Question: Do clinicians providing abortion practicing in states that restrict abortion experience more moral distress than those practicing in states that protect abortion? -/- Findings: In this national, purposive survey study of 310 clinicians providing abortion, moral distress was elevated among all clinicians, with those practicing in restrictive states reporting higher levels of moral distress compared with those practicing in protective states. -/- Meaning: The findings suggest that structural changes addressing bans on necessary health care, such as federal protection for (...) abortion, are needed at institutional, state, and federal policy levels to address clinician moral distress. (shrink)

Background: Current practice frequently fails to provide care consistent with the preferences of decisionally-incapacitated patients. It also imposes significant emotional burden on their surrogates. Algorithmic-based patient preference predictors (PPPs) have been proposed as a possible way to address these two concerns. While previous research found that patients strongly support the use of PPPs, the views of surrogates are unknown. The present study thus assessed the views of experienced surrogates regarding the possible use of PPPs as a means to help make (...) treatment decisions for decisionally-incapacitated patients. -/- Methods: This qualitative study used semi-structured interviews to determine the views of experienced surrogates [n=26] who were identified from two academic medical centers and two community hospitals. The primary outcomes were respondents’ overall level of support for the idea of using PPPs and the themes related to their views on how a PPP should be used, if at all, in practice. -/- Results: Overall, 21 participants supported the idea of using PPPs. The remaining five indicated that they would not use a PPP because they made decisions based on the patient’s best interests, not based on substituted judgment. Major themes which emerged were that surrogates, not the patient’s preferences, should determine how treatment decisions are made, and concern that PPPs might be used to deny expensive care or be biased against minority groups. -/- Conclusions: Surrogates, like patients, strongly support the idea of using PPPs to help make treatment decisions for decisionally-incapacitated patients. These findings provide support for developing a PPP and assessing it in practice. At the same time, patients and surrogates disagree over whose preferences should determine how treatment decisions are made, including whether to use a PPP. These findings reveal a fundamental disagreement regarding the guiding principles for surrogate decision-making. Future research is needed to assess this disagreement and consider ways to address it. (shrink)

A biographical sketch of the Hologenome Theory.

Since the ENCODE project published its final results in a series of articles in 2012, there is no consensus on what its implications are. ENCODE’s central and most controversial claim was that there is essentially no junk DNA: most sections of the human genome believed to be «junk» are functional. This claim was met with many reservations. If researchers disagree about whether there is junk DNA, they have first to agree on a concept of function and how function, given a (...) particular definition, can be discovered. The ENCODE debate centered on a notion of function that assumes a strong dichotomy between evolutionary and non-evolutionary function and causes, prevalent in the Modern Evolutionary Synthesis. In contrast to how the debate is typically portrayed, both sides share a commitment to this distinction. This distinction is, however, much debated in alternative approaches to evolutionary theory, such as the EES. We show that because the ENCODE debate is grounded in a particular notion of function, it is unclear how it connects to broader debates about what is the correct evolutionary frame- work. Furthermore, we show how arguments brought forward in the controversy, particularly arguments from mathematical population genetics, are deeply embedded in their particular disciplinary contexts, and reflect substantive assumptions about the evolution of genomes. With this article, we aim to provide an anatomy of the ENCODE debate that offers a new perspective on the notions of function both sides employed, as well as to situate the ENCODE debate within wider debates regarding the forces operating in evolution. (shrink)

Binz et al. highlight the potential of meta-learning to greatly enhance the flexibility of AI algorithms, as well as to approximate human behavior more accurately than traditional learning methods. We wish to emphasize a basic problem that lies underneath these two objectives, and in turn suggest another perspective of the required notion of “meta” in meta-learning: knowing what to learn.

Heyes presents a compelling account of how cultural evolutionary processes shape and create “rules,” or norms, of social behavior. She suggested that normativity depends on implicit, genetically inherited, domain-general processes and explicit, culturally inherited, domain-specific processes. Her approach challenges the nativist point of view and provides supporting evidence that shows how social interactions are responsible for creating mental processes that assist in understanding and behaving according to rules or norms. We agree. In our commentary, we suggest that it is not (...) only that mental processes for grasping norms are recreated in each generation but also that social interactions shape the kinds of social groups that are recognized (for a more extensive discussion, see Kish Bar-On & Lamm, 2023). We highlight evidence showing that accounts of norm psychology thus require a richer notion of human groups. (shrink)