This paper considers multiple meanings of the expression ‘dual use’ and examines lessons to be learned from the life sciences when considering ethical and policy issues associated with the dual-use nature of nanotechnology (and converging technologies). After examining recent controversial dual-use experiments in the life sciences, it considers the potential roles and limitations of science codes of conduct for addressing concerns associated with dual-use science and technology. It concludes that, rather than being essentially associated with voluntary (...) self-governance of the scientific community, codes of conduct should arguably be part of a broader regulatory oversight system. (shrink)

The fact that information and communication technologies (ICTs) increasingly shape our online and offline lifeworlds has lead to the emergence of a new societal threat in the form of vulnerabilities in critical ICT systems that may be exploited by malicious actors. Cybersecurity researchers work on finding such vulnerabilities and on identifying new attack vectors, i.e. they systematically step into the role of attackers. Normatively, however, the goal of this research is to strengthen ICTs against cyberattacks and, thus, to reduce (...) the societal threat. However, this implies a dual-use potential: as in any discipline, results in cybersecurity research need to be published at some point and the disclosure of vulnerabilities to software companies and ICT administrators is an integral part of ensuring that ICT vulnerabilities are closed; such a disclosure, however, can be misused by attackers, as well. Thus, instruments for ethical orientation in regard of these dual-use issues seem to be necessary to identify potential issues and to guide researchers in dealing with them. While corresponding resources, such as codes of conduct, already exists for cybersecurity research, we will show that they currently do not adequately address the need for ethical orientation in the academic context. This, we argue, creates the need for a new research ethics culture in cybersecurity research. (shrink)

Source code is a form of human communication, albeit one where the information shared between the programmers reading and writing the code is constrained by the requirement that the code executes correctly. Programming languages are more syntactically constrained than natural languages, but they are also very expressive, allowing a great many different ways to express even very simple computations. Still, code written by developers is highly predictable, and many programming tools have taken advantage of this (...) phenomenon, relying on language model surprisal as a guiding mechanism. While surprisal has been validated as a measure of cognitive load in natural language, its relation to human cognitive processes in code is still poorly understood. In this paper, we explore the relationship between surprisal and programmer preference at a small granularity—do programmers prefer more predictable expressions in code? Using meaning‐preserving transformations, we produce equivalent alternatives to developer‐written code expressions and run a corpus study on Java and Python projects. In general, language models rate the code expressions developers choose to write as more predictable than these transformed alternatives. Then, we perform two human subject studies asking participants to choose between two equivalent snippets of Java code with different surprisal scores (one original and transformed). We find that programmers do prefer more predictable variants, and that stronger language models like the transformer align more often and more consistently with these preferences. (shrink)

Pietraszewski's representation scheme is parsimonious and intuitive. However, internal mental representations may be subject to resource constraints that prefer more unusual systems such as sparse coding or compressed sensing. Pietraszewski's scheme may be most useful for understanding how agents communicate. Conflict may be driven in part by the complex interplay between parsimonious public representations and more resource-efficient internal ones.

The moral status of professional boundaries and the ethical nature of dual and multiple overlapping human relationships in contemporary clinical practice remain enduring problems in all health care disciplines. In this paper I explore the ethics of dual or multiple overlapping relationship and apply a virtue ethics framework to the case of psychotherapy.After clarifying the context and meaning of commonly used terminology, and considering what some of the key Australian codes of ethics relevant to psychotherapy advise about (...) class='Hi'>dual relationships, I identify some commonly occurring situations where overlapping relationships are unavoidable. A case study from a rural context where size, isolation, and community expectations profoundly impact on the capacity of a psychotherapist to maintain clearly defined professional therapeutic relationship boundaries is analysed. The rural example is pertinent. A virtue ethics approach goes some way toward alleviating perceptions about the nature of dual relationships that contribute to an enduring reticence amongst psychotherapists (and other professionals) to practice in rural settings.Clearly, if a dual relationship involves exploitation then that relationship is a boundary crossing that should rightly be categorised as a boundary violation. Boundary violations are exploitative and unethical. However, some dual relationships may involve boundary crossings that are not necessarily boundary violations. Despite their general prohibition by Australian (and many other countries’) codes of ethics relevant to psychotherapy, I argue that in certain situations, if a psychotherapist (who crosses a professional relationship boundary) acts with professional integrity from the distinct professional role-related virtues and/or regulative ideals that ensure the goals of psychotherapy (to increase autonomy and psychological wellbeing) are met, then a dual or multiple overlapping relationship in psychotherapy will be ethical. (shrink)

In 2012, and 2014 Libraries and Learning Services from the University of Auckland created two online courses to introduce students to the concept of academic integrity and its associated values and expectations. The challenge was to introduce the somewhat dry subject matter to a diverse group of students in an engaging way and to avoid large tracts of text that were difficult to comprehend. Initial research undertaken by the development team suggested that visually representing bodies of text was an effective (...) way of communicating with the target audience. Dual coding theory, multimodal instructional design and cognitive load theories provided a framework for the learning design approach taken by the design team who ultimately selected Richard Mayer’s (2001) Cognitive Theory of Multimedia Learning as a basis for designing the two courses. This paper outlines how the two courses were designed in accordance principles outlined in Mayer’s theory and how the design team integrated seven of Mayer’s twelve principles to create dynamic, visual and aural elements such as animations, narrations and text to engage learners in a more meaningful learning process. (shrink)

In the era of eLearning 4.0, many researchers have suggested that multimodal input helps to enhance second language vocabulary learning. However, previous studies on the effects of multimodal teaching have failed to yield definitive conclusions. Furthermore, only few studies on the multimodal input of vocabulary learning have aimed at junior high school students and have focused on explicit vocabulary instruction in class. To explore the effects of multimodal input on English as a foreign language learners’ vocabulary learning and summarize effective (...) methods, this study adopts a mixed-method approach. Based on dual coding theory and cognitive load theory, the teaching materials in this study were designed using the resources provided by the multimodal corpus iWeb and other websites. A total of 60 junior high school students who learned EFL and had a similar English proficiency level were divided into an experimental group and a control group. Target words were selected through questionnaire I. During the experiment, the CG learned from monomodal materials while the EG received multimodal input, and an immediate post-test was delivered to the two groups. Questionnaire II was distributed in the EG, and five students of the EG were randomly selected for an interview. One week later, a delayed post-test was conducted on the EG and CG. The results showed that the EG performed better in the post-test but did worse than the CG in the delayed post-test. The results of the questionnaire and the interview suggest that students held both positive and negative attitudes toward the multimodal input approach in vocabulary learning. The study concludes with some implications for choosing a multimodal input approach in vocabulary learning, along with a number of suggestions on how to optimize its positive influence and minimize its negative effects. (shrink)

Chapter 1 First Person Access to Mental States. Mind Science and Subjective Qualities -/- Abstract. The philosophy of mind as we know it today starts with Ryle. What defines and at the same time differentiates it from the previous tradition of study on mind is the persuasion that any rigorous approach to mental phenomena must conform to the criteria of scientificity applied by the natural sciences, i.e. its investigations and results must be intersubjectively and publicly controllable. In Ryle’s view, philosophy (...) of mind needs to adopt an antimentalist stance to achieve this aim. Antimentalism not only definitively rejects the idea that mind is a substance separated from the body, it also denies that mental phenomena radically differ from physical phenomena by virtue of several unique features. Most problematically, mental phenomena have a conscious character (mental states are related to specific qualitative feelings) and are accessible only to the first-person (only the subject knows directly what s/he is experiencing inside his/her mind). Ryle takes a strong stance on antimentalism going so far as to maintain that an approach to mind which aims to meet the criteria of scientificity set by the natural sciences must avoid any reference to internal, unobservable mental states. In his view (which is considered a specifically philosophical version of psychological behaviorism and also addresses questions put forward in psychological research), mental states can be redescribed in terms of behavioral dispositions. In this chapter, we address the historical roots of the antimentalist view and analyze its relation to the later tradition of research on mind. We show that, compared to the antimentalist stance, functionalism and cognitivism take a step back when they maintain that direct reference to mental states is necessary since mental states cause and therefore explain human behavior. This step backwards is often interpreted as a return to mentalism. However, this is only partially true. Indeed, we suggest that these later traditions retain one important element of Ryle’s antimentalism, i.e. the idea that mental states must be uniquely identified using external and publicly observable criteria, while excluding any reference to introspection and those qualitative dimensions of a mental state, which are accessible only to the first-person. According to the perspective we put forward, this epistemological stance has continued to influence contemporary research on mind and current philosophical and psychological theories which both tend to exclude the subjective qualities of human experience from their accounts of how the mind works. The issue we raise here is whether this is legitimate or whether subjective qualities do play a role with respect to the way our mind works. The conclusion of this chapter anticipates the argument the book makes in in favor of this latter position, starting from a particular angle, i.e. the problem of how we categorize concepts related to our internal states. -/- Chapter 2 The Misleading Aspects of the Mind/Computer Analogy. The Grounding Problem and the Thorny Issue of Propriosensitive Information -/- Abstract. After the crisis of behaviorism, cognitivism and functionalism became the predominant models in the field of psychology and of philosophy, respectively. Their success is mainly due to the new key they use for interpreting mental processes: the mind/computer analogy. On the basis of this analogy, mental operations are seen as cognitive processes based on computations, i.e. on manipulations of abstract symbols which are in turn understood as informational unities (representations). This chapter identifies two main problems with this model. The first is how these symbols can relate to and communicate with perception and thus allow us to identify and classify what we perceive through the senses. Here we limit ourselves to presenting this issue in relation to the classical symbol grounding problem originally put forward by Harnad on the basis of Searle’s Chinese room argument. An attempt to address the problem raised here will be made in chap. 3. The second point we discuss in relation to the mind/computer analogy concerns the idea of information it fosters. Indeed, following this analogy, information is something available in the external world which can be captured by the senses and transmitted to the central system without being influenced or modified by the procedures of transmission. This perspective does not take into account that – unlike computers – in living beings information is acquired by means of the body. As Ulric Neisser has already pointed out, the body is itself an informational source that provides us with additional sensory experience that influences (modifies or complements) the information extracted from the external world by the senses. To develop this line of analysis and to determine exactly what information is provided by the body and how this might influence cognition, we examine Sherrington’s and Gibson’s positions. Moving on from their views, we qualify bodily information in terms of ‘proprioception’. We use ‘proprioception’ in a broad sense to describe any kind of experience we have of our internal states (including postural information as well as sensations related to the general state of the body and its parts). Following Damasio’s and Craig’s studies, we further elaborate this position, arguing that living beings are equipped with an internal propriosensitive monitoring system which maps all the changes that constantly occur in our body and that give us perceptual (‘proprioceptive’ or propriosensitive) information about what happens inside us. Moreover, relying on Goldie’s and Ratcliffe’s view, we show that emotional information can also be considered as a form of ‘proprioception’ which contributes to determining everything we perceive. This analysis leads us to the second main thesis of this book: ‘proprioception’ is a form of internal perception and it is an essential component of the sensory information we can access and use for all cognitive purposes. -/- Chapter 3 Semantic Competence from the Inside: Conceptual Architecture and Composition -/- Abstract. Concepts are essential constituents of thought: they are the instruments we use to categorize our experience, i.e. to classify things and group them together in homogeneous sets. Here we define concepts as the internal mental information (representations) that allows us, among other things, to master words in natural language. By analyzing the way in which individuals master word meanings we explore a number of hypotheses regarding the nature of concepts. Following Diego Marconi’s research, we differentiate between two kind of abilities that underpin lexical competence – so-called ‘referential’ and ‘inferential competence’ – and we suggest that, in order to support these abilities, concepts must also include two corresponding kinds of information, i.e. inferential and referential information. We point out that the most widely used and acknowledged theories of concepts do not make this distinction, instead broadly characterizing the information used for categorization in terms of propositionally described feature lists. However, we show that while feature lists can explain inferential competence, they do not account for referential competence. To address the issue of referential competence we examine Ray Jackendoff’s hypothesis that to account for the possibility of linking perceptual and conceptual information we need to assume the existence of a (visual) representation that encodes the geometric and topological properties of objects and bridges the gap between the percept and the concept. Furthermore, we analyze the extension of this work by Jesse Prinz who introduced the notion of a proxytype, a perceptual representation of a class of objects that incorporates structural and parametric information related to their appearance. However, as we point out, proxytypes can only explain the relationship between perception and concepts with respect to instances that can be perceived through the senses and that belong to the same class by virtue of their physical similarity. We suggest that this notion be extended to include larger conceptual classes. To accomplish this, we further develop Mark Johnson, George Lakoff and Jean Mandler’s idea of a schematic image and argue that conceptual representations include a perceptual schema. Perceptual schemata are non-linguistic, structured experiential gestalts (patterns or maps) that make use of information taken from all sensory modalities, including body perception. They accomplish a quasi-conceptual function: they allow us to recognize and to classify different instances. In this work, we hypothesize that perceptual schemata are an essential component of concepts, but not identical to them. Instead, we suggest that concepts include both perceptual and propositional information with perceptual schemata providing the ‘perceptual core concept’ that grounds related propositional information. -/- Chapter 4 In the Beginning There Were Categories. The Bodily Origin of Prelinguistic Categorical Organization: The Example of Folkbiological Taxonomies -/- Abstract. Studies of categorization in psychology and the cognitive sciences have made use of the notions of ‘category’ and ‘concept’ without precisely defining what is meant by either; in fact, often these terms have been used as synonyms, making it difficult to address specific issues related to conceptual development. This chapter begins by discussing the definitions of, as well as the distinctions between, ‘categories’ and ‘concepts’ in the classical philosophical tradition (Aristotle, Kant and Husserl). We introduce our view of categories with reference to Husserl. Categorization is defined as the way in which our experience is originally (pre-linguistically) organized in a passive and fully unconscious manner on the basis of universal structuring principles. Conceptualization is explained as a later process in which the earlier categorical macro-classes are further subdivided into more specific and detailed sets; this later process also relies on linguistic learning and exposure to culture. On the basis of Ray Jackendoff, Jean Mandler, George Lakoff and Mark Johnson’s work, we hypothesize that categorization is a two-step process that begins with the formation of homogeneous sets of entities partitioned into regions that describe the ontological boundaries of the objects that humans perceive (categories) and continues at a later stage with the development of more specific classifications (concepts). In this chapter, we mainly address three related issues: Why should we assume that there is categorical organization which precedes the development of a conceptual system? How do categories and concepts relate to each other? Shall we hypothesize that categories are innate or that they are formed before concepts on the basis of information and organizational structure available at a very early developmental stage? We show that categorical partitions are necessary for categorization and, following Mandler, that the general categories we form at an early age do not match our adult superordinate concepts. As for the third issue, we argue that there might be no need to assume that categories are innately present in the human mind, since their formation can be explained – at least in certain cases – by basic mechanisms that work on body (propriosensitive) information. This hypothesis will not be discussed in general, but in relation to a particularly relevant example of categorical partition, i.e. the folk-biological dichotomy between ANIMATE/INANIMATE. This is compared with other dichotomies that derive from it, but are not directly categorical such as LIVING/NON-LIVING and BIOLOGICAL/NON-BIOLOGICAL. -/- Chapter 5 Internal States: From Headache to Anger. Conceptualization and Semantic Mastery -/- Abstract. Here we ask if we can also apply the distinction between referential and inferential competence we introduced in Chapter 3 to words that do not refer to things that are perceived using the external senses, especially to words/concepts that denote bodily experiences (such as pain, thirst, hunger, etc.) or emotions. We introduce and discuss the hypothesis that – even though such words/concepts do not refer to intersubjectively identifiable entities in the external world – they do have a kind of referent that can be accessed via direct perception, more specifically ‘proprioception’, as we have defined it in terms of all propriosensitive information we can consciously access. In the first part of the chapter, we specifically consider terms denoting bodily experiences such as ‘pain’ or ‘hunger’ and argue that their referents are identified and classified from a first-personal point of view on the basis of four main characteristics: their specific intensity, their localization in the body, their co-occurrence with other signals and above all their specific qualitative sensations. Emotions are addressed in the second part of the chapter. We suggest that there is a continuity between bodily experiences and emotions. In particular, we argue for a perceptual theory of emotions in line with that proposed by James and Lange at the end of the 19th century and developed more recently by authors such as Damasio (see also chap. 2§5, §6). The hypothesis we put forward is that the referential information that supports the categorization of emotions and therefore also our mastery of terms referring to emotions consists in the perception (i.e. the ‘proprioception’) of those bodily states and changes in bodily states which constitute our emotional experience. In the context of this discussion we examine some objections to this line of reasoning that arise from a cognitivist perspective and following authors such as Oatley, Johnson-Laird and Frijda, we distinguish between basic emotions that can be identified and classified solely on the basis on how they feel and complex emotions whose identification and classification additionally depends on cognitive factors. To describe how emotions are identified and classified on the basis of how they feel, we rely on Marcel and Lambie’s distinction between an ‘emotion state’ and an ‘emotion experience’. Both notions indicate kinds of feelings that we consciously experience. However, they describe first-order and second order emotion awareness respectively. The emotion state is the feeling we have of the bodily states and changes that occur when we are experiencing an emotion, while the emotion experience is the fully developed and integrated emotion we both experience and are, with reflection, aware of experiencing. On the basis of this differentiation, we also show that the same characteristics that aid in the identification and classification of bodily experiences (specific qualitative sensations; somatic localization; specific intensity; presence/absence of specific concomitant sensations) can also be used for the identification and classification of emotions – at least basic emotions. In the last two sections of the chapter we present some clinical evidence on the semantic competence of people who suffer from Alexithymia and Autism Spectrum Disorder which supports the conclusions of our preceding analyses. -/- Chapter 6 The ‘Proprioceptive’ Component of Abstract Concepts -/- Abstract. In this chapter, we address the issue of whether the mastery of abstract words requires only inferential knowledge and thus, if the concepts that support the mastery of abstract words include only linguistic information. We start by differentiating the notions of ‘abstract’ and ‘general’ which are often erroneously confused. We then identify a strict definition of abstract, as contrasted with ‘concrete’, that applies to words or concepts whose referent cannot be experienced by the senses. We argue that abstract words/concepts would be better described as theoretical, because they are usually conceived as structured sets of inferential knowledge expressed linguistically; that is, as small theories. Pointing out parallels with Carnap’s analysis of this issue in philosophy of science, we hypothesize that words/concepts denoting non-observable entities are not all ‘equally theoretical’, because their link to sensory experience can be stronger or weaker. We revive the distinction, inspired by Quine, between theoretical and intertheoretical concepts/words. This distinction relies on the fact that the former – unlike the latter – retains a strong, although indirect, connection with perception. In Quine’s discussion, perception is understood uniquely in terms of observability, i.e. of external sensory experience. Here we argue, however, that bodily, ‘proprioceptive’ (i.e. propriosensitive) experience can also serve to referentially ground theoretical (i.e. abstract) concepts/words. We frame this issue using the example of the theoretical concept ‘freedom’ and Lakoff’s hypothesis that this concept is developed on the basis of bodily information. We contrast this with the example of ‘democracy’ which more closely resembles an intertheoretical concept/word. Furthermore, we show that one of the classical views put forward in psycholinguistic research to explain how abstract concepts are mentally represented – i.e. Paivio’s Dual Coding Theory – points in the same direction as our analysis. The same is true of Barsalou’s work suggesting that we use internal information to understand at least some abstract words. To sustain this position, we put forward two lines of evidence: the first comes from psycholinguistic studies while the second examines deficits of semantic competence exhibited by people with Autism Spectrum Disorder. On the basis of our analysis, we put forward a classification that distinguishes between different kinds of concreteness and different degrees of abstraction: concepts/words referring to body experiences and basic emotions are described as analogous to concrete concepts/words because they are grounded in perceptual (i.e. propriosensitive) experience, while abstract concepts/words are considered more or less abstract depending on whether they are intratheoretical (and rely entirely on inferential information) or theoretical (and are partially grounded in perceptual – or more often in propriosensitive perceptual – information). In the last section of the chapter we consider two scales that have been used in psycholinguistic research to measure the degree of concreteness vs. abstractness of words and we show that – used conjointly – they can provide a measure of the internal vs. external grounding of specific words. (shrink)

The potential for dual use of research in the life sciences to be misused for harm raises a range of problems for the scientific community and policy makers. Various legal and ethical strategies are being implemented to reduce the threat of the misuse of research and knowledge in the life sciences by establishing a culture of responsible conduct.

The chapter argues from an ethology-inspired internalist perspective that ‘colour’ is not a homogeneous and autonomous attribute, but rather plays different roles in different conceptual forms underlying perception. It discusses empirical and theoretical evidence that indicates that core assumptions underlying orthodox conceptions are grossly inadequate. The assumptions pertain to the idea that colour is a kind of autonomous and unitary attribute. It is regarded as unitary or homogeneous by assuming that its core properties do not depend on the type of (...) ‘perceptual object’ to which it pertains and that‘colour per se’ constitutes a natural attribute in the functional architecture of the perceptual system. It is regarded as autonomous by assuming that it can be studied in isolation of other perceptual attributes. More generally, the chapter argues on the bases of corresponding empirical and theoretical evidence that perception cannot be understood as the ‘recovery’ of physical world structure from sensory structure by input-based computational processes. Rather, the sensory input serves as a kind of sign for biologically relevant aspects of the external world that activates biologically given conceptual forms with their internal parameters. Although the sensory input is a causally necessary requirement for the activation of conceptual forms, the perceptual computations triggered are under the control of an internal programme based on a set of conceptual forms. (shrink)

Rapid development of e-learning courses for ethics-and-compliance programs led to substantial success in producing engaging multimedia training toolkits aimed at breaking through barriers of indifference and distrust by combining learning with fun. However, a pleasant training experience is no guarantee of its ultimate success in improving organizational ethics. Drawing on Paivio’s Dual Coding Theory, this paper presents a model for evaluating multimedia learning from a moral viewpoint. The main argument advanced in the paper is that entertaining multimedia training modules, (...) as commonly offered in the business world, may deliver an unintended message which runs counter to the very goal of ethics training. The Rocked or Shocked? videogame—a multimedia-based ethics training module—will serve as a case study for detecting the complicated role of entertainment in ethics training and examining the ethical meanings conveyed through the pictorial/event channel. The paper concludes with recommendations for the design of multimedia ethics training. (shrink)

Elman (2009) proposed that the traditional role of the mental lexicon in language processing can largely be replaced by a theoretical model of schematic event knowledge founded on dynamic context-dependent variables. We evaluate Elman’s approach and propose an alternative view, based on dual coding theory and evidence that modality-specific cognitive representations contribute strongly to word meaning and language performance across diverse contexts which also have effects predictable from dual coding theory.

The chapter argues from an ethology-inspired internalist perspective that ‘colour’ is not a homogeneous and autonomous attribute, but rather plays different roles in different conceptual forms underlying perception. It discusses empirical and theoretical evidence that indicates that core assumptions underlying orthodox conceptions are grossly inadequate. The assumptions pertain to the idea that colour is a kind of autonomous and unitary attribute. It is regarded as unitary or homogeneous by assuming that its core properties do not depend on the type of (...) ‘perceptual object’ to which it pertains and that‘colour per se’ constitutes a natural attribute in the functional architecture of the perceptual system. It is regarded as autonomous by assuming that it can be studied in isolation of other perceptual attributes. More generally, the chapter argues on the bases of corresponding empirical and theoretical evidence that perception cannot be understood as the ‘recovery’ of physical world structure from sensory structure by input-based computational processes. Rather, the sensory input serves as a kind of sign for biologically relevant aspects of the external world that activates biologically given conceptual forms with their internal parameters. Although the sensory input is a causally necessary requirement for the activation of conceptual forms, the perceptual computations triggered are under the control of an internal programme based on a set of conceptual forms. (shrink)

Spatial aspects of words are associated with their canonical locations in the real world. Yet little research has tested whether spatial associations denoted in language comprehension generalize to their corresponding images. We directly tested the spatial aspects of mental imagery in picture and word processing (Experiment 1). We also tested whether spatial representations of motion words produce similar perceptual-interference effects as demonstrated by object words (Experiment 2). Findings revealed that words denoting an upward spatial location produced slower responses to targets (...) appearing at the top of the display, whereas words denoting a downward spatial location produced slower responses to targets appearing at the bottom of the display. Perceptual-interference effects did not obtain for pictures or for words lacking a spatial relation. These findings provide greater empirical support for the perceptual-symbols system theory (Barsalou, 1999, 2008). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Loopholes, Gaps, and What Is Held Fast”Lorraine Code (bio)Keywordsepistemology, incredulity, knowing other people, memory, testimonyNancy Potter’s compelling essay points to some of the limitations of the theoretical apparatus that the post-positivist empiricist epistemologies of the Anglo-American mainstream make available for evaluating experiential memory claims in general, and “false memory syndrome” in particular. The loopholes and gaps in these theories of knowledge push urgent questions about testimony, (...) trust, and the politics of knowledge into a prominent place on the agendas of successor epistemology projects. These politics are enacted in societies whose dominant rhetoric privileges eye-witness evidence and “knowledge by acquaintance” as sources of objective knowledge, yet whose practices of incredulity—of granting and withholding acknowledgement to testimonial knowledge claims—expose power-saturated structures of dominance and subordination and of arbitrarily uneven distributions of epistemic authority. 1For classical empiricists and their successors, perception, memory and testimony, hierarchically ordered with perception on top, count as the principal sources of empirical knowledge. This ordering maps the relative reliability of the processes, with perception ranking as most stable, reliable and secure, memory coming second on all of these scores, and testimony ranking a poor third, closer to opinion, hearsay and rumor than to the other more respectable sources. Perception, for these theories, is “immediate” in that it is direct, bare, uncontaminated either by the particularities of the perceiving subject or of the perceptual event: from its presumed (but contestable) immediacy, all the rest follows. Memory counts as perception at one remove, its reliability a function of the relative “vividness” of the perceptions it commemorates. The esteem commonly claimed for eye-witness testimony derives from this conception of memory, which is believed to ground the testimony because of its presumed proximity to “immediate” perception. Yet testimony, even in its restricted “knowledge by description” form, tends by contrast with perception and memory to be a shaky affair; and as the temporal distance between event and testimony increases, so knowledge of matters unavailable to direct observation fares less and less well in classical and post-positivist epistemologies. A distrust of testimony is at once understandable and odd, because so small a proportion both of communal and of “individual” knowledge indeed derives from first-hand observations and experiences: most of it comes from testimony in an extended sense that encompasses books, teachings, media reports, all of the sources and resources on which both secular and scholarly knowledge relies for much of its substance. This expanded construction of the term runs alongside [End Page 255] the first-personal “testimonial” sense that is more plainly operative in discussions of false memory syndrome which, despite its experiential source, is often likewise contested on grounds that discredit the “privileged access” status that these same epistemologies claim for experience at first hand.Epistemologists commonly assimilate testimony to monologic, observational knowledge, deriving its constitutive features from instances where a testimonial utterance can pose as another perception—this time an auditory one—in a personal set of knowledge-producing observations (e.g., Fricker 1987). Because the speaker may be lying or mistaken, the process may fail to transmit knowledge; but this failure can be read as a simple perceptual error or a misremembering. Such approaches ignore the constitutive function of an interpreter/listener in fostering or thwarting testimonial knowledge to subsume it, too, much under an observational model. Indeed, not only do they separate the knower from the known and the process of knowing, as Potter observes, they also separate the knower from other knowers to guard against their influencing (= contaminating) the knowledge-production process. Experiences where an interlocutor actually enables the production of knowledge do not figure in such analyses, 2 whose effect is to suggest that giving or hearing testimony invokes no more significant moral-political issues than do acts of perceiving tables and chairs: that hearing, like seeing, is believing. (Norman Malcolm’s analysis of memory, which Potter cites, would also underwrite such a view of testimony.) Yet standard empiricist and post-positivist epistemologies generate an inquisitorial model of eliciting testimony in which the more generalized “testimony” in the knowledge that people acquire from books, media reports, conversation, reference sources recedes from... (shrink)

I evaluate post-Quinean naturalized epistemology as a resource for postcolonial and feminist epistemology. I argue that naturalistic inquiry into material conditions and institutions of knowledge production has most to offer epistemologists committed to maintaining continuity with the knowledge production of specifically located knowers. Yet naturalistic denigrations of folk epistemic practices and stereotyped, hence often oppressive, readings of human nature challenge the naturalness of the nature they claim to study. I outline an ecologically modelled epistemology that focuses on questions of epistemic (...) responsibility and community, while refusing the reductivism of totalizing theory, and producing realistic moral-epistemic analyses of specific, local epistemic resources to ground its normative injunctions. (shrink)

Brette criticizes the notion of neural coding because it seems to entail that neural signals need to “decoded” by or for some receiver in the head. If that were so, then neural coding would indeed be homuncular, requiring an entity to decipher the code. But I think Brette's plea to think instead in terms of complex, interactive causal throughput is preaching to the converted. Turing has already shown the way. In any case, the metaphor of neural coding has little (...) to do with the symbol grounding problem. (shrink)

This chapter contains section titled: Critical Interrogations Feminism and Epistemology Whose Knowledge? Naturalizing, Reconfiguring, Situating Ecological Naturalism Bibliography.

Current work in the evolution of language and communication is emphasising a close relationship between the evolution of speech, language and gestural action. This paper briefly explores some evolutionary implications of a range of closely related impairments of speech, language and gesture arising from left frontal brain lesions. I discuss aphasic lexical speech automatisms and their resolution with some recovery into agrammatism with apraxia of speech, an impairment of speech planning and programming. I focus attention on the most common (...) forms of LSAs, expletives and the pronoun+modal/aux subtype, and propose that further research into these phenomena can contribute to the debate. I briefly discuss recent studies of progressively degenerating neurological conditions resulting in progressive patterns of cognitive impairments that promises to provide insight into the evolutionary relationships between speech, language and gesture. (shrink)

Background: International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance (...) and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion: Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand that actions for occupational health extend beyond just the workplace. Summary: A stronger articulation of occupational health practice with advocacy for prevention should be an ethical norm. Ethical codes should ideally harmonize and balance individual and community needs so as to provide stronger moral authority guidelines. There is a need to consider an African Charter on Bioethics as complementary and strengthening of existing codes for the region. (shrink)

Are idioms stored in memory in ways that preserve their surface form or language or are they represented amodally? We examined this question using an inci- dental cued recall paradigm in which two word idiomatic expressions were presented to adult bilinguals proficient in Russian and English. Stimuli included phrases with idiomat- ic equivalents in both languages (e.g. “empty words/пycтыe cлoвa”) or in one language only (English—e.g. “empty suit/пycтoй кocтюм” or Russian—e.g. “empty sound/пycтoй звyк”), or in neither language (e.g. “empty rain/пycтoй (...) дoждь”). If idioms are stored in a language-specific format, then phrases with idiomatic equivalents in both languages would have dual representation, and should therefore be more easily recalled than phrases with idiomatic meaning in only one language. This result was obtained. As such, the findings support the dual-coding theory of memory and are also compatible with models of the bilingual lexicon that include language tags or nodes. (shrink)

This paper examines moral dilemmas faced by family caregivers of older adults who employ live-in migrant care workers. Being both a family caregiver as well as an employer of a live-in migrant care worker often puts family members at a crossroad, where moral decisions must be made. Lacking a formal role, family members do not have a professional code of ethics or other clear rules that can guide their actions, and their choices are rooted in cultural, community, familial, and (...) personal values. This paper discusses moral dilemmas that result from family caregivers’ dual commitment, to the wellbeing of their older sick relative who is the recipient of care, and to the wellbeing of the live-in care worker whom they employ. The paper uses relational ethics as a theoretical framework to discuss three cases that involve complex moral decision making in real life. (shrink)

There is a new theory of information based on logic. The definition of Shannon entropy as well as the notions on joint, conditional, and mutual entropy as defined by Shannon can all be derived by a uniform transformation from the corresponding formulas of logical information theory. Information is first defined in terms of sets of distinctions without using any probability measure. When a probability measure is introduced, the logical entropies are simply the values of the probability measure on the sets (...) of distinctions. The compound notions of joint, conditional, and mutual entropies are obtained as the values of the measure, respectively, on the union, difference, and intersection of the sets of distinctions. These compound notions of logical entropy satisfy the usual Venn diagram relationships since they are values of a measure. The uniform transformation into the formulas for Shannon entropy is linear so it explains the long-noted fact that the Shannon formulas satisfy the Venn diagram relations--as an analogy or mnemonic--since Shannon entropy is not a measure on a given set. What is the logic that gives rise to logical information theory? Partitions are dual to subsets, and the logic of partitions was recently developed in a dual/parallel relationship to the Boolean logic of subsets. Boole developed logical probability theory as the normalized counting measure on subsets. Similarly the normalized counting measure on partitions is logical entropy--when the partitions are represented as the set of distinctions that is the complement to the equivalence relation for the partition. In this manner, logical information theory provides the set-theoretic and measure-theoretic foundations for information theory. The Shannon theory is then derived by the transformation that replaces the counting of distinctions with the counting of the number of binary partitions it takes, on average, to make the same distinctions by uniquely encoding the distinct elements--which is why the Shannon theory perfectly dovetails into coding and communications theory. (shrink)

In Faculty Misconduct in Collegiate Teaching, higher education researchers John Braxton and Alan Bayer address issues of impropriety and misconduct in the teaching role at the postsecondary level. Braxton and Bayer define and examine norms of teaching behavior: what they are, how they come to exist, and how transgressions are detected and addressed. Do faculty members across various collegiate settings, for example, share views about appropriate and inappropriate teaching behaviors, as they share expectations regarding actions related to research? And what (...) mechanisms are utilized to correct inappropriate behavior on the part of college and university teachers? The authors' work is based on survey results obtained from faculty members at research universities, liberal arts colleges, and two-year community, junior, and technical colleges. Braxton and Bayer's focus is on undergraduate teaching in four disciplines: biology, history, mathematics, and psychology. In their analyses, the authors examine how individual, disciplinary, and institutional differences influence professorial behavior. In contrast to the more explicitly understood and enforced rules of conduct in research, the authors find that teaching norms are informally defined and observed. They argue that a formal code of ethics for undergraduate teaching would serve the dual purpose of improving undergraduate education and elevating the status of college teaching. A groundbreaking study of contemporary academe, Faculty Misconduct in Collegiate Teaching is required reading for all university and college instructors and administrators. (shrink)

Les rituels sont les synapses dans le tissu culturel d'où sont issus les éléments qui gouvernent la vie en commun et la communication des êtres humains. Il en est ainsi depuis le commencement de toute société humaine. Mais ce n'est qu'au XX siècle que se manifeste un véritable intérêt pour le fonctionnement et l'importance culturelle des rituels. Il s'agit d'un tournant inspiré par les théories des ethnologues, et placé sous le signe du cultural turn et du performative turn du (...) XX siècle. On se détourne alors des pratiques jusque-là en vigueur de l'abstraction et de la représentation. Or, depuis le «Banquet» de Platon et l'instauration de la «Cène» chrétienne, l'un des rituels les plus importants est l'acte socialement codé de l'ingestion de nourriture, le repas. Avec l'Eat art dont il est le concepteur, Daniel Spoerri a repris ce thème et contribué, par le truchement du rituel piège, à poser un regard neuf sur l'acte de manger au XXe siècle. Tel que Spoerri le met en scène, le «rituel piège» attire l'attention sur le rôle de fondation de sens que joue le rituel dans la culture. Mais il fait apparaître également que les rituels se transforment en pièges idéologiques où tombe quiconque les prend « à la lettre » ou comme des évidences. Spoerri est un des artistes du XX et de ce début du XXI siècle qui, par le biais de leur art, rendent compte de la double fonction du rituel dans la culture: d'une part, le rituel maintient en vie le processus culturel; d'autre part, il est producteur d'idéologies qui font passer des mythes politiques pour naturels, prenant au piège consommateur de nourriture et consommateur d'art tout à la fois.Rituals are the synapses in the cultural fabric which has produced the elements that govern the coexistence and communication of human beings. This is so since the beginning of human society. But it is only 20th century that demonstrates a genuine interest in the operation and cultural importance of rituals. It is a milestone inspired by the theories of ethnologists, and placed under the sign of the cultural turn and performative turn of the twentieth century. It then turns practices far into force of abstraction and representation. However, since the "Banquet" of Plato and the establishment of the "Last Supper" Christian, one of the most important rituals is the act socially coded ingestion of food, meal. Eat with the art of which he is the designer, Daniel Spoerri took up this theme and contributed through the ritual trap, put a new perspective on the act of eating in the twentieth century. Spoerri as the stages, the "ritual trap" draws attention to the role of Foundation meaningful ritual plays in the culture. But it also shows that the rituals are transformed into ideological traps which falls whoever takes "the letter" or as evidence. Spoerri is one of the artists of the 20th and the beginning of the 21st century, through their art, reflect the dual role of ritual in culture: on the one hand, the ritual keeps life the cultural process, on the other hand, it is a producer of ideologies that pass for political myths natural trapping consumer food and consumer of art at the same time. (shrink)

Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

In the late 1980s, an Institute of Medical Ethics working party on the teaching of medical ethics defined the subject as follows.1 Medical Ethics, it stated, has ‘two meanings’: ‘traditionally’ it ‘has referred to the standards of professional competence and conduct which the medical profession requires of its members’; ‘increasingly’, it ‘refers to the study of ethical or moral problems raised by the practice of medicine’. Thirty years on, teaching, learning and research in medical ethics retains this dual emphasis (...) on the normative as well as the problematic. In the same vein, most papers in this issue of the Journal raise ethically problematic questions which have practical moral implications for what eventually ought, or ought not to be done, to or by individuals or populations in the context of healthcare. The urgent need for a well-argued medical ethics was acknowledged by the IME working party when it observed that many of the problems now ‘increasingly’ raised by the practice of medicine ‘cannot be resolved simply by appealing to professional codes, or to science, religion, the law or even common sense’. Such problems, the report added, ‘often arise… when principles previously accepted begin to be questioned, or are understood imperfectly or even misrepresented’. That these categories remain relevant, again is illustrated by papers in this issue. At the most fundamental, if also perhaps the most speculative level, are questions previously asked about the moral status of consciousness in animals or in non-communicating brain-injured patients for example, but now also being asked in relation to cerebral organoids or ‘mini-brains’. As Lavazza and Massimini explain in their ground-breaking paper on the subject organoids are ‘three-dimensional biological structures grown in vitro from different kinds of stem-cells that self-organise mimicking real organs with specific cell-types’: these now …. (shrink)

The human genome consists of more than 3 billion base pairs built from four different nucleotides that hold the genetic information for the entire organism. The genome is commonly divided into coding and noncoding DNA sequences, with coding DNA sequences defined as those that can be transcribed into mRNA and translated into proteins, or genes. The genetic code determines the impact of a nucleotide change in a gene on the protein sequence and function, and it is essential to understanding (...) the genetic basis of many congenital diseases. The Human Genome Project has accelerated our understanding about the genome function. We now know that our genome consists of 20,000–25,000 genes that occupy only.. (shrink)

Although scientists dating back to Darwin have noted the importance of the body in communicating emotion, current research on emotion communication tends to emphasize the face. In this article we review the evidence for bodily expressions of emotions—that is, the handful of emotions that are displayed and recognized from certain bodily behaviors (i.e., pride, joy, sadness, shame, embarrassment, anger, fear, and disgust). We also review the previously developed coding systems available for identifying emotions from bodily behaviors. Although no extant (...) coding system provides an exhaustive list of bodily behaviors known to communicate a panoply of emotions, our review provides the foundation for developing such a system. (shrink)

Codes of ethics currently offer no guidance to scientists acting in capacity of expert. Yet communicating their expertise is one of the most important activities of scientists. Here I argue that expert communication has a specifically ethical dimension, and that experts must face a fundamental trade-off between "actionability" and "transparency" when communicating. Some recommendations for expert communication are suggested.

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss protocol on communication and wellbeing of older persons with DSL and their communication partners in the Netherlands and Belgium.MethodsParticipants and their communication partners were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment (...) modifications and effective communication strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired. Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843. (shrink)

The competition in higher education has increased, while lecturers are involved in multiple assignments that include teaching, research and publication, consultancy, and community services. The demanding nature of academia leads to excessive work load and stress among academicians in higher education. Notably, offering the right motivational mix could lead to job satisfaction and performance. The current study aims to demonstrate the effects of extrinsic and intrinsic motivational factors influencing job satisfaction and job performance among academicians working in Malaysian private higher (...) educational institutions. Cross-sectional data were collected from the Malaysian PHEIs and the randomly selected 343 samples. The data analysis was performed with the dual analysis of partial least square structural equation modeling and artificial neural network analysis. As a result, it was found that financial rewards, promotion, performance appraisal, classroom environment, and code of conduct significantly predicted job satisfaction. The code of conduct, autonomy, and self-efficacy strongly influenced job performance. The relationship between job satisfaction and job performance was highly moderated by self-efficacy. It was suggested from the ANN analysis that the three prominent factors influencing job satisfaction are financial rewards, performance appraisal, and code of conduct. The analysis supported three significant factors influencing job performance: self-efficacy, performance appraisal, and code of conduct. The management of PHEIs should build the correct policies to transform job satisfaction into job performance. Self-efficacy plays an essential role in activating job performance. Other significant motivating factors that promote job satisfaction and performance, such as emotional intelligence, mindfulness, and other personal traits, should be included in future studies. In addition, future research could use a mixed-method or multi-respondent approach to investigate the important variables and their impact on lecturers’ job satisfaction and performance. (shrink)

This study examines the dual discursive articulation in the Instagram posts of the street library community, Literasi Trotoar (LIAR), in Purwakarta, Indonesia. The study focuses on two groups of posts: those directed towards the LIAR community and the general public, and those aimed at the Indonesian government. To analyse the posts, this study adopts ‘Multimodal Critical Discourse Analysis (MCDA),’ which focuses on both the language and visual elements of the posts. The findings reveal the presence of two integrated and (...) inseparable types of articulation within the posts. Firstly, articulation serves as a discursive tool to persuade the public to embrace the ideology of anarchism within the context of in-group power relations. This articulation is strategically employed for positive in-group representation, in-group ideological glorification, subject interpellation, ideological legitimation, and power formation. Secondly, articulation functions as a discursive mechanism to challenge the authority of the government within the context of out-group power relations. This articulation is strategically utilized for negative out-group representation using a narrative model of populism, out-group ideological debasement, subject resistance, ideological delegitimization, and power exertion. This study proposes a model termed ‘dual discursive articulation,’ which integrates two discursive objectives: persuasion and resistance. (shrink)

This paper examines the implementation, communication and benefits of corporate codes of ethics by the top companies operating in Australia, Canada and Sweden. It provides an international comparison across three continents. It is also based on a longitudinal approach where three national surveys were performed in 2001–2002 and replications of the same surveys were performed in 2005–2006. The empirical findings of this research show in all three countries that large organisations indicate a substantial interest in corporate codes of ethics. (...) There are, however, differences in the ways that the companies in each country implement and communicate their corporate codes of ethics and the benefits that they see being derived from them. The longitudinal comparison between 2001–2002 and 2005–2006 indicates changes in the implementation, communication and benefits of corporate codes of ethics in the three countries. (shrink)

The media, advertising and public relations are all regulated in some degree by ethical codes of practice, but do they work and do they help practitioners? The author is Senior Lecturer in public relations and philosophy at Leeds Business School, Leeds Metropolitan University, Leeds LS2 8AF. She is currently preparing material for a new MA in Business Policy and Ethics, to be offered jointly by Leeds Metropolitan University and the University of Leeds.

We present a theoretical framework bearing on the evolution of written communication. We analyze writing as a special kind of graphic code. Like languages, graphic codes consist of stable, conventional mappings between symbols and meanings, but (unlike spoken or signed languages) their symbols consist of enduring images. This gives them the unique capacity to transmit information in one go across time and space. Yet this capacity usually remains quite unexploited, because most graphic codes are insufficiently informative. They may (...) only be used for mnemonic purposes or as props for oral communication in real-time encounters. Writing systems, unlike other graphic codes, work by encoding a natural language. This allows them to support asynchronous communication in a more powerful and versatile way than any other graphic code. Yet, writing systems will not automatically unlock the capacity to communicate asynchronously. We argue that this capacity is a rarity in non-literate societies, and not so frequent even in literate ones. Asynchronous communication is intrinsically inefficient because asynchrony constrains the amount of information that the interlocutors share and limits possibilities for repair. This would explain why synchronous, face-to-face communication always fosters the development of sophisticated codes (natural languages), but similar codes for asynchronous communication evolve with more difficulties. It also implies that writing cannot have evolved, at first, for supporting asynchronous communication. (shrink)

Business and Society Review, Volume 127, Issue 1, Page 69-96, Spring 2022.

Like nuclear energy, most technologies could have dual use—for health and well being and disaster and terror. Some research publications have brought to the forefront the tragic consequences of the latter potential through their possible use. Monitoring life science research and development (R&D) to prevent possible misuse is a challenging task globally, more so in developing economies like India, which are emerging as major biotech hubs. As a signatory to the Biological and Toxin Weapons Convention, India has put in (...) motion a process of evolving a series of measures to manage dual-use technology. The Indian Council of Medical Research (ICMR) has taken a lead in drafting model codes of conduct, ethics and practice for use by other S&T agencies to tailor them as per their requirements. Taking cue from the discussions held by the editors of the various medical and science journals in the developed world, the Indian Journal of Medical Research, the official publication of the ICMR, is working on policy and uniform practice of publication of dual-use research results. The Government of India too has promulgated legal provisions to minimize the risks of misuse of technology, like the Weapons of Mass Destruction Act. Clearly, no single agency would be able to manage the dual-use of technology effectively. Multiple agencies have to come together to work in tandem for effective implementation of various measure and also like Janus, ensure that they are neither too restrictive nor intrusive to discourage the development of science. (shrink)

An evaluation of mental capacity is critical to a clinician's judgment about whether or not persons can make medical treatment decisions on their own behalf, and uncertainty about their ability to meaningfully participate in that process is one of the more common reasons an ethics consult is requested. The care of decisionally incapable patients—particularly those who lack advance care documents and no living relative who can speak for them—presents a quandary to healthcare personnel attempting to plan care in their best (...) interest, especially when options are multiple but none are ideal. These situations can be further complicated if involving a patient with a dual diagnosis of mental retardation and mental illness living in a community group home. (shrink)