Encouraged by the financial incentives in the Health Information Technology for Economic and Clinical Health Act of 2009, electronic health record adoption is on the rise. According to a study by the Centers for Disease Control and Prevention published in 2014, 78% of office-based physicians had adopted some type of EHR system, up from 18% in 2001. Implementation of EHRs able to support the Department of Health and Human Services “meaningful use” requirements has also significantly increased since 2010. Such a (...) growth in EHR adoption with the capacity to achieve “meaningful use” standards suggests that the goal of nationwide, interoperable health records is moving closer to a reality.While movement toward a system-wide, interoperable EHR promises benefits of such an electronic information management tool, the risks related to patients’ privacy of their health information remains a concern. (shrink)

Encouraged by the financial incentives in the Health Information Technology for Economic and Clinical Health Act of 2009, electronic health record adoption is on the rise. According to a study by the Centers for Disease Control and Prevention published in 2014, 78% of office-based physicians had adopted some type of EHR system, up from 18% in 2001. Implementation of EHRs able to support the Department of Health and Human Services “meaningful use” requirements has also significantly increased since 2010. Such a (...) growth in EHR adoption with the capacity to achieve “meaningful use” standards suggests that the goal of nationwide, interoperable health records is moving closer to a reality.While movement toward a system-wide, interoperable EHR promises benefits of such an electronic information management tool, the risks related to patients’ privacy of their health information remains a concern. (shrink)

An empirical study of whether the ordinary conception of race in the United States is biological or social, and how different conceptions connect to racism.

Must a society aim indefinitely for continued economic growth? Proponents of economic growth advance three central challenges to the idea that a society, having attained high levels of income and wealth, may justly cease to pursue further economic growth: if environmentally sustainable and the gains fairly distributed, first, continued economic growth could make everyone within a society and globally, and especially the worst off, progressively better off; second, the pursuit of economic growth spurs ongoing innovation, which enhances people’s opportunities and (...) protects a society against future risks; and third, continued economic growth fosters attitudes of openness, tolerance, and generosity, which are essential to the functioning of a liberal democratic society. This article grants these challenges’ normative foundations, to show that, even if one accepts their underlying premises as requirements of justice, a society may still justly cease to aim for economic growth, so long as it continues to aim for and realize gains on other dimensions. I argue that, while continued economic growth might instrumentally serve valuable ends, it is not necessary for their realization, as a society can achieve these ends through other means. (shrink)

The HIPAA Rules continue to support and bolster the importance of protecting the privacy and security of patients' protected health information. The HIPAA training requirements are at the cornerstone of meaningful implementation and provide a ripe opportunity for critical education.

Three experiments test the theory that verb meanings are more malleable than noun meanings in different semantic contexts, making a previously seen verb difficult to remember when it appears in a new semantic context. Experiment 1 revealed that changing the direct object noun in a transitive sentence reduced recognition of a previously seen verb, whereas changing the verb had little impact on noun recognition. Experiment 2 revealed that verbs exhibited context effects more similar to those shown by superordinate nouns rather (...) than basic-level nouns. Experiment 3 demonstrated that the degree of meaning change in a target word resulting from changes in semantic context influenced the magnitude of context effects, but context effects remained larger for verbs than for nouns even when the degree of meaning change was similar for nouns and verbs. These results are discussed with respect to the imageability and grammatical roles played by nouns and verbs in a sentence. (shrink)

Individuals often face administrative hurdles in attempting to access health care, public programmes, and other legal statuses and entitlements. These ordeals are the products, directly or indirectly, of institutional and policy design choices. I argue that evaluating whether such ordeals are justifiable or desirable instruments of social policy depends on assessing, beyond their targeting effects, the process-related burdens they impose on those attempting to navigate them and these burdens’ distributive effects. I here examine specifically how ordeals that levy time costs (...) reduce and constrain individuals’ free time, and how such time-cost ordeals may thereby create, deepen and compound disadvantages. (shrink)

Three experiments test the theory that verb meanings are more malleable than noun meanings in different semantic contexts, making a previously seen verb difficult to remember when it appears in a new semantic context. Experiment 1 revealed that changing the direct object noun in a transitive sentence reduced recognition of a previously seen verb, whereas changing the verb had little impact on noun recognition. Experiment 2 revealed that verbs exhibited context effects more similar to those shown by superordinate nouns rather (...) than basic‐level nouns. Experiment 3 demonstrated that the degree of meaning change in a target word resulting from changes in semantic context influenced the magnitude of context effects, but context effects remained larger for verbs than for nouns even when the degree of meaning change was similar for nouns and verbs. These results are discussed with respect to the imageability and grammatical roles played by nouns and verbs in a sentence. (shrink)

This book addresses the topic of personhood—who is a “person” or “human,” and what rights or dignities does that include—as it has been addressed through the lens of science fiction. Chapters include discussions of consciousness and the soul, artificial intelligence, dehumanization and othering, and free will. Classic and modern sci-fi texts are engaged, as well as film and television. This book argues that science fiction allows us to examine the profound question of personhood through its speculative and imaginative nature, highlighting (...) issues that are already visible in our present world. (shrink)

Machiavelli consistently advises that well-ordered republics must ‘keep their citizens poor’. Although this maxim recurs throughout the Discourses, Machiavelli never directly elaborates on what this prescription for civic poverty requires. To the limited extent that this maxim has received critical examination, it is commonly regarded as contending that citizens must live in a condition of material austerity. Through an analysis of Machiavelli's writings on the German free cities, this article challenges this interpretation and argues that rather than requiring that citizens (...) live at some particular level of poverty, the maxim instead requires only that citizens maintain certain attitudes towards poverty and wealth. (shrink)

In the eighteenth century, the economic problem was reformulated according to a particular set of politico-economic components, in which the pursuit of individual freedom was elevated to an ethical and political ideal. Subsequent developments of this individualist philosophy together with the achievements of technological progress now appear as a threat to future existence. Extensive environmentaldegradation and persistent global inequalities of wealth demand a new reformulation of the economic problem. Sustainable development has emerged as the most recent economic strategy for addressing (...) concerns about ecological integrity and social justice. Although there is a recognized continuum of understanding about the concept—from conservative to radical—it has been argued that only the radical version of sustainable development embodies the ethical capacity to address these concerns. Simultaneously the perennial existential question “How should we live?” has been raised anew along with the novel ethico-moral question: “How should we arrange our systems of production and consumption to ensure the sustainability of the Earth under conditions of conspicuous and pressing environmentallylimiting conditions?” Moreover, the strong normative dimension embodied in the radical version of sustainability represents a challenge to liberal democracy and its understanding of individual and collective goods. I argue that the radical approach has the capacity to relieve what is an inherently acute tension of modern life and to reconcile individual autonomy with the wider social and ecological good. (shrink)

One of the more interesting counter-intuitive findings in organizational research is that success breeds failure. This counter-intuitive has been described in termsof core rigidities, core incompetencies, and even the Icarus Paradox. The literature on these topics has concluded that success yields overconfidence and myopia in firms and their managers, and this eventually causes failure. We augment this literature by suggesting that success breeds not only internal pathologies that cause firms to misuse their established resources over time, but also external pathologies (...) that cause firms to lose access to new resources. In particular, success influences stakeholders’ perceptions of firms, causing firms to lose the benefits of underdog status and gain the problems of overlord status. We term this notion that success warps images of the successful, leading to their decline over time, the Helios Paradox, and suggest that dominant firms must counter natural tendencies to succumb to both the Icarus and Helios Paradoxes if they are to remain successful over time. (shrink)

Recent decades have seen a dramatic transformation in the mode of governing, with government increasingly outsourced to a network of private actors, spanning education, prisons, regulation, arbitration, the military, and access to healthcare and welfare. Chiara Cordelli’s The Privatized State probes the ethical and philosophical questions raised by this transformation, and develops a distinctive account of the wrong of privatization: that a privatized government cannot be a legitimate government. In so doing, Cordelli engages and advances not only pressing questions about (...) privatization, but also broader questions about public administration, political representation, democratic authority, and neorepublicanism. This symposium brings together scholars for a wide-ranging discussion of this transformation in governance and the deep and challenging questions it raises. (shrink)

The National Institutes of Health and other federal health agencies are considering establishing a national biobank to study the roles of genes and environment in human health. A preliminary public engagement study was conducted to assess public attitudes and concerns about the proposed biobank, including the expectations for return of individual research results. A total of 141 adults of different ages, incomes, genders, ethnicities, and races participated in 16 focus groups in six locations across the country. Focus group participants voiced (...) a strong desire to be able to access individual research results. Recognizing the wide range of possible research results from a large cohort study, they repeatedly and spontaneously suggested that cohort study participants be given ongoing choices as to which results they received. (shrink)

It has been well documented how language-specific cues may be used for word segmentation. Here, we investigate what role a language-independent phonological universal, the sonority sequencing principle (SSP), may also play. Participants were presented with an unsegmented speech stream with non-English word onsets that juxtaposed adherence to the SSP with transitional probabilities. Participants favored using the SSP in assessing word-hood, suggesting that the SSP represents a potentially powerful cue for word segmentation. To ensure the SSP influenced the segmentation process (i.e., (...) during learning), we presented two additional groups of participants with either (a) no exposure to the stimuli prior to testing or (b) the same stimuli with pauses marking word breaks. The SSP did not influence test performance in either case, suggesting that the SSP is important for word segmentation during the learning process itself. Moreover, the fact that SSP-independent segmentation of the stimulus occurred (in the latter control condition) suggests that universals are best understood as biases rather than immutable constraints on learning. (shrink)

To assess ethics pedagogy in science and engineering, we developed a new tool called the Engineering and Science Issues Test. ESIT measures moral judgment in a manner similar to the Defining Issues Test, second edition, but is built around technical dilemmas in science and engineering. We used a quasi-experimental approach with pre- and post-tests, and we compared the results to those of a control group with no overt ethics instruction. Our findings are that several stand-alone classes showed a significant improvement (...) compared to the control group when the metric includes multiple stages of moral development. We also found that the written test had a higher response rate and sensitivity to pedagogy than the electronic version. We do not find significant differences on pre- test scores with respect to age, education level, gender or political leanings, but we do on whether subjects were native English speakers. We did not find significant differences on pre- test scores based on whether subjects had previous ethics instruction; this could suggest a lack of a long-term effect from the instruction. (shrink)

Motivated by disparities in gun violence, sharp increases in gun ownership, and a changing gun policy landscape, we conducted a nationally representative survey of U.S. adults (n=2,778) in 2021 to compare safety-related views of white, Black, and Hispanic gun owners and non-owners. Black gun owners were most aware of homicide disparities and least expecting of personal safety improvements from gun ownership or more permissive gun carrying. Non-owner views differed. Health equity and policy opportunities are discussed.

To assess ethics pedagogy in science and engineering, we developed a new tool called the Engineering and Science Issues Test (ESIT). ESIT measures moral judgment in a manner similar to the Defining Issues Test, second edition, but is built around technical dilemmas in science and engineering. We used a quasi-experimental approach with pre- and post-tests, and we compared the results to those of a control group with no overt ethics instruction. Our findings are that several (but not all) stand-alone classes (...) showed a significant improvement compared to the control group when the metric includes multiple stages of moral development. We also found that the written test had a higher response rate and sensitivity to pedagogy than the electronic version. We do not find significant differences on pre-test scores with respect to age, education level, gender or political leanings, but we do on whether subjects were native English speakers. We did not find significant differences on pre-test scores based on whether subjects had previous ethics instruction; this could suggest a lack of a long-term effect from the instruction. (shrink)

A 2011 National Academies of Sciences report called for an “Information Commons” and a “Knowledge Network” to revolutionize biomedical research and clinical care. We interviewed 41 expert stakeholders to examine governance, access, data collection, and privacy in the context of a medical information commons. Stakeholders' attitudes about MICs align with the NAS vision of an Information Commons; however, differences of opinion regarding clinical use and access warrant further research to explore policy and technological solutions.

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms (...) of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

Neuroscience communication is increasingly taking place on multidirectional social media platforms, creating new opportunities but also calling for critical ethical considerations. Twitter, one of the most popular social media applications in the world, is a leading platform for the dissemination of all information types, including emerging areas of neuroscience such as optogenetics, a technique aimed at the control of specific neurons. Since its discovery in 2005, optogenetics has been featured in the public eye and discussed extensively on social media, but (...) little is known about how this new technique is portrayed and who the users participating in the conversation are. To address this gap, we conducted content analysis of a sample of 1000 tweets mentioning “optogenetics” over a one-year period between 2014 and 2015. We found that academic researchers are the largest group contributing to the conversation, that the tweets often contain links to third-party websites from news organizations and peer-reviewed journals, and that common thematic motifs include the applications of optogenetics specifically for the control of brain activity and the treatment of disease. We also found that the majority of the tweets are neutral in their tone regarding optogenetics. As Twitter serves as a current and dynamic forum for exchange about advances in neuroscience, the conversation about optogenetics on this engaging platform can inform socially-responsive knowledge dissemination efforts in this area. (shrink)

_Philosophers on Race _adds a new dimension to current research on race theory by examining the historical roots of the concept in the works of major Western philosophers.

_Philosophers on Race _adds a new dimension to current research on race theory by examining the historical roots of the concept in the works of major Western philosophers.

Thomas Hurka has recently proposed a utilitarian theory which would effect a compromise between Average and Total utilitarianism, the better to deal with issues in population ethics. This Compromise theory would incorporate the principle that the value which an extra happy person contributes to a possible world is a decreasing function of the total population of that world: that happy people are of diminishing marginal value. In spite of its initial plausibility I argue against this principle. I show that the (...) Compromise theory is actually no improvement over the two original versions of utilitarianism; in particular, it is subject to almost all the objections which are fatal to Average utilitarianism, and more besides. And I attempt to dispell the appearance that intuition supports the Compromise theory as against Total utilitarianism, by arguing that the latter's Repugnant Conclusion, when properly understood, is not intuitively unacceptable. Total utilitarianism remains a plausible ethical theory, while both the Average and the Compromise theories should be definitely rejected. (shrink)

We consider the moral and social ingredients in physicians' relationships with patients of diminished capacity by considering certain claims made about friendship and the physician's role. To assess these claims we look at the life context of two patients as elaborated examples provided in two novels: Woman on the Edge of Time (1976) by Marge Piercy, a radical feminist; and It's Hard to Leave While the Music's Playing (1977) by I. S. Cooper, a prominent physician-researcher. At issue is how the (...) doctor-patient relationship should be structured. In question is whether the physician's friendship and professional expertise, together with the diminished capacity of the patient, authorize medical paternalism. From our examination, we find compelling insights against appealing to friendship both in good doctor-patient relationships and in more typical, not-so-good ones. (shrink)