Neuroimaging offers great potential to clinicians and researchers for a host of mental and physical conditions. The use of imaging has been trumpeted for forensic psychiatric and psychological evaluations to allow greater insight into the relationship between the brain and behavior. The results of imaging certainly can be used to inform clinical diagnoses; however, there continue to be limitations in using neuroimaging for insanity cases due to limited scientific backing for how neuroimaging can inform retrospective evaluations of mental state. In (...) making this case, this paper reviews the history of the insanity defense and explains how the use of neuroimaging is not an effective way of improving the reliability of insanity defense evaluations. (shrink)

In this paper, I introduce a special case of epistemic injustice that I call ‘structural contributory injustice’. This conception aims to capture some dimensions of how policy—separately from individual agential interactions—can generate epistemic injustice at a group level. I first locate the case within Kristie Dotson’s original conception of contributory injustice. I then consider one potential case of structural contributory injustice—namely, the policy problem of significant financial risk burden on students considering university in the USA. Finally, I consider potential policy (...) reforms in response to this injustice. (shrink)

ABSTRACTAnxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analysis of 97 depression, anxiety, and suicidality-related items among 616 psychiatric outpatients indicated a 3-class solution, specifically: a higher suicide-risk class uniquely differentiated from both other classes by high reported levels of depression and anxious arousal; (...) a lower suicide-risk class that reported levels of anxiety sensitivity and generalised worry comparable to Class 1, but lower levels of depression and anxious arousal; and a low to non-suicidal class that reported relatively low levels across all depression and anxiety measures. Discriminants of the higher suicide-risk class included borderline personality disorder; report... (shrink)

Tool use research has suffered from a lack of consistent theoretical frameworks. There is a plethora of tool use definitions and the most widespread ones are so inclusive that the behaviors that fall under them arguably do not have much in common. The situation is aggravated by the prevalence of anecdotes, which have played an undue role in the literature. In order to provide a more rigorous foundation for research and to advance our understanding of the interrelation between tool use (...) and cognition, we suggest the adoption of Fragaszy and Mangalam's (2018) tooling framework, which is characterized by the creation of a body-plus-object system that manages a mechanical interface between tool and surface. Tooling is limited to a narrower suite of behaviors than tool use, which might facilitate its neurocognitive investigation. Indeed, evidence in the literature indicates that tooling has distinct neurocognitive underpinnings not shared by other activities typically classified as tool use, at least in primates. In order to understand the extent of tooling incidences in previous research, we systematically surveyed the comprehensive tool use catalog by Shumaker et al. (2011). We identified 201 tool use submodes, of which only 81 could be classified as tooling, and the majority of the tool use examples across species were poorly supported by evidence. Furthermore, tooling appears to be phylogenetically less widespread than tool use, with the greatest variability found in the primate order. However, in order to confirm these findings and to understand the evolution and neurocognitive mechanisms of tooling, more systematic research will be required in the future, particularly with currently underrepresented taxa. (shrink)

This qualitative study describes the lived experience of physicians who work in communities that have experienced a public mass shooting. Semi-structured interviews were conducted with seventeen physicians involved in eight separate mass casualty shooting incidents in the United States. Four major themes emerged from constant comparative analysis: The psychological toll on physicians: “I wonder if I'm broken”; the importance of and need for mass casualty shooting preparedness: “[We need to] recognize this as a public health concern and train physicians to (...) manage it”; massive media attention: “The media onslaught was unbelievable”; and commitment to advocacy for a public health approach to firearm violence: “I want to do whatever I can to prevent some of these terrible events.”. (shrink)

This volume brings together eminent theologians, philosophers and political theorists to discuss such questions as how religious understandings have shaped the moral landscape of contemporary culture; the possible contributions of theology and theologically informed moral argument to contemporary public life; the problem of religious and moral discourse in a pluralistic society; and the proper relationship between religion and culture.

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of laws intended (...) to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies. (shrink)

Pullman (2023) compares medically-assisted dying (MAiD) laws and rates of medically-assisted deaths in Canada and California, noting some differences in the legal regime and a higher rate of MAiD i...

Ethics courses are most commonly evaluated using reaction measures. However, little is known about the specific types of reaction data being collected and how these reaction data relate to improvements in trainee performance. Using a sample of 381 ethics training sessions, major reaction data categories were identified. Content and course satisfaction were the most frequently collected types of reaction criteria. Furthermore, content relevance and course satisfaction showed strong, positive relationships with performance criteria, whereas content satisfaction demonstrated a moderate, negative relationship. (...) These results and future directions for ethics training evaluation are discussed. (shrink)

As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable as a reproductive (...) alternative to gestation within a human womb under certain circumstances. If the safety and efficacy of full ectogenesis are established, if ethical dilemmas are sufficiently well addressed, and if the technology is offered as a reproductive option to cisgender heterosexual individuals or couples desiring to become parents, there is a moral obligation grounded in social justice to ensure that full ectogenesis be made available to individuals or couples identifying as members of sexual‐ or gender‐minority groups who likewise seek to pursue parenthood. We examine the history of access to current family‐building options, including assisted reproductive technology, surrogacy and adoption, for these populations and conclude that in the absence of robust empirical evidence suggesting an increased risk of harm to children of individuals and couples who identify as members of sexual‐ or gender‐minority groups, equitable access to ectogenesis as a pathway to parenthood for sexual and gender minorities must be assured as a matter of reproductive justice. (shrink)

Analysis and case studies show that including different orientations toward the natural world makes for more effective scientific practice and science education.

Of the various loci of systematic theology that call for sustained philosophical investigation, the doctrine of sanctification stands out as a prime candidate. In response to that call, William Alston developed three models of the sanctifying work of the Holy Spirit: the fiat model, the interpersonal model, and the sharing model. In response to Alston’s argument for the sharing model, this paper offers grounds for a reconsideration of the interpersonal model. We close with a discussion of some of the implications (...) of one’s understanding of the transforming work of the Holy Spirit for practical Christian spirituality. (shrink)

Based on an unfinished manuscript by the late philosopher Dallas Willard, this book makes the case that the 20th century saw a massive shift in Western beliefs and attitudes concerning the possibility of moral knowledge, such that knowledge of the moral life and of its conduct is no longer routinely available from the social institutions long thought to be responsible for it. In this sense, moral knowledge--as a publicly available resource for living--has disappeared. Via a detailed survey of main developments (...) in ethical theory from the late 19th through the late 20th centuries, Willard explains philosophy's role in this shift. In pointing out the shortcomings of these developments, he shows that the shift was not the result of rational argument or discovery, but largely of arational social forces--in other words, there was no good reason for moral knowledge to have disappeared. The Disappearance of Moral Knowledge is a unique contribution to the literature on the history of ethics and social morality. Its review of historical work on moral knowledge covers a wide range of thinkers including T.H Green, G.E Moore, Charles L. Stevenson, John Rawls, and Alasdair MacIntyre. But, most importantly, it concludes with a novel proposal for how we might reclaim moral knowledge that is inspired by the phenomenological approach of Knud Logstrup and Emmanuel Levinas. Edited and eventually completed by three of Willard's former graduate students, this book marks the culmination of Willard's project to find a secure basis in knowledge for the moral life. (shrink)

While the 2022 Supreme Court of the United States decision in Dobbs v Jackson Women’s Health Organization may bring the contingent rights of pregnant people to refuse interventions into sharper foc...

Using qualitative data based on interviews with 22 married infertile couples living in western New York State, we describe the ways in which husbands and wives interact in the process of constructing their infertility. The wives experienced infertility as a cataclysmic role failure. Husbands tended to see infertility as a disconcerting event but not as a tragedy. Couples tended to see infertility as a problem for wives. Frustration and lack of communication were typical consequences of the confrontation of husbands' and (...) wives' perspectives on infertility. Interactions with medical professionals tended to reinforce these consequences. These interactions between wives, husbands, and medical professionals may lead to taking wrong directions in treatment and to ignoring treatment options. Some of the problems we describe could be lessened by adopting a model of couple-centered treatment in a setting that incorporated routine counseling. (shrink)

This paper is a philosophical defense of the doctrine of penal substitution. I begin with a delineation of Richard Swinburne’s satisfaction-type theory of the atonement, exposing a weakness of it which motivates a renewed look at the theory of penal substitution. In explicating a theory of penal substitution, I contend that: (i) the execution of retributive punishment is morally justified in certain cases of deliberate wrongdoing; (ii) deliberate human sin against God constitutes such a case; and (iii) the transfer of (...) the retributive punishment due sinners to Christ is morally coherent. Whatever else might be said for and against such a conception of the doctrine of the atonement, the plausibility of the theory presented here should give us pause in the often hasty rejection of the doctrine of penal substitution. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

We are grateful to Friesen and colleagues for drawing attention to the tension between the protection of populations that may experience vulnerability with their inclusion in research (Friesen et a...

Previous studies found similarities in adults’ disgust responses to benign (e.g. obesity) and actual disease signs (e.g. influenza). However, limited research has compared visual (i.e. benign and actual) to cognitive (i.e. disease label) disease cues in different age groups. The current study investigated disgust responses across middle childhood (7–9 years), late childhood (10–12 years), adolescence (13–17 years), and adulthood (18+ years). Participants viewed individuals representing a benign visual disease (obese), sick-looking (staphylococcus), sick-label (cold/flu), and healthy condition. Disgust-related outcomes were: (1) (...) avoidance, or contact level with apparel the individual was said to have worn, (2) disgust facial reactions, and (3) a combination of (1) and (2). Avoidance was greater for the sick-looking and sick-label than the healthy and obese conditions. For facial reaction and combination outcomes, middle childhood participants responded with greater disgust to the sick-looking than the healthy condition, while late childhood participants expressed stronger disgust towards the sick-looking and obese conditions than the healthy condition. Adolescents and adults exhibited stronger disgust towards sick-label and sick-looking than obese and healthy conditions. Results suggest visual cues are central to children’s disgust responses whereas adolescents and adult responses considered cognitive cues. (shrink)

This is a “bottom-up” paper in the sense that it draws lessons in defining disciplinary categories under study from a series of empirical studies of interdisciplinarity. In particular, we are in the process of studying the interchange of research-based knowledge between Cognitive Science and Educational Research. This has posed a set of design decisions that we believe warrant consideration as others study cross-disciplinary research processes.

What does it mean to be a good thinker? Which virtues work together in someone who possesses good intellectual character? Although recent research on virtues has highlighted the benefits of individual intellectual virtues, being an excellent thinker is likely a function of possessing multiple intellectual virtues. Specifically, a good thinker would both recognize one’s intellectual shortcomings and possess an eagerness to learn driven by virtues such as love of knowledge, curiosity, and open-mindedness. Good intellectual character may only successfully manifest when (...) individuals possess not just one or a few intellectual virtues, but a larger set of such virtues to different degrees. However, little is currently known about what combination of virtues are necessary for good thinking. We argue that it is important to identify and clarify the nature of the good thinker and outline a profile methodology for achieving this goal. This approach characterizes the good thinker in terms of a profile of multiple intellectual virtues. Understanding this profile can allow greater insight into the extent to which people possess such a profile, and the potential for societal benefits of educating for these qualities. (shrink)

Against various detractors , this book develops a foundationalist theory of epistemic justification. In contrast with Laurence BonJour and borrowing from John McDowell, the essential argument is that conceptualized perpetual experience provides a non-doxastic foundation for perceptual beliefs about physical objects.

In 2013, controversy sparked student protests, campus debates, and national attention when Smith College denied admittance to Calliope Wong—a trans woman. Since then, eight women’s colleges have revised their admissions policies to include different gender identities such as trans women and genderqueer people. Given the recency of such policies, we interrogate the ways the category “woman” is determined through certain alignments of biology-, legal-, and identity-based criteria. Through an inductive analysis of administrative scripts appearing both in student newspapers and in (...) trans admittance policies, we highlight two areas U.S. women’s colleges straddle while creating these policies: inclusion/exclusion scripts of self-identification and legal documentation, and tradition-/activism-speak. Through these tensions, women’s college admittance policies not only construct “womanhood” but also serve as regulatory norms that redo gender as a structuring agent within the gendered organization. (shrink)