisms.

Recent models of psychopathology and psychotherapy highlight the importance of interpersonal factors. The current review offers a biological perspective on these interpersonal processes by examining inter-brain synchrony—the coupling of brain activity between people interacting with one another. High inter-brain synchrony is associated with better relationships in therapy and in daily life, while deficits in the ability to achieve inter-brain synchrony are associated with a variety of psychological and developmental disorders. The review suggests that therapy improves patients’ ability to achieve such (...) synchrony through inter-brain plasticity—a process by which recurring exposure to high inter-brain synchrony leads to lasting change in a person’s overall ability to synchronize. Therapeutic sessions provide repeated situations with high inter-brain synchrony. This can lead to a long-term increase in the ability to synchronize, first with the therapist, then generalized to other interpersonal relationships, ultimately leading to symptom reduction. The proposed inter-brain plasticity model offers a novel biological framework for understanding relational change in psychotherapy and its links to various forms of psychopathology and provides testable hypotheses for future research. Understanding this mechanism may help improve existing psychotherapy methods and develop new ones. (shrink)

School choice is most often viewed through the lens of provision: most of the debate on the issue searches for desirable ways to offer vouchers, scholarships or other tools that provides choice as a way to achieve equality and/or freedom. This paper focuses on the consumer side of school choice, and utilises behavioural economics as well as ethnographic and network studies to consider ways to structure choice which respond to actual cognitive and social processes of choice. These empirical studies give (...) scholars and policy-makers who grapple with school choice a perspective that should affect the principled design of these programs as well as their execution. The paper considers the ways in which actual choice processes should affect current visions of school choice. It concludes with recommendations concerning the design of choice sets and the accessibility of information regarding choice, which together can assist school choice policies in better fulfilling their promise of equality and freedom. (shrink)

The state's commitment to educating all children can be framed as a matter of human capital development, or the economic benefits accrued to individuals and society as a result of educational attainment; it can be framed as a matter of capabilities, or the development of functionings that enable human flourishing; and it can be framed as a matter of rights. In this essay Sigal Ben-Porath considers the relative merits of the three approaches, elaborating the implications each of these different (...) frameworks has for the education of children with disabilities. While the capabilities approach, which arises from and relates to the rights approach, is sensitive to the needs of individuals with disabilities (more than the human capital approach is, in any case), Ben-Porath concludes that a rights framework can best express through educational policy the state's commitment to the education of all children, regardless of ability. (shrink)

In this paper we present an informal review of our recent work whose goal is to develop a mathematical theory of the physical phenomenon of emission and absorption of radiation by systems of nonrelativistic matter such as atoms and molecules.

There is common agreement that preschool-level science education affects children’s curiosity, their positive approach towards science, and their desire to engage with the subject. Children’s natural curiosity drives them to engage enthusiastically in all forms of exploration. Engaging in scientific exploration necessitates self-regulation capabilities and a wide repertoire of cognitive and metacognitive strategies. The purpose of this study was to examine to what extent preschoolers (aged 5‒6 years) implement nascent inquiry skills, metacognitive awareness, and self-regulation capabilities during play-based scientific exploration (...) tasks. An additional purpose was to investigate the relationships between these capabilities, a relationship not yet investigated in the context of play-based, scientific exploration among young children. The study consisted of 215 preschoolers, from 10 preschools. For this study, we developed two scientific exploration tasks—structured and open-ended. Our motivation was to examine whether preschoolers’ capabilities will differ in the context of structured task which is aligned with the view that young children need guidance and explicit instructions compared to the context of open-ended, play-based task–allowing the children to apply and test their intuitive theories and skills. During performance participants were videotaped. Their verbal and non-verbal responses were analyzed by means of a scoring scheme. The results of a micro-analysis of about 100 hours of video showed that given the opportunity, even without setting explicit goals and instructions, children exhibit inquiry capabilities: they ask questions, plan, hypothesize, use tools, draw conclusions. Asking questions and planning were better manifested during the structured task. Children also manifested higher levels of attention, persistence, and autonomy during the structured task. However, significant higher scores of self-regulation indications were revealed in the context of the open-ended, play-based, exploration task. Moreover, results indicate significant correlations between the five measures of preschoolers’ inquiry capabilities and measures of metacognitive strategic awareness and self-regulation. The results of the present study suggest the importance of combining various learning environments and experiences in early science education that encourage children to engage in structured exploration alongside play-based, open-ended, exploration. (shrink)

Over the past several decades, medical ethics has gained a solid foothold in medical education and is now a required course in most medical schools. Although the field of medical ethics is by nature eclectic, moral philosophy has played a dominant role in defining both the content of what is taught and the methodology for reasoning about ethical dilemmas. Most educators largely rely on the case‐based method for teaching ethics, grounding the ethical reasoning in an amalgam of theories drawn from (...) moral philosophy, including consequentialism, deontology, and principlism.In this article we hope to make a case for augmenting the focus of education in medical ethics. We propose complementing the traditional approach to medical ethics with a more embedded approach, one that has been described by others as “microethics,” the ethics of everyday clinical practice. (shrink)

Members of societies involved in an intractable conflict usually consider costs that stem from the continuation of the conflict as unavoidable and even justify for their collective existence. This perception is well-anchored in widely shared conflict-supporting narratives that motivate them to avoid information that challenges their views about the conflict. However, since providing information about such major costs as a method for moderating conflict-related views has not been receiving much attention, in this research, we explore this venue. We examine what (...) kind of costs, and under what conditions, exposure to major costs of a conflict affects openness to information and conciliatory attitudes among Israeli Jews in the context of the intractable Israeli–Palestinian conflict. Study 1 revealed that interventions based on messages providing information on mental health cost, economic cost, and cost of the conflict to Israeli democracy had no significant effect on perceptions of the participants of these prices, openness to new information about the conflict, or support for conciliatory policies. However, the existing perceptions that participants had about the cost of the conflict to Israeli democracy were positively associated with openness to alternative information about the conflict and support for conciliatory policies. Therefore, in Study 2, we tested whether providing information about future potential costs to the two fundamental characteristics of Israel, a democracy or a Jewish state, created by the continuation of the conflict, will induce attitude change regarding the conflict. The results indicate that information on the future cost to the democratic identity of Israel significantly affected the attitude of the participants regarding the conflict, while the effect was moderated by the level of religiosity. For secular participants, this manipulation created more openness to alternative information about the conflict and increased support for conciliatory policies, but for religious participants, it backfired. We discuss implications for the role of information about losses and the relationship between religiosity and attitudes regarding democracy and conflict. (shrink)

Preimplantation genetic testing for polygenic disorders (PGT-P) has been commercially available since 2019. PGT-P makes use of polygenic risk scores for conditions which are multifactorial and are significantly influenced by environmental and lifestyle factors. If current predictions are accurate, then absolute risk reductions range from about 0.02% to 10.1%, meaning that between 10 and 5,000 in vitro fertilization patients would need to be tested with PGT-P to prevent one offspring from becoming affected in the future, depending on the condition and (...) the number of embryos available. Survey and interview data reveal that patients and the public have largely favorable views regarding the use of PGT-P for disease prevention; however, clinicians and professional organizations have many reservations. The use of PGT-P raises multiple social and ethical concerns including the need for adequate counseling, the setting of realistic expectations, the application of distributive justice, the impact of environmental and social determinants of health, and the potential exacerbation of health inequities. Clinicians expressed significant concerns relating to the cost of PGT-P, the potential time-consuming counseling for reproductive endocrinologists and genetic counselors, the intentional creation of supernumerary embryos, and patients’ unrealistic expectations regarding “healthiest disease-free” embryos. Furthermore, current evidence lacks long-term outcome data and generalizability. Prior to offering PGT-P to patients, additional clinical validation studies are needed. Also, ethical and social considerations raised by PGT-P should be carefully delineated. Systemic practices to increase equitable access to unbiased genetic counseling and reproductive services would be desirable prior to the ethical implementation of PGT-P. (shrink)

Providing equitable food security for a growing population while minimizing environmental impacts and enhancing resilience to climate shocks is an ongoing challenge. Here, we quantify the resource intensity, environmental impacts and nutritional output of a small (0.075 ha) low-input subsistence Mediterranean agroecological farm in a developed nation that is based on intercropping and annual crop rotation. The farm provides one individual, the proprietor, with nutritional self-sufficiency (adequate intake of an array of macro- and micro-nutrients) with limited labor, no synthetic fertilizers (...) or herbicides, and zero waste, effectively closing a full farm-table-farm cycle. We find that the agroecological farm outperforms conventional farming as practiced in the same country in terms of both lower environmental burdens, across all examined environmental metrics (63% lower on average) per kg produce, and higher nutritional score (66% higher on average). Per equal farmland, the environmental lopsidedness was even higher (79% lower than conventional farming on average), with nearly the same nutritional score (3% lower on average). Moreover, when considering total land area, which includes farmland and supporting non-agricultural lands, as well as postgate impacts and food losses, the advantage of the agroecological system over conventional farming is even more pronounced. Situated within a Mediterranean region that is undergoing rapid climate change, this food system is a unique case study of nutrition- and environment-oriented food production system. While its deployment potential is limited by lack of supportive policies, it nonetheless represents one of the most starkly bold alternatives to current food systems. (shrink)

An integral subresiduated lattice ordered commutative monoid (or integral srl-monoid for short) is a pair \(({\textbf {A}},Q)\) where \({\textbf {A}}=(A,\wedge,\vee,\cdot,1)\) is a lattice ordered commutative monoid, 1 is the greatest element of the lattice \((A,\wedge,\vee )\) and _Q_ is a subalgebra of _A_ such that for each \(a,b\in A\) the set \(\{q \in Q: a \cdot q \le b\}\) has maximum, which will be denoted by \(a\rightarrow b\). The integral srl-monoids can be regarded as algebras \((A,\wedge,\vee,\cdot,\rightarrow,1)\) of type (2, 2, (...) 2, 2, 0). Furthermore, this class of algebras is a variety which properly contains the varieties of integral commutative residuated lattices and subresiduated lattices respectively. In this paper we study the quasivariety of \(\{\wedge,\cdot,\rightarrow,1\}\) -subreducts of integral srl-monoids, which will be denoted by \(\mathsf {SR^s}\). In particular, we show that \(\mathsf {SR^s}\) is a variety. We also characterize simple and subdirectly irreducible algebras of \(\mathsf {SR^s}\) respectively. Finally, through a Hilbert style system, we present a logic which has as algebraic semantics the variety \(\mathsf {SR^s}\) and we apply this result in order to present an expansion of the previous logic which has as algebraic semantics the variety of integral srl-monoids. (shrink)

Providing effective feedback to patients in a rehabilitation training program is essential. As technologies are being developed to support patient training, they need to be able to provide the users with feedback on their performance. As there are various aspects on which feedback can be given, it is important to ensure that users are not overwhelmed by too much information given too frequently by the assistive technology. We created a rule-based set of guidelines for the desired hierarchy, timing, and content (...) of feedback to be used when stroke patients train with an upper-limb exercise platform which we developed. The feedback applies to both success on task completion and to the execution of compensatory movements, and is based on input collected from clinicians in a previous study. We recruited 11 stroke patients 1–72 months from injury onset. Ten participants completed the training; each trained with the rehabilitation platform in two configurations: with motor feedback and with no motor feedback. The two conditions were identical, except for the feedback content provided: in both conditions they received feedback on task success; in the MF condition they also received feedback on making undesired compensatory movements during the task. Participants preferred the configuration that provided feedback on both task success and quality of movement. This pilot experiment demonstrates the feasibility of a system providing both task-success and movement-quality feedback to patients based on a decision tree which we developed. (shrink)

The present study aimed to investigate three questions concerning Kahneman’s Endowment Effect. (a) Does the Endowment Effect apply to negotiations on intangible items such as intellectual resources and time invested in academic chores? (b) Does the sequence in which proposals are presented to the negotiators influence the Endowment Effect and, if so, how? (c) Does the Endowment Effect have the same impact in on-going negotiations as in one-shot negotiations? The investigation focused on the trade-off made by students between advanced courses (...) and seminars, which we term as Academic Chores Trade-Off (ACTO). The results indicated the existence of the Endowment Effect in negotiations on the above intangible items (ACTO) but could also be partially interpreted as reflecting the negotiators attempts to improve their positions. The results also supported the existence of a Sequence Effect combined with an intensification of the Endowment Effect. The Endowment Effect in on-going negotiations was not found to be significantly different from that in the one-shot format. (shrink)

Patient and family emotional harm after medical errors may be profound. At an Agency for Healthcare Research and Quality conference to establish a research agenda on this topic, the authors used visual images as a gateway to personal reflections among diverse stakeholders. Themes identified included chaos and turmoil, profound isolation, organizational denial, moral injury and betrayal, negative effects on families and communities, importance of relational skills, and healing effects of human connection. The exercise invited storytelling, enabled psychological safety, and fostered (...) further collaborative discussion. The authors discuss implications for quality/safety, educational innovation, and qualitative research. (shrink)

Purpose This study aims to examine the long-term effects of an Israeli digital literacy government program for disadvantaged populations, as they are perceived by participants of the program one year after completing the course. Design/methodology/approach Participants in the program were interviewed about the effects of participating in the program, their experiences and satisfaction, in retrospect, a year after they completed the program. Findings The main reasons for joining the program included cognitive motivations, mainly interest to become familiar with internet applications, (...) followed by employment aspiration. Positive benefits from participation included accumulated knowledge, confidence in using technology, empowerment and enhanced sense of self-efficacy. Interviewees also reported that as they could not practice or communicate with instructors once they completed the program, a significant portion of the accumulated gains faded. Social implications Social and practical implications: Digital technologies constitute key infrastructure to facilitate public participation, as well as for gaining social, political and economic capital. Therefore, there is a significant social value in reducing digital inequality by increasing digital literacy of disadvantaged populations, i.e. citizens with low socioeconomic status and low digital literacy. This study sheds light on the benefits gained from such programs, as perceived by past participants. Originality/value While previous studies evaluating digital literacy programs focus on specific technical improvements and short-term gains, this study investigates the long-term effects and shortcomings of the program as perceived by participants. (shrink)

Brock Macdonald1, Evi Vakiani2, Rhonda K Yantiss3, Jun Lee4, Robert S Brown Jr5, Samuel H Sigal61Division of Gastroenterology, Department of Medicine, University of California-San Francisco, San Francisco, CA, 2Department of Pathology, Memorial Sloan–Kettering Cancer Center, New York, NY, 3Department of Pathology and Laboratory Medicine, New York Weill Cornell Medical College, New York, NY, 4Division of Nephrology, Department of Medicine, Weill Cornell Medical College, New York, NY, 5Division of Gastroenterology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, (...) NY, 6Division of Gastroenterology and Hepatology, Department of Medicine, New York University, New York, NY, USA: The use of sirolimus as an alternative to calcineurin inhibitors for posttransplant immunosuppression is associated with a variety of inflammatory conditions. In this report, we describe the case of a 34-year-old man who developed abnormal liver tests 6 years after live-donor kidney transplantation and 5 years after initiation of sirolimus-based immunosuppression. Elevated aminotransferase levels persisted after withdrawal of potentially hepatotoxic medications, and serologic evaluation for viral hepatitis, autoimmune disease, and genetic disorders was unrevealing. Liver biopsy revealed prominent hepatocellular injury associated with a mixed inflammatory infiltrate and liver tests normalized within 2 weeks of discontinuation of sirolimus. In this report, we review previous reports of sirolimus hepatotoxicity and propose a unifying hypothesis for the various inflammatory conditions that have been attributed to sirolimus.Keywords: sirolimus, immunosuppression, transplant, inflammatory conditions, hepatotoxicity. (shrink)