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There is a broadly held view that neonatologists are ethically obligated to act to override parental nontreatment decisions for imperiled premature newborns when there is a reasonable chance of a good outcome. It is argued here that three types of uncertainty undercut any such general obligation: (1) the vagueness of the boundary at which an infant’s deficits become so intolerable that death could be reasonably preferred; (2) the uncertainty about whether aggressive treatment will result in the survival of a reasonably healthy child or, alternatively, the survival of a child with intolerable deficits; and (3) the inability to determine an acceptable ratio between the likelihoods of those two outcomes. It is argued that the broadly held view accords insufficient weight to the fact that newborn intensive care increases the likelihood of harm to the child by effecting survival with intolerable deficits. Though treatment may offer a reasonable chance of a good outcome, it is argued that there are situations in which neonatologists should nonetheless defer to parental nontreatment decisions.  相似文献   
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This essay is written in the belief that questions relating to the treatment of impaired and imperiled newborns cannot be adequately resolved in the absence of a general moral theory of parent-child relations. The rationale for treatment decisions in these cases should be consistent with principles that ought to govern the normal work of parenting. The first section of this paper briefly examines the social contract theory elaborated by John Rawls in his renowned book A Theory of Justice and extracts from it normative principles that can guide us in our attempt to lay a rational foundation for parenthood. The second section clarifies the implications of a Rawlsian theory for the problem at hand by examining several standards that have been proposed for the treatment of impaired newborns: the strict right-to-life standard, the medical decision standard, and the quality-of-life standard. A Rawlsian standard, by contrast, is autonomy-based. That is, it would have us base our treatment decisions on consideration of the child's capacity for developing critical rationality in making decisions on his or her own. This standard, it is suggested, avoids morally objectionable features of the others.  相似文献   
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While there is now considerable experimental evidence that, on the one hand, participants assign to the indicative conditional as probability the conditional probability of consequent given antecedent and, on the other, they assign to the indicative conditional the “defective truth-table” in which a conditional with false antecedent is deemed neither true nor false, these findings do not in themselves establish which multi-premise inferences involving conditionals participants endorse. A natural extension of the truth-table semantics pronounces as valid numerous inference patterns that do seem to be part of ordinary usage. However, coupled with something the probability account gives us—namely that when conditional-free ? entails conditional-free ψ, “if ? then ψ” is a trivial, uninformative truth—we have enough logic to derive the paradoxes of material implication. It thus becomes a matter of some urgency to determine which inference patterns involving indicative conditionals participants do endorse. Only thus will we be able to arrive at a realistic, systematic semantics for the indicative conditional.  相似文献   
24.
Parental gender‐stereotyped perceptions of newborns—particularly their physical characteristics—have been discussed as important determinants of sex role socialization from birth on. However, corresponding empirical evidence is inconclusive. We propose that inconsistent findings on gender‐correlated perceptions are due to whether or not actual physical differences between newborn girls and boys are properly (statistically or experimentally) taken into account. In our study, 55 mother–father pairs rated both their own and two unknown newborns, labeled either female or male. Although we successfully replicated the typical gender‐correlated perceptions of own newborns' physical characteristics, all effects were explainable by actual physical sex differences in length and weight at birth. Similarly, no gender‐specific rating differences emerged as a function of labeled gender of unknown children matched in actual physical characteristics. Altogether, the findings demonstrate the vital importance of considering existing sex differences between newborn girls and boys for drawing valid conclusions on gender stereotyping of newborns.  相似文献   
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Heart rates and behavioural states of 14 breast-fed and 14 bottlefed newborn infants were assessed every 30 seconds for 2 continuous hours. The 240 observations of heart rate were treated as time-series data and spectrum-analysed for behavioural rhythmicities. Of the 28 infants, 25 showed reliable cycles in heart rate; 22 of the 25 infants showed a dominant frequency with a 30–60 min periodicity, one that approximates the basic-rest activity cycle (BRAC). In addition to this basic cycle, additional higher frequency cycles in long-term heart rate variability were evident in the spectra of many infants. Breast-fed newborns had greater numbers of reliable cycles in heart rate than bottle-fed newborns. Further, breast-fed newborns had lower overall mean heart rates and lower mean heart rates in Quiet and Active Sleep states than bottle-fed newborns. Bottle-fed newborns were observed more often in Quiet Sleep than breast-fed newborns. Without knowledge of the specific mechanisms causing these behavioural differences, the results of this study suggest that the context in which breast-feeding occurs results in a more complex and energy-efficient pattern of behavioural organization than the context of bottle-feeding.  相似文献   
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