Since 2002, legislation in Spain has allowed for the creation and documentation of end-of-life decisionmaking. Over the intervening years, the actual implementation of such documents is very low. Through extensive analysis of the literature, this article explores the current status of the use of and attitudes toward advance directives in Spain and then proposes strategies for improvement in their implementation.

In eighteenth-century, colonial Sri Lanka, the Dutch church kept extensive registers of the local population. These “school thombos” contain individual registration of baptism, marriage, school attendance and death. This article argues that the school thombos reveal moral control over family life by the Dutch East India Company and the Dutch Reformed Church, while offering locals a legal and religious identity to employ in negotiating the Dutch colonial bureaucracy. These rarely studied registers shed new light on Sri Lankan family history and the practices of Dutch colonialism. What do they tell us about conjunctures of locals with colonial religion in eighteenth-century Sri Lanka? The school thombo was an instrument used to register and regulate family life, with specific functions and uses by different actors. This article explores the format, objectives and use of the school thombo. Why was the school thombo created and who were registered in these sources? What were the micro practices of drawing up the school thombo? The article is supported by several case studies that illustrate how the school thombo found its way into family life while demonstrating the value of written identities.

Agricultural emissions in most countries have been increasing against a backdrop of decreasing non-agricultural emissions. The climate change treaties contain a qualification that appears to exempt the agricultural sector from mitigation of greenhouse gas emissions where there is a ‘threat to food production’. This potential mitigation exception gives rise to the risk that states will invoke a threat to food production in order to shield their agricultural sector from intensifying mitigation pressure. A systematic analysis of documentation issued pursuant to the climate treaties reveals that many states, both developed and developing, have made statements suggesting that their agricultural sector is relieved of some or all of the pressure placed on other economic sectors to deliver mitigation outcomes. However, this concern that mitigation of agricultural emissions will threaten food production is only weakly supported, even as it threatens achievement of the Paris Agreement's goal of keeping global warming ‘well below 2°C’.

Human decisions are increasingly supported by decision support systems (DSS). Humans are required to remain “on the loop,” by monitoring and approving/rejecting machine recommendations. However, use of DSS can lead to overreliance on machines, reducing human oversight. This paper proposes “reflection machines” (RM) to increase meaningful human control. An RM provides a medical expert not with suggestions for a decision, but with questions that stimulate reflection about decisions. It can refer to data points or suggest counterarguments that are less compatible with the planned decision. RMs think against the proposed decision in order to increase human resistance against automation complacency. Building on preliminary research, this paper will (1) make a case for deriving a set of design requirements for RMs from EU regulations, (2) suggest a way how RMs could support decision-making, (3) describe the possibility of how a prototype of an RM could apply to the medical domain of chronic low back pain, and (4) highlight the importance of exploring an RM’s functionality and the experiences of users working with it.

Artificial intelligence (AI) systems have demonstrated impressive performance across a variety of clinical tasks. However, notoriously, sometimes these systems are “black boxes.” The initial response in the literature was a demand for “explainable AI.” However, recently, several authors have suggested that making AI more explainable or “interpretable” is likely to be at the cost of the accuracy of these systems and that prioritizing interpretability in medical AI may constitute a “lethal prejudice.” In this paper, we defend the value of interpretability in the context of the use of AI in medicine. Clinicians may prefer interpretable systems over more accurate black boxes, which in turn is sufficient to give designers of AI reason to prefer more interpretable systems in order to ensure that AI is adopted and its benefits realized. Moreover, clinicians may be justified in this preference. Achieving the downstream benefits from AI is critically dependent on how the outputs of these systems are interpreted by physicians and patients. A preference for the use of highly accurate black box AI systems, over less accurate but more interpretable systems, may itself constitute a form of lethal prejudice that may diminish the benefits of AI to—and perhaps even harm—patients.

In 1919, a parliamentary act reconstructed the relations between the British state and the Church of England. The passage of this act had considerable constitutional, political, ecclesiastical, and religious significance, and it is best understood by considering all of these aspects together. The church obtained a new statutory status, a large degree of self-government, and a special legislative procedure that augmented the privileges of its ecclesiastical establishment. All this was achieved without the intense political struggles that had accompanied many church and state issues during the previous hundred years. The apparent ease of the Enabling Act's passage was symptomatic of transformations in the relationship between the Church of England and nonconformity, in public religion, and in the character of British politics. But it was also the outcome of an impressive feat of persuasion and organization. Although the act did not secure the intended degree of spiritual independence, as became painfully evident during the parliamentary prayer book crisis in 1927–28, it placed the church establishment in a more secure position, allowing it to reform its administration and finances and to gain further advantages and new forms of relevance in future years.

In this paper, I will argue that a number of well-known health interventions or initiatives could be considered anarchist, or at the very least are consistent with anarchist thinking and principles. In doing this I have two aims: First, anarchism is a misunderstood term—by way of example, I hope to first sketch out what anarchist solutions in health and healthcare could look like; second, I hope to show how anarchist thought could stand as a means to improve the health of many, remedying health inequalities acting as a buffer for the many harms that threaten health and well-being. On this second point, I will argue that there are a number of theoretical and instrumental reasons why greater engagement with anarchism and anarchist thinking is needed, along with how this could contribute to health and in addressing broader injustices that create and perpetuate poor health.

The study of stonemasons’ marks in ancient constructions, a subject that has been systematically investigated since the 1980s to the present, tends to focus on a few standard uses and consider other seemingly random patterns as issues of preservation, leaving the archaeological potential of such marks largely untapped. This article presents a methodological approach to explain these apparently arbitrary patterns and a diachronic analysis of local labour organization at Sagalassos in south-western Turkey in four case studies: the Upper Agora, Lower Agora, Hadrianic Nymphaeum, and Makellon. The spatial analysis of the stonemasons’ marks and examination of the stone carving techniques and epigraphic data suggest that the different marks were either produced by the same individuals and/or formed part of the same construction process.

Requests by patients for providers of specific demographic backgrounds pose an ongoing challenge for hospitals, policymakers, and ethicists. These requests may stem from a wide variety of motivations; some may be consistent with broader societal values, although many others may reflect prejudices inconsistent with justice, equity, and decency. This paper proposes a taxonomy designed to assist healthcare institutions in addressing such cases in a consistent and equitable manner. The paper then reviews a range of ethical and logistical challenges raised by such requests and proposed guidance to consider when reviewing and responding to them.

Position papers on artificial intelligence (AI) ethics are often framed as attempts to work out technical and regulatory strategies for attaining what is commonly called trustworthy AI. In such papers, the technical and regulatory strategies are frequently analyzed in detail, but the concept of trustworthy AI is not. As a result, it remains unclear. This paper lays out a variety of possible interpretations of the concept and concludes that none of them is appropriate. The central problem is that, by framing the ethics of AI in terms of trustworthiness, we reinforce unjustified anthropocentric assumptions that stand in the way of clear analysis. Furthermore, even if we insist on a purely epistemic interpretation of the concept, according to which trustworthiness just means measurable reliability, it turns out that the analysis will, nevertheless, suffer from a subtle form of anthropocentrism. The paper goes on to develop the concept of strange error, which serves both to sharpen the initial diagnosis of the inadequacy of trustworthy AI and to articulate the novel epistemological situation created by the use of AI. The paper concludes with a discussion of how strange error puts pressure on standard practices of assessing moral culpability, particularly in the context of medicine.

Some albums entail more than meets the ear. In the Age of Ravel and In the Age of Debussy surround representative works of Maurice Ravel (1875–1937) and Claude Debussy (1862–1918) with contextualizing selections from contemporaries. Compellingly rendered by Ransom Wilson and François Dumont, these discs document six decades of innovation. They also illuminate intriguing connections as well as fascinating contrasts among familiar and unfamiliar works. And each celebrates the art of the French flute. But there's more.

In a single serving of boba tea, the non-human actors of the tall plastic cups, plastic dome lids, and the giant plastic straws dominate, but receive little attention. This article uses recent theories and discussions of new materialism to bring together cultural analysis of the boba tea consumption phenomenon that could be relevant for reflecting on a sustainable future. The article contributes to social research of waste by focusing on the mediating functions of plastic before it becomes waste. My central argument is that plastic is not merely a physical and impartial container in the contemporary food and beverage industry. It plays an indispensable role in the visualization, mass mediation, and consumption of the boba tea beverage. While current waste research often focuses on the “afterlife” of plastic waste as it relates to underclass waste workers, recycling economy and global waste trade, this article highlights the performative function of plastic as it changes the way we imagine time, gender, and waste. I show it is the plastic cup that enables boba tea to be so visually and gastronomically satisfying in an age when the photogenicity and “Instagrammability” of food and beverage have become more relevant to taste and distinctions.

This article is based on an EAA session in Kiel in 2021, in which thirteen contributors provide their response to Robb and Harris's (2018) overview of studies of gender in the European Neolithic and Bronze Age, with a reply by Robb and Harris. The central premise of their 2018 article was the opposition of ‘contextual Neolithic gender’ to ‘cross-contextual Bronze Age gender’, which created uneasiness among the four co-organizers of the Kiel meeting. Reading Robb and Harris's original article leaves the impression that there is an essentialist ‘Neolithic’ and ‘Bronze Age’ gender, the former being under-theorized, unclear, and unstable, the latter binary, unchangeable, and ideological. While Robb and Harris have clearly advanced the discussion on gender, the perspectives and case studies presented here, while critical of their views, take the debate further, painting a more complex and diverse picture that strives to avoid essentialism.

Pekka Louhiala crosses disciplines and decades to present a remarkably detailed review of the existing literature on placebos, placebo effects, and related concepts. The problem at hand—and Louhiala does aptly frame it as a problem—is a striking lack of consensus among researchers, scholars, and clinicians regarding virtually all aspects of the placebo topic. In capturing the complexity of this problem, Louhiala expertly compiles an extensive catalog of placebo literature that effectively gives the reader both a map of the territory and a legend to decipher it. He does not, however, give us clear directions to find our way out of the conceptual maze. The focus is often more on the problems than their solutions, which is simultaneously the most notable weakness and the greatest strength of the book.