As national and state health care policy -making becomes contentious and complex, there is a need for a forum to debate and explore public concerns and values in health care, give voice to local citizens, to facilitate consensus among various stakeholders, and provide feedback and direction to health care institutions and policy makers. This paper explores the role that regional health care ethics committees can play and provides two contrasting examples of Networks involved in facilitation of public input into and (...) the development of health care policies and adoption of state-wide practices. (shrink)

The complexities of professional ethics are best understood and interpreted within their sociohistorical context. This paper focuses on the experience of 20 rural psychologists from across Canada, a context rife with demographic and practice characteristics that may instigate ethical issues. Employing hermeneutic phenomenology, these qualitative research results are indicative of professional struggles that impacted the participants’ experience of professional ethics and raised key questions about policy and practise. Concerns regarding competition highlight potential professional vulnerability, beget the idea of fostering general (...) psychological practice, and question the role of professional bodies in addressing rural shortages. Dependency on government funding models and decisions highlights the benefits and medical cost-offset effect of psychological services’ role in funded medical care. The controversial prescriptive authority debate for psychologists raises myriad concerns that are particularly salient to rural practitioners. These include changes to training and practice, with risks of psychopharmacology gaining prominence over behavioural health interventions. National inconsistencies in level of registration add to the growing shortage of practitioners. Finally, the results illuminate the need for advocacy to move beyond the literature and into public policy to increase public awareness, decrease the stigma of mental illness, and develop rural Canadian psychology. Although limited to this study, these results allowed for a fuller and more robust understanding of rural practice in consideration of professional ethics, which may inform policy, science, or ethical clinical practice. (shrink)

The question of how psychoanalysts are affected by their patients is of perennial interest. Edward Glover posed the question in an informal survey in 1940, but little came of his efforts. Now, more than half a century later, Judy Kantrowitz rigorously explores this issue on the basis of a unique research project that obtained data from 399 fully trained analysts. These survey responses included 194 reported clinical examples and 26 extended case commentaries on analyst change. Kantrowitz begins _The Patient's (...) Impact on the Analyst_ by documenting how the process of analysis fosters an interactional process out of which patient and analyst alike experience therapeutic effects. Then, drawing on the clinical examples provided by her survey respondents, she offers a detailed exploration of the ways in which clinically triggered self-reflection represents a continuation of the analyst's own personal understanding and growth. Finally, she incorporates these research findings into theoretical reflections on how analysts obtain and integrate self-knowledge in the course of their ongoing clinical work. This book is a pioneering effort to understand the therapeutic process from the perspective of its impact on the analyst. It provides an enlarged framework of comprehension for recent discussions of self-analysis, countertransference, interaction, and mutuality in the analytic process. Combining a wealth of experiential insight with thoughtful commentary and synthesis, it will sharpen analysts' awareness of how they work and how they are affected by their work. (shrink)

The purpose of the current study was to examine the reliability and validity of the RESTQ-Sport-36 for use in the collegiate student-athlete population. A total of 494 collegiate student-athletes competing in National Collegiate Athletic Association Division I, II, or III sanctioned sport completed the RESTQ-Sport-36 and Brief Profile of Mood States. Structural equation modeling procedures were used to compare first order to hierarchical model structures. Results of a confirmatory factor analysis and exploratory structural equation modeling analysis indicated that the first (...) order 12-factor structure demonstrated the best fit of all models tested. Support was not observed for the fit of any hierarchical model. Moderate to strong correlations were observed between stress and recovery subscales and mood states, thus supporting the construct validity of the abbreviated RESTQ measurement model. The current findings provide support for the measure’s use in this population and give pause as it relates to the scoring and interpretation of hierarchical factors such as Total Stress and Total Recovery. Overall, the current results indicate that the RESTQ-Sport-36 may be a useful tool for collegiate student-athlete training load and competition monitoring. (shrink)

The essays are tied together by the idea that our understanding of cognition is likely to be enhanced by consideration of mechanisms and processes at its ...

The development and utility of genetically modified crops for smallholders around the world is controversial. Critical questions include what traits and crops are to be developed; how they can be adapted to smallholders’ ecological, social and economic contexts; which dissemination channels should be used to reach smallholders; and which policy environments will enable the greatest benefits for smallholders and the rural poor. A key question is how the voices of smallholders who have experience with or desire to use GM technologies (...) enter the larger debate. Africa has the greatest number of smallholders and poor with the least exposure to GM crops. Because of the well-established use of GM crops in South Africa by commercial farmers, we formed a community of practice involving smallholders, extension, researchers, non-profits and agribusiness in KwaZulu-Natal to examine the conditions under which GM crops are used by smallholders, how smallholders interact with GM technologies and what insights smallholders and other stakeholders can provide regarding these questions. One of the advantages of the CoP approach is that it brings stakeholders together in a non-hierarchical way that encourages new ways of thinking and new partnerships. Such interaction around a specific project can enhance the voice of smallholders in a variety of ways. In our project, smallholder participants have increased their knowledge and can make better decisions about GM technologies, which had been barriers for them. Notably, they have also improved their knowledge of maize production practices, accessed new practice networks, and met new researchers and resource providers. They are now being integrated into these networks in a way that should improve their livelihoods and make the wants and needs of smallholders better known. Such knowledge and experience has improved their voice in agriculture and rural development discussions. (shrink)

When external groups accuse a business organization of unethical practices, managers of the accused organization usually offer a communicative response to attempt to protect their organization's public image. Even though many researchers readily concur that analysis of these communicative responses is important to our understanding of business and society conflict, few investigations have focused on developing a theoretical framework for analyzing these communicative strategies used by managers. In addition, research in this area has suffered from a lack of empirical investigation. (...) In this paper we address both of these weaknesses in the existing literature. First, we explicate Impression Management Theory as an appropriate framework for studying organizational communicative responses, paying particular attention to the concept of accounts. Second, we critique previous investigations of organizational accounts and discuss the major contributions of our study. Third, we propose a coding system and content analyze the accounts offered by managers from 21 organizations that were recently the targets of consumer boycotts. Finally, we report the results of our empirical investigation and discuss ethical issues related to organizational accounts. (shrink)

The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move (...) these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness. (shrink)

The volume brings together a collection of original papers on some of the main tenets of Joseph Raz's legal and political philosophy: Legal positivism and the nature of law, practical reason, authority, the value of equality, incommensurability, harm, group rights, and multiculturalism. James Griffin and Yael Tamir raise questions concerning Raz's notion of group rights and its application to claims of cultural and political autonomy, while Will Kymlicka and Bernhard Peters examine Raz's theory of multicultural society. Lukas Meyer investigates the (...) applicability of the notion of harm in the intergenerational context. Other papers are devoted to fundamental theoretical tenets of Raz's work. Hillel Steiner and Andrei Marmor examine Raz's account of value pluralism and incommensurability in light of what these authors consider to be goods whose equal distribution must be valued for its own sake. Robert Alexy and Timothy Endicott discuss traditional issues of jurisprudence and legal philosphy with special attention to Raz's contribution. Rüdiger Bittner, Bruno Celano, and J. E. Penner discuss and criticize aspects of Raz's theory of practical reason. Jeremy Waldron presents a critique of Raz's interpretation of authority.This volume concludes with a chapter by Joseph Raz in which he responds to arguments in the foregoing essays. (shrink)

Bioethicists frequently call for empirical researchers to engage participants and community members in their research, but don't themselves typically engage community members in their normative research. In this article, we describe an effort to include members of the public in normative discussions about the risks, potential benefits, and ethical responsibilities of social and behavioral genomics (SBG) research. We reflect on what might—and might not— be gained from engaging the public in normative scholarship and on lessons learned about public perspectives on (...) the risks and potential benefits of SBG research and the responsible conduct and communication of such research. We also provide procedural lessons for others in bioethics who are interested in engaging members of the public in their research. (shrink)

The meaningful consideration of cultural practices, values and beliefs is a necessary component in the effective translation of advancements in neuroscience to clinical practice and public discourse. Society’s immense investment in biomedical science and technology, in conjunction with an increasingly diverse socio-cultural landscape, necessitates the study of how potential discoveries in neurodegenerative diseases such as Alzheimer disease are perceived and utilized across cultures. Building on the work of neuroscientists, ethicists and philosophers, we argue that the growing field of neuroethics provides (...) a pragmatic and constructive pathway to guide advancements in neuroscience in a manner that is culturally nuanced and relevant. Here we review a case study of one issue in culturally oriented neuroscience research where it is evident that traditional research ethics must be broadened and the values and needs of diverse populations considered for meaningful and relevant research practices. A global approach to neuroethics has the potential to furnish critical engagement with cultural considerations of advancements in neuroscience. (shrink)

Much social theory takes for granted the core conceit of modern culture, that modern actors-individuals, organizations, nation states-are autochthonous and natural entities, no longer really embedded in culture. Accordingly, while there is much abstract metatheory about "actors" and their "agency," there is arguably little theory about the topic. This article offers direct arguments about how the modern (European, now global) cultural system constructs the modern actor as an authorized agent for various interests via an ongoing relocation into society of agency (...) originally located in transcendental authority or in natural forces environing the social system. We see this authorized agentic capability as an essential feature of what modern theory and culture call an "actor," and one that, when analyzed, helps greatly in explaining a number of otherwise anomalous or little analyzed features of modern individuals, organizations, and states. These features include their isomorphism and standardization, their internal decoupling, their extraordinarily complex structuration, and their capacity for prolific collective action. (shrink)

Objectives To characterize recruitment approaches to research on the brain and mind that involves Indigenous peoples. Methods We conducted a secondary analysis of a Harding et al. (2021) scoping review. Reviewers screened studies (_n_ = 66) for sampling methods, recruitment and engagement, positionality statements, and details on ethics approvals. Synthesis We identified twenty-nine (29) English-language articles relevant to the analysis. Of these, 52% (_n_ = 15/29) reported a mix of sampling methods; 45% (_n_ = 13/29) contained statements or information about (...) author positionalities. While, overall, 24% (_n_ = 7/29) of the studies were missing information about ethics protocols, we observe an improvement over time in the reporting of approvals and use of community-engaged participant recruitment methods. Current brain research studies demonstrate ways of collaborating with Indigenous communities that meet existing ethics guidelines. To be wholly responsive to the needs of Indigenous peoples, however, researchers may need to exceed existing ethical benchmarks.. Positionality statements successfully detailed the relationships of the research teams with the communities with which they work, and contextualized recruitment methods. Conclusion Improved quality and meaningfulness of brain research with Indigenous peoples and trust in the research process and public health will be enhanced when remaining gaps in protecting and reporting of participant recruitment methods are closed. (shrink)

In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and potential benefits. They conclude with a discussion of responsible behavior in the context of SBG research. (...) SBG research that compares individuals within a group according to a “sensitive” phenotype requires extra attention to responsible conduct and to responsible communication about the research and its findings. SBG research (1) on sensitive phenotypes that (2) compares two or more groups defined by (a) race, (b) ethnicity, or (c) genetic ancestry (where genetic ancestry could easily be misunderstood as race or ethnicity) requires a compelling justification to be conducted, funded, or published. All authors agree that this justification at least requires a convincing argument that a study's design could yield scientifically valid results; some authors would additionally require the study to have a socially favorable risk‐benefit profile. (shrink)

Commodity chain analysis (Bair and Ramsay, 2003 Multinational Companies and Global Human Resource Strategies) is used to explore where economic pressure (from consumers) or socio-political pressure (from governments and NGOs) can be applied to reduce worker exploitation. Six paths are illustrated with examples of successful and unsuccessful application of pressure. Three conclusions are reached :Economic pressure on companies and brand owners is more likely to lead to improved workplace conditions than socio-political pressure; Brand owners are more likely to implement improved (...) workplace conditions than retailers; and Retailers who are under extreme consumer price pressure will resist improving workplace conditions. (shrink)

Currently living people cannot be said to be wronged because of the wrongless emissons of greenhouse gases by past people. According to the usual subjunctive-historical understanding of harm, currently living people cannot be said to be harmed by the impact of greenhouse emissions on their well-being. By relying on a subjunctive-threshold notion of harm we can justify conclusions about both the present generation’s duties not to violate the rights of future generations, and the present generation’s duties to compensate currently living (...) people for the harms inflicted upon them through the lasting impact of wrongless past harms. This interpretation supports a forward-looking understanding of the grounds of our relating to wrongless past harms. The significance of past harms lies in their consequences for the well-being of currently living and future people. The subjunctive-threshold notion of harm lends support to a standard of minimal, general, and universal justice. Those actors who are in a position to fulfill its requirements are under a duty to do so. Especially the rich and powerful countries ought to counteract the harmful impact of past greenhouse emissions. (shrink)

Research is increasingly recognised as a key component of medical curricula, offering a range of benefits including development of skills in evidence-based medicine. The literature indicates that experienced academic supervision or mentoring is important in any research activity and positively influences research output. The aim of this project was to investigate the human research ethics experiences and knowledge of three groups: medical students, and university academic staff and clinicians eligible to supervise medical student research projects; at two Australian universities. Training (...) in research ethics was low amongst academic staff and clinicians eligible to supervise medical student research. Only two-thirds of academic staff and students and less than half of clinicians surveyed indicated that specific patient consent was required for a doctor to include patient medical records within a research publication. There was limited awareness of requirements for participant information and consent forms amongst all groups. In the case of clinical trials, fewer clinicians and students than academics indicated there was a requirement to obtain consent. Awareness of the ethics committee focus on respect was low across all groups. This project has identified significant gaps in human research ethics understanding among medical students, and university academic staff and clinicians. The incorporation of research within medical curricula provides the impetus for medical schools and their institutions to ensure that academic staff and clinicians who are eligible and qualified to supervise students’ research projects are appropriately trained in human research ethics. (shrink)

The proliferation of news and information sources has motivated a need to identify those providing legitimate journalism. One temptation is to go the route of such fields as medicine and law, namely to formally professionalize. This gives a clear method for determining who is a member, with an array of associated responsibilities and rewards. We argue that making such a formal move in journalism is a mistake: Journalism does not meet the traditional criteria, and its core ethos is in conflict (...) with the professional mindset. We thus shift the focus from whether the person is journalist to whether the work satisfies the conditions that characterize legitimate journalism. In explaining those conditions we also look at mechanisms for enhancing the power of persons doing journalism, drawing upon lessons from the labor movement. We also consider a self-declaration model while urging increased literacy from all participants in the news gathering and consuming enterprise. (shrink)

In Buddhism, Meditation and Free Will: A Theory of Mental Freedom , Rick Repetti explains how the dynamics of Buddhist meditation can result in a kind of metacognition and metavolitional control that exceeds what is required for free will and defeats the most powerful forms of free will skepticism. This article argues that although the Buddhist path requires and enhances the kind of mental and volitional control Repetti describes, the central dynamic of the path and meditation is better understood as (...) a process of habituation. This not only involves the dis‐identification from mental and emotional content that Repetti discusses—and is commonly emphasized in modern presentations of mindfulness or insight (vipassanā ) meditation—but also a transformation of the heart that is effected through the complementary psychological and somatic qualities associated with calm abiding (samatha ) and concentration (samādhi ) and emphasized in the Pali Nikāyas and commentaries. (shrink)

While outcomes for children with T-cell acute lymphoblastic leukemia have improved dramatically, survival rates for patients with relapsed/refractory disease remain dismal. Prior studies indicate that glucocorticoid resistance is more common than resistance to other chemotherapies at relapse. In addition, failure to clear peripheral blasts during a prednisone prophase correlates with an elevated risk of relapse in newly diagnosed patients. Here we show that intrinsic GC resistance is present at diagnosis in early thymic precursor T-ALLs as well as in a subset (...) of non-ETP T-ALLs. GC-resistant non-ETP T-ALLs are characterized by strong induction of JAK/STAT signaling in response to interleukin-7 stimulation. Removing IL7 or inhibiting JAK/STAT signaling sensitizes these T-ALLs, and a subset of ETP T-ALLs, to GCs. The combination of the GC dexamethasone and the JAK1/2 inhibitor ruxolitinib altered the balance between pro- and anti-apoptotic factors in samples with IL7-dependent GC resistance, but not in samples with IL7-independent GC resistance. Together, these data suggest that the addition of ruxolitinib or other inhibitors of IL7 receptor/JAK/STAT signaling may enhance the efficacy of GCs in a biologically defined subset of T-ALL.Leukemia advance online publication, 30 May 2017; doi:10.1038/leu.2017.136. (shrink)

The volume brings together a collection of original papers on some of the main tenets of Joseph Raz's legal and political philosophy: Legal positivism and the nature of law, practical reason, authority, the value of equality, incommensurability, harm, group rights, and multiculturalism.