Attitudes about Brain–Computer Interface (BCI) technology among Spanish rehabilitation professionals

Funding for open access charge: Universidad de Granada/CBUA. Intelligent Neuro-Technologies Restoring Functions of Action and Communication: An Evaluation Study (Interfaces) AC15/00085 (FEDER), EXTEND (H2020 Research Project, ref. 779982) and EthAI + 3 (PID2019-104943RB-100).To assess—from a qualitative perspective—the perceptions and attitudes of Spanish rehabilitation professionals (e.g. rehabilitation doctors, speech therapists, physical therapists) about Brain–Computer Interface (BCI) technology. A qualitative, exploratory and descriptive study was carried out by means of interviews and analysis of textual content with mixed generation of categories and segmentation into frequency of topics. We present the results of three in-depth interviews that were conducted with Spanish speaking individuals who had previously completed a survey as part of a larger, 3-country/language, survey on BCI perceptions. 11 out of 15 of these Spanish respondents (survey) either strongly or somewhat accept the use of BCI in rehabilitation therapy. However, the results of our three in-depth interviews show how, due to a strong inertia of attitudes and perceptions about BCI technology, most professionals feel reluctant to use BCI technology in their daily practice (interview).Universidad de Granada/CBUA AC15/00085 779982 PID2019-104943RB-10

Testing the Motivational Strength of Positive and Negative Duty Arguments Regarding Global Poverty

We would also like to thank Thomas Pogge and Peter Singer for helping us develop the versions of the arguments used in Study 2 and the replication study, Jaclyn Murray for the Spanish backtranslation, and Marcus Mayorga for assistance with the statistical analyses used in the paper.Two main types of philosophical arguments have been given in support of the claim that the citizens of affluent societies have stringent moral duties to aid the global poor: "positive duty" arguments based on the notion of beneficence and "negative duty" arguments based on noninterference. Peter Singer's positive duty argument (Singer Philosophy and Public Affairs 1:229-243, Singer 1972) and Thomas Pogge's negative duty argument (Pogge 2002) are among the most prominent examples. Philosophers have made speculative claims about the relative effectiveness of these arguments in promoting attitudes and behaviors that could lead to the alleviation of poverty. In this article we present the results of two empirical studies that evaluate these claims, and suggest that both arguments have a modest effect on people's attitudes and behaviors regarding global poverty. In a replication of the second study, the negative duty argument, in particular, had a statistically significant effect on donations. We discuss the theoretical and practical significance of these results and suggest directions for further research on the role that philosophical arguments can play in engendering concern and action on pressing moral problems

Ethical assessments and mitigation strategies for biases in AI-systems used during the COVID-19 pandemic

This research has been funded thanks to the “Ayudas Fundación BBVA a Equipos de Investigación Científica SARS-CoV-2 y COVID-19” in Humanities.The main aim of this article is to reflect on the impact of biases related to artificial intelligence (AI) systems developed to tackle issues arising from the COVID-19 pandemic, with special focus on those developed for triage and risk prediction. A secondary aim is to review assessment tools that have been developed to prevent biases in AI systems. In addition, we provide a conceptual clarification for some terms related to biases in this particular context. We focus mainly on non-racial biases that may be less considered when addressing biases in AI systems in the existing literature. In the manuscript, we found that the existence of bias in AI systems used for COVID-19 can result in algorithmic justice and that the legal frameworks and strategies developed to prevent the apparition of bias have failed to adequately consider social determinants of health. Finally, we make some recommendations on how to include more diverse professional profiles in order to develop AI systems that increase the epistemic diversity needed to tackle AI biases during the COVID-19 pandemic and beyond.Fundación BBVA SARS-CoV-2, COVID-1

Attitudes of European students towards family decision‑making and the harmonisation of consent systems in deceased organ donation: a cross‑national survey

Background: European countries are increasingly harmonising their organ donation and transplantation policies. Although a growing number of nations are moving to presumed consent to deceased organ donation, no attempts have been made to harmonise policies on individual consent and the role of the family in the decision-making process. Little is known about public awareness of and attitudes towards the role of the family in their own country and European harmonisation on these health policy dimensions. To improve understanding of these issues, we examined what university students think about the role of the family in decision-making in deceased organ donation and about harmonising consent policies within Europe. Methods: Using LimeSurvey© software, we conducted a comparative cross-sectional international survey of 2193 university students of health sciences and humanities/social sciences from Austria (339), Belgium (439), Denmark (230), Germany (424), Greece (159), Romania (190), Slovenia (190), and Spain (222). Results: Participants from opt-in countries may have a better awareness of the family’s legal role than those from opt-out countries. Most respondents opposed the family veto, but they were more ambivalent towards the role of the family as a surrogate decision-maker. The majority of participants were satisfied with the family’s legal role. However, those who were unsatisfied preferred to limit family involvement. Overall, participants were opposed to the idea of national sovereignty over consent policies. They favoured an opt-out policy harmonisation and were divided over opt-in. Their views on harmonisation of family involvement were consistent with their personal preferences. Conclusions: There is overall division on whether families should have a surrogate role, and substantial opposition to granting them sole authority over decision-making. If European countries were to harmonise their policies on consent for organ donation, an opt-out system that grants families a surrogate decision-making role may enjoy the widest public support.CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI

Death pluralism: a proposal

Open Access funding provided thanks to the CRUE‑CSIC agreement with Springer Nature. This paper has been funded by the INEDyTO II project PID2020‑118729RB‑I00, by the Dead Bodies project PID2020‑119717GA‑I00 and by the Banc Sabadell foundation.The debate over the determination of death has been raging for more than fifty years. Since then, objections against the diagnosis of brain death from family members of those diagnosed as dead-have been increasing and are causing some countries to take novel steps to accommodate people's beliefs and preferences in the determination of death. This, coupled with criticism by some academics of the brain death criterion, raises some questions about the issues surrounding the determination of death. In this paper, we discuss some of the main approaches to death determination that have been theoretically proposed or currently put into practice and propose a new approach to death determination called "weak pluralism" as a reasonable ethical and political alternative to respect diversity in death determination.CRUE‑CSICINEDyTO II: PID2020‑118729RB‑I00Dead Bodies PID2020‑119717GA‑I00Banc Sabadell foundatio

Pluralism on the meaning of brain death or rethinking the dead donor rule

Desde 1968, el cese irreversible del funcionamiento de todo el cerebro, llamado muerte cerebral, es asimilado a la muerte del individuo. La aceptación casi universal de ese criterio neurológico de la muerte tuvo consecuencias decisivas para la medicina contemporánea, como la limitación del esfuerzo terapéutico en esos pacientes o la extracción de sus órganos para realizar trasplantes. Parte del éxito del nuevo criterio se debe a que la asimilación del estado de muerte cerebral a la muerte fue presentada por la medicina —y acríticamente asumida por la mayoría de las sociedades— como un hecho científico y objetivo. Sin embargo, algunas personas no creen que los pacientes en muerte cerebral estén realmente muertos. Mostraremos en este trabajo que esas personas no están necesariamente equivocadas. Se puede argumentar que, en realidad, la justificación del criterio neurológico no es científica, sino moral. Esbozaremos la tesis de que los problemas relacionados con el estatuto de los pacientes en muerte cerebral se deben a una confusión entre cuestiones fácticas y normativas. Por otro lado, defenderemos que la donación de órganos y la limitación del esfuerzo terapéutico pueden ser éticamente aceptables incluso si consideramos que los pacientes en muerte cerebral están vivos. Como alternativa a la regla del donante fallecido, proponemos una justificación de la donación de órganos de pacientes en muerte cerebral basada en las nociones (morales) de daño y consentimiento: lo que verdaderamente justifica la extracción de órganos de pacientes en muerte cerebral no es que estén muertos, sino que desean donar sus órganos y que, al tener irreversiblemente afectado su cerebro, no pueden ser dañados.Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was succesfully accepted in part because the assimilation of brain death state to death was presented by medicine —and acritically assumed by most of societies— as a scientific and objective fact. Nevertheless, many people do not think that the patients suffering brain death are actually dead. We show here that those people are not necessarily wrong. It can be argued that, in fact, the justification of the neurological criterion is not scientific but moral. We outline the thesis that the problem surrounding the vital status of brain dead patients is due to a confusion between factual and normative questions. Furthermore, we claim that the donation of organs and the withdrawal of life-support could be ethically acceptable even if the patients suffering brain death are considered as alive. As an alternative to the dead donor rule, we propose a justification for organ donation of brain-dead patients based on the (moral) concepts of harm and consent: what truly justifies the procurement of organs on those patients is not that they are dead, but that they wish to donate their organs and that, since they have irreversibly lost their brain, they cannot be harmed

Mapping trust relationships in organ donation and transplantation: a conceptual model

“Research in Ethics of Organ Donation and Transplantation” (INEDyTO) [MINECO FFI201 88913-P]. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This research has been conducted as part of the following projects: “Research in Ethics of Organ Donation and Transplantation” (INEDyTO) [MINECO FFI201 88913-P]; “Epistemological and bioethical analysis of the criteria for determining death” (ABCDm) MICINN: PID2020-119717GA-I00]; “Moral science and institutional design lab” (MSIDLab) [PID2020-119791RAI00].The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates."Research in Ethics of Organ Donation and Transplantation" (INEDyTO) FFI201 88913-PCRUE-CSIC agreementSpringer NatureABCDm, MICINN: PID2020-119717GA-I00MSIDLab: PID2020-119791RAI0

End-of-Life Narratives of Patients who Request Medical Assistance in Dying: A Qualitative Study Protocol

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work has been developed in the framework of the following research projects: INEDYTO (code PID2020-118729RB-I00), funded by the Spanish Ministry of Science and Innovation and «Narrativas de pacientes que solicitan la ayuda para morir» (code BEC-2022-019), funded by Fundació Grífols de Bioètica. Iris Parra Jounou thanks the funding of the Spanish Research Agency (code PID2019-105422GB-I00).Many groups (healthcare professionals, lawyers, philosophers, non-governmental organisations, bioethics committees, journalists, religious groups, etc.) participate in the bioethical debate about medical assistance in dying (MAiD). Bioethics literature on the topic involve different approaches (analytic, empirical, policy oriented, activist) and various normative perspectives (discourses based on deontological premises as the sanctity of life and human dignity, or on utilitarianism, libertarianism, etc.), some of which are at times irreconcilable. Regarding empirical studies, some voices (e.g., healthcare professionals) have been widely considered but the voice of people who request MAiD has been neglected. Understanding the personal and medical circumstances that lead to MAiD, which can only be achieved by listening to the phenomenological discourse of those involved, is key. This study aims to provide knowledge from the testimonies and experiences of patients who have initiated a MAiD request. We believe this research protocol can increase our understanding of a social and academic controversy that lacks important information to be complete. By doing so, this type of research could inform and improve end-of-life public policies, and particularly the health care of individuals who request a MAiD. We propose a qualitative phenomenological study using semi-structured interviews of people in the process of requesting MAiD, as outlined in the Ley Organica 3/2021, de regulacion de la eutanasia (LORE), the Spanish Law on the Regulation of Euthanasia. The study is conducted nationally using a convenience sampling. The number of interviews is determined sequentially and cumulatively, depending on the richness of the narratives and the saturation of the information that has been collected. For the purposes of analysis, the interviews are transcribed verbatim and pseudonymised afterwards. Data analysis is conducted at the same time as data collection. The proposed study has received a favourable report from the Coordinating Committee on Biomedical Research Ethics of Andalusia (CCEIBA).Spanish Ministry of Science and Innovation INEDYTO (PID2020-118729RB-I00)Fundació Grífols de Bioètica (BEC-2022-019)Spanish Research Agency (PID2019-105422GB-I00

Attitudes about Brain-Computer Interface (BCI) technology among Spanish rehabilitation professionals

To assess—from a qualitative perspective—the perceptions and attitudes of Spanish rehabilitation professionals (e.g. rehabilitation doctors, speech therapists, physical therapists) about Brain–Computer Interface (BCI) technology. A qualitative, exploratory and descriptive study was carried out by means of interviews and analysis of textual content with mixed generation of categories and segmentation into frequency of topics. We present the results of three in-depth interviews that were conducted with Spanish speaking individuals who had previously completed a survey as part of a larger, 3-country/language, survey on BCI perceptions. 11 out of 15 of these Spanish respondents (survey) either strongly or somewhat accept the use of BCI in rehabilitation therapy. However, the results of our three in-depth interviews show how, due to a strong inertia of attitudes and perceptions about BCI technology, most professionals feel reluctant to use BCI technology in their daily practice (interview)

Public perception of organ donation and transplantation policies in Southern Spain

Background: This research explores how public awareness and attitudes towards donation and transplantation policies may contribute to Spain’s success in cadaveric organ donation. Materials and Methods: A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Results: Most participants trust Spain’s donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), while few non-donors have expressed their refusal (14%). Only a minority is aware of the presumed consent system in force (28%) and feel sufficiently informed regarding the requirements needed to be an organ donor (16%). Participants mainly consider that relatives should represent the deceased’s preferences and be consulted when the deceased’s wishes are unknown, as is the case in Spain. Conclusions: Public trust in the transplant system may contribute to Spain’s high performance in organ donation. High levels of societal support towards organ donation and transplantation do not correspond in Spain with similar levels of public awareness of donation and transplantation policies.Project INEDyTO Spanish Government (MINECO FFI2017-88913-P)Institute for Advanced Social Studies (IESA-CSIC