Greetings from Stephen Latham, Director


The semester is winding down, but we still have a few excellent events in store. This Wednesday, April 17,  former Editor-in-Chief of JAMA Dr. Catherine DeAngelis (Johns Hopkins) will present a seminar on “Patient Care and Medical Professionalism,” from 4:30 to 6 at the Cohen Auditorium of the Child Study Center. The event is sponsored by the Pediatric Ethics Program of Yale-New Haven Children’s Hospital.


Several dates to save for next week: Our Terry Visiting Bioethics Scholar Tom Murray (President Emeritus of The Hastings Center) will give a talk entitled “Why We Play: Technology, Values and Embodiment in Sport” at 5pm on Tuesday the 23rd at ISPS. In addition to being a leading bioethics scholar, Tom currently serves as Chair of the Ethical Issues Review Panel for the World Anti-Doping Agency. Are the values inherent in and promoted by sport under threat from enhancement technologies? Come find out!
 

Andrew Light (Global Ethics, George Mason) will give a Technology and Ethics talk on Wednesday the 24th on “The Ethics and Governance of Geoengineering” (ISPS, 4:15).

Well-known bioethicist Peter Singer (Bioethics, Princeton) will give this year’s Castle Lectures. Singer’s topic is “Effective Altruism.” The lectures will take place from 4:00 to 5:30 at Sterling Memorial Library, on Tuesday, Wednesday and Thursday, April 23, 24 and 25. The Castle Lectures are sponsored by the Program on Ethics, Politics & Economics, a program of ISPS.

Congratulations to our colleagues at the Hastings Center, whose special report on making healthcare systems “learn” was the subject of a special Institute of Medicine meeting in late March. The IOM is using the report to guide its deliberations on providing practical steps to improve health-system quality-improvement and safety initiatives.

If you have information or news for this weekly newsletter, send it to me at Stephen.Latham@Yale.edu, with the word “Frimail” in your subject-line.

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Updates from the Summer Institute

From Associate Director Carol Pollard

*Summer Seminar Leader Evie Lindemann has a solo art show, “Cycles of Transformation,” now at Albertus Magnus College in New Haven.  The art work depicts the power of art in living with bodily injury, grief, and loss.  “In 2007 I had a very serious accident that crushed and fractured my left hand; it involved unrelenting pain, surgery, and physical therapy for many months…in a second art series, I began doing anticipatory grief work when my beloved sister developed lung cancer.  I have continued with it since her death.  We often exchanged art images (she was a fine arts photographer who lived in California, and several of her photographs are in this show.  My art work sustained me through some very difficult years, and as I look back, I see that each image created a foot step on a path to inner healing.”  (Congratulations Evie!)

*Jennifer Brown writes “I am on the road in South Carolina and received an e-mail about this medical humanities summer course in Padua.  Can you please pass it on to other Summer Students?”  (Thanks Jenn!  See the Other Items section of this newsletter for the information.)

*Summer Seminar Leader Steve Dahlberg writes “Baby due May 19 here!”  (Congratulations Steve!)

*Zohar Lederman writes “I am now one of the editors in the journal The Intima: A Journal of Narrative Medicine. Please tell the students to send their articles, stories to us.  I can’t promise anything, but the next deadline is August 1st.”  Click here for more information.

*Arpitha Upendra (Arpi) writes: “Things have been great at work, and I’ve been busy with a symposium that the Lab is organizing to bring environmental thinkers together. I also have been selected to attend an interesting summer school program in Switzerland.  Here is a link to the program and participants (http://www.globalenvironments.org/courses/gesa-2013/participants/). I am aiming to travel to the US next summer for work and meeting family and maybe a stop in New Haven.  I will keep you posted on that front.”  (GOOD LUCK, Arpi!  Students, please look at the URL.  What an interesting program!)

Carol

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This Week on Campus

Monday, April 15

Ethnicity/Race/Gender Panel Discussion
Time: 5 PM
Location: 100 Wall St, room 207
Panelists: Roy Eidelson, Writer, Consultant, past pres of Psychologists for Social Responsibility
                 Michael Siegel, Boston Univ School of Public Health, Community Health Sciences
                 Stephen Latham, Director of Yale Interdisciplinary Center for Bioethics
                 Kica Matos, Dir of Immigrant Rights and Racial Justice, Ctr for Community Change
                 Steve Horn, Research Fellow for DeSmogBlog, Writer for TruthOut & other pubs
                 Allen Ruff, U.S. Historian, Social and Political Activist, Radio Host, and Author
Respondent: Birgit Brander Rasmussen, American Studies and Ethnicity, Race & Migration
Topic: Knowledge and Power: A Conversation about the Military and National Security in Academia

Tuesday, April 16

School of Nursing Lecture
Time: 4 PM
Location: 100 Church Street South, 2nd floor lecture hall
Speaker: Linda Robinson
Topic: Sunday Morning, Shamwana: Women's Health after War

Schulman Lecture in Science & the Humanities
Time: 5 PM
Location: 53 Wall St, auditorium
Speaker: Tamar Gendler, Vincent J Scully Professor of Philosophy
Topic: Holding Your Horses: Ancient and Modern Strategies for Regulating Internal Strife

Wednesday, April 17

EPA Risk Assessment Forum
Time: 3 PM
Location: online
Speaker: Jonathan Levy, Environmental Health, Boston University School of Public Health
Topic: Cumulative Risk

Pediatric Ethics Lecture
Time: 4:30 PM
Location: 230 South Frontage Rd, Cohen Auditorium
Speaker: Dr. Catherine DeAngelis, Johns Hopkins University, Former Editor-in-Chief of JAMA
Topic: Patient Care and Medical Professionalism

Health Film Screening
Time: 7 PM
Location: 55 Park St, auditorium
Film: Escape Fire: The Fight to Rescue American Healthcare

Thursday, April 18

Human Rights Workshop
Time: 4:15 PM
Location: 127 Wall St, room 128
Speaker: Alison Parker, Director, US Program, Human Rights Watch
Topic: Rights and Roadblocks: Human Rights Analysis and US Domestic Policymaking

YCEI/YCELP Lecture
Time: 6 PM
Location: 127 Wall St, room 121
Speaker:Sarah A. Krakoff, University of Colorado Law School
Topic: Parenting the Planet

Friday, April 19

Agrarian Studies Colloquium
Time: 11 AM
Location: 77 Prospect St, room B012
Speaker: Rheana Parreñas, Anthropology, Harvard University
Topic: Arrested Autonomy: A Zoo-Ethnography of Indefinitely Deferred Independence in Sarawak, Malaysia

Zigler Center Lecture
Time: 11:30 AM
Location: 100 Wall St, room 116
Speaker: Janice Gruendel, PhD, Deputy Commissioner, DCF, State of CT
Topic: Transforming DCF: Building a Comprehensive Children's State Agency

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Conferences & Off Campus Events

The Academy for Professionalism in Health Care invites you to participate in its 1st Annual Meeting: Building a Foundation Toward Medical Professionalism: The Role of Humanities and Ethics in Health Care Education,  May 3rd and 4th, 2013 in Chicago, IL.  Here is our website: http://primemedicine.org/index_/APHC_2013_Meeting.html. Last call - registration may close April 17th.

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7th International Conference on Ethical Issues in Biomedical Engineering, April 20-21, 2013. For more information visit the website http://www.downstate.edu/orthopaedics/bioethicsconf2013/.

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Other Items of Interest

Fondazione Lanza, a Center of Advanced Studies in Ethics (Padua, Italy), in collaboration with the Chair of History of Medicine at the University of Padua and the Chair of Medical Humanities at the Marmara University in Istanbul, is pleased to announce the first edition of the Summer Course on Medical Humanities, that will take place in Padua and Venice from Sunday 8 to Friday 13, September 2013. Contents: Medical Humanities and Bioethics; Charity and Its Artistic Interpretations; Medical History and Medical Humanities; Painting, Literature, Sculpture, Architecture, Cinema and Medicine; Arts, Medicine and Psychiatry. General Information: To see the complete programme, to apply, and for logistic information, please, visit the following website: www.fondazionelanza.it/medicalhumanities/. Application fee: 650,00 euro (comprising lectures, guided tours, local transfers, and teaching materials). Accommodation, travel, and meals expenses are not included. Deadlines: Application Form until 31 May 2013 - Payment: until 15 July 2013

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Johns Hopkins Berman Institute of Bioethics Intensive Summer Courses in Bioethics , June 17-21 & 24-28, 2013. Join the Johns Hopkins Berman Institute of Bioethics this summer for introductory and advanced courses in Bioethics, offered through the Berman Institute Bioethics Intensives (BI2) program. BI2 provides an engaging bioethics educational opportunity for current students; medical, legal, and policy professionals; researchers; scholars and others. Download a program flyer.  For More information & To Register Visit: www.bioethicsinstitute.org/intensives, Email: bioethics@jhu.edu , Phone: 410-614-5550.

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Ethics and Research Leadership: Paving the Path for Innovation and the Human Good.  This is a continuing education course for the professional development of researchers in any/all fields, research administrators, executives, managers, and related subject matter experts and professionals. Continuing education credit hours (CMEs, Nursing CEs, General CEUs) will be provided. The course is being held June 5, 6, 7 at Tuskegee University in Tuskegee, Alabama. It will begin the evening of June 5th, extend all day June 6th, and end by noon on June 7th. Detailed information can be found on the SRA International website at: http://npotte1.wix.com/tuskegee-sra-13

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Articles of Interest

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In the News

Disability

Morris, Frank. After Years Of Struggle, Veteran Chooses To End His Life. NPR. 7 April 2013.
After a dozen years at war, an estimated 2 million active-duty service members will have returned home by the end of 2013. Some reintegrate without much struggle, but for others it's not so easy. The psychological wounds of war can sometimes prove to be just as fatal as the physical ones. For injured veterans such as Tomas Young, life is a daily struggle. But this Iraq War veteran, who says his physical and emotional pain is unbearable, has decided to end his life. Continue reading…

Drugs & Pharmaceuticals

Borrell, Brendan. The WHO vs. the Tea Doctor. Slate. 4 April 2013.
The tea comes from sweet wormwood (Artemisia annua), the Chinese plant that is a source for the world's most powerful anti-malarial treatments, which combine artemisinin derivatives with an older class of drugs. It can also be grown in wetter parts of Africa, and a year’s supply costs no more than a few dollars. Which is why you may be surprised to learn that the World Health Organization and a majority of malaria researchers are adamantly opposed to it. To be fair, there are compelling reasons not to endorse an herbal tea in a fight against a potentially deadly disease. Continue reading…

Environment

Lovett, Ian. Slaking a Region’s Thirst While Cleaning Its Beaches. New York Times. 7 April 2013.
Surfers here have long lived by a simple rule: When it rains, no matter how good the waves may be, stay out of the water. Those who do head out to the Venice Pier on a rainy day might have their bravery (or naïveté) repaid with pinkeye, a fever or diarrhea. Even in this water-starved region, storm and other runoff has become the primary source of water pollution. But now, local officials are trying to deal with runoff pollution and another problem — the lack of drinking water — with an ambitious plan to make the runoff drinkable. Continue reading…

Law and Bioethics

Belluck, Pam. Judge Strikes Down Age Limits on Morning-After Pill. New York Times. 5 April 2013.
A federal judge on Friday ordered that the most common morning-after pill be made available over the counter for all ages, instead of requiring a prescription for girls 16 and younger. But his acidly worded decision raises a broader question about whether a cabinet secretary can decide on a drug’s availability for reasons other than its safety and effectiveness. Continue reading…

Sweeping Anti-Abortion Bill Expected to Become Kan. Law. NPR. 6 April 2013.
Kansas legislators gave final passage to a sweeping anti-abortion measure Friday night, sending Gov. Sam Brownback a bill that declares life begins "at fertilization" while blocking tax breaks for abortion providers and banning abortions performed solely because of the baby's sex. Continue reading…

Specter, Michael. Can We Patent Life? New Yorker. 2 April 2013.
The intellectual and commercial bounty from that research has already been enormous, and it increases nearly every day, as we learn ways in which specific genes are associated with diseases—or with mechanisms that can prevent them. We are edging closer to one of modern science’s central goals: an era of personalized medicine, in which an individual’s treatment for scores of illnesses could be tailored to his specific genetic composition. That, of course, assumes that we own our own genes. Continue reading…

Medical Ethics 

Greenberg, Gary. The D.S.M. and the Nature of Disease. New Yorker. 9 April 2013.
When the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders hits the stores on May 22nd, it will signal the end of a fraught thirteen-year campaign. Every revision of the D.S.M. causes controversy; that’s what happens when experts argue in public about the nature of human suffering. But never has the process provoked warfare so brutal, with attacks coming from within the profession as well from psychiatry’s usual opponents. Continue reading…

Public Health

Stein, Rob. China’s Air Pollution Linked to Millions of Early Deaths. NPR. 2 April 2013.
More than 1 million people are dying prematurely every year from air pollution in China, according to a new analysis." This is the highest toll in the world and it really reflects the very high levels of air pollution that exist in China today," says Robert O'Keefe of the Health Effects Institute in Boston, who presented the findings in Beijing this week. Alarm has been growing in recent years about the air in China. On many days in many cities, it's thick with smog. Continue reading…

Kwoh, Leslie. When Your Boss Makes You Pay for Being Fat. Wall Street Journal. 5 April 2013.
Are you a man with a waist measuring 40 inches or more? If you want to work at Michelin North America Inc., that spare tire could cost you. Employees at the tire maker who have high blood pressure or certain size waistlines may have to pay as much as $1,000 more for health-care coverage starting next year. Continue reading…

Bidgood, Jess. Ban on Free Condoms Jeopardizes Group’s Work with Catholic College. New York Times. 7 April 2013.
Chelsea Lennox, a junior at Boston College, the Gothic university overlooking this natty Boston suburb, picked up a bouquet of brightly colored condom packages and put them into the envelope that she views as a tiny beacon of sexual health resources at the deeply Catholic institution. Continue reading…

Research Ethics

Tavernise, Sabrina. U.S. Says Study of Babies Failed to Disclose Risks. New York Times. 10 April 2013.
The lead investigators on a large study of the effects of oxygen levels on extremely premature babies failed to inform the infants’ parents that the risks of participating could involve increased chances of blindness or death, the federal Department of Health and Human Services has warned in a letter. Continue reading…

Kolata, Gina. Science Articles Accepted (Personal Checks, Too). New York Times. 7 Aprile 2013. The number of these journals and conferences has exploded in recent years as scientific publishing has shifted from a traditional business model for professional societies and organizations built almost entirely on subscription revenues to open access, which relies on authors or their backers to pay for the publication of papers online, where anyone can read them.  But some researchers are now raising the alarm about what they see as the proliferation of online journals that will print seemingly anything for a fee. They warn that nonexperts doing online research will have trouble distinguishing credible research from junk. “Most people don’t know the journal universe,” Dr. Goodman said. “They will not know from a journal’s title if it is for real or not.” Continue reading…

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In the Journals

Melo-Martan, Immaculada de. Sex Selection and the Procreative Liberty Framework. Kennedy Institute of Ethics Journal. March 2013.
The practice of sex selection for social reasons has raised serious criticism. Advocates of this practice, however, insist that objections to it are unfounded and that legal bans are ethically unjustified. Usually, proponents use a rights-based liberal approach as the framework to evaluate this practice. Under this framework, reproductive choice is a basic freedom and interference with individuals autonomous reproductive choices is illegitimate, unless their actions are shown to seriously harm others. As persuasive as this framework might be in relation to many aspects of reproduction, I argue that it is inappropriate when dealing with sex selection for social purposes. Continue reading...

Tamir, Savian. Obligated Aliens: Recognizing Sperm Donors Ethical Obligation to Disclose Genetic Information. Kennedy Institute of Ethics Journal. March 2013.
Sperm donors obligations are typically constrained to the immediate circumstances surrounding the donation and to its time frame. This paper makes the case for recognizing an ongoing ethical obligation that binds sperm donors to disclose, in a timely manner, meaningful genetic information to recipients and donor-conceived children. The paper delineates and conceptualizes the suggested (potentially reciprocal) duty and argues that it is not the genetic link between the donor and the donor-conceived child that binds donors by said duty, but rather social responsibility. Accordingly, an original perception of the donor as an obligated alien is suggested and developed. The main thesis of the paper is supported inter alia by a comparison between transmitting infectious diseases and passing faulty genes on to donor-conceived children. The paper also provides an in-depth analysis of the conflicting interests of the parties generated by such an obligation and proposes a model for embedding this ethical duty in a (legal) contractual framework. Continue reading...

Tan, Jacina O.A. Cultural and Ethical issues in the Treatment of Eating Disorders in Singapore. Asian Bioethics Review. March 2013.
The ethical issues involved in the treatment of eating disorders have received considerable discussion in the literature, with debates chiefly focusing on the issue of compulsion ( Ayton et al. 2009; Giordano 2003; Dresser 1985; Draper 2000; Rathner 1998; Vandereycken and Beumont 1998; Tiller et al. 1993; Carney et al. 2005). Some empirical ethics research has also been conducted with patients, parents and mental health professionals concerning issues such as the ethics of compulsion and the impact of having an eating disorder on decision-making ( Serpell et al. 2004; Tan et al. 2008; Tan et al. 2010; Tan 2006; Newton et al. 2005; Serpell and Treasure 2002; Serpell et al. 1999). Most of these discussions and research studies, however, have taken place in Europe, Australasia and the United States, mirroring the fact that most eating disorder research is also based in Europe, Australasia and the United States. Continue reading...

Boydell, Katherine. Pediatric Physician Researchers: Coping with Tensions in Dual Accountability. Narrative Inquiry in Bioethics. Winter 2012.
Potential conflicts between the roles of physicians and researchers have been described at the theoretical level in the bioethics literature (Czoli, et al., 2011). Physicians and researchers are generally in mutually distinct roles, responsible for patients and participants respectively. With increasing emphasis on integration of research into clinical settings, however, the role divide is sometimes unclear. Consequently, physician researchers must consider and negotiate salient ethical differences between clinical and research based obligations (Miller et al, 1998). This paper explores the subjective experiences and perspectives of 30 physician researchers working in three Canadian pediatric settings. Drawing on qualitative interviews, it identifies ethical challenges and strategies used by physician researchers in managing dual roles. It considers whether competing obligations could have both positive and adverse consequences for both physician researchers and patients. Finally, we discuss how empirical work, which explores the perspectives of those engaged in research and clinical practice, can lead the way to understanding and promoting best practice. Continue reading...

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Opinion

Ars Technica

Shaw, Kate. When it comes to vaccination, bad news is contagious. April 11, 2013.
In recent years, the controversy about vaccine safety has exploded online. Fueled by pseudoscience, conspiracy theories, and ignorance, a surprisingly large number of people today refuse to vaccinate themselves or their children. According to a 2011 poll, nearly a quarter of Americans have changed their opinion on vaccination in the last five years, and for the vast majority of these people, that change has been in a negative direction. Continue reading…

Timmer, John. Climate science once again finds itself fighting with hockey sticks. April 9, 2013.
About a month ago, a team of scientists came out with a clearer picture of a story whose rough outlines we already knew. These researchers simply wanted to reconstruct the temperatures that the Earth experienced during the Holocene, the current warm period that started at the end of the last glacial period. Although the new perspective didn't include anything especially surprising, it set off howls of controversy on the Internet, which reached such intensity that the authors of the research felt they needed to publish an FAQ describing their work in more detail. Continue reading…

Timmer, John. “Natural male enhancement” pills pulled for having unnatural ingredient. April 8, 2013.
The FDA has worked with a consumer products company to pull a "natural male enhancement" product off the market as an ironic consequence of the fact that it was likely to work. FDA testing has shown that the ROCK-It MAN Male Enhancement Capsules, sold as being an all-natural product, contain a close chemical relative of the drug marketed as Viagra. As a result, the product creates a risk of a dangerous interaction with common heart medications. Continue reading…

Los Angeles Times

Editorial. California’s dairy dilemma. April 9, 2013.
Although the recession drove many businesses into bankruptcy, times have been particularly hard for the state's dairy farmers. Almost 400 California dairies have closed in the last five years — 105 in 2012 alone — plagued by soaring prices for feed and an antiquated regulatory system that keeps their prices artificially low, at least in the farmers' view. The right solution for the long term would be to scrap the current approach in favor of a market-based one, but there's little political will to take such a disruptive step. Instead, policymakers are debating ways to help dairymen at the expense of cheese makers — and their customers. Continue reading…

Editorial. Crime legislation: focus on facts, not fear. April 7, 2013.
California already had what were arguably the nation's toughest sex offender laws in 2006 when voters, spurred on nightly by fear-mongering television hosts such as Nancy Grace and Bill O'Reilly, adopted this state's version of Jessica's Law. Proposition 83 required all convicted sex felons, whether violent or not, whether still on parole or not, and whether at high or low risk of reoffending, to wear electronic monitoring devices for the rest of their lives. Drafters ignored the fact that there was virtually no evidence that global positioning satellite tracking reduces the number or severity of sex crimes, and they didn't consider whether to allocate the high costs of perpetual monitoring to the state or to county governments. They didn't think through how to penalize parolees and post-parole registrants who cut off or disabled their ankle monitors. Continue reading…

Editorial. Ban super rat poisons. April 5, 2013.
Poison-control centers receive about 15,000 calls a year from parents of children younger than 6 who have been exposed to poison that was intended to kill rats or mice, according to a January report by the U.S. Environmental Protection Agency. A disproportionate number of those children are black and Latino, and living in poverty. Continue reading…

New York Times

Editorial. Mental illness in California Prisons. April 10, 2013.
There are about 33,000 mentally ill prisoners in state prisons in California, close to 30 percent of the prison population. The number of suicides in state prisons has soared in recent years, to about 24 suicides per 100,000 inmates a year, a rate nearly twice the national average. Continue reading…

Editorial. Eating with our eyes closed. April 9, 2013.
The food that comes from factory farms is ultimately consumed by the public, which gives the public an interest in knowing how that food is produced. But in most of the major agricultural states, laws have been introduced or passed that would make it illegal to gather evidence, by filming or photography, about the internal operations of factory farms where animals are being raised. Continue reading…

Editorial. Gruesome ads that work. April 8, 2013.
There is limited value in telling smokers that their deadly habit may kill them. They already know that, yet most ignore the warnings. But showing smokers gruesome images of people who have been maimed or disfigured by tobacco seems to have a much bigger effect. Continue reading…

Editorial. Good sense on the morning-after pill. April 5, 2013.
A federal district judge in New York has overturned the Obama administration’s ban preventing girls younger than 17 from purchasing emergency contraceptive pills over the counter. It was a well-deserved rebuke to a politically motivated decision that overrode sound science and the health needs of young girls in order to placate political opponents of emergency contraception. Continue reading…

Slate

Smith, Tara. Nature’s Bioterrorist Agents. April 10, 2013.
Water birds, to an influenza researcher, are more than majestic swans and charming mallards. They are instead stealthy vectors of novel influenza viruses, some of nature’s bioterrorist agents, chauffeuring dangerous microbes from place to place without showing symptoms of infection themselves. Wild waterfowl are reservoirs for every imaginable combination of influenza viruses, though the vast majority of those viral cocktails don’t seem to infect humans. Continue reading…

Plait, Phil. The March of Antireality Continues. April 5, 2013.
Lately I’ve been trying to write more about science, rather than write about those who attack it. I love science, and I love promoting it. It gives us wonder, knowledge, advances in technology and medicine, increases our lifespan and the joy that fills it. It also reveals the world as it truly is, and while that may not always be comforting (or joyous), it’s the way things are. We need to acknowledge that. Continue reading…

Washington Post

Editorial. Federal dollars for mapping the brain. April 5, 2013.
In the 4th century B.C., Aristotle argued that what separates humans from animals is our unique ability to reason. Some 2,300 years later, our best thinkers can tell us relatively little about how that reasoning takes place — how the brain operates normally, or what’s happening when it behaves irregularly. President Obama announced this week that he wants to change that. Continue reading…

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