Introspection, or metacognition, is the capacity to reflect on our own thoughts and behaviours. Here, we investigated how one specific metacognitive ability develops in adolescence, a period of life associated with the emergence of self-concept and enhanced self-awareness. We employed a task that dissociates objective performance on a visual task from metacognitive ability in a group of 56 participants aged between 11 and 41 years. Metacognitive ability improved significantly with age during adolescence, was highest in late adolescence and plateaued going (...) into adulthood. Our results suggest that awareness of one’s own perceptual decisions shows a prolonged developmental trajectory during adolescence. (shrink)

Metacognition is the capacity to evaluate the success of one's own cognitive processes in various domains; for example, memory and perception. It remains controversial whether metacognition relies on a domain-general resource that is applied to different tasks or if self-evaluative processes are domain specific. Here, we investigated this issue directly by examining the neural substrates engaged when metacognitive judgments were made by human participants of both sexes during perceptual and memory tasks matched for stimulus and performance characteristics. By comparing patterns (...) of fMRI activity while subjects evaluated their performance, we revealed both domain-specific and domain-general metacognitive representations. Multivoxel activity patterns in anterior prefrontal cortex predicted levels of confidence in a domain-specific fashion, whereas domain-general signals predicting confidence and accuracy were found in a widespread network in the frontal and posterior midline. The demonstration of domain-specific metacognitive representations suggests the presence of a content-rich mechanism available to introspection and cognitive control. (shrink)

Human behavior depends on the ability to effectively introspect about our performance. For simple perceptual decisions, this introspective or metacognitive ability varies substantially across individuals and is correlated with the structure of focal areas in prefrontal cortex. This raises the possibility that the ability to introspect about different perceptual decisions might be mediated by a common cognitive process. To test this hypothesis, we examined whether inter-individual differences in metacognitive ability were correlated across two different perceptual tasks where individuals made judgments (...) about different and unrelated visual stimulus properties. We found that inter-individual differences were strongly correlated between the two tasks for metacognitive ability but not objective performance. Such stability of an individual’s metacognitive ability across different perceptual tasks indicates a general mechanism supporting metacognition independent of the specific task. (shrink)

Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a (...) set of clearly defined procedures for these decisions. The procedures are based on the principle of nonmaleficence and typically include consultation with hospital ethics committees, reflecting the guidelines of relevant professional associations. Ethical debates about when CPR can and should be limited tend to rely more on discussions of theory, principles, and case studies than systematic empirical study of the situations in which such limitations are applied. Sociologists of bioethics call for empirical study, arguing that what ethicists and health professionals believe they are doing when they draft policies or invoke principles does not always mirror what is happening on the ground. In this article, we begin the task of modeling the empirical analyses sociologists call for, focusing on a cohort at Massachusetts General Hospital. We inductively analyzed ethics committee notes and medical records of nineteen patients whose surrogates did not accept the decision to withhold CPR. (shrink)

The scientific study of consciousness emerged as an organized field of research only a few decades ago. As empirical results have begun to enhance our understanding of consciousness, it is important to find out whether other factors, such as funding for consciousness research and status of consciousness scientists, provide a suitable environment for the field to grow and develop sustainably. We conducted an online survey on people’s views regarding various aspects of the scientific study of consciousness as a field of (...) research. 249 participants completed the survey, among which 80% were in academia, and around 40% were experts in consciousness research. Topics covered include the progress made by the field, funding for consciousness research, job opportunities for consciousness researchers, and the scientific rigor of the work done by researchers in the field. The majority of respondents (78%) indicated that scientific research on consciousness has been making progress. However, most participants perceived obtaining funding and getting a job in the field of consciousness research as more difficult than in other subfields of neuroscience. Overall, work done in consciousness research was perceived to be less rigorous than other neuroscience subfields, but this perceived lack of rigor was not related to the perceived difficulty in finding jobs and obtaining funding. Lastly, we found that, overall, the global workspace theory was perceived to be the most promising (around 28%), while most non-expert researchers (around 22% of non-experts) found the integrated information theory (IIT) most promising. We believe the survey results provide an interesting picture of current opinions from scientists and researchers about the progresses made and the challenges faced by consciousness research as an independent field. They will inspire collective reflection on the future directions regarding funding and job opportunities for the field. (shrink)

Wagering contingent on a previous decision, or post-decision wagering, has recently been proposed to measure conscious awareness. Whilst intuitively appealing, it remains unclear whether economic context interacts with subjective confidence and how such interactions might impact on the measurement of awareness. Here we propose a signal detection model which predicts that advantageous wagers placed on the identity of preceding stimuli are affected by loss aversion, despite stimulus visibility remaining constant. This pattern of predicted results was evident in a psychophysical task (...) where we independently manipulated perceptual and economic factors. Changes in wagering behaviour induced by changes in wager size were largely driven by changes in criterion, consistent with the model. However, for near-threshold stimuli, a reduction in wagering efficiency was also evident, consistent with an apparent but potentially illusory decrease in awareness of the stimulus. These findings challenge an assertion that post-decision wagering provides a direct index of subjective awareness. (shrink)

Contrasting brain states when subjects are aware compared to unaware of a presented stimulus has allowed researchers to isolate candidate neural correlates of consciousness. Here we propose that an important next step in this research program is to investigate, perhaps paradoxically, brain states that covary with reports of absences of awareness. Specifically, we propose that in order to distinguish content-specific and content-invariant neural correlates of consciousness, a distinction needs to be made between the neural correlates of awareness of stimulus absence, (...) and the neural correlates of absence of awareness. We ground this distinction in higher-order computational models of consciousness, where the state of higher-order nodes is invariant to the specific contents of awareness. To map the different levels of these models to neurophysiological correlates, we suggest two empirical approaches – inverted designs and two-dimensional awareness reports – in which reports about awareness and stimulus presence can be dissociated. (shrink)

This study uses three audit-specific ethical dilemmas to assess the level of ethical reasoning between Chinese accounting students (as proxies for new entrants to the auditing profession) and experienced auditors. A sample of U.S. accounting students is used as a base for comparison. Consistent with expectations based on particularly salient aspects of Chinese national culture, we find the Chinese students’ levels of ethical reasoning to be significantly lower than those of their U.S. counterparts in the two cases that invoked these (...) cultural attributes. In contrast, the Chinese students’ level of ethical reasoning is slightly higher than that of the U.S. students in the third, control case. We further find that the Chinese auditors’ levels of ethical reasoning are even lower than those of the Chinese students in two cases, while not being significantly different in the third. Together, these findings suggest that cross-national differences in auditors’ ethical reasoning depend on the nature of the ethical dilemma and caution against wholesale inferences about ethical reasoning levels in China. (shrink)

Kammerer and Frankish (this issue) propose an exciting new research programme on the computational form of introspective systems. Pursuing this goal requires measures that can isolate introspective capacity from response biases and first-order processes. I suggest that metacognitive psychophysics is well placed to meet this challenge, allowing the mapping of introspective architectures in humans, animals, and artificial systems.

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation despite patient or surrogate requests and whether physicians follow these recommendations. This was a retrospective cohort of all adult patients at a large academic medical center for whom an ethics consult was requested for disagreement over DNR status. Patient demographic predictors of ethics (...) consult outcomes were analyzed. In 42 of the 116 cases, the patient or surrogate agreed to the clinician recommended DNR order following ethics consultation. In 72 of 74 of the remaining cases, ethics consultants recommended not offering CPR. Physicians went on to write a DNR order without patient/surrogate consent in 57 of those cases. There were no significant differences in age, race/ethnicity, country of origin, or functional status between patients where a DNR order was and was not placed without consent. Physicians were more likely to place a DNR order for patients believed to be imminently dying. The median time from DNR order to death was 4 days with a 90-day mortality of 88.2%. In this single-center cohort study, there was no evidence that patient demographic factors affected ethics consultants’ recommendation to withhold CPR despite patient/surrogate requests. Physicians were most likely to place a DNR order without consent for imminently dying patients. (shrink)

Through the World Health Organization’s definition of midwifery, midwives are frequently heard to describe themselves as autonomous practitioners. In this article this notion is refuted. An overview of individual and collective autonomy is first presented to contextualize the subsequent discussion. Then the notion of autonomy in relation to midwifery practice in Scotland and New Zealand is critiqued through tracing the history of midwives and midwifery in these two countries. Issues relating to midwifery registration, medicalization of birth and consumerism are discussed. (...) Each of these categories is suggested as limiting to autonomous practice within midwifery. (shrink)

This study compared the family characteristics, victimization histories, and number of perpetration offenses of juvenile offenders who admitted to having had sex with animals to juvenile offenders who did not. The study found that 96% of the juveniles who had engaged in sex with nonhuman animals also admitted to sex offenses against humans and reported more offenses against humans than other sex offenders their same age and race. Those juveniles who had engaged in sex with animals were similar to other (...) sex offenders in that they also came from families with less affirming and more incendiary communication, lower attachment, less adaptability, and less positive environments. Those juveniles who had engaged in sex with animals reported victimization histories with more emotional abuse and neglect and a higher number of victimization events than other offenders. This would seem to indicate that sex with animals may be an important indicator of potential or co-occurring sex offenses against humans and may be a sign of severe family dysfunction and abuse that should be addressed in the arenas of psychological intervention, juvenile justice programs, and public policy. (shrink)

In the past 20, years the impact of progressive educational theories have become influential in nurse education particularly in relation to partnership and empowerment between lecturers and students and the development of student autonomy. The introduction of these progressive theories was in response to the criticisms that nurse education was characterized by hierarchical and asymmetrical power relationships between lecturers and students that encouraged rote learning and stifled student autonomy. This article explores how the work of Michel Foucault can be mobilized (...) to think about autonomy in three different yet overlapping ways: as a historical event; as a discursive practice; and as part of an overall strategy to produce a specific student subject position. The implications for educational practice are that, rather than a site where students are empowered, nurse education is both a factory and a laboratory where new subjectivities are continually being constructed. This suggests that empowering practices and disciplinary practices uneasily co‐exist. Critical reflection needs to be directed not only at structural dimensions of power but also on ourselves as students and lecturers by asking a Foucauldian question: How are you interested in autonomy? (shrink)

We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation’s first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was (...) consulted, and salient features of the consults themselves. We include three case studies that illustrate important consult themes during this period. Our findings expand knowledge about the structure and workings of hospital ethics committees and illustrate how one ethics committee has developed and utilized policies on end-of-life care. More generally, we model a sociological approach to the study of clinical ethics consultation that could be utilized to contextualize institutional practices over time. (shrink)

Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)

Metacognition – the ability to represent, monitor and control ongoing cognitive processes – helps us perform many tasks, both when acting alone and when working with others. While metacognition is adaptive, and found in other animals, we should not assume that all human forms of metacognition are gene-based adaptations. Instead, some forms may have a social origin, including the discrimination, interpretation, and broadcasting of metacognitive representations. There is evidence that each of these abilities depends on cultural learning and therefore that (...) cultural selectionmight shape humanmetacognition. The cultural origins hypothesis is a plausible and testable alternative that directs us towards a substantial new programme of research. (shrink)

The US neutrino community gathered at the Workshop on the Intermediate Neutrino Program at Brookhaven National Laboratory February 4-6, 2015 to explore opportunities in neutrino physics over the next five to ten years. Scientists from particle, astroparticle and nuclear physics participated in the workshop. The workshop examined promising opportunities for neutrino physics in the intermediate term, including possible new small to mid-scale experiments, US contributions to large experiments, upgrades to existing experiments, R&D plans and theory. The workshop was organized into (...) two sets of parallel working group sessions, divided by physics topics and technology. Physics working groups covered topics on Sterile Neutrinos, Neutrino Mixing, Neutrino Interactions, Neutrino Properties and Astrophysical Neutrinos. Technology sessions were organized into Theory, Short-Baseline Accelerator Neutrinos, Reactor Neutrinos, Detector R&D and Source, Cyclotron and Meson Decay at Rest sessions.This report summarizes discussion and conclusions from the workshop. (shrink)

Ideology is maintained anddriven by powerful symbols. Agricultural mediasuch as farm magazines achieve this byappropriating societal values of currency andincorporating them in imagery that accompanyadvertisements of agricultural products,including pesticides. Critical questionsrelating to environmental sustainability andsocial risks associated with the use of suchproducts are often masked as a result. Contentanalyses of two mid-western farm magazines fromthe 1940s to 1990s trace the socialconstruction of pesticide advertisements overtime, illuminating changing images ofpesticides in farm magazine advertisements inresponse to changes in the socio-culturalsetting. Changing images (...) reflect how theagricultural industry strategically repositionsitself to sustain market and corporate profitby co-opting dominant cultural themes atspecific historical moments in mediaadvertising. Sustainability implications in thebroad context of agriculture and society areexamined. (shrink)