In order to slow down the inexorable increase in spending on health care, the British government has implemented an initiative proposed by Griffiths. This initiative is designed to make doctors more accountable for the decisions they may take. In this essay I argue first, that the conflation of two decisions (financial and clinical) leads to unnecessary ethical dilemmas and secondly, that as psychologically it is difficult to take two decisions simultaneously, inevitably the clinician is forced to name either the financial (...) or the clinical decision as the prior problem. To decide for the former inevitably strains the traditional doctor/patient relationship of mutual trust. (shrink)

Based on the results of open ended interviews with managers in a variety of organizational positions, moral questions encountered in everyday managerial life are described. These involve transactions with employees, peers and superiors, customers, suppliers and other stakeholders. It is suggested that managers identify transactions as involving personal moral concern when they believe that a moral standard has a bearing on the situation and when they experience themselves as having the power to affect the transaction. This is the first in (...) a research series of three papers. (shrink)

Psychopaths routinely disregard social norms by engaging in selfish, antisocial, often violent behavior. Commonly characterized as mentally disordered, recent evidence suggests that psychopaths are executing a well-functioning, if unscrupulous strategy that historically increased reproductive success at the expense of others. Natural selection ought to have favored strategies that spared close kin from harm, however, because actions affecting the fitness of genetic relatives contribute to an individual’s inclusive fitness. Conversely, there is evidence that mental disorders can disrupt psychological mechanisms designed to (...) protect relatives. Thus, mental disorder and adaptation accounts of psychopathy generate opposing hypotheses: psychopathy should be associated with an increase in the victimization of kin in the former account but not in the latter. Contrary to the mental disorder hypothesis, we show here in a sample of 289 violent offenders that variation in psychopathy predicts a decrease in the genetic relatedness of victims to offenders; that is, psychopathy predicts an increased likelihood of harming non-relatives. Because nepotistic inhibition in violence may be caused by dispersal or kin discrimination, we examined the effects of psychopathy on (1) the dispersal of offenders and their kin and (2) sexual assault frequency (as a window on kin discrimination). Although psychopathy was negatively associated with coresidence with kin and positively associated with the commission of sexual assault, it remained negatively associated with the genetic relatedness of victims to offenders after removing cases of offenders who had coresided with kin and cases of sexual assault from the analyses. These results stand in contrast to models positing psychopathy as a pathology, and provide support for the hypothesis that psychopathy reflects an evolutionary strategy largely favoring the exploitation of non-relatives. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Pregnant women and their interests have been underrepresented in health research. Little is known about issues relevant to women considering research participation during pregnancy. We performed in-depth interviews with 22 women enrolled in either one of two trials sponsored by the National Institutes of Health to assess the safety and immunogenicity of the H1N1 vaccine during pregnancy. Three themes characterized women’s decisions to participate in research: they valued early access to the vaccine, they perceived a safety advantage when participating in (...) research, and they wanted to help advance scientific knowledge. However, there were also some considerations that would disincline them to participate in research—for instance, a significant risk of maternal or fetal harm, the presence of a placebo arm in a study, or a requirement to significantly change planned therapy or behavior. Pregnant women who participated in the H1N1 vaccine trials viewed research favorably, citing its advantages over standard clinical care. These findings emphasize that access to benefit should guide policy for including pregnant women in research. (shrink)

A new criterion is introduced for judging the suitability of various fuzzy logics for practical uncertain reasoning in a probabilistic world and the relationship of this criterion to several established criteria, and its consequences for truth functional belief, are investigated.

Exceptional human experiences (EHEs) have garnered increasing research attention, particularly with regard to the characteristics and potential functional aspects of these experiences. The current study sought to replicate and expand upon previous research on EHEs by using a mixed-methods approach to examine the characteristics of EHEs in a large adult sample. The participants were 869 healthy adults who completed a survey that allowed participants to share both quantitative ratings and qualitative descriptions of EHEs. The results revealed that 96.7% of respondents (...) had experienced at least one EHE, and EHEs were generally rated as having a positive impact on the participants' lives. Participants reported a variety of EHEs, with two primary themes emerging in the qualitative analysis: perception and function of EHEs. The results suggest that EHEs may serve a positive, functional purpose in the lives of those who experience them. (shrink)

We investigated how people interpret conditionals and how stable their interpretation is over a long series of trials. Participants were shown the colored patterns on each side of a six-sided die, and were asked how sure they were that a conditional holds of the side landing upwards when the die is randomly thrown. Participants were presented with 71 trials consisting of all combinations of binary dimensions of shape (e.g., circles and squares) and color (e.g., blue and red) painted onto the (...) sides of each die. In two experiments (N1 = 66, N2 = 65), the conditional event was the dominant interpretation, followed by conjunction, and material conditional responses were negligible. In both experiments, the percentage of participants giving a conditional event response increased from around 40% at the beginning of the task to nearly 80% at the end, with most participants shifting from a conjunction interpretation. The shift was moderated by the order of shape and color in each conditional’s antecedent and consequent: participants were more likely to shift if the antecedent referred to a color. In Experiment 2 we collected response times: conditional event interpretations took longer to process than conjunction interpretations (mean difference 500 ms). We discuss implications of our results for mental models theory and probabilistic theories of reasoning. (shrink)

Plato is one of the key ancient authors studied by both classicists and philosophers. This long-awaited new edition contains seven of the dialogues of Plato, and is the first in the five-volume complete edition of his works in the Oxford Classical Texts series. The result of many years of painstaking scholarship, the new volume will replace the now nearly 100 year old original edition, and is destined to become just as long-lasting a classic.

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional (...) nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg’s Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students’ professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses. (shrink)

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is (...) sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research. © 2023 The Author(s). Published by Oxford University Press on behalf of the American Institute of Biological Sciences. (shrink)

Susan Schneider (2019) has proposed two new tests for consciousness in AI (artificial intelligence) systems, the AI Consciousness Test and the Chip Test. On their face, the two tests seem to have the virtue of proving satisfactory to a wide range of consciousness theorists holding divergent theoretical positions, rather than narrowly relying on the truth of any particular theory of consciousness. Unfortunately, both tests are undermined in having an ‘audience problem’: Those theorists with the kind of architectural worries that motivate (...) the need for such tests should, on similar grounds, doubt that the tests establish the existence of genuine consciousness in the AI in question. Nonetheless, the proposed tests constitute progress, as they could find use by some theorists holding fitting views about consciousness and perhaps in conjunction with other tests for AI consciousness. (shrink)

This essay reviews six different approaches to intellectual property. It and argues that none of these accounts provide an adequate justification of intellectual property laws and policies because (1) there are many different types of intellectual property, and (2) a variety of incommensurable values play a role in the justification of intellectual property. The best approach to intellectual property is to assess and balance competing moral values in light of the particular facts and circumstances.

The paper discusses Dr. Floris Tomasini's paper “What Is Bioethics: Notes toward a New Approach?”. Based on Tomasini's account of methodological and ethical pluralism, the paper explores the demarcation problem of bioethics and suggests a full methodological laissez-faire.

Psychiatry is increasingly dominated by the reductionist claim that mental illness is caused by neurobiological abnormalities such as chemical imbalances in the brain. Critical psychiatry does not believe that this is the whole story and proposes a more ethical foundation for practice. This book describes an original framework for renewing mental health services in alliance with people with mental health problems. It is an advance over the polarization created by the "anti-psychiatry" of the past.

Inappropriate authorship is a common problem in biomedical research and may be becoming one in bioethics, due to the increase in multiple authorship. This paper investigates the authorship policies of bioethics journals to determine whether they provide adequate guidance for researchers who submit articles for publication, which can help deter inappropriate authorship. It was found that 63.3% of bioethics journals provide no guidance on authorship; 36.7% provide guidance on which contributions merit authorship, 23.3% provide guidance on which contributions do not (...) merit authorship, 23.3% require authors to take responsibility for their contributions or for the article as a whole, 20% provide guidance on which contributions merit an acknowledgement but not authorship, 6.7% require authors to describe their contributions, and only 3.3% distinguish between authorship in empirical and conceptual research. To provide authors with effective guidance and promote integrity in bioethics research, bioethics journals should adopt authorship policies that address several important topics, such as the qualifications for authorship, describing authorship contributions, taking responsibility for the research and the difference between authorship in empirical and conceptual research. (shrink)

Amyloid-beta peptide plaque in the brain is the primary diagnostic criterion of Alzheimer's disease . The physiological role of Abeta are poorly understood. We have previously determined an Abeta interacting domain in the promoters of AD-associated genes . This AbetaID interacts in a DNA sequence-specific manner with Abeta. We now demonstrate novel Abeta activity as a possible transcription factor. Herein, we detected Abeta-chromatin interaction in cell culture by ChIP assay. We observed that human neuroblastoma cells treated with FITC conjugated Abeta1-40 (...) localized Abeta to the nucleus in the presence of H2O2-mediated oxidative stress. Furthermore, primary rat fetal cerebrocortical cultures were transfected with APP and BACE1 promoter-luciferase fusions, and rat PC12 cultures were transfected with polymorphic APP promoter-CAT fusion clones. Transfected cells were treated with different Abeta peptides and/or H2O2. Abeta treatment of cell cultures produced a DNA sequence-specific response in cells transfected with polymorphic APP clones. Our results suggest the Abeta peptide may regulate its own production through feedback on its precursor protein and BACE1, leading to amyloidogenesis in AD. (shrink)

In Gorgias, Socrates stands accused of argumentative "foul play" involving manipulation by shame. Polus says that Socrates wins the fight with Gorgias by shaming him into the admission that "a rhetorician knows what is right . . . and would teach this to his pupils" . And later, when Polus himself has been "tied up" and "muzzled" , Callicles says that he was refuted only because he was ashamed to reveal his true convictions. These allegations, if justified, directly undermine Socrates' (...) claim to be improving his interlocutors by argument. For if Socrates' use of shame tends to produce insincere assertion, then elenchus cannot serve as a tool for moral reform. In an important recent paper, Jessica Moss presents a new apologia for Socrates on these old charges. According to Moss, although Socrates adopts a strategy of shaming rather than reasoning his interlocutors into agreement, this is legitimate because his appeals to shame function as appeals to a moral sense, which connect a person to his own "deep" convictions. Moreover, she claims that shame "can be a more effective tool of persuasion than reason," for it is capable, where reason is not, of dislodging a person's "intuitive" moral beliefs. This essay argues that each of these points is mistaken. (shrink)