Abstract: The field of life extension is full of ideas but they are unstructured. Here we suggest a comprehensive strategy for reaching personal immortality based on the idea of multilevel defense, where the next life-preserving plan is implemented if the previous one fails, but all plans need to be prepared simultaneously in advance. The first plan, plan A, is the surviving until advanced AI creation via fighting aging and other causes of death and extending one’s life. Plan B is (...) cryonics, which starts if plan A fails, and assumes cryopreservation of the brain until technical capabilities to return it to life appear. Plan C is digital immortality in the sense of collecting data about the person now so future AI will be able to recreate a model of a person. Plan D is the hope based on some unlikely scenarios of infinite survival, like so-called “quantum immortality”. All these plans have personal and social perspective. The personal aspect means efforts of the increasing chances of personal survival via taking care about one’s own health, signing cryocontract or collecting digital immortality data. The social aspect means the participation in collective work towards creation and increase of the availability of life extension technologies, which includes funding scientific research, promotion of life extension value and direct performing of research and implementation, as well as preventing global catastrophic risk. All plans converge at the end, as their result is the indefinite survival as an uploaded mind inside an ecosystem, created by a superintelligent AI. (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs focused (...) on one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

This article draws upon the civic republican tradition to offer new conceptual resources for the normative assessment of mental capacity law. The republican conception of liberty as non-domination is used to identify ways in which such laws generate arbitrary power that can underpin relationships of servility and insecurity. It also shows how non-domination provides a basis for critiquing legal tests of decision-making that rely upon ‘diagnostic’ rather than ‘functional’ criteria. In response, two main civic republican strategies are recommended for securing (...) freedom in the context of the legal regulation of psychological disability: self-authorisation techniques and participatory shaping of power. The result is a series of proposals for the reform of decisional capacity law, including a transition towards purely functional assessment of decisional capacity, surer legal footing for advanced care planning, and greater control over the design and administration of decision-making capacity laws by those with psychological disabilities. (shrink)

Editorial on papers relating to among other infanticide and intersex.

This article investigates the impact of political violence on the health of young children in Congo. Within the framework of differences in differences, we found negative effects of exposure to violence on children's health. Political violence also increases the likelihood that children will be underweight and underweight. Children who have faced such difficulties tend to be disproportionately affected.

HOW TO CITE: Castillo, P. (2021). Cuida tu cerebro con deporte: avances neuroeducativos [Take care of your brain with sport: neuroeducational advances]. In J. M. Romero Rodríguez, M. P. Cáceres Reche, J. C. De la Cruz Campos & M. Ramos Navas-Parejo (Eds.), Investigación educativa ante los actuales retos migratorios (pp. 245-260). Dykinson. ____________________________________________________________________________________________________ _______________________________________________ CÓMO CITAR: Castillo, P. (2021). Cuida tu cerebro con deporte: avances neuroeducativos. En J. M. Romero Rodríguez, M. P. Cáceres Reche, J. C. De la Cruz Campos (...) y M. Ramos Navas-Parejo (Eds.), Investigación educativa ante los actuales retos migratorios (pp. 245-260). Dykinson. (shrink)

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task of ensuring that the right sorts of information gets to the right sorts of people remains. We argue that the many efforts underway to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations. This in turn requires that the management of information and knowledge within healthcare (...) organizations be combined with models of resources and processes of patient care that are based on a general ontology of social interaction. The Health Level 7 (HL7) is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. HL7 has advanced a widely used messaging standard that enables healthcare applications to exchange clinical and administrative data in digital form. HL7 focuses on the interface requirements of the entire healthcare system and not exclusively on the requirements of one area of healthcare such as pharmacy, medical devices, imaging or insurance transactions. This has inspired the development of a powerful abstract model of patient care called the Reference Information Model (RIM). The present paper begins with an overview of the core classes of the HL7 (Version 3) RIM and a brief discussion of its “actcentered” view of healthcare. Central to this account is what is called the life cycle of events. A clinical action may progress from defined, through planned and ordered, to executed. These modalities of an action are represented as the mood of the act. We then outline the basis of an ontology of organizations, starting from the theory of speech Acts, and apply this ontology to the HL7 RIM. Special attention is given to the sorts of preconditions that must be satisfied for the successful performance of a speech act and to the sorts of entities to which speech acts give rise (e.g. obligations, claims, commitments, etc.). Finally we draw conclusions for the efficient communication and management of medical information and knowledge within and between healthcare organizations, paying special attention to the role that medical documents play in such organizations. (shrink)

How do we care well for a human being: ourselves or another? Non-Kantian scholars rarely identify the philosophy of Kant as a particularly useful resource with which to understand the full complexity of human care. Kant’s philosophy is often taken to presuppose that a philosophical analysis of good human life needs to attend only to how autonomous, rational agents—sprung up like mushrooms out of nowhere, without a childhood, never sick, always independent—ought to act respectfully, and how they can (...) be forced to interact rightfully. Questions involving aspects of human life captured by what Eva Kittay aptly phrased “the fact of dependency” (1999) —such as our vulnerable, fragile, and embodied social natures, asymmetrical care relations, and deep systemic injustices—are therefore commonly thought to be beyond the grasp of Kant and of Kantian philosophy. Against this historically prominent understanding of Kant’s practical philosophy, below I engage and draw upon recent Kant scholarship which shows both the inadequacy of such rationalist readings and the fruitfulness of using Kant’s practical philosophy to enhance our understanding of human care relations. After situating my approach in the existing, relevant secondary literature on Kant’s human agent, I explore key features of Kant’s accounts of human nature and the highest good. I pay special attention to his proposal that our human nature comprises reflective and unreflective aspects and patterns that we (ought to) strive to develop, transform, and integrate in wise ways through our faculty of desire. In addition, I emphasize the dangers that our ineradicable propensity to do bad things (evil) poses for our projects of self- and other- care. I proceed by outlining how Kant’s account of moral (ethical and legal) responsibility for self and others is developed through his theories of freedom, that is, through his theory of virtue (virtuous internal freedom with its account of perfect and imperfect duties) and his theory of right (rightful external freedom with its account of innate, private, and public right). On the conception I am advancing, we are pretty messy, fragile, and vulnerable beings whose projects of caring are difficult, ongoing, and complex. On the one hand, we (should) strive to care for ourselves (by striving to manage and heal badly functioning parts and by developing, transforming, and integrating immature or distinct parts of ourselves into good wholes) and for others (assisting them in their projects of management and healing and of developing, transforming, and integrating themselves into good wholes) in ways that are both respectful and attentive to the particular people we are—people with lives of our own to live—and the kinds of relationships we share. On the other hand, we should, and can, be forced to interact rightfully, meaning interaction consistent with one another’s basic (innate, private, and public) rights and, hence, contribute to reform projects that improve our inherited, imperfect legal-political systems with regard to care relations. Bringing Kant’s philosophy into dialogue with care theorists, I conclude, advances the insights of both traditions by showing one way to arrive at a multifaceted, yet unified account of human care relations where our embodied, social as well as our rational natures are given due consideration. (shrink)

Advance directives are intended to extend patient autonomy by enabling patients to prospectively direct the care of their future incapacitated selves. There has been much discussion about issues such as whether the future incompetent self is identical to the agent who issues the advance directives or whether advance directives can legitimately secure patient autonomy. However, there is another important question to ask: to what extent and in what conditions is it ethically appropriate for one to limit the liberty or (...) agency of one’s future incompetent self by issuing an advance directive? -/- In this paper, I use a virtue-ethical approach to explore this question, focusing on the case of an advance directive for the future self with moderate dementia. First, I examine virtuous attitudes with regard to autonomy and argue that one can manifest vices or ethically undesirable character traits in trying to intervene in the future self’s life. In particular, I argue that this case can manifest vices such as disdainfulness, intellectual arrogance, and self-dictatorship, which is the vice of trying to control one’s life to an excessive degree, and that a self-dictator fails to give due moral consideration to the future self’s liberty or agency. I then introduce the Daoist idea of wu-wei, which recommends embracement of what happens in one’s life, as one of the possible remedies for the overemphasis on the value of autonomy and control. (shrink)

Both Martin Heidegger and Harry Frankfurt have argued that the fundamental feature of human identity is care. Both contend that caring is bound up with the fact that we are finite beings related to our own impending death, and both argue that caring has a distinctive, circular and non-instantaneous, temporal structure. In this paper, I explore the way Heidegger and Frankfurt each understand the relations among care, death, and time, and I argue for the superiority of Heideggerian version (...) of this nest of claims. Frankfurt claims that we should conceive of the most basic commitments which practically orient a person in the world and define his identity (“volitional necessities”) as naturalistic facts, foundational for and located completely without the normative space of reasons. In support of this he appeals to the supposedly foundational role played in human life by the instinct for self-preservation, what Frankfurt calls the “love of living.” The claim is that in questions of practical identity there is a definite priority of the factual over the normative. Frankfurt’s naturalistic model of volitional necessity is motivated by a misunderstanding of the temporal structure of care, a misunderstanding that helps lead him to an implausible conception of the basic structures of human identity. Heidegger advances an anti-naturalistic conception of caring, one bound up with his way of understanding how human beings relate to their own future. I argue that the existential, temporal, and normative significance that Frankfurt attributes to the naturalized “love of living” is better captured by the Heideggerian claim that human identity is defined by being “for-the-sake-of” certain projects and commitments, a way of being lived out in the way Heidegger calls “being-towards-death.”. (shrink)

The first signs of historical settlements in Tirana date back to the year 1614. These settlements and their road system belongs to the Ottoman city structure. Nowadays this historic northeast area of Tirana consists of a conglomeration of buildings that date back to different historical periods. A good part of these dwellings are informal ones, which damage the morphology of the area. This paper is considering a genuine historical basis to create an intervention model in this specific area of Tirana. (...) The total surface of the area which is rigorously analyzed is 2.08 ha. Regulatory plans that will be considered for this analysis are the regulatory plans of 1917, 1921, 1937, 1953, 1980, up to today (the existing situation of the city of Tirana). The whole area will be analyzed including the typical road system; the typical structure of the dwellings, and the typical morphology of the area. All dwellings will be filed, according to historical dating situation and the existing situation. The current local general (PPV) plan provides a radical intervention in this area which seriously damages the historical heritage of the city of Tirana. This article aims and focuses on a territorial development model recovering it and not damaging it, (in contradiction with the current regulatory plan). The new model will be clearly detailed (up-to-level plans). The city of Tirana needs historical heritage and historical identity. How can one damage such treasure which the time took care so much to create and preserve? Such allusions are to be spoken out loudly! (shrink)

What I call medically enabled suicides have four distinctive features: 1. They are instigated by actions of a suicidal individual, actions she intends to result in a physiological condition that, absent lifesaving medical interventions, would be otherwise fatal to that individual. 2. These suicides are ‘completed’ due to medical personnel acting in accordance with recognized legal or ethical protocols requiring the withholding or withdrawal of care from patients (e.g., following an approved advance directive). 3. The suicidal individual acts purposefully (...) to ensure that medical personnel will act on these protocols. 4. These suicides do not involve medical personnel providing aid in dying in the standard sense, either through (a) active voluntary euthanasia, or (b) assistance by means of prescriptions, etc. -/- Regardless of how common medically enabled suicides are, they raise compelling questions at the interface of medicine and individual choice. After first clarifying the concept of medically enabled suicide and exploring some of the reasons why it might be attractive to suicidal individuals, I then investigate two apparent dilemmas that medically enabled suicides raise for medical care providers. The first alleges that medical care providers may not contribute to harming their patients, and so they may not contribute to their patients’ suicides. The second alleges that if care providers, as a matter of personal conscience, believe that suicide is wrong, then they may not be compelled to contribute to their patient’s acting wrongly by assenting to the wishes of a patient pursuing medically enabled suicide. Both dilemmas arise from the fact that while medical personnel are bound by widely accepted precepts of medical ethics to honor the competent wishes of their patients, medically enabled suicides entangle them in their patients’ suicidal plans in ways that result in their contributing to those suicides. I conclude that neither dilemma should be resolved in the direction of medical personnel having the right to refrain from involvement in medically enabled suicides. Thus, while we may find medically enabled suicide distasteful or exploitative, a strong case cannot be made that medical personnel refusing to involve themselves in such suicides is ethically permissible. (shrink)

That a standard of medical care must outline services that benefit the patient is relatively uncontroversial. However, one must determine how the practices outlined in a medical standard of care should benefit the patient. I will argue that practices outlined in a standard of medical care must not detract from the patient’s well-functioning and that clinicians can refuse to provide services that do. This paper, therefore, will advance the following two claims: (1) a standard of medical (...) class='Hi'>care must not cause dysfunction, and (2) if a physician is medically rational to not provide some service which fails to meet the above condition (i.e. fails to be a standard of medical care), then she may refuse to do so. I then apply my thesis to the prescription of puberty blockers to children with gender dysphoria. (shrink)

Clinical guidelines are special types of plans realized by collective agents. We provide an ontological theory of such plans that is designed to support the construction of a framework in which guideline-based information systems can be employed in the management of workflow in health care organizations. The framework we propose allows us to represent in formal terms how clinical guidelines are realized through the actions of are realized through the actions of individuals organized into teams. We provide various levels (...) of implementation representing different levels of conformity on the part of health care organizations. Implementations built in conformity with our framework are marked by two dimensions of flexibility that are designed to make them more likely to be accepted by health care professionals than standard guideline-based management systems. They do justice to the fact 1) that responsibilities within a health care organization are widely shared, and 2) that health care professionals may on different occasions be non-compliant with guidelines for a variety of well justified reasons. The advantage of the framework lies in its built-in flexibility, its sensitivity to clinical context, and its ability to use inference tools based on a robust ontology. One disadvantage lies in its complicated implementation. (shrink)

In his paper, ‘What moral work can Nussbaum’s account of human dignity do in the context of dementia care?’, Soofi seeks to modify Nussbaum’s conception of dignity to deal with four key objections that arise when appeals to dignity are made in the context of dementia care. We will not discuss the first of these, the redundancy of dignity talk, since this issue has already been much discussed in the literature. Instead, we will focus on the remaining three (...) issues raised, that of the exclusion of persons with advanced dementia from having dignity, unjustified speciesism as a ground of human dignity, and the unclear practical implications that follow from having dignity. (shrink)

Conceptual analysis has been a traditional methodology within analytic philosophy, but it also has been the target of numerous attacks. On the other hand, explication has been undergoing a revival as a methodological alternative due to the revisionary element associated with it. This allows for a scientific reconstruction of our ordinary notions, which would share virtues associated with scientific concepts. However, there is now a popular variant of conceptual analysis which resembles closely the explicative methodology: the two-step methodology advanced (...) by the advocates of the Canberra Plan. Although explication is a wider and more ambitious program, I will argue that both methodologies can be regarded as attempts to bring philosophical methodology and its products closer to scientific ones. However, I will also point out that, although the goal is advantageous, there still remain some theoretical problems. (shrink)

African Traditional Religion and medicine are integral parts of life and culture of the Africans and have greatly influenced their conceptions about human health and wholeness. Their many realities that Africans have not been able to abandon, in spite of the allurements of western civilization, Christianity, Islam and the advances in the biomedical sciences. The aim of this paper is to highlight the meaning of health and wholeness as central issues of concern in African Traditional Religion and Medicine. The misconception, (...) abuse and derogatory attitudes even from some notable Africans towards alternative medicine, as well as the all need of integrating both the alternative and orthodox medicine to bring about total wholeness, serves as the research problem. This paper argued that the biopsycho-socio-ecological model of health and wholeness is fundamental to the African Traditional Religion and Medicine. This model brings together the different aspects of human life and treats the human person as an integral and harmonious whole in perpetual relationship with the sacred, the human community and the environment. This paper therefore recommends that first, Africa has to open to modern medical discoveries and practices and secondly, African Traditional Religion and Medicine concern should be mainstreamed into the medical practice in health care services in contemporary Nigeria. It finally conclude that the alternative medicine despite the arrays of it inadequacies, objections and misconceptions, the practice has come to stay. (shrink)

I review three existing arguments in favor of having some childcare done by nonparents and then I advance five arguments, most of them original, to the same conclusion. My arguments rely on the assumption that, no matter who provides it, childcare will inevitably go wrong at times. I discuss the importance of mitigating bad care, of teaching children how to enter caring relationships with people who are initially strangers to them, of addressing children's structural vulnerability to their caregivers, of (...) helping children and parents contain the ambivalent feelings of the child-parent relationship, and of distributing the responsibility of care and the ensuing blame for bad care more widely. I conclude that nonparental childcare should be universal. (shrink)

The growing proportion of elderly people in society, together with recent advances in robotics, makes the use of robots in elder care increasingly likely. We outline developments in the areas of robot applications for assisting the elderly and their carers, for monitoring their health and safety, and for providing them with companionship. Despite the possible benefits, we raise and discuss six main ethical concerns associated with: (1) the potential reduction in the amount of human contact; (2) an increase in (...) the feelings of objectification and loss of control; (3) a loss of privacy; (4) a loss of personal liberty; (5) deception and infantilisation; (6) the circumstances in which elderly people should be allowed to control robots. We conclude by balancing the care benefits against the ethical costs. If introduced with foresight and careful guidelines, robots and robotic technology could improve the lives of the elderly, reducing their dependence, and creating more opportunities for social interaction. (shrink)

This chapter explores two questions in detail: How should we determine the threshold for costs that individuals are asked to bear through insurance premiums or care-related out-of-pocket costs, including user fees and copayments? and What is an adequate relationship between costs and benefits? This chapter argues that preventing impoverishment is a morally more urgent priority than protecting households against income fluctuations, and that many health insurance plans may not adequately protect individuals from health care costs that threaten to (...) drop their financial status below a decent minimum. A design that places greater emphasis on preventing impoverishment and finances the achievement of that goal by reducing unnecessary subsidies to better-off households would better accord with a sufficientarian approach to health care. -/- . (shrink)

This paper explored the frameworks of the learning continuity plan that shaped basic education delivery as issued by the Department of Education-Central Office in light of Sulong Edukalidad and KITE (K- K to 12 Curriculum review and update; I- Improvement of the learning environment, T- Teachers' upskilling and reskilling; and E- Engagement of stakeholders for support and collaboration) as national flagship programs. In particular, the paper examined the adoption and contextualization of the frameworks by the Regional Office - CALABARZON, which (...) is the PIVOT4A QuBE; 4A represents the four strategic thrusts, which are: (a) aligning focus and intervention, (b) advancing handholding initiatives, (c) amplifying defined technical assistance to target delivery units, and (d) appraising stakeholders on the progress of the intervention, and QuBE is the acronym for Quality Basic Education. For its part, the Schools Division Office of Laguna espouses LAGO Laguna or Leaders Actions towards Greater Outcomes. Furthermore, the school learning continuity plan of the San Pedro Relocation Center National High School Landayan Annex is summarized through the acronym SAGWAN or Sustaining & Advocating Genuine Welfare & Actions in the New Normal as the flagship program. In addressing the new normal in education, the juxtapositions of the said flagship programs that stem from national to regional, division, and school levels, are discussed. It also analyzed diversity and inclusiveness, as well as the guiding educational philosophies, in the conduct of school projects, programs, and activities (PPAs). (shrink)

The need to better balance the promotion of scientific and technological innovation with risk management for consumer protection has inspired several recent reforms attempting to make regulations more flexible and adaptive. The pharmaceutical sector has a long, established regulatory tradition, as well as a long history of controversies around how to balance incentives for needed therapeutic innovations and protecting patient safety. The emergence of disruptive biotechnologies has provided the occasion for regulatory innovation in this sector. This article investigates the regulation (...) of advanced biotherapeutics in the European Union and shows that it presents several defining features of an adaptive regulation regime, notably institutionalized processes of planned adaptation that allow regulators to gather, generate, and mobilize new scientific and risk evidence about innovative products. However, our in-depth case analysis highlights that more attention needs to be paid to the consequences of the introduction of adaptive regulations, especially for critical stakeholders involved in this new regulatory ecosystem, the capacity and resource requirements placed on them to adapt, and the new tradeoffs they face. In addition, our analysis highlights a deficit in how we currently evaluate the performance and public value proposition of adaptive regulations vis-à-vis their stated goals and objectives. (shrink)

This chapter offers a plea for the media to reframe its coverage of campus controversies from free expression to academic freedom. These freedoms are entwined, but distinct. Freedom of expression is extended to all persons with no expectation of quality control, apart from legal prohibitions against defamation, threats, etc. By contrast, academic freedom is a cluster of freedoms afforded to scholarly personnel for a particular purpose – namely, the pursuit of universities’ academic mission to seek truth and advance understanding in (...) the service of society. An academic freedom framing better reflects the distinctive social purpose around which universities are organized, as well as universities’ duty of care to employees and students. While universities have a legal and moral duty of care to all employees and students, the unjust, exclusionary past and present of higher education arguably makes that duty particularly acute in the case of equity-deserving (e.g., racialized, Indigenous, disabled or 2SLGBTQ+) people. Finally, academic freedom framing for campus media stories is less monolithic than free expression framing, allowing for a more nuanced understanding of campus controversies while keeping universities accountable to the public they serve. In this chapter, I survey three very different campus controversies at a single Canadian university, and the media response each received. I show how an academic freedom frame for those stories would have produced better reportage while reducing opportunities for bad actors to manipulate both universities and the media. At the end of the day, the real crisis at universities isn’t the cancellation of ill-judged events that were never a part of the academic mission; it is the ongoing erosion of academic freedom. (shrink)

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only (...) 2% of CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

In adversarial machine learning, attackers add carefully crafted perturbations to input, where the perturbations are almost imperceptible to humans, but can cause models to make wrong predictions. In this paper, we did comprehensive review of some of the most recent research, advancement and discoveries on adversarial attack, adversarial sampling generation, the potency or effectiveness of each of the existing attack methods, we also did comprehensive review on some of the most recent research, advancement and discoveries on adversarial defense strategies, the (...) effectiveness of each defense methods, and finally we did comparison on effectiveness and potency of different adversarial attack and defense methods. We came to conclusion that adversarial attack will mainly be blackbox for the foreseeable future since attacker has limited or no knowledge of gradient use for NN model, we also concluded that as dataset becomes more complex, so will be increase in demand for scalable adversarial defense strategy to mitigate or combat attack, and we strongly recommended that any neural network model with or without defense strategy should regularly be revisited, with the source code continuously updated at regular interval to check for any vulnerability against newer attack. (shrink)

In the darkness of difficult times, in the degradation of human nature and in the slumber of consciences, we resolutely affirm with the accuracy of the hermeneutic lógos and the mild gentleness of the óneiro the centrality of the human person within the pedagogical discourse. In the knowledge and care of the dignity, richness and wholeness constitutive of the potential of intentional consciousness we recognize the specific object of educational theory and the safe path to the global empowerment of (...) individual and society. That is why we conceive of tea-ching as a paideia of virtues: that is to say, as a most excellent art to which the whole of existence is to be devoted. That is why our children and pupils are welcomed, loved and accustomed to freely exercise their will and judgment, guided by imagination, enthusiasm, history, great ideals, faith and example, so that their hearts and intelligence learn to recognize, cherish and grow the seeds of hope in a better future. (shrink)

Éric Delassus | : Selon Fabienne Brugère, un point de rencontre existe entre l’éthique spinoziste et les éthiques du care, le care pouvant être envisagé comme une réactualisation du conatus spinoziste. Cet article vise à démontrer que cette convergence peut s’établir à partir d’une éthique narrative inspirée de la pensée de Paul Ricoeur. Cela concerne principalement la perception que l’on peut avoir de soi en tant que corps et esprit, dans la mesure où l’esprit est défini par Baruch (...) Spinoza comme « idée du corps ». L’éthique spinoziste invite à se rendre utile aux autres pour augmenter notre puissance d’être et nous libérer d’une servitude qui n’est pas sans rapport avec la vulnérabilité telle que définie dans les éthiques du care. L’humain.e vulnérable a besoin pour se sentir exister d’avoir une idée cohérente de son corps, et le récit est l’une des voies lui permettant de progresser dans cette direction. Encore faut-il, pour y parvenir, trouver des pourvoyeuses et pourvoyeurs de care disposé.e.s à écouter, aptes à susciter en soi le désir de se raconter. | : According to Fabienne Brugère, there is common ground between Spinoza’s ethics and the ethics of care, which can be regarded as a renewal of the Spinozan concept of ‘conatus.’ This article aims to demonstrate that this form of convergence can be based upon a narrative ethic as inspired by Paul Ricoeur’s thought. It is mainly about how people can perceive themselves both as mind and body, insofar as “mind” is defined by Spinoza as the “idea of the body.” The Spinozan ethic leads us to make ourselves useful to other people in order to expand our capacity to be and to free ourselves from a form of servitude that is somewhat linked to vulnerability as it is defined in the ethics of care. Therefore, vulnerable people each need to develop consistent ideas of their bodies if they wish to feel that they do exist. Narrative is one of the many ways of advancing in that direction. However, vulnerable people should not be alone; they must be accompanied by care providers who have a sympathetic ear and who can arouse in them the desire to tell and share their stories. (shrink)

Ronald Dworkin argued that Advance Directives informed by a principle of autonomy ought to guide decisions in relation to the treatment of those in care for dementia. The principle of autonomy in play presupposes a form of competence that is tied to the individual person making the Directive. This paper challenges this individualist assumption. It does so by pointing out that the competence of a patient is inherently relational, and the key illustrative case to make this point is the (...) case of music therapy. In music therapy, a relatively recent treatment modality in aged care, patients previously thought to be permanently unresponsive are shown on the contrary to be capable of significant levels of social agency. The conclusion to draw is that Advance Directives that fail to acknowledge the real possibility of such relational competence are misapplied. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment (...) to both distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

The declaration of the COVID-19 pandemic by the World Health Organization on March 11, 2020, led to unprecedented events. All regions of the world participated in implementing preventive health measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. The pandemic started global disruption of socio-economic systems, covering the postponement or cancellation of public events, supply shortages, schools and universities’ closure, evacuation of foreign citizens, a rise in unemployment and inflation, misinformation, the anti-vaccine movement, and incidents of discrimination (...) toward people affected by or suspected of having coronavirus disease. Attempts have been made to protect the oldest age group at risk, but in many cases, this has led to over-restriction and age discrimination. The rationale for working on the Research Topic "Socio-economic systems in the post-pandemic world: Design thinking, strategic planning, management, and public policy" was the need to start reflecting on resilience and lessons learned from this public health event that revealed the global unpreparedness in critical areas. Also, the pandemic triggered both top-down and bottom-up responses that needed more in-depth analyzes. This Research Topic covers interdisciplinary contributions addressing new thinking, challenges, and transformations required for post-pandemic global, national, regional, and local realities. The presented Research Topic combines studies focused on recognizing the actions and interventions leading to the recovery of socio-economic systems during the tail end and after the pandemic. The studies delivered recommendations regarding, among others, the care of vulnerable, planning socio-economic restart, and imagining the "new normal.". (shrink)

How can we allocate scarce health care resources justly? In particular, are markets the most efficient way to deliver health services? Much blood, sweat and ink has been shed over this issue, but rarely has either faction challenged the unspoken assumption behind the claim made by advocates of markets: that efficiency advances the interests of both individuals and society. Whether markets actually do increase efficiency is arguably a matter for economists, but the deeper ethical question is whether efficiency is (...) the correct criterion, in terms of social justice and individual needs. (shrink)

The article analyses the necessary conditions an argument for popular punishment would need to meet, and argues that it faces the challenge of a dilemma of reasonableness: either popular views on punishment are unreasonable, in which case they should carry no weight, or they are reasonable, in which case the reasons that support them, not the views, should carry weight. It proceeds to present and critically discuss three potential solutions to the dilemma, arguing that only an argument for the beneficial (...) effects of coherence between popular views and penal policy is persuasive, but that it makes popular punishment less important than proponents claim, and offers a justification proponents will find it difficult to advance. (shrink)

This study aimed to understand the preserved elements of self-identity in persons with moderate to severe dementia attributable to Alzheimer’s disease. A semi-structured interview was developed to explore the narrative self among residents with dementia in a residential care facility and residents without dementia in an independent living setting. The interviews were transcribed verbatim from audio recordings and analyzed for common themes, while being sensitive to possible differences between the groups. The participants with dementia showed evidence of self-reference even (...) though losses in explicit memory were evident. The most noticeable difference between the two groups was time frame reference. Nonetheless, all participants showed understanding of their role in relationships and exhibited concrete preferences. Our findings suggest that memory loss and other cognitive deficits associated with moderate to severe dementia do not necessarily lead to a loss of “self.”. (shrink)

On 11 March 2020, the World Health Organization declared a pandemic of the COVID-19 coronavirus disease that was first recognized in China in late 2019. Among the primary effects caused by the pandemic, there was the dissemination of health preventive measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. This includes the global disruption of socio-economic systems including the postponement or cancellation of various public events (e.g., sporting, cultural, or religious), supply shortages and fears of the same, (...) schools and universities closure, evacuation of foreign citizens, a rise of unemployment, changes in the international aid schemes, misinformation, and incidents of discrimination toward people affected by or suspected of having the COVID-19 disease. The pandemic has brought to the fore unpreparedness in critical areas that require attention, amid prospects and challenges. Moreover, considerable reorganization efforts are required with implications for assets, resources, norms, and value systems. COVID-19 is challenging the concept of globalization and stimulating responses at the levels of local and regional socio-economic systems that lead to the mobilization of assets that have been unrecognized earlier on, such as various forms of economic capital, social capital, cultural capital, human capital, and creative capital. For example, through digital channels, local groups are forming to create schemes of support for physical and mental wellbeing. These emerging exchanges lead to various social and technological innovations by building on skills and assets that are less important in the free-market economy, such as empathy, skills for crafts, making and fixing; locally grown microgreens; and micromanufacturing. Isolation and local living are also making it much harder to ignore the civic responsibilities towards communities, meant as individuals, vulnerable groups, and local businesses. Whilst the pandemic is limiting physical participation, this challenging time is uncovering alternative ways of mutual support, which may create long-term benefits for socio-economic systems, including environmental and biodiversity protection, reduction of the air pollution, and climate action. The pandemic’s threat to public health will hopefully be overcome with implications for disruption for an extended period that we are unable to forecast at this stage. It is key to focus on studies recognizing the activities and interventions leading to the recovery of socio-economic systems after the pandemic. Reflecting and planning on how societies and economies will go back to “business as usual” requires new forms of communication and cooperation, imaginative design thinking, new styles of management, as well as new tools and forms of participation in various public policies. Many questions related to the care of the vulnerable, economic restart, and the risk of future pandemics, to mention but a few, are already occupying the academic, scientific, experts, and activist communities, who have started to imagine the “new normal.”. (shrink)

BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. Most (...) physicians were male (66%) and of Southeast Asian descent (66%). All physicians explained the plan of care to the patients; most believed that their patient understood. However, many patients did not. Physicians rarely asked the patient for their opinion. In all those cases, the decision had been made previously by the doctors. No decisions were made with the patient. Patients sometimes disagreed. CONCLUSIONS: Shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict. PRACTICE IMPLICATIONS: Some hospitalized patients are interested in discussing treatment. Improving hospital communication can foster patient autonomy. (shrink)

Understanding choice of family planning provider is fundamental for policy makers and program managers as they seek ways to both improve the coverage and increase the sustainability and efficiency of family planning services for Egypt to achieve its population objectives. This study focuses first on providing a descriptive profile of the patterns of reliance on sources of family planning services during the early 2000s. Binomial logit models are then estimated to obtain a more in depth understanding of (...) the determinants of the choice of family planning providers in Egypt using the 2000 Egypt Demographic and Health Survey. The study offers insights into a number of aspects of family planning service provision about which there has been less previous investigation. There are marked differences in the extent to which Egyptian women rely on public or private providers for family planning services depending on the type of method they are seeking. Among the more important findings is the consistency women display in the choice of provider among women reporting multiple segments of use. With regard to the determinants of the choice of provider for family planning services, perhaps the most interesting finding is that household wealth was not a significant determinant of the choice of provider. This may reflect that private sources met the demand for family planning services of significant proportions of women in rural areas and among those in the low income groups. (shrink)

This chapter deals with Thomas Browne’s most famous work, Religio Medici, and especially with his account of Charity. The first paragraph focuses on Browne’s specific account of the relationship between natural and supernatural. This view is inspired by Bacon, Sebunde, and Montaigne, and is crucial to understand the background of Browne’s view about the virtue of Charity. The second paragraph is about Browne’s specific understanding of Charity, which seems to be a middle stage between the traditional, Scholastic doctrine, and the (...) Kantian idea of moral law, independent from the practical law and the desire of the subject. The third paragraph deals with Religio Medici’s reversal of the traditional “order” of Charity, as well as Browne’s accounts of abnegation and friendship as an effective way for a charity to the self which meets many aspects of Foucault’s ἑπιμέλεια έαuτου. The fourth paragraph is about Browne’s analogical understanding of medicine and morality, as well as his use of the meditatio mortis. (shrink)

Copyright is at the centre of both popular and academic debate. That emotions are running high is hardly surprising – copyright influences who contributes what to culture, how culture is used, and even the kind of persons we are and come to be. Consequentialist, Lockean, and personality interest accounts are generally advanced in the literature to morally justify copyright law. I argue that these approaches fail to ground extensive authorial rights in intellectual creations and that only a small subset (...) of the rights accorded by copyright law is justified. The pared-down version of copyright that I defend consists of the right to attribution, the right to have one’s non-endorsement of modifications or uses of one’s work explicitly noted, and the right to a share of the profit resulting from the commercial uses of one’s work. I also cursorily explore whether contribution to another person’s work gives rise to moral interests. (shrink)

Background: Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers (...) can vary between the different diseases. -/- Methods: We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. -/- Results: ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. -/- Conclusion: This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care. (shrink)

Feminist bioethicists of a variety of persuasions discuss the 2013 case of Marlise Munoz, a pregnant woman whose medical care was in dispute after she became brain dead.

This chapter advances a twofold analytical strategy. Firstly, an extrapolation of the legal method, i.e. the application of general rules to particular cases, into a general tool for both description and problem solving. Secondly, through the integration of the legal method with a phenomenological approach for the study of social worlds. This provides the basis for an integrated approach potentially deployable in relation to all social phenomena at the micro, meso and macro levels. This makes it an alternative to the (...) methodology of the social sciences, i.e. economics, political economy, political science and sociology. The social sciences have become characterized by hyper formalistic and opaque modelling and simplistic assumptions resulting in a structural incapacity of scholarly innovation with the consequence that they are incapable of answering ‘big questions’ and lacks the ability to reflect critically upon the basic structure of society and core assumptions about the composition of the social world. (shrink)

The study investigated factors that influence the uptake of maternal healthcare services by women in Zimbabwe, using a logit model. Data from the Zimbabwe Demographic Health Survey (ZDHS, 2015) was used. Deteriorating maternal health indicators motivated the study. The effect of socio-economic and demographic factors on the probability of utilising maternal healthcare services was examined. Descriptive statistics and a logit model were used for data analysis. Results from the logit model show that region of residence, insurance cover, educational level, employment (...) status, maternal age, birth order, place of residence, number of living children, maternal age and household income all influence the utilisation of maternal healthcare services by women in Zimbabwe. Basing on research findings, the study recommends that relevant authorities make more available vocational training centres and education institutions since education was found to influence the uptake of maternal healthcare services. There is need to encourage family planning so as to reduce the number of children, especially among the apostolic sect, which affects the uptake of maternal healthcare. Compulsory national health insurance schemes could be adopted to mitigate the effect of low income that discourages the use of institutional facilities for delivery. The issue of balanced regional development needs to be pursued through accelerating devolution to ensure equal access to maternal healthcare facilities in all provinces. (shrink)

In modern hospitals in developed countries, deaths are determined usually after a prearranged schedule of resuscitative efforts. By default, death is diagnosed and determined after “full code” or after the failure of intensive resuscitation. In end-of-life contexts, however, various degrees of less-than-full resuscitation and sometimes no resuscitation are allowed after the consent and shared decision-making of the patient and/or surrogates. The determination of brain death is a unique exception in these contexts because such an end-of-life care plan is usually (...) not offered until after brain death is declared. This essay analyzes and critiques three arguments for denying the family and/or surrogate a chance to consent to or forego the diagnostic protocol of brain death and choose an alternative end-of-life plan. First, opponents of consent for the determination of brain death argue that presenting it as a selectable end-of-life plan undermines the integrity of death determination. The second argument is that it is inconsistent to allow foregoing the determination of brain death when the determination of circulatory death is non-negotiable. The third argument is that allowing the patient/surrogate to forego the determination of brain death would jeopardize the fair and appropriate utilization of intensive care resources and potentially reduce organ donor pools. After closer conceptual examinations of these three arguments, this essay concludes that these arguments are conceptually and morally problematic. It defends an alternative patient-centered end-of-life care plan based on consent and shared decision-making. (shrink)

Michael Thompson recently advanced a “naïve action theory” as an alternative to the “sophisticated” accounts of action displayed by ordinary folk psychology. In what follows I defend the plausibility of intentional psychology and folk psychological explanations. I do this in two ways. First I question that naïve explanations are more naïve than the ones provided by folk psychology and suggest that the latter are phenomenologically prior to the former. Second, I focus on the role of intentionality in deliberation and (...) action planning, suggesting that folk psychology provides a better answer than naïve theory to the question of what makes actions intentional. (shrink)

Resumen Hermenéutica y toma de decisiones en ética clínica La moderna hermenéutica se interesa por las condiciones de posibilidad de la comprensión humana. Sus aportaciones son de indudable interés para el campo de la ética biomédica, donde médico y paciente tratan de comprenderse mutuamente con el fin de concretar determinado proyecto de cuidados. Sin embargo, esta aproximación está lejos de ser aprovechable para formar una pauta concreta de cara a la toma de decisiones en este campo. La hermenéutica acierta al (...) poner el centro de gravedad en el diálogo, en lugar de en el método, pero olvida que, en Gadamer, el diálogo está dirigido a la verdad. Esto es lo que se tratará de poner de manifiesto en este trabajo, intentado establecer la conexión de dicha noción con las de bien, historia y comunidad. -/- Abstract Modern hermeneutics deals with the conditions of the possibilities of human understanding. Its contributions are particularly pertinent to clinical ethics, where patient and doctor seek to mutually understand one another in order to establish a determined care plan. Nevertheless, this approach is far from useful for the formulation of a concrete standard for decision making in this area. Hermeneutics is effective in putting the focus on dialogue, rather than method. But it overlooks the fact that dialogue, according to Gadamer, is directed towards truth. The present article aims to highlight this point, and seeks to establish the connection between this notion of truth and ideas of good, history and community. -/- Resumo Hermenêutica e a tomada de decisões em ética clínica A hermenêutica moderna interessa-se pelas condições de possibilidade da compreensão humana. Indubitavelmente, os seus contributos são de interesse para a ética biomédica, na qual o médico e o paciente tratam de compreender-se mutuamente a fim de concretizar um determinado projeto de cuidados. No entanto, esta perspectiva está longe de poder ser utilizada como padrão concreto para a tomada de decisões neste campo. A hermenêutica tem razão ao colocar o centro de gravidade no diálogo e não no método, entretanto, esquece-se de que, em Gadamer, o diálogo está orientado para a verdade. É precisamente isso que se pretende evidenciar neste trabalho, procurando estabelecer-se a conexão entre a referida noção de verdade com as noções de bem, história e comunidade. (shrink)

Recent advances in natural language processing have given rise to a new kind of AI architecture: the language agent. By repeatedly calling an LLM to perform a variety of cognitive tasks, language agents are able to function autonomously to pursue goals specified in natural language and stored in a human-readable format. Because of their architecture, language agents exhibit behavior that is predictable according to the laws of folk psychology: they function as though they have desires and beliefs, and then make (...) and update plans to pursue their desires given their beliefs. We argue that the rise of language agents significantly reduces the probability of an existential catastrophe due to loss of control over an AGI. This is because the probability of such an existential catastrophe is proportional to the difficulty of aligning AGI systems, and language agents significantly reduce that difficulty. In particular, language agents help to resolve three important issues related to aligning AIs: reward misspecification, goal misgeneralization, and uninterpretability. (shrink)

The author reviews the planned withdrawal of healthcare from the primary public hospital, Grady Memorial Hospital, of Atlanta, Georgia. Prior to passage of the Affordable Care Act of 2010, at least half of the patients had no public or private health insurance and their care was financially supported by State and County funding as well as supplementation from Emory University. New administration in the elected positions of the State and County and at the University reached agreement to decrease (...) care. The University President stated that the Hippocratic Oath was no longer valid for salaried physicians who must follow the direction of their business manager. The author, a tenured Professor, was forcibly transferred to the Veterans Hospital, which also was withholding standard medical care, including life-saving medications. Organizing multiple concerned organizations including members of the King Center, the Carter Center, the Open Door Community Center, Gay Rights, etc., (Grady Coalition) multiple public protests were successful in raising the necessary funds to continue adequate care at Grady and begin an investigation of the Veterans Affairs Hospital. (shrink)

Persons care about their future selves. They reason about their future selves’ interests; they plan for their future selves’ happiness and they worry about their future selves’ suffering. This paper is interested in the interplay between diachronic prudential reason and certain accounts of the metaphysics of personal identity that fall under the broad umbrella ‘conventionalist’. Some conventionalists conclude that under certain conditions there are intractable decisions for there is no fact of the matter regarding whether a person-stage ought (prudentially) (...) to ϕ. This paper will suggest otherwise. These decisions are not intractable if we allow that it is sometimes rational for a person-stage to discount the utility of certain future person-stages. The paper then goes on to explore an alternative position that conventionalists might occupy which does not involve any such discounting: prudential relativism. According to prudential relativism it is impossible to offer a single, correct, answer to the question: should person-stage, P, ϕ at t? For according to prudential relativism there is no stage-independent stance from which to evaluate whether a person-stage ought to ϕ. Yet it is not, for all that, intractable, from P’s perspective, whether or not to ϕ. (shrink)

The paper presents the outlines of an ontology of plans and guidelines, which is then used as the basis for a framework for implementing guideline-based systems for the management of workflow in health care organizations. The framework has a number of special features, above all in that it enables us to represent in formal terms assignments of work-items both to individuals and to teams and to tailor guideline to specific contexts of application in health care organizations. It is (...) designed also to enable implementations to do justice to the fact that the processes carried out in health care organizations may deviate in different ways from the norms set forth in corresponding guideline definitions. This means that implementations built in conformity with the framework will be marked by a type of flexibility that might make them more likely to be accepted by healthcare professionals than are standard guideline-based management systems. (shrink)

When this article was first planned, writing was going to be exclusively about two things - the origin of life and human evolution. But it turned out to be out of the question for the author to restrict himself to these biological and anthropological topics. A proper understanding of them required answering questions like “What is the nature of the universe – the home of life – and how did it originate?”, “How can time travel be removed from fantasy and (...) science fiction, to be made scientific and practical?”, and “How can the proposed young age of genus Homo be made to actually be reasonable – when simply stating it would be solid ground for instant rejection and dismissal?” The result is that the article also talks about subjects like Artificial Intelligence, General Relativity, and cosmology. -/- From where did life originate? God? Evolution? Panspermia? If the tendency of humans and scientists to regard undiscovered science as pseudoscience can be overcome, Einstein gave another alternative to consider when he introduced General Relativity. Time isn’t linear – progressing in a straight line from past to present to future. That assumption ignores Relativity which states that space AND TIME are curved. Where did life and the genetic code come from? Can the answer build AI? -/- The first question can be answered by the section of this article titled SETI, Evolution, and Time which says life (possibly multicellular and intelligent) and the genetic code came from humans acquiring knowledge of these things over the centuries, then applying that knowledge – via terraforming, accumulation of raw materials like amino acids and nucleic acids, genetic engineering - to a time in the past when life didn’t exist. From that origin, life evolved through innumerable mutations and adaptations, with humans once again acquiring knowledge of it in cyclic (nonlinear) time. -/- The second question is answered by saying artificial intelligence (AI) as the product of life is only half of the equation. The other half refers to Relativity’s curved space-time and violation of the notion that time always travels from past to future. We have always lived in an artificially intelligent, non-probabilistic universe where everything in time and space is connected into one thing by quantum entanglement – making the brain and genes products of binary-digit activity or artificial intelligence (life is not merely dependent on biology’s “lock and key” mechanisms but also possesses AI). -/- The earliest documented representative of the genus Homo is Homo habilis, which evolved around 2.8 million years ago. Scientists used to believe there was a straight line from H. habilis to us, Homo sapiens. This article will use the “advanced” waves loved by Physics Nobel laureate Richard Feynman, view the history of science through the lens of Conic Sections applied to Relativity’s curved space-time, and incorporate the necessity of so-called imaginary time * – popularized by Prof. Stephen Hawking. While the evolutionary proposals are more in agreement with this early straight line than with modern theories, Albert Einstein’s General Relativity is used to transform the straight line into a curved line, ultimately concluding that Homo habilis (H. habilis) originated only (and unbelievably, as far as today’s science and technology is concerned) ~250,000 years ago. Other branches and dead ends of Homo – e.g. Neanderthals – are the result of mutations and adaptations, with the resultant modifications to anatomy and physiology. The surprisingly young age of H. habilis allows nearly 200,000 years for habilis, or one of its descendants, to reach Australia … if this country’s indigenous Aboriginal population did, as claimed, reach this “island continent” 60,000 years ago. -/- * The ultraviolet catastrophe, also called the Rayleigh–Jeans catastrophe, is a failure of classical physics to predict observed phenomena: it can be shown that a blackbody - a hypothetical perfect absorber and radiator of energy - would release an infinite amount of energy, contradicting the principles of conservation of energy and indicating that a new model for the behaviour of blackbodies was needed. At the start of the 20th century, physicist Max Planck derived the correct solution by making some strange (for the time) assumptions. In particular, Planck assumed that electromagnetic radiation can only be emitted or absorbed in discrete packets, called quanta. Albert Einstein postulated that Planck's quanta were real physical particles (what we now call photons), not just a mathematical fiction. From there, Einstein developed his explanation of the photoelectric effect (when quanta or photons of light shine on certain metals, electrons are released and can form an electric current). So it appears entirely possible that another supposed mathematical trickery (imaginary time and the y-axis of Wick rotation) will find practical application in the future. -/- The article includes mathematical references to cosmology (spoiler alert – you’ll read about things like Vector-Tensor-Scalar Geometry, topology, the “eternal present”, Einstein’s Unified Field, the inverse-square law, and there being no Big Bang and no multiverse - but there will also be no equations). -/- The other subheadings in this essay are – -/- NONLINEAR TIME AND ELECTRICAL ENGINEERING (about a 2009 electrical engineering experiment at America’s Yale University, and cosmic wormholes) -/- BITS AND TOPOLOGY (base-2 maths aka Binary digiTS, Mobius strips, and figure-8 Klein bottles) -/- WICK ROTATION, CAUSALITY, AND UNITING TIME (do past, present and future co-exist in an “eternal present”?) -/- DIGITAL BRAIN, DIGITAL UNIVERSE (if the brain and the universe are ultimately composed of binary digits, we'll someday be able to do the same things with the brain and universe that we now do with computers) -/- PROPOSAL: HUMAN AND ANIMAL INSTINCTS ARE THE RESULT OF THE UNIVERSE BEING UNIFIED BY BINARY DIGITS (AND TOPOLOGY) (If everything in the universe is ultimately composed of electronic BITS, then the universe must possess Artificial Intelligence - some prefer the term Cosmic Consciousness) -/- INFORMATION THEORY CONQUERS A RED GIANT (preserving Earth by keeping the Sun near today’s level of activity forever). 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