Although in Italy there is currently no effective law on physician-assisted suicide or euthanasia, Decision No. 242 issued by the Italian Constitutional Court on September 25, 2019 established that an individual who, under specific circumstances, has facilitated the implementation of an independent and freely-formed resolve to commit suicide by another individual is exempt from criminal liability. Following this ruling, some citizens have submitted requests for assisted suicide to the public health system, generating a situation of great uncertainty in the application (...) processes. As a matter of fact, shared and defined procedures are lacking as Decision 242/2019 merely added some principles on which the legislature will have to base its future intervention. This paper analyses the advisory role that the Decision attributes to territorial ethics committees with the aim of stimulating discussions on their role in oversight mechanisms. The proposed conclusion is that the envisaged role does not appear consistent with the functions of these bodies and is ultimately substantially undefined and unjustified. (shrink)

In this paper, we examine the issue of characterizing natural selection. Usually, natural selection is characterized as a force, as a statistical concept, and as a certain causal structure (e.g., a mechanism). We focus on the characterization of natural selection as a mechanism, and, considering the unsettled debate on the issue, particularly in the light of new mechanistic accounts, argue for a pathway characterization. We examine this issue by addressing the following three questions: (i) how does a strategic consideration (...) of mechanisms, according to which, roughly, is methodologically best to give primacy to the cognitive-epistemic power of mechanistic modelling and scientific methods even in evolutionary biology, relate to the extant interpretations of natural selection as a mechanism? (ii) Which part of the process of natural selection could be, if at all, characterized as a pathway, specifically, considering pathway’s strategic aspect, i.e., its modelling and methods? Accordingly, (iii) how do the concepts of mechanism and pathway relate to each other in this domain? In the present paper, we address primarily the first two questions. Thus, with regard to (i), we examine the characterization of natural selection as a mechanism. In particular, we apply the strategic consideration of mechanisms to other types of causal structures as well, such as that of a pathway. That discussion leads us to addressing question (ii), and to some extent (iii), where we argue that certain stages of natural selection conform to specific strategic pathway features. (shrink)

Essentialism rests on two epistemological pillars: a priori arguments for the necessity of essences, and an experiential pathway—the vivid phenomenological sense that things possess necessary, mind-independent, intrinsic natures. Anti-essentialist critiques from Quine and Buddhist śūnyatā doctrine have largely dismantled the first pillar. This paper closes the second. Drawing on the predictive coding framework, we argue that hierarchical generative networks operating under prediction-error minimisation produce high-stability attractors whose functional profile—stability, cross-contextual consistency, independence from will, resistance to revision—matches exactly what the (...) perception of a mind-independent essential nature would produce. From within the network's closed feedback loop, the two are structurally indistinguishable: no internal test can mark the difference. The phenomenological sense of essence therefore provides no independent evidence for the existence of essences. Husserl's Wesensschau, the strongest version of the experiential pathway, is shown to probe attractor-basin boundaries rather than disclose mind-independent essences: its methodological validity is preserved, but its status as an independent source of knowledge about essences is undercut. The experiential pathway from phenomenology to metaphysics is closed. (shrink)

Gender dysphoria (GD) is marked by an incongruence between a person’s biological sex at birth, and their felt gender (or gender identity). There is continuing debate regarding the benefits and drawbacks of physiological treatment of GD in children, a pathway, beginning with endocrine treatment to suppress puberty. Currently, the main alternative to physiological treatment consists of the so-called “wait-and-see” approach, which often includes counseling or other psychotherapeutic treatment. In this paper, we argue in favor of a “third pathway” (...) for the diagnosis and treatment of GD in youths. To make our case, we draw on a recent development in bioethics: the phenomenological approach. Scholars such as Slatman and Svenaeus have argued that the extent to which the body can (or should be) manipulated or reconstructed through medical intervention is not only determined by consideration of ethical frameworks and social and legal norms. Rather, we must also take account of patients’ personal experience of their body, the personal and social values associated with it, and their understanding of its situation in their life: their narrative identities. We apply this phenomenological approach to medicine and nursing to the diagnosis and treatment of GD in youth. In particular, we discuss Zahavi and Martiny’s conception of the phenomenological interview, in order to show that narrative techniques can assist in the process of gender identification and in the treatment of youth presenting with GD. We focus on two case studies that highlight the relevance of a narrative-based interview in relations between patients, HCPs, and family, to expose the influence of social ideologies on how young people presenting with GD experience their bodies and gender. (shrink)

Following the Second Summit on Human Gene Editing in Hong Kong in 2018, where the birth of two girls with germline genome editing was revealed, the need for a responsible pathway to the clinical application of human germline genome editing has been repeatedly emphasised. This paper aims to contribute to the ongoing discussion on research ethics issues in germline genome editing by exploring key issues related to the initial applications of CRISPR in reproductive medicine. Following an overview of the (...) current discussion on bringing germline genome editing into clinical practice, we outline the specific challenges associated with such interventions and the features that distinguish them from conventional clinical testing of new medical treatments. We then review proposed ethical requirements for initial heritable genome editing, such as the absence of reasonable alternatives, the existence of sufficient and reliable preclinical data, appropriate informed consent, requirements related to safety, and long-term follow-up. (shrink)

Legal interpretations of the Uniform Determination of Death Act (UDDA) can and have evolved over time. Interpretation of the statutory term “irreversible” (circulation cannot ever resume) to mean “...

The Liverpool Care Pathway for the Dying has recently been the topic of substantial media interest and also been subject to the independent Neuberger Review. This review has identified clear failings in some areas of care and recommended the Liverpool Care Pathway be phased out. I argue that while the evidence gathered of poor incidences of practice by the Review is of genuine concern for end of life care, the inferences drawn from this evidence are inconsistent with the (...) causes for the concern. Seeking to end an approach that is widely seen as best practice and which can genuinely deliver high quality care because of negative impressions that have been formed from failing to implement it properly is not a good basis for radically overhauling our approach to end of life care. I conclude that improvements in training, communication, and ethical decision-making, without the added demand to end the Liverpool Care Pathway would have resulted in a genuine advance in end of life care. (shrink)

While the effects of COVID-19 are being felt globally, the pandemic disproportionately affects lower- and middle-income countries (LMICs) by exacerbating existing global health disparities. In this article, we illustrate how intersecting upstream social determinants of global health form a disparity pathway that compromises LMICs’ ability to respond to the pandemic. We consider pre-existing disease burden and baseline susceptibility, limited disease prevention resources, and unequal access to basic and specialized health care, essential drugs, and clinical trials. Recognizing that ongoing and (...) underlying disparity issues will require long-term correction efforts, this pathway approach is nonetheless helpful to inform ethical responses to this global pandemic. It can facilitate international cooperation during the pandemic to reduce the disparate burdens among different regions without imposing significant burden on any particular contributor. The pathway approach allows international stakeholders in various social positions to respond to different components of the pathway based on their respective strengths and resources to help break the cycle of global health inequity. Guided by the ethical principles of relational and pragmatic solidarity, we argue for a coordinated global division of labor such that different stakeholders can collaborate to foster equitable healthcare access during this pandemic. (shrink)

The aim of this research is to ascertain whether a firm’s environmental motivations may help to predict how complete or incomplete its environmental management will be, understanding incomplete management to be that which neglects one or more of the three keys aspects of such management, namely, monitoring, action and results. We specifically posit that while motivations based on the search for legitimation lead to more incomplete styles of environmental management, competitive motivations entail a more complete management. The analyses conducted with (...) a sample of 1,902 plants provide empirical evidence in favour of such reasoning. The contribution this research makes, therefore, is not restricted solely to showing the effect motivations have on the environmental performance of organisations, as it also introduces a new dimension of environmental management—the degree of completeness, which needs to be considered when understanding and evaluating this effect. (shrink)

What does it feel like to be a bat? Is conscious experience of echolocation closer to that of vision or audition? Or do bats process echolocation nonconsciously, such that they do not feel anything about echolocation? This famous question of bats' experience, posed by a philosopher Thomas Nagel in 1974, clarifies the difficult nature of the mind–body problem. Why a particular sense, such as vision, has to feel like vision, but not like audition, is totally puzzling. This is especially so (...) given that any conscious experience is supported by neuronal activity. Activity of a single neuron appears fairly uniform across modalities and even similar to those for non-conscious processing. Without any explanation on why a particular sense has to feel the way it does, researchers cannot approach the question of the bats' experience. Is there any theory that gives us a hope for such explanation? Currently, probably none, except for one. Integrated information theory has potential to offer a plausible explanation. IIT essentially claims that any system that is composed of causally interacting mechanisms can have conscious experience. And precisely how the system feels is determined by the way the mechanisms influence each other in a holistic way. In this article, I will give a brief explanation of the essence of IIT. Further, I will briefly provide a potential scientific pathway to approach bats' conscious experience and its philosophical implications. If IIT, or its improved or related versions, is validated enough, the theory will gain credibility. When it matures enough, predictions from the theory, including nature of bats' experience, will have to be accepted. I argue that a seemingly impossible question about bats' consciousness will drive empirical and theoretical consciousness research to make big breakthroughs, in a similar way as an impossible question about the age of the universe has driven modern cosmology. (shrink)

A hypothesis on the evolutionary origin of the genetic pathway of sex determination in the nematode Caenorhabditis elegans is presented here. It is suggested that the pathway arose in steps, driven by frequency‐dependent selection for the minority sex at each step, and involving the sequential acquisition of dominant negative, neomorphic genetic switches, each one reversing the action of the previous one. A central implication is that the genetic pathway evolved in reverse order from the final step in (...) the hierarchy up to the first. The possible applicability of the model to the other well‐characterized sex determination pathway, that of Drosophila melanogaster, and to sex determination in mammals, is discussed, along with some potential implications for pathway evolution in general. Finally, the specific molecular and population genetic questions that the model raises are described and some tests are proposed. (shrink)

The low rates of regular exercise and overall physical activity (PA) in the general population represent a significant public health challenge. Previous research suggests that, for many people, exercise leads to a negative affective response and, in turn, reduced likelihood of future exercise. The purpose of this paper is to examine this exercise–affect–adherence relationship from an evolutionary perspective. Specifically, we argue that low rates of physical exercise in the general population are a function of the evolved human tendency to avoid (...) unnecessary physical exertion. This innate tendency evolved because it allowed our evolutionary ancestors to conserve energy for physical activities that had immediate adaptive utility such as pursuing prey, escaping predators, and engaging in social and reproductive behaviors. The commonly observed negative affective response to exercise is an evolved proximate psychological mechanism through which humans avoid unnecessary energy expenditure. The fact that the human tendencies toward negative affective response to and avoidance of unnecessary physical activities are innate does not mean that they are unchangeable. Indeed, it is only because of human-engineered changes in our environmental conditions (i.e., it is no longer necessary for us to work for our food) that our predisposition to avoid unnecessary physical exertion has become a liability. Thus, it is well within our capabilities to reengineer our environments to once again make PA necessary or, at least, to serve an immediate functional purpose. We propose a two-pronged approach to PA promotion based on this evolutionary functional perspective: first, to promote exercise and other physical activities that are perceived to have an immediate purpose, and second, to instill greater perceived purpose for a wider range of physical activities. We posit that these strategies are more likely to result in more positive (or less negative) affective responses to exercise, better adherence to exercise programs, and higher rates of overall PA. (shrink)

In this chapter I argue that one way in which friendship contributes to moral growth is by means of developing self-knowledge. The chapter starts out with an explanation of the privileged space that friendship offers for the cultivation of character. Next, the chapter develops the connection between friendship and self-knowledge. Here, the chapter makes a distinction between self-knowledge on the psychological level, and self-knowledge on the anthropological level. The chapter then turns to an analysis of the two proposed core texts (...) on friendship, Lewis' The Four Loves and Laín Entralgo's On Friendship, in order to articulate a pathway for character education at university. (shrink)

Various countries have alternative pathway policies for 2-year community college graduates to articulate to 2-year university study, forming a “2+2” pathway. However, few studies have explored university staff members’ perceptions of this “2+2” transfer pathway and their understanding of transfer students’ transition experiences. This descriptive qualitative study addressed this research gap. Forty-two academic and supporting staff participated in the focus group interviews. Specifically, the study explored the assets and challenges of the “2+2” pathway from the university (...) staff perspective in Hong Kong. The articulation pathway and TSs are highly recognized for their prior learning, academic performances, and the value of the second chance. However, while the university staff were sympathetic to the challenges filling these transfer pathways, their offering of help was limited by government funding and policies restrictions. It is recommended that policies should be established at government and university levels to recognize and tackle TSs’ unique needs to alleviate their heavy workloads through better articulation between community college and university studies. Improving articulation will allow TSs time for social involvement in university life and thus enhance their mental well-being. (shrink)

High levels of somatic symptom distress represent a core component of both mental and physical illness. The exact aetiology and pathogenesis of this transdiagnostic phenomenon remain largely unknown. The Affective Picture Paradigm (APP) represents an innovative experimental paradigm to study somatic symptom distress. Based on the HiTOP framework and a population-based sampling approach, associations between facets of somatic symptom distress and symptoms induced by the APP were explored in two studies (N1 = 201; N2 = 254) using structural equation bi-factor (...) models. Results showed that the APP effect was significantly positively correlated with general somatic symptom distress (PHQ-15, HiTOP), cardio-respiratory symptoms (PHQ-15), as well as difficulties identifying feelings. In conclusion, negative affective cues in the APP can elicit somatic symptoms, particularly in people with higher levels of somatic symptom distress. Difficulties identifying feelings might contribute to this phenomenon. Results are compatible with a predictive processing account of somatic symptom perception. (shrink)

This chapter sets the preconditions and limits for ECM. It distinguishes between four different levels of extension: momentary extension, integrated extension, prosthetic incorporation, and functional incorporation. The last of these is required for ECM: the external tool must be part of the transparent bodily point of view and under the sensorimotor control of the subject. Based on the notion of functional incorporation, a set of demarcation criteria (“the glue & trust criteria”) for ECM will be developed. They include quasi-transparency, sensorimotor (...) control, ownership, sense of agency, and sense-making attitude. This chapter closes with a discussion of sensory substitution technology as a concrete example of functional incorporation and which fulfils the glue & trust criteria. (shrink)

The cGAS‐STING signaling pathway plays a pivotal role in sensing cytosolic DNA and initiating innate immune responses against various threats, with disruptions in this pathway being associated with numerous immune‐related disorders. Therefore, precise regulation of the cGAS‐STING signaling is crucial to ensure appropriate immune responses. Recent research, including ours, underscores the importance of protein condensation in driving the activation and maintenance of innate immune signaling within the cGAS‐STING pathway. Consequently, targeting condensation processes in this pathway presents (...) a promising approach for modulating the cGAS‐STING signaling and potentially managing associated disorders. In this review, we provide an overview of recent studies elucidating the role and regulatory mechanism of protein condensation in the cGAS‐STING signaling pathway while emphasizing its pathological implications. Additionally, we explore the potential of understanding and manipulating condensation dynamics to develop novel strategies for mitigating cGAS‐STING‐related disorders in the future. (shrink)

While sound ethical standards are important in all research, ethical issues and challenges differ between disciplines and fields of study. Self-study in teacher education often includes specific ethical issues that are rooted in the very nature of self-study. The purpose of this chapter is to define the ethical framework we adhere to as we – three teacher educators at the University of Iceland, School of Education –conduct a self-study of our educational practice. The aim of the research is to identify (...) the ethical dimensions influencing our research and practice. The data emerge from collaborative self-study we have conducted for the last 5 years on our collaborative group supervision of Master's projects and include research journals, notes from meetings, and feedback from and communication with students. We focus on incidents we have identified as deserving ethical consideration. (shrink)

Advances in perinatology have permitted the survival of fragile neonates. Quality of life has been considered a key element in medical decision-making. In this review we analyse the role of Q...

Moral virtue development is grounded in social relationships that foster the socioemotional intelligence underlying moral virtue. Recent research shows a decrease in socioemotional intelligence with implications for moral virtue development. This project is a feasibility study of a theatrical intervention with parent-child dyads to increase socioemotional intelligence and proto-virtuous character by improving parent-child mutual responsiveness. Our theatrical approach combines direct development of mutual responsiveness and practice of moral virtue scripts, providing a powerful and seamless integration of philosophy, theatre art and (...) social science. (shrink)

The continuing growth of semiotics signifies increased awareness of global communicative processes. Expansion of the communicative universe through semiotic research furthers the transformation of our contemporary experience. Semiotics thus provides a means to articulate transmodernity. We validate this assertion through semiotic analysis of an everyday object, by which we discover an infinite horizon. With that horizon, we transcend the global culture of addiction and reach the spiritual science that is necessary to develop a lasting paradigm for humankind.