The important roles of prediction and prior experience are well established in music research and fit well with Clark's concept of unified perception, cognition, and action arising from hierarchical, bidirectional predictive processing. However, in order to fully account for human musical intelligence, Clark needs to further consider the powerful and variable role of affect in relation to prediction error.

What accounts for the continued lack of clarity over the legal procedures for the patenting of DNA sequences? The patenting system was built for a "bricks-and-mortar" world rather than an information economy. The fact that genes are both material molecules and informational systems helps explain the difficulty that the patent system is going to continue to have.

Access to abortion is becoming increasingly restricted for many women in the United States. Besides the longstanding financial barriers facing low-income women in most states, a newer source of scarcity has emerged. The relatively small number of physicians willing to perform the procedure is compromising the ability of women in certain parts of the country to obtain an abortion.Do physicians have a duty to respond to this situation? Do they have a professional responsibility to ensure that abortions are reasonably available (...) to the women who want to terminate their pregnancies? Or, is abortion so morally and socially controversial as to remove any professional obligation to provide reasonable access?Both law and medical ethics have traditionally protected physicians’ freedom to refuse to perform any procedure, including abortion, that conflicts with their religious or other moral beliefs. (shrink)

Access to abortion is becoming increasingly restricted for many women in the United States. Besides the longstanding financial barriers facing low-income women in most states, a newer source of scarcity has emerged. The relatively small number of physicians willing to perform the procedure is compromising the ability of women in certain parts of the country to obtain an abortion.Do physicians have a duty to respond to this situation? Do they have a professional responsibility to ensure that abortions are reasonably available (...) to the women who want to terminate their pregnancies? Or, is abortion so morally and socially controversial as to remove any professional obligation to provide reasonable access?Both law and medical ethics have traditionally protected physicians’ freedom to refuse to perform any procedure, including abortion, that conflicts with their religious or other moral beliefs. (shrink)

Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and (...) ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics. (shrink)

BackgroundPast research shows that physicians experience high ill-being but also high well-being.ObjectiveTo shed light on how medical faculty’s experiences of their job demands and job resources might differentially affect their ill-being and their well-being with special attention to the role that the work-life interface plays in these processes.MethodsQualitative thematic analysis was used to analyze interviews from 30 medical faculty at a top research hospital in Canada.FindingsMedical faculty’s experiences of work-life conflict were severe. Faculty’s job demands had coalescing effects on their (...) stress, work-life conflict, and exhaustion. Although supportive job resources helped to mitigate the negative effects of job demands, stimulating job resources contributed to greater work-life conflict, stress, and exhaustion. Thus, for these medical faculty job resources play a dual-role for work-life conflict. Moreover, although faculty experienced high emotional exhaustion, they did not experience the other components of burnout. Some faculty engaged in cognitive reappraisal strategies to mitigate their experiences of work-life conflict and its harmful consequences.ConclusionThis study suggests that the precise nature and effects of job demands and job resources may be more complex than current research suggests. Hospital leadership should work to lessen unnecessary job demands, increase supportive job resources, recognize all aspects of job performance, and, given faculty’s high levels of work engagement, encourage a climate that fosters work-life balance. (shrink)

This chapter contains sections titled: Introduction Background Incentives and guidance from the criminal law Other regulatory incentives and guidance Civil incentives Conclusion.

Music can reduce stress and anxiety, enhance positive mood, and facilitate social bonding. However, little is known about the role of music and related personal or cultural variables in maintaining wellbeing during times of stress and social isolation as imposed by the COVID-19 crisis. In an online questionnaire, administered in 11 countries, participants rated the relevance of wellbeing goals during the pandemic, and the effectiveness of different activities in obtaining these goals. Music was found to be the most effective activity (...) for three out of five wellbeing goals: enjoyment, venting negative emotions, and self-connection. For diversion, music was equally good as entertainment, while it was second best to create a sense of togetherness, after socialization. This result was evident across different countries and gender, with minor effects of age on specific goals, and a clear effect of the importance of music in people's lives. Cultural effects were generally small and surfaced mainly in the use of music to obtain a sense of togetherness. Interestingly, culture moderated the use of negatively valenced and nostalgic music for those higher in distress. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

George Yancy gathers white scholarship that dwells on the experience of whiteness as a problem without sidestepping the question’s implications for Black people or people of color. This unprecedented reversion of the “Black problem” narrative challenges contemporary rhetoric of a color-evasive world in a critically engaging and persuasive study.

Mr. C is a twenty‐two‐year‐old who was flown to a level‐1 trauma center after diving headfirst into shallow water. Prior to this accident, he was in excellent health. At the scene, he had been conscious but was paralyzed and had no sensation below his neck. The emergency medical services team immobilized Mr. C's neck with a cervical collar and intubated him for airway protection before transport. As Mr. C's medical care proceeds, he expresses a desire for extubation, although it was (...) not clear that he had the capacity to make this (or any other) decision. It also was unclear whether this desire reflected his authentic wishes to be allowed to die or stemmed from feelings of discomfort and agitation. Over a period of several days, Mr. C's sedation was lightened, and the psychiatry service conducted a formal decision‐making capacity assessment. Mr. C continues to express a desire to withdraw life‐sustaining medical treatment. However, the psychiatry service is concerned that Mr. C seems to lack adequate insight into what it would mean to die.What does it mean to respect Mr. C's autonomy? (shrink)

Over the last decade, empirical research on compassion has burgeoned in the biomedical, clinical, translational, and foundational sciences. Increasingly sophisticated understandings and measures of compassion continue to emerge from the abundance of multi- and cross-disciplinary studies. Naturally, the diversity of research methods and theoretical frameworks employed presents a significant challenge to consensus and synthesis of this knowledge. To bring the empirical findings of separate and sometimes siloed disciplines into conversation with one another requires an examination of their disparate assumptions about (...) what compassion is and how it can be known. Here, we present an integrated theoretical review of methodologies used in the empirical study of compassion. Our goal is to highlight the distinguishing features of each of these ways of knowing compassion, as well as the strengths and limitations of applying them to specific research questions. We hope this will provide useful tools for selecting methods that are tailored to explicit objectives (methods matching), taking advantage of methodological complementarity across disciplines (methods-mixing), and incorporating the empirical study of compassion into fields in which it may be missing. (shrink)

Anthropogenic climate change is arguably one of the biggest problems that confront us today. There is ample evidence that climate change is likely to affect adversely many aspects of life for all people around the world, and that existing solutions such as geoengineering might be too risky and ordinary behavioural and market solutions might not be sufficient to mitigate climate change. In this paper, we consider a new kind of solution to climate change, what we call human engineering, which involves (...) biomedical modifications of humans so that they can mitigate and/or adapt to climate change. We argue that human engineering is potentially less risky than geoengineering and that it could help behavioural and market solutions succeed in mitigating climate change. We also consider some possible ethical concerns regarding human engineering such as its safety, the implications of human engineering for our children and society, and we argue that these concerns can be addressed. Our upshot is that human engineering deserves further consideration in the debate about climate change. (shrink)

Objective: To examine changes in patients’ desired control of the deep brain stimulator and perception of global life control throughout DBS.Methods: A consecutive cohort of 52 patients with Parkinson’s disease was recruited to participate in a prospective longitudinal study over three assessment points. Semi-structured interviews assessing participants’ desire for stimulation control and perception of global control were conducted at all three points. Qualitative data were coded using content analysis. Visual analog scales were embedded in the interviews to quantify participants’ perceptions (...) of control over time.Results: Participants reported significant increases in their perception of global control over time and significant declines in their desired control of the stimulation. These changes were unrelated to improvements in motor symptoms. Improvements in global control were negatively correlated with a decline in desired stimulation control. Qualitative data indicate that participants have changed, nuanced levels of desired control over their stimulators. Increased global life control following DBS may be attributed to increased control over PD symptoms, increased ability to engage in valued activities, and increased overall self-regulation, while other domains related to global control remained unaffected by DBS.Conclusions: There are few empirical data documenting patients’ desire for stimulation control throughout neuromodulation and how stimulation control is related to other aspects of control despite the growing application of neuromodulation devices to treat a variety of disorders. Our data highlight distinctions in different types of control and have implications for the development of patient-controlled neurostimulation devices. (shrink)

This chapter contains sections titled: Bioethics Genethics Medical Ethics.

Philosophies of Difference engages with the concept of difference in relation to a number of fundamental philosophical and political problems. Insisting on the inseparability of ontology, ethics and politics, the essays and interview in this volume offer original and timely approaches to thinking nature, sexuate difference, racism, and decoloniality. The collection draws on a range of sources, including Latin American Indigenous ontologies and philosophers such as Henri Bergson, Jacques Derrida, Luce Irigaray, Immanuel Kant, Maurice Merleau-Ponty, Charles Mills, and Eduardo Viveiros (...) de Castro. -/- The contributors think embodiment and life by bringing continental philosophy into generative dialogue with fields including plant studies, animal studies, decoloniality, feminist theory, philosophy of race, and law. Affirming the importance of interdisciplinarity, Philosophies of Difference contributes to a creative and critical intervention into established norms, limits, and categories. Invoking a conception of difference as both constitutive and generative, this collection offers new and important insights into how a rethinking of difference may ground new and more ethical modes of being and being-with. Philosophies of Difference unearths the constructive possibilities of difference for an ethics of relationality, and for elaborating non-anthropocentric sociality. -/- The chapters in this book were originally published in a special issue in Australian Feminist Law Journal. (shrink)

The principle of procreative beneficence, first suggested by Julian Savulescu, argues that: If couples have decided to have a child, and selection is possible, then they have a significant moral reason to select the child, of the possible children they could have, whose life is expected, in light of the relevant available information, to go best or at least not worse than any of the others. While the validity of this moral principle has been widely contested, in this paper we (...) move away from these issues and grant, for the sake of argument, that PB is a valid moral principle, and that the justification for PB provided by Savulescu and co-authors is sound. We do this in order to explore the implications and consequences of accepting PB and show that even if we put aside questions about the validity and theoretical foundations of this principle, PB has many interesting, astonishing and highly problematic implications that have not been made explicit in the writing of Savulescu and others who support the notion of an obligation to bring to birth the best child possible :204, 2002). We suggest that these implications should be taken into account when considering both the soundness and strength of PB. (shrink)

Access to investigational drugs is a concern to patients and regulatory agencies. In order to determine potential trial participants’ views on access to investigational drugs, we surveyed one hundred people who had been referred to a phase I clinical trial. Most respondents indicated that patients had a right to investigational drugs, that the drugs should be offered only in the context of research, that getting access to these drugs is too hard, and that knowing the right people and being persistent (...) increased the likelihood of gaining access. Respondents did not think that investigational drugs should be given to anyone who wanted them, or that physicians were aware of the latest investigational agents. They most frequently recommended two allocation criteria: offering investigational drugs to those who would benefit most or were most needy; and allocating them to maximize scientific advancement. Respondents who understood the purpose of the trial were more likely to choose the second criterion. (shrink)

I explore how gender can shape the pragmatics of speech. In some circumstances, when a woman deploys standard discursive conventions in order to produce a speech act with a specific performative force, her utterance can turn out, in virtue of its uptake, to have a quite different force—a less empowering force—than it would have if performed by a man. When members of a disadvantaged group face a systematic inability to produce a specific kind of speech act that they are entitled (...) to perform—and in particular when their attempts result in their actually producing a different kind of speech act that further compromises their social position and agency—then they are victims of what I call discursive injustice. I examine three examples of discursive injustice. I contrast my account with Langton and Hornsby's account of illocutionary silencing. I argue that lack of complete control over the performative force of our speech acts is universal, and not a special marker of social disadvantage. However, women and other relatively disempowered speakers are sometimes subject to a distinctive distortion of the path from speaking to uptake, which undercuts their social agency in ways that track and enhance existing social disadvantages. (shrink)