Preliminaries to artificial consciousness: A multidimensional heuristic approach.

The pursuit of artificial consciousness requires conceptual clarity to navigate its theoretical and empirical challenges. This paper introduces a composite, multilevel, and multidimensional model of consciousness as a heuristic framework to guide research in this field. Consciousness is treated as a complex phenomenon, with distinct constituents and dimensions that can be operationalized for study and for evaluating their replication.

Clinical, Ethical, and Legal Considerations Raised by Self-Reported Genital Mutilation Following Voluntary Cosmetic Labiaplasty.

An increasing number of women are undergoing female genital cosmetic surgery (FGCS). Labiaplasty, the most commonly performed FGCS, consists of a surgical procedure to decrease the inner labia size so that no or less tissue protrudes beyond the outer labia. Anatomically, it is similar to female genital mutilation/cutting (FGM/C) Type 2a.

Factors Associated With Nonattendance for Osteoporosis Evaluation Following Fragility Fracture.

This study assessed patient demographic factors associated with nonattendance for osteoporosis evaluation after being referred to our Bone Health Clinic (BHC), a hospital-based outpatient Fracture Liaison Service (FLS), for a fragility fracture. 507 patients sustaining a fragility fracture were referred to the BHC over a 39-month period. Retrospective chart review was conducted to capture osteoporosis evaluation attendance rates and demographic factors (age, gender, race, area deprivation index, insurance type, and fracture type).

Credit and blame for AI-generated content: Effects of personalization in four countries.

Generative artificial intelligence (AI) raises ethical questions concerning moral and legal responsibility-specifically, the attributions of credit and blame for AI-generated content. For example, if a human invests minimal skill or effort to produce a beneficial output with an AI tool, can the human still take credit? How does the answer change if the AI has been personalized (i.e.

Moral enhancement and cheapened achievement: Psychedelics, virtual reality and AI.

A prominent critique of cognitive or athletic enhancement claims that certain performance-improving drugs or technologies may 'cheapen' resulting achievements. Considerably less attention has been paid to the impact of enhancement on the value of moral achievements. Would the use of moral enhancement (bio)technologies, rather than (solely) 'traditional' means of moral development like schooling and socialization, cheapen the 'achievement' of morally improving oneself? We argue that, to the extent that the 'cheapened achievement' objection succeeds in the domains of cognitive or athletic enhancement, it could plausibly also succeed in the domain of moral enhancement-but only regarding certain forms.

Digital Doppelgängers and Lifespan Extension: What Matters?

There is an ongoing debate about the ethics of research on lifespan extension: roughly, using medical technologies to extend biological human lives beyond the current "natural" limit of about 120 years. At the same time, there is an exploding interest in the use of artificial intelligence (AI) to create "digital twins" of persons, for example by fine-tuning large language models on data specific to particular individuals. In this paper, we consider whether digital twins (or digital doppelgängers, as we refer to them) could be a path toward a kind of life extension-or more precisely, a kind of extension-that does not rely on biological continuity.

Enabling Demonstrated Consent for Biobanking with Blockchain and Generative AI.

Participation in research is supposed to be voluntary and informed. Yet it is difficult to ensure people are adequately informed about the potential uses of their biological materials when they donate samples for future research. We propose a novel consent framework which we call "demonstrated consent" that leverages blockchain technology and generative AI to address this problem.

Labiaplasty in Minors: Medicalizing Mutilation?

Labial hypertrophy, which lacks an accepted definition, is generally understood to refer to morphological and aesthetic characteristics of the labia believed to deviate from a perceived norm. Such ostensive deviation has the potential to affect many domains of a person's well-being, as does its surgical treatment, labiaplasty. Nearly 24,000 labiaplasty procedures were performed in the United States in 2022, representing a greater than three-fold increase since numbers were first reported in 2013.

Rural-Urban Disparities in the Surgical Treatment of Carpal Tunnel Syndrome in the United States.

Purpose: Rural populations are at risk for poorer access to health services and lower quality care, and recent policy efforts have focused on the reduction of rural-urban health inequities. The objective of this study was to identify differences in (1) patient demographic factors, (2) the utilization of confirmatory electrodiagnostic (EDS) testing, and (3) preoperative EDS severity between rural and urban populations undergoing carpal tunnel release (CTR).

Methods: We retrospectively identified 1,297 patients who underwent CTR at a tertiary referral center from July 2008 to June 2013.

One R or the other - an experimental bioethics approach to 3R dilemmas in animal research.

Sacrificial dilemmas such as the trolley problem play an important role in experimental philosophy (x-phi). But it is increasingly argued that, since we are not likely to encounter runaway trolleys in our daily life, the usefulness of such thought experiments for understanding moral judgments in more ecologically valid contexts may be limited. However, similar sacrificial dilemmas are experienced in real life by animal research decision makers.

Integrating gender analysis into research: reflections from the Gender-Net Plus workshop.

Gender equality has been a crosscutting issue in Horizon 2020 with three objectives: gender balance in decision-making, gender balance and equal opportunities in project teams at all levels, and inclusion of the gender dimension in research and innovation content. Between 2017 and 2022, the EU funded, in collaboration with national agencies, 13 transnational projects under "GENDER-NET Plus" that explored how to best integrate both sex and gender into studies ranging from social sciences, humanities, and health research. As the projects neared completion, forty researchers from these interdisciplinary teams met in November 2022 to share experiences, discuss challenges, and consider the best ways forward to incorporate sex and gender in research.

Risks of Reoperation in Surgically Treated Fractures of the Proximal Phalanx.

Purpose: The objective of this study was to determine the risk factors and the rate of reoperation after closed reduction percutaneous pinning (CRPP) of isolated closed single-digit proximal phalanx fractures.

Methods: A retrospective cohort study was conducted for patients who underwent CRPP of non-thumb closed proximal phalanx fractures between 2010 and 2020 at two level-I trauma centers and two community teaching hospitals. Demographics, fracture, and treatment characteristics were collected.

Evaluating Prescriber Adherence to a Standardized Postoperative Opioid Prescription Protocol for Cubital Tunnel Surgery.

Purpose: Concerns regarding the ongoing opioid epidemic have led to the implementation of standardized postoperative opioid-prescribing protocols for many common hand surgical procedures. This study investigated patient- and procedure-specific factors affecting adherence to a standardized postoperative opioid-prescribing protocol after cubital tunnel surgery.

Methods: A retrospective review of patients who underwent primary cubital tunnel surgery within one academic medical system between October 1, 2016 (after the implementation of a standardized postoperative opioid-prescribing protocol) and March 1, 2020 was performed.

Advance Medical Decision-Making Differs Across First- and Third-Person Perspectives.

Background: Advance healthcare decision-making presumes that a prior treatment preference expressed with sufficient mental capacity ("T1 preference") should trump a contrary preference expressed after significant cognitive decline ("T2 preference"). This assumption is much debated in normative bioethics, but little is known about lay judgments in this domain. This study investigated participants' judgments about which preference should be followed, and whether these judgments differed depending on a first-person (deciding for one's future self) versus third-person (deciding for a friend or stranger) perspective.

Valuing the Acute Subjective Experience.

Psychedelics, including psilocybin, and other consciousness-altering compounds such as 3,4-methylenedioxymethamphetamine (MDMA), currently are being scientifically investigated for their potential therapeutic uses, with a primary focus on measurable outcomes: for example, alleviation of symptoms or increases in self-reported well-being. Accordingly, much recent discussion about the possible value of these substances has turned on estimates of the magnitude and duration of persisting positive effects in comparison to harms. However, many have described the value of a psychedelic experience with little or no reference to such therapeutic benefits, instead seeming to find the experience valuable in its own right.