Problems with prioritization: exploring ethical solutions to inequalities in HIV care

Enormous gaps between HIV burden and health care availability in low-income countries raise severe ethical problems. This article analyzes four HIV-priority dilemmas with interest across contexts and health systems. We explore principled distributive conflicts and use the Atkinson index to make explicit trade-offs between health maximization and equality in health. We find that societies need a relatively low aversion to inequality to favor treatment for children, even with large weights assigned to extending the lives of adults: higher inequality aversion is needed to share resources equally between high-cost and low-cost treatment; higher inequality aversion is needed to favor treatment rather than prevention, and the highest inequality aversion is needed to favor sharing treatment between urban and rural regions rather than urban provision of treatment. This type of ethical sensitivity analysis may clarify the ethics of health policy choice.     

Chinese researchers promote biomedical regulations: what are the motives of the biopolitical dawn in China and where are they heading?

In the past five years, China has experienced increased efforts to regulate activities in biomedical research and practice. Background is provided on some of the key developments in Chinese bioethics especially in relation to genetics, stem cells, cloning, and reproductive medicine. This background sets the stage for a document entitled "Ethical Guidelines for Human Embryonic Stem Cell Research," proposed by the Bioethics Committee of the Southern China National Human Gene Research Center, Shanghai, which is reprinted in this volume of the Kennedy Institute of Ethics Journal.     

High-fidelity perceptual long-term memory revisited--and confirmed

Experiments on short-term perceptual memory for elemental visual attributes, such as contrast, motion, orientation, and spatial frequency, have relied on a delayed discrimination technique in which the subject compares two stimuli presented at different points in time and memory is indexed by discrimination thresholds measured for the different time intervals between reference and test. In a variant of this procedure, used in experiments on long-term memory, the presentation of a single reference is followed by a memory test that combines two-alternative forced-choice decisions with the method of constant stimuli. With this procedure, it is impossible to distinguish the effects of criterion-setting processes and memory on performance, but this confound can be eliminated by testing many subjects and having each subject make a single decision. The resulting "group thresholds" are stable across time intervals of 24 hr, confirming previous findings of high-fidelity storage in the long-term memory range.     

John Lind memorial symposium

John Lind, Professor of Pediatrics at the Karolinska Institute, emphasized that “the family is born in the maternity hospital.” He had a warm concern for all parents and infants and was extremely influential in both pediatric and child-rearing practices in Sweden and in the promotion of infant and caregiver-infant interaction research. Lind initiated and/or stimulated the scientific study of the infant's cry, parent-infant interactions, the role of the father in the perinatal environment, fetal and neonatal perception, and perinatal hospital practices. In many respects, his work predated contemporary emphases on perinatal coaching programs, social support (doula) during labor and delivery, parent education on childrearing, the use of ethnographic data for contemporary perinatal practices, interdisciplinary team approaches to study of infant care and development, changes in newborn nursery practices, and, above all, care and sensitivity to the initial synchronization of the parent-infant interaction system. This paper honors John Lind's contributions to our knowledge of infant development and parent-infant interaction, his influences on the field of pediatrics and the interdisciplinary study of infancy, and his commitment to enhancement of the quality of life for infants and their families. Although his life has ended, his ideas will continue to inspire and challenge the study of early human development for many years to come.     

Remembering 1500 pictures: the right hemisphere remembers better than the left

We hypothesized that the right hemisphere would be superior to the left hemisphere in remembering having seen a specific picture before, given its superiority in perceptually encoding specific aspects of visual form. A large set of pictures (N=1500) of animals, human faces, artifacts, landscapes, and art paintings were shown for 2s in central vision, or tachistoscopically (for 100ms) in each half visual field, to normal participants who were then tested 1-6 days later for their recognition. Images that were presented initially to the right hemisphere were better recognized than those presented to the left hemisphere. These results, obtained with participants with intact brains, large number of stimuli, and long retention delays, are consistent with previously described hemispheric differences in the memory of split-brain patients.     

Empirical Conditions for a Reidean Geometry of Visual Experience

Thomas Reid’s Geometry of Visibles, according to which the geometrical properties of an object’s perspectival appearance equal the geometrical properties of its projection on the inside of a sphere with the eye in its centre allows for two different interpretations. It may (1) be understood as a theory about phenomenal visual space—i.e. an account of how things appear to human observers from a certain point of view—or it may (2) be seen as a mathematical model of viewpoint-relative but mind-independent relational properties of objects. This paper makes a systematic and a historical claim. I shall argue, first, that given certain features of the human visual system phenomenal visual space differs in several aspects from Reidean visual space. Secondly, I suggest that, since Reid was aware of some of these empirical facts, we should interpret Reid as endorsing the second interpretation of the Geometry of Visibles.     

Research Note: Performing Bach's Passion Music in a Late Modern Context

The performance of Bach's Passion of St. Matthew in the Cathedral of Kristiansand (Norway) in 2010 is examined here as a characteristic cultural encounter with sacred symbols in a late modern context. The present study attempts to illuminate how modern participants reflect on the sacred origin of the work and its emotive appeal. The study is interdisciplinary, combining musicology and sociology of religion. Our methodological approach comprises observation, individual interviews with organizers and conductors, and group interviews with singers. The event is contextualized by theories of modern musicology, general sociology, and the sociology of religious emotion. Our findings indicate that, despite a variety of religious interpretations and attitudes, the work's reference to common existential conditions of human life inspires a sharing of emotions.     

The Ways of Humans: The Emergence of Sense and Common Sense Through Language Production

The present paper is an extension of Elstrup (Integrative Psychological and Behavioral Science, doi:10.1007/s12124-009-9095-x, 2009). Primarily, it is argued that the model presented in ‘The ways of humans’ describes the functional foundation of an emergent hierarchy and therefore cannot be reduced to its elements. Next, some ideas concerning the language mechanism, sense making and common sense are developed. Finally, it is argued that the scientific exploration of human development needs a unit of measurement. It is suggested that this unit can be found in time dependent sense making.     

Sleep directly following learning benefits consolidation of spatial associative memory

The last decade has brought forth convincing evidence for a role of sleep in non-declarative memory. A similar function of sleep in episodic memory is supported by various correlational studies, but direct evidence is limited. Here we show that cued recall of face-location associations is significantly higher following a 12-h retention interval containing sleep than following an equally long period of waking. Furthermore, retention is significantly higher over a 24-h sleep-wake interval than over an equally long wake-sleep interval. This difference occurs because retention during sleep was significantly better when sleep followed learning directly, rather than after a day of waking. These data demonstrate a beneficial effect of sleep on memory that cannot be explained solely as a consequence of reduced interference. Rather, our findings suggest a competitive consolidation process, in which the fate of a memory depends, at least in part, on its relative stability at sleep onset: Strong memories tend to be preserved, while weaker memories erode still further. An important aspect of memory consolidation may thus result from the removal of irrelevant memory "debris."     

医学伦理学——欧洲与中国的桥

跨文化医学伦理学研究,要求我们以理智的方式去应对全球化。既要维护多样性,又要明确共同利益、亦要追求共同目标。任何文化都不能强行提出一些标准去规范国际间的生物医学。自主权应坚持义务论的解释,否则一个强势风气将会支配利益的选择解释,将文化多样性在伦理学中铸成一个统一的模式,形成自主权的“通货膨胀倾向”。