The UK launch of the Science Enterprise Challenge in 1999 has stimulated interest in the evolutions of science-based firms and this paper argues that Popper’s seminal diverse contributions to philosophy are directly relevant to them. It begins by commenting on the applications of both Kuhn’s and Popper’s concepts to technological (as against) scientific evolutions. It then suggests how Popper’s approaches are applicable to the development and assessment of new technology within the framework of Freeman’s stakeholders approach. Monsanto’s development of GMOs (...) is used as an illustrative case. (shrink)

A medical student's ability to present a case history is a critical skill that is difficult to teach. Case histories presented without theatrical engagement may fail to catch the attention of their intended recipients. More engaging presentations incorporate ‘stage presence’, eye contact, vocal inflection, interesting detail and succinct, well organised performances. They convey stories effectively without wasting time. To address the didactic challenge for instructing future doctors in how to ‘act’, the Mayo Medical School and The Mayo Clinic Center for (...) Humanities in Medicine partnered with the Guthrie Theater to pilot the programme ‘Telling the Patient's Story’. Guthrie teaching artists taught storytelling skills to medical students through improvisation, writing, movement and acting exercises. Mayo Clinic doctors participated and provided students with feedback on presentations and stories from their own experiences in patient care. The course's primary objective was to build students' confidence and expertise in storytelling. These skills were then applied to presenting cases and communicating with patients in a fresher, more engaging way. This paper outlines the instructional activities as aligned with course objectives. Progress was tracked by comparing pre-course and post-course surveys from the seven participating students. All agreed that the theatrical techniques were effective teaching methods. Moreover, this project can serve as an innovative model for how arts and humanities professionals can be incorporated for teaching and professional development initiatives at all levels of medical education. (shrink)

Investigator and institutional financial conflicts of interest have raised concerns about both the integrity of clinical research and protecting the rights and welfare of research participants. In response, professional groups and governmental bodies have issued guidance for managing conflicts of interest to minimize their potential untoward effects. Although a variety of approaches have been offered, a common protection is to disclose financial interests in research to potential research participants as part of the recruitment and informed consent process. This approach reinforces (...) a basic norm of candor, ideally allowing potential research participants to evaluate whether financial interests should affect their decision to participate in research. Disclosure to potential research participants is viewed as an alternative to having regulators or research institutions limit or prohibit all financial interests in research, assuming that not all such interests are unacceptable. (shrink)

Strategies for disclosing investigators' financial interests to potential research participants have been adopted by many research institutions. However, little is known about how decisions are made regarding disclosures of financial interests to potential research participants, including what is disclosed and the rationale for making these determinations. We sought to understand the attitudes, beliefs, and practices of institutional review board chairs, conflict of interest committee chairs, and investigators regarding disclosure of financial interests to potential research participants. Several themes emerged, including general (...) attitudes toward conflicts of interest, circumstances in which financial interests should be disclosed, rationales and benefits of disclosure, what should be disclosed, negative effects of and barriers to disclosure, and timing and presentation of disclosure. Respondents cited several rationales for disclosure, including enabling informed decision making, promoting trust in researchers and research institutions, and reducing legal liability. There was general agreement that disclosure should happen early in the consent process. Respondents disagreed about whether to disclose the amounts of particular financial interests. Clarifying the goals of disclosure and understanding how potential research participants use the information will be critical in efforts to ensure the integrity of clinical research and to protect the rights and interests of participants. (shrink)

For medical interventions there is a gap between what clinical scientific research has established as likely to carry clinical benefit and what the National Institute for Clinical Excellence (NICE) has judged as cost-effective. This gap is the affordability gap. It is created by a value judgement made by NICE and affirmed by the Secretary of State for Health. This value judgement operates to affect other value judgements made in actual clinical situations where at least one choice of treatment falls into (...) the affordability gap. This paper considers how the creation of this affordability gap impacts upon actual clinical decisions. It explores these issues in the context of the choice between a drug-eluting stent and a bare metal stent for elective coronary angioplasty. It also argues that the option of an NHS procedure with a top-up fee to cover the cost of the affordability gap is a genuine one; that this option could improve clinical outcomes; that it is morally acceptable; and that the rules that prevent the utilization of this option should be relaxed. (shrink)

Empirical research has increasingly turned its attention to distributed cognition. Acts of remembering are embedded in a social, interactional context; cognitive labor is divided between a rememberer and external sources. The present article examines the benefits and costs associated with distributed, collaborative, conversational remembering. Further, we examine the consequences of joint acts of remembering on subsequent individual acts of remembering. Here, we focus on influences on memory through social contagion and socially shared retrieval-induced forgetting. Extending beyond a single social interaction, (...) we consider work that tracks the propagation of socially shared retrieval-induced forgetting throughout larger networks made up of several agents. Although much work has focused on how distributing cognition can augment memory, this is not the primary lesson we draw from the conversational remembering literature. Rather, mnemonic convergence between communicators is a boon to sociality. It allows the formation and maintenance of mnemonic communities, rather than expanding capacity or accuracy of memory per se. (shrink)

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. (...) In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. (shrink)

Principles of legislation.--Principles of the civil code.--Principles of the penal code.

Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations (‘the problem of extrapolation’). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is (...) often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the ‘extrapolator’s circle’. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation. (shrink)

Cloud computing deals with voluminous heterogeneous data, and there is a need to effectively distribute the load across clusters of nodes to achieve optimal performance in terms of resource usage, throughput, response time, reliability, fault tolerance, and so on. The swarm intelligence methodologies use artificial intelligence to solve computationally challenging problems like load balancing, scheduling, and resource allocation at finite time intervals. In literature, sufficient works are being carried out to address load balancing problem in the cloud using traditional swarm (...) intelligence techniques like ant colony optimization, particle swarm optimization, cuckoo search, bat optimization, and so on. But the traditional swarm intelligence techniques have issues with respect to convergence rate, arriving at the global optimum solution, complexity in implementation and scalability, which limits the applicability of such techniques in cloud domain. In this paper, we look into performance modeling aspects of some of the recent competitive swarm artificial intelligence based techniques like the whale, spider, dragonfly, and raven which are used for load balancing in the cloud. The results and analysis are presented over performance metrics such as total execution time, response time, resource utilization rate, and throughput achieved, and it is found that the performance of the raven roosting algorithm is high compared to other techniques. (shrink)

This article engages the question—what is the right business‐society relationship? We consider three perspectives that seek to address the relationship: corporate social responsibility (CSR), social entrepreneurship (SE), and conscious capitalism (CC). We take a macroapproach considering how commentary about these approaches establishes a direction for corporate practice and its relationship to key stakeholder groups. We argue that these perspectives are ‘D'iscourses that provide arguments for and articulations about the direction of corporate practice and the business‐society relationship. To organize our review (...) of each perspective, and focus our critique, for each we highlight (a) drivers and influencers, (b) core assumptions and defining features, and (c) approaches and exemplars. Although distinct, all emphasize effective business practices as key to meeting social needs. CSR suggests legitimizing business practice; SE relocates business practices; and CC seeks to reimagine/rehabilitate business for social good. Ultimately, we conclude that these Discourses lack a clear communicative focus in terms of decision making within these organizations. We attend to this and other implications, and offer avenues for further research. (shrink)

We investigate the entrepreneurial opportunities and ethical dilemmas presented by technological turbulence. More specifically we investigate the line between Baumol’s [J. Polit. Econ. 98 (1990) 893] productive (e.g. innovation), unproductive (e.g. rent seeking) and destructive (e.g. criminal) entrepreneurship through three examples of Internet innovation – spam (destructive), music file sharing (unproductive), and Internet pharmacies (potentially productive). The emergence of accessible Internet technologies, under present norms, has created the potential for all three entrepreneurial activities. Because of the propensity for self-serving biases (...) and for bending the rules, the need for creativity in overcoming obstacles and overall liabilities of newness, entrepreneurs are likely to challenge established industrial morals and laws. Unlike new entrants, incumbents must abide by the currently accepted norms, and thus suffer from “liabilities of oldness”. The challenge for new entrants is to change sociopolitical legitimacy, whereas incumbents need to defend the established norms. We discuss competitive and other issues that result from technological turbulence and innovation. (shrink)

For centuries medical schools in Britain and elsewhere had a fairly static curriculum based on what might be called the 'three Rs' of medicine, and consequently had to make room for new subjects as the need arose in a fashion which was sometimes makeshift. However, Southampton University has only had a medical school for six years, and therefore their course on medical ethics and legal medicine was carefully integrated into the curriculum after some preliminary experiments carried out by a subcommittee (...) which is continually reviewing the situation. Medical ethics has now a definite place in the fourth year, preceded by an introduction to ethical problems encountered in medicine in the first year. Not only do members of the medical faculty participate in this teaching but also members of the faculties of law and the arts. (shrink)

As part of a larger research study, we present model language for disclosing financial interests in clinical research to potential research participants, and we describe the empirical basis and theoretical assumptions used in developing the language. The empirical process for creating appropriate disclosure language resulted in a generic disclosure statement for cases in which no risk to participants’ welfare or the scientific integrity of the research is expected, and nine more specific disclosure statements for cases in which some risk is (...) expected. The disclosure statements are not meant to be canonical, but were instead designed to reflect the typical situations in which disclosure of financial interest might be considered by an institutional review board or conflict of interest committee. Individual institutions could modify key phrases to suit their purposes, and others could use the language in future empirical work on informed consent to better refine the options for disclosing financial interests in clinical research. (shrink)

In research textbooks, and much of the research practice, they describe, qualitative processes and interpretivist epistemologies tend to dominate visual methodology. This article challenges the assumptions behind this dominance. Using exemplification from three existing visual data sets produced through one large education research project, this article considers the affordances and constraints of the research process focusing particularly on analysis. It examines how and when the visual can be incorporated, gives some critical reflections on the role and use of visual methods (...) to fulfil different research intents, and, in particular, considers combining large, open-ended data sets with acceptable and rigorous analysis techniques. We then explore arguments about the nature of visual data, what is considered epistemologically appropriate and the decision-making which accompanies any appraisal of process in education research. The intention is to challenge ourselves, and fellow visual methods researchers, to develop a more complete understanding of the theory and practice of visual research. (shrink)

This paper reports laboratory data for games that are played only once. These games span the standard categories: static and dynamic games with complete and incomplete information. For each game, the treasure is a treatment in which behavior conforms nicely to predictions of the Nash equilibrium or relevant refinement. In each case, however, a change in the payoff structure produces a large inconsistency between theoretical predictions and observed behavior. These contradictions are generally consistent with simple intuition based on the interaction (...) of payoff asymmetries and noisy introspection about others’ decisions. (shrink)

Many argue that transgenic technology will have wide-ranging implications for farmers in developing nations. A key concern is that competencies may be destroyed by predominantly foreign multinational transgenic technologies, exacerbating problems of social exclusion in the case of subsistence farmers. Conversely, those that fail to adopt the technology may become uncompetitive, particularly in commodity-based export markets. Drawing on interview data conducted in Brazil and supporting data collected in North America, Europe and China, we found that the impact of transgenic technology (...) varies. It has less impact on farmers that adapt the products to their crop systems and environment, and greater negative implications for less formally educated subsistence farmers in consequence of both complexity and compatibility. Earlier attempts at industrializing agriculture through technological innovation led to vastly improved agricultural output and exports, but the benefits of productivity was not equitably distributed [D. Lee: 2005, American Journal of Agricultural Economics 87, 1325-1334], nor was it designed to meet specific local environmental and socioeconomic farmer conditions, exacerbating social exclusion. Multinationals attempting to introduce transgenic technology without considering the broader social and ethical implications will invite resistance. We discuss the implications for policy makers, multinationals and small-scale farmers. (shrink)

The Patient Self-Determination Act (PSDA) requires hospitals to ask patients upon admission whether they have an advance directive. Although the PSDA has received extensive criticism, little attention has been paid to the cost of the law, either during its legislative course or following its implementation. Nonetheless, several tangible and intangible costs are associated with the PSDA. Such costs may be incurred by different parties. This paper examines the costs and benefits of the PSDA and illustrates the extent of some of (...) its tangible costs. The incremental start-up cost for one institution's response to the PSDA is estimated to be $49,304 ($1.31 per admission) and the total implementation cost of the program to be $114,528. In addition, the national incremental start-up cost for hospitals to implement the PSDA is estimated to be between $43,625,114 and $101,569,922. Finally, the potential implications of the PSDA for future governmental health care ethics regulation are discussed. (shrink)

Previous meta-analyses support a female advantage in decoding non-verbal emotion (Hall, 1978, 1984), yet the mechanisms underlying this advantage are not understood. The present study examined whether the female advantage is related to greater female attention to the eyes. Eye-tracking techniques were used to measure attention to the eyes in 19 males and 20 females during a facial expression recognition task. Women were faster and more accurate in their expression recognition compared with men, and women looked more at the (...) eyes than men. Positive relationships were observed between dwell time and number of fixations to the eyes and both accuracy of facial expression recognition and speed of facial expression recognition. These results support the hypothesis that the female advantage in facial expression recognition is related to greater female attention to the eyes. (shrink)

My mother is losing her mother to Alzheimer's disease. Although my mother feels loss, I am connecting through my grandmother to our ancestors, including a deceased father and paternal grandmother. I am also connecting to a daughter who has lost her mother, through a grandmother who, through her loss of memory, is more open to kin networks than my mother. Through deepening connections to my maternal grandmother and to my daughter, I feel I am losing my mother. I look to (...) revolutionary mothering as a way to reconnect shattered bonds and find lost mothers. This article honors the important work of Saidiya Hartman, Dorothy Roberts, and countless revolutionary mothers. (shrink)

Many scientists and philosophers of science are troubled by the relative isolation of developmental from evolutionary biology. Reconciling the science of development with the science of heredity preoccupied a minority of biologists for much of the twentieth century, but these efforts were not corporately successful. Mainly in the past fifteen years, however, these previously dispersed integrating programmes have been themselves synthesized and so reinvigorated. Two of these more recent synthesizing endeavours are evolutionary developmental biology and developmental systems theory. While the (...) former is a bourgeoning and scientifically well-respected biological discipline, the same cannot be said of DST, which is virtually unknown among biologists. In this review, we provide overviews of DST and EDB, summarize their key tenets, examine how they relate to one another and to the study of epigenetics, and survey the impact that DST and EDB have had on biological theory and practice. (shrink)

Self-criticism is a trait associated with increased psychopathology, but self-criticism is also a personality state reflecting an action that people do in moments of time. In the current study, we explored factors associated with heightened self-criticism in daily life. Participants (N = 197) received five random prompts per day for one week on their mobile phones, where they reported their current affect (negative and positive affect), willpower self-efficacy, distress intolerance, degree of support and criticism from others, current context (location, activity, (...) hunger, tiredness) and momentary self-criticism. We first demonstrated that self-criticism varies over time and across contexts, and is associated with heightened trait self-criticism. Then, using multilevel modelling, we explored the contextual factors associated with greater self-criticism. We found that self-criticism was higher when people were at home, and more tired. We also found higher self-criticism to be associated with greater negative and lower positive affect, greater distress intolerance, lower willpower and greater perceived criticism from others. In addition, self-criticism predicted subsequent distress intolerance, willpower and positive affect in lagged analyses. This study provides evidence that both environmental and psychological factors are associated with the dynamics of self-critical thoughts. (shrink)

The current research applied a mid-level evolutionary theory that has been successfully employed across numerous animal species—life history theory—in an attempt to understand the Dark Triad personality trait cluster (narcissism, psychopathy, and Machiavellianism). In Study 1 (N = 246), a measure of life history strategy was correlated with psychopathy, but unexpectedly with neither Machiavellianism nor narcissism. Study 2 (N = 321) replicated this overall pattern of results using longer, traditional measures of the Dark Triad traits and alternative, future-discounting indicators of (...) life history strategy (a smaller-sooner, larger-later monetary dilemma and self-reported risk-taking behaviors). Additional findings suggested two sources of shared variance across the Dark Triad traits: confidence in predicting future outcomes and openness to short-term mating. (shrink)

Developments in neuroscience have raised the possibility that pharmaceuticals may be used to enhance memory, mood, and attention in people who do not have an illness or disorder, a practice known as “cognitive enhancement.” We describe historical experiences with two medicinal drugs for which similar enhancement claims were made, cocaine in the late 19th and early 20th centuries, and amphetamines in the mid 20th century. These drugs were initially introduced as medicinal agents in Europe and North America before becoming more (...) widely used for a variety of purposes, including what would nowadays be considered cognitive enhancement. Their trajectory of use conformed to the typical use cycle of psychotropic drugs. There was an initial steep rise in prescribing for medical use, followed by expanded nonmedical use that was fueled by enthusiasm for the drugs’ effects. As the number of regular users increased, problems related to use (such as addiction) became apparent, societal concern increased, and laws were passed banning nonmedical use and eventually, medical use. This historical experience draws attention to the adverse side effects of enhancement use that only become apparent with regular, wide-scale use of a drug. We highlight the similarities between the enthusiasms for cocaine and amphetamines and the current enthusiasms for using prescription stimulants for cognitive enhancement. We argue bioethicists should not encourage the cognitive enhancement use of drugs such as methylphenidate in the absence of evidence on the efficacy and safety of their use for cognitive enhancement purposes. (shrink)

CITATION: Ewuoso, C., Hall, S. & Dierickx, K. 2017. How do healthcare professionals manage ethical challenges regarding information in healthcare professional/patient clinical interactions? a review of concept- or argument-based articles and case analyses. South African Journal of Bioethics and Law, 10:75-82, doi:10.7196/SAJBL.2017.v10i2.610.

The considerable attention to financial interests in clinical research has focused mostly on academic medical centers, even though the majority of clinical research is conducted in community practice settings. To fill this gap, this article maps the practices and policies in 73 community hospitals and several hundred specialized facilities around the country for reviewing clinical investigators’ financial relationships with research sponsors. Community hospitals face a substantially different mix of issues than academic medical centers do because their physician researchers are usually (...) not employees, and more of their studies are later-phase, multicenter trials. Accordingly, community physicians stand to benefit personally from per capita payments, but they tend to have less direct influence over research findings when compared with their academic peers. These and other contrasts require separate guidance for community-based organizations that takes into account their particular needs, circumstances, and institutional capacities. (shrink)

Conrad Hal Waddington integrated genetics with embryology and evolution by formulating and providing experimental evidence for the mechanisms of canalization and genetic assimilation in the context of stabilizing selection, and by fostering an epigenetic rather than the prevailing gene-centered view of embryonic development and of evolutionary change in development and adult form. Waddington saw phenotypes as processes, not static structures and behaviors. Trained in geology at Cambridge, Waddington turned to experimental studies on the chemical nature of the primary organizer and (...) developed the concepts of evocation and individuation as separable components of embryonic induction. A move after WW II to Edinburgh provided Waddington with his professional home for the rest of his career, during which he integrated genetics and development into an evolutionarily relevant discipline. Our conception of embryonic development as a highly integrated series of canalized pathways owes much to Waddington’s development of the concepts of canalization, chreods, epigenetics, and the epigenotype. The integrated, heritable, epigenetic organization of embryonic development is Waddington’s lasting legacy to development. He demonstrated organismal response to environmental change and hidden genetic variation, integrated environmental responsiveness into heritable change in response to selection, and coupled development, environment, and evolution. (shrink)

give a proof of the existence of nonlocal influences acting on correlated spin-1/2 particles in the singlet state which does not require any particular interpretation of quantum mechanics (QM). (Except Stapp holds that the proof fails under a many-worlds interpretation of QM—a claim we analyse in 1.2.) Recently, in responding to Redhead's ([1987], pp. 90-6) criticism that the Stapp 1 proof fails under an indeterministic interpretation of QM, Stapp [1989] (henceforth Stapp 2), has revised the logical structure of his proof (...) including its crucial locality assumption. Our main aim is to show that this revision is a step in the wrong direction because it faces two difficulties which undermine the resulting proof's significance (3.1) and validity (3. 2). We also clarify and extend the Stapp 1 proof (1. 1) with the aid of Lewis' analysis of counterfactuals (1. 2) and causal dependence (2. 2 and 2. 3). In so doing, we are able to identify two new defects in the Stapp 1 proof (1. 3 and 2. 1) in addition to corroborating Redhead's criticism (2. 2). Also, the additional assumptions which save the Stapp 1 proof's validity are detailed (2. 3) and some new difficulties for the determinist are pointed out by exploiting a slightly extended version of the proof (2. 4). In providing this full analysis of the Stapp 1 proof, we also construct the necessary framework within which to provide a critique of Stapp 2's proof (3). *Portions of this paper were presented by R. K. Clifton to the 1988 British Society for the Philosophy of Science Conference at the University of Southampton. R. K. Clifton wishes to thank the Natural Sciences and Engineering Research Council of Canada, the Royal Commission for the Exhibition of 1851, and the Governing Body of Peterhouse at Cambridge University for support during this work. (shrink)