The Endless Umbilical Cord: Parental Obligation to Grown Children

One might think that parental obligation to children ends with the end of childhood. I argue that if we consider why parents are obligated to their children, we will see that this view is false. Creating children exposes them to life’s risks. When we expose others to risks, we are often obligated to minimize damages and compensate for harms. Life’s risks last a lifetime, therefore parental obligation to one’s children does too. Grown children’s autonomy, and grown children’s independent responsibility for some of their own problems, can sometimes limit what parental responsibility demands of parents but it doesn’t do away with the responsibility. I argue that my conclusions are not as counterintuitive as they might initially seem. I also consider the implications that parental obligation to grown children might have on the oft assumed obligation that grown children have to care for their parents

Ultimate Meaning: We Don't Have It, We Can't Get It, and We Should Be Very, Very Sad

Life is pointless. That’s not okay. I show that. I argue that a point is a valued end and that, as agents, it makes sense for us to want our efforts and enterprises to have a point. Valued ends provide justifying reasons for our acts, efforts, and projects. I further argue that ends lie separate from the acts and enterprises for which they provide a point. Since there can be no end external to one’s entire life since one’s life includes all of one’s ends, leading and living one’s life as a whole cannot have a point. Finally, I argue that since we live our lives and structure our living­a­human­life efforts both in parts and as a whole, it is fitting to be sad to recognize that leading and living a life is pointless. My discussion helps make sense of the literature that frequently talks around this topic but often does so vaguely and indirectly

Whose Problem Is Non-Identity?

Teleological theories of reason and value, upon which all reasons are fundamentally reasons to realize states of affairs that are in some respect best, cannot account for the intuition that victims in non-identity cases have been wronged. Many philosophers, however, reject such theories in favor of alternatives that recognize fundamentally non-teleological reasons, second-personal reasons that reflect a moral significance each person has that is not grounded in the teleologist’s appeal to outcomes. Such deontological accounts appear to be better positioned to identify the wrong committed against non-identity victims because a person wrongs another on such accounts if she violates his second-personal claims -- overall benefit to victims presents no obstacle to the identification of second-personal wrongdoing. Derek Parfit argues that non-identity is a problem for these deontological theories as well because the alleged victims are properly understood as consenting to the action in question, thereby waiving any such second-personal claim. But his arguments misrepresent the role of consent on such theories by articulating it through appeal to the very teleological theory of reasons that their advocates dismiss as inadequate. Properly understood, Parfit’s appeal to consent understood as retroactive endorsement only provides the answer on such deontological accounts to the question of whether, given that the non-identity victim is second-personally wronged, he is nonetheless better off existing. Indeed, it becomes clear that it is teleological theories for which non-identity poses a particular problem: they cannot -- while their deontological counterparts can – account for the intuition that non-identity victims have been wronged

Radiomic Texture Analysis Mapping Predicts Areas of True Functional MRI Activity.

Individual analysis of functional Magnetic Resonance Imaging (fMRI) scans requires user-adjustment of the statistical threshold in order to maximize true functional activity and eliminate false positives. In this study, we propose a novel technique that uses radiomic texture analysis (TA) features associated with heterogeneity to predict areas of true functional activity. Scans of 15 right-handed healthy volunteers were analyzed using SPM8. The resulting functional maps were thresholded to optimize visualization of language areas, resulting in 116 regions of interests (ROIs). A board-certified neuroradiologist classified different ROIs into Expected (E) and Non-Expected (NE) based on their anatomical locations. TA was performed using the mean Echo-Planner Imaging (EPI) volume, and 20 rotation-invariant texture features were obtained for each ROI. Using forward stepwise logistic regression, we built a predictive model that discriminated between E and NE areas of functional activity, with a cross-validation AUC and success rate of 79.84% and 80.19% respectively (specificity/sensitivity of 78.34%/82.61%). This study found that radiomic TA of fMRI scans may allow for determination of areas of true functional activity, and thus eliminate clinician bias

Changes in Outcomes and Factors Associated With Survival in Melanoma Patients With Brain Metastases

BACKGROUND: Treatment options for patients with melanoma brain metastasis (MBM) have changed significantly in the last decade. Few studies have evaluated changes in outcomes and factors associated with survival in MBM patients over time. The aim of this study is to evaluate changes in clinical features and overall survival (OS) for MBM patients. METHODS: Patients diagnosed with MBMs from 1/1/2009 to 12/31/2013 (Prior Era; PE) and 1/1/2014 to 12/31/2018 (Current Era; CE) at The University of Texas MD Anderson Cancer Center were included in this retrospective analysis. The primary outcome measure was OS. Log-rank test assessed differences between groups; multivariable analyses were performed with Cox proportional hazards models and recursive partitioning analysis (RPA). RESULTS: A total of 791 MBM patients (PE, n = 332; CE, n = 459) were included in analysis. Median OS from MBM diagnosis was 10.3 months (95% CI, 8.9-12.4) and improved in the CE vs PE (14.4 vs 10.3 months, P \u3c .001). Elevated serum lactate dehydrogenase (LDH) was the only factor associated with worse OS in both PE and CE patients. Factors associated with survival in CE MBM patients included patient age, primary tumor Breslow thickness, prior immunotherapy, leptomeningeal disease, symptomatic MBMs, and whole brain radiation therapy. Several factors associated with OS in the PE were not significant in the CE. RPA demonstrated that elevated serum LDH and prior immunotherapy treatment are the most important determinants of survival in CE MBM patients. CONCLUSIONS: OS and factors associated with OS have changed for MBM patients. This information can inform contemporary patient management and clinical investigations

Risk, Responsibility, and Procreative Asymmetries

The author argues for a theory of responsibility for outcomes of imposed risk, based on whether it was permissible to impose the risk. When one tries to apply this persuasive model of responsibility for outcomes of risk imposition to procreation, which is a risk imposing act, one finds that it doesn’t match one’s intuitions about responsibility for outcomes of procreative risk. This mismatch exposes a justificatory gap for procreativity, namely, that procreation cannot avail itself of the shared vulnerability to risks and their constraints—to the balance one is forced to strike between one’s interest in being free to impose risks on others and one’s interest in being safe from harm resulting from the risk imposed by others—which serves to justify risk imposition, generally. Whereas most risk impositions involve trade-offs of liberty and security among people who share the vulnerabilities associated with the taking, imposing, or being constrained from imposing risks, procreation involves the introduction of people into that position of vulnerability in the first place. Thus, when one procreates, one imposes risks in the absence of the shared vulnerability that usually serves as a justification for risk imposition. Procreative risks may not be wrongfully imposed, but they aren’t permissibly imposed in a manner fully comparable to other permissibly imposed risks. This makes procreation a unique form of risk imposition, with unique implications for its justification and for one’s responsibility for its outcomes. This insight can help explain several puzzling procreative asymmetries

Between Sisyphus's Rock and a Warm and Fuzzy Place: Procreative Ethics and the Meaning of Life

This paper suggests that there are three kinds of meaning: Everyday, Cosmic, and Ultimate. Everyday meaning refers to the value and significance in our everyday lives, including values such as beauty, morality, and truth, and the significance of engagement with them. Cosmic meaning refers to our meaningful role in the cosmos: to the significance and value of our cosmic niche, to the purposes of the cosmos and our place in it. Ultimate meaning is the end-regarding justifying reason, the valued end, or the point of leading a life at all. It is here argued that procreating can be a deep source of Everyday meaning, and perhaps Cosmic meaning. But nothing can provide us with Ultimate meaning. The implications this may have for procreative ethics is considered

Replies to Critics (Replies to critics re "Ultimate Meaning: We Don't Have It, We Can't Get It, and We Should Be Very, Very Sad")

This article responds to the two replies, published in this issue, to my article “Ultimate Meaning: We Don’t Have It, We Can’t Get It, and We Should Be Very, Very Sad,” published in the first issue of this journal. In the first reply, Turp, Hollinshead, and Rowe present an internalist challenge to my account of value, and a relational conception of the self as a challenge to my premise that leading a life includes everything you do and aim at within the project, effort, or enterprise of living and leading a life. I respond to the internalist challenge by showing it does not succeed in inserting values into acts. I respond to the relational conception of the self by noting that, regardless of the nature of the self, the project of leading a life includes all the things you do and aim at within that project, effort, or enterprise. Thus, we can accept a relational account of the self and allow for other-regarding values but that does not change the location of our pursuit of those values: they remain located within the meta-project of leading a life, leaving the meta-project of leading and living a life with nowhere to reach for a point. In the second reply, Cowan argues against feeling sad about life’s pointlessness. In response, I argue that sad facts warrant sadness. I further argue that there are reasons other than happiness to value truth, including the very, very sad truth about the ultimate pointlessness of our lives