An assessment of the impacts of the REDD+ pilot project on community forests user groups (CFUGs) and their community forests in Nepal.

REDD+ has the potential to reduce greenhouse gas emissions, meet climate stabilisation targets and protect biological diversity. Consequently, millions of dollars are being channelled into developing countries rich in forests, for pilot projects that will provide data for the design of REDD+ projects that are based on incentives and performance. This paper evaluates the impacts of REDD+ pilot projects on community forests and associated user groups (CFUGs) in Nepal.

The essential moral self.

It has often been suggested that the mind is central to personal identity. But do all parts of the mind contribute equally? Across five experiments, we demonstrate that moral traits-more than any other mental faculty-are considered the most essential part of identity, the self, and the soul. Memory, especially emotional and autobiographical memory, is also fairly important.

Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening.

Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening.

Criteria for fairly allocating scarce health-care resources to genetic tests: which matter most?

The use of genetic tests is expanding rapidly. Given limited health-care budgets throughout Europe and few national coverage decisions specifically for genetic tests, decisions about allocating scarce resources to genetic tests are frequently ad hoc and left to lower-level decision makers. This study assesses substantive ethical and economic criteria to prioritize genetic services in a reasonable and fair manner.

Introduction: Reconsidering Disorders of Consciousness in Light of Neuroscientific Evidence.

Disorders of consciousness pose a substantial ethical challenge to clinical decision making, especially regarding the use of life-sustaining medical treatment. For these decisions it is paramount to know whether the patient is aware or not. Recent brain research has been striving to assess awareness by using mainly functional magnetic resonance imaging.

Evaluating an evidence-based curriculum in undergraduate palliative care education: piloting a phase II exploratory trial for a complex intervention.

Background: By 2013 Palliative Care will become a mandatory examination subject in the medical curriculum in Germany. There is a pressing need for effective and well-designed curricula and assessment methods. Debates are on going as how Undergraduate Palliative Care Education (UPCE) should be taught and how knowledge and skills should be assessed.

Molecular genetics research in ADHD: ethical considerations concerning patients' benefit and resource allocation.

Immense resource allocations have led to great data output in genetic research. Concerning ADHD resources spent on genetic research are less than those spent on clinical research. But there are successful efforts made to increase support for molecular genetics research in ADHD.

Who gets a teach-back? Patient-reported incidence of experiencing a teach-back.

To ensure comprehension, clinicians have been urged to use "teach-backs"-explicitly asking patients to repeat back key points of instruction-with every patient receiving new care management instructions. Yet, it is not known whether certain patient groups are more likely to receive teach-backs than others. This study used results from the patient survey of the Communication Climate Assessment Toolkit to examine patient-reported incidence of teach-back by patient education level, age, language preference, race/ethnicity, and perception of sufficient time with doctors.

Using a risk assessment approach to determine which factors influence whether partially bilingual physicians rely on their non-English language skills or call an interpreter.

Background: Partially bilingual physicians may weigh a number of factors in deciding whether to use their own limited non-English language skills or call an interpreter when caring for patients with limited English proficiency. Yet little is known about this decision process or how it might fail. In a patient safety approach to exploration of this complex, potentially high-stakes decision, key risk factors that may contribute to miscommunication during health care encounters in non-English languages were identified.

Neuroprediction, Violence, and the Law: Setting the Stage.

In this paper, our goal is to (a) survey some of the legal contexts within which violence risk assessment already plays a prominent role, (b) explore whether developments in neuroscience could potentially be used to improve our ability to predict violence, and (c) discuss whether neuropredictive models of violence create any unique legal or moral problems above and beyond the well worn problems already associated with prediction more generally. In "Violence Risk Assessment and the Law", we briefly examine the role currently played by predictions of violence in three high stakes legal contexts: capital sentencing ("Violence Risk Assessment and Capital Sentencing"), civil commitment hearings ("Violence Risk Assessment and Civil Commitment"), and "sexual predator" statutes ("Violence Risk Assessment and Sexual Predator Statutes"). In "Clinical vs.

The desired moral attitude of the physician: (III) care.

In professional medical ethics, the physician traditionally is obliged to fulfil specific duties as well as to embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired moral attitude of physicians. In a series of three articles, three of the discussed concepts are presented in an interpretation that is meant to characterise the morally emotional part of this attitude: "empathy", "compassion" and "care".

What makes killing wrong?

What makes an act of killing morally wrong is not that the act causes loss of life or consciousness but rather that the act causes loss of all remaining abilities. This account implies that it is not even pro tanto morally wrong to kill patients who are universally and irreversibly disabled, because they have no abilities to lose. Applied to vital organ transplantation, this account undermines the dead donor rule and shows how current practices are compatible with morality.

Custom, contract, and kidney exchange.

In this Essay, we examine a case in which the organizational and logistical demands of a novel form of organ exchange (the nonsimultaneous, extended, altruistic donor (NEAD) chain) do not map cleanly onto standard cultural schemas for either market or gift exchange, resulting in sociological ambiguity and legal uncertainty. In some ways, a NEAD chain resembles a form of generalized exchange, an ancient and widespread instance of the norm of reciprocity that can be thought of simply as the obligation to “pay it forward” rather than the obligation to reciprocate directly with the original giver. At the same time, a NEAD chain resembles a string of promises and commitments to deliver something in exchange for some valuable consideration--that is, a series of contracts.

The desired moral attitude of the physician: (I) empathy.

In professional medical ethics, the physician traditionally is obliged to fulfil specific duties as well as to embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired underlying attitude of physicians. In this article, one of them--empathy--is presented in an interpretation that is meant to depicture (together with the two additional concepts compassion and care) this attitude.

The desired moral attitude of the physician: (II) compassion.

Professional medical ethics demands of health care professionals in addition to specific duties and rules of conduct that they embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired implied attitude of physicians. In a sequel of three articles, a set of three of these concepts is presented in an interpretation that is meant to characterise the morally emotional part of this attitude: "empathy", "compassion" and "care".

Factors that motivate young pharmacists to work in rural communities in the Ukraine.

Introduction: A number of identified factors can influence clinicians' location of practice decisions; however, little is known about the location decisions of pharmacists. In general, males are more likely to work in rural and remote regions, and students with a rural background are more likely to work in rural communities after graduation. In the Ukraine, pharmaceutical health care is important because a patient's first visit is often to the pharmacy, rather than to a GP.

Conceptual and ethical issues with brain-hardware interfaces.

Purpose Of Review: Progress in neurosciences, increasing computational power, and ongoing miniaturization of micro-technological components enable both a better understanding of human brain functions and development of new diagnostic and therapeutic tools. Research and development as well as clinical application of devices designed for recording neural signals from the brain or stimulating brain areas respectively raise conceptual and ethical questions.

Recent Findings: Ethical issues of stimulating devices are mainly discussed in the field of deep brain stimulation.

Care drain: the political making of health worker migration.

Migration of formal and informal health-care workers is a global phenomenon - and, as this article demonstrates, one that is produced by government policies and practices. Nurses and lesser-trained caregivers migrate from many lower-income countries to richer ones (including from the Philippines to the United States, from South Africa to England, from Central Asia to Turkey). Using the Austrian experience to illustrate how policies and lack of enforcement of labor laws lead to migration and mistreatment of health-care professionals and informal caregivers, this article recommends how to alleviate health-care staff shortages in Africa and elsewhere through policymaking in Europe and North America.