Successful tutoring depends in part on child tutors’ ability to recognise and interpret accurately signals of misunderstanding by their tutees. Age- and gender-related differences were investigated in a study which exposed 80 children to a video-recorded episode involving a target child receiving ambiguous instructions in her attempts to move a model car along a designated route on a playmat roadway from one destination to another. The results showed that explicit, general and facial modes of displaying puzzlement by the target child (...) were judged as equally powerful expressions of degree of puzzlement, but 8-10 year olds judged the target child as significantly more puzzled than did 7 year olds. Older children were also more likely to attribute the puzzlement of the target child to the ambiguous instructions than to her verbal or facial expression of puzzlement. Girls were generally more accurate than boys in judging facial expressions and less likely than boys to give wrong or alternatively ambiguous responses when given the opportunity to correct the video-recorded ambiguous instructions. The results throw some light on the developing sensitivities of boys and girls in recognising and attributing failures of understanding by other children. (shrink)

Introduction: Vulnerability is a poorly understood concept in research ethics, often aligned to autonomy and consent. A recent addition to the literature represents a taxonomy of vulnerability developed by Kipnis, but this refers to the conduct of clinical trials rather than qualitative research, which may raise different issues. Aim: To examine issues of vulnerability in cancer and palliative care research obtained through qualitative interviews. Method: Secondary analysis of qualitative data from 26 black Caribbean and 19 white British patients with advanced (...) cancer. Results: Four domains of vulnerability derived from Kipnis’s taxonomy were identified and included: (i) communicative vulnerability, represented by participants impaired in their ability to communicate because of distressing symptoms; (ii) institutional vulnerability, which referred to participants who existed under the authority of others—for example, in hospital; (iii) deferential vulnerability, which included participants who were subject to the informal authority or the independent interests of others; (iv) medical vulnerability, which referred to participants with distressing medical conditions; and (v) social vulnerability, which included participants considered to belong to an undervalued social group. Participants from both ethnic groups populated all these domains, but those who were black Caribbean were more present among the socially vulnerable. Conclusions: Current classifications of vulnerability require reinterpretation when applied to qualitative research at the end of life. We recommend that researchers and research ethics committees reconceptualise vulnerability using the domains identified in this study and consider the research context and interviewers’ skills. (shrink)

Most of what has been written about Buber and education tend to be studies of two kinds: theoretical studies of his philosophical views on education, and specific case studies that aim at putting theory into practice. The perspective taken has always been to hold a dialogue with Buber's works in order to identify and analyse critically Buber's views and, in some cases, to put them into practice; that is, commentators dialogue with the text. In this article our aims are of (...) a different kind. First and fundamentally, we demonstrate the political and social ontological basis of Buber's thought; that is, we show that Buber, the philosopher of dialogue, held an authentic dialogue with his time, and demonstrate that Buber's work, in this case I and Thou, holds a dialogue with its Zeitgeist; that is the text dialogues with its Zeitgeist. This approach leads us to our second aim, which is to demonstrate that Buber's thought remains relevant to our times, particularly when it serves as a dialogical educational tool with which to resolve conflict of all types and to aid dialogue towards peace in inter‐community relations. (shrink)

Prenatal genetic testing is becoming available for an increasingly broad set of diseases, and it is only a matter of time before parents can choose to test for hundreds, if not thousands, of genetic conditions in their fetuses. Should access to certain kinds of fetal genetic information be limited, and if so, on what basis? We evaluate a range of considerations including reproductive autonomy, parental rights, disability rights, and the rights and interests of the fetus as a potential future child. (...) We conclude that parents should be able to access information that could be useful during pregnancy, but that testing for non-medical information should be limited. Next, we argue that the government lacks a compelling state interest in regulating prenatal genetic testing and propose that regulation should occur through medical professional organizations. Finally, we present a framework for determining what testing physicians should recommend, offer neutrally, or not offer at all. (shrink)

When the HPV vaccine was released over a decade ago, there was intense opposition to mandating the vaccine, including among bioethics and legal scholars. Some of the original concerns are now obsolete, while other objections continue to present an obstacle to mandating the vaccine. This essay responds to earlier critiques of mandatory HPV vaccination and offers a series of arguments in support of a vaccine mandate. The first section briefly addresses initial concerns that are no longer relevant. The second section (...) makes the ethical case for mandating HPV vaccination, based on three principles: 1) the best interests of children, 2) solidarity, and 3) health equity. The final section addresses concerns related to implementation of the vaccine, including the validity of linking vaccination to school entry. The essay concludes that we have a moral imperative to protect children from the leading cause of cervical cancer, and that mandating HPV vaccination is the best way to ensure that children of all backgrounds receive the vaccine before they have been exposed to the virus. (shrink)

Nobel Laureate Kazou Ishiguro’s (2010) novel “Never Let Me Go” follows individuals intentionally bred to donate their organs over multiple years, ultimately dying when the final “vital organs” are...

Since the human genome was decoded, great emphasis has been placed on the unique, personal nature of the genome, along with the benefits that personalized medicine can bring to individuals and the importance of safeguarding genetic privacy. As a result, an equally important aspect of the human genome – its common nature – has been underappreciated and underrepresented in the ethics literature and policy dialogue surrounding genetics and genomics. This article will argue that, just as the personal nature of the (...) genome has been used to reinforce individual rights and justify important privacy protections, so too the common nature of the genome can be employed to support protections of the genome at a population level and policies designed to promote the public's wellbeing. In order for public health officials to have the authority to develop genetics policies for the sake of the public good, the genome must have not only a common, but also a public, dimension. This article contends that DNA carries a public dimension through the use of two conceptual frameworks: the common heritage framework and the common resource framework. Both frameworks establish a public interest in the human genome, but the CH framework can be used to justify policies aimed at preserving and protecting the genome, while the CR framework can be employed to justify policies for utilizing the genome for the public benefit. A variety of possible policy implications are discussed, with special attention paid to the use of large-scale genomics databases for public health research. (shrink)

Work—family policy strategies reflect gendered assumptions about the roles of men and women within families and therefore may lead to significantly different outcomes, particularly for families headed by single mothers. The authors argue that welfare states have adopted strategies based on different assumptions about women's and men's roles in society, which then affect women's chances of living in poverty cross-nationally. The authors examine how various strategies are associated with poverty rates across groups of women and also examine more directly the (...) effects of specific work—family policies on poverty rates. They find that while family benefits and child care for young children unequivocally lower poverty rates, particularly for families headed by a single mother, long parental leaves have more ambivalent effects. The findings suggest that it is critical to examine the gendered assumptions underlying work—family policies rather than viewing all work—family policies as the same. (shrink)

Berger and Miller argue that contemporary medical education directed toward “cultural competency” fails to address the structural inequities and systemic racism underpinning health dispariti...

Using the 1979-2006 waves of the National Longitudinal Survey of Youth, we investigate how the earnings bonus for fatherhood varies by characteristics associated with hegemonic masculinity in the American workplace: heterosexual marital status, professional/managerial status, educational attainment, skill demands of jobs, and race/ethnicity. We find the earnings bonus for fatherhood persists after controlling for an array of differences, including human capital, labor supply, family structure, and wives’ employment status. Moreover, consistent with predictions from the theory of hegemonic masculinity within bureaucratic (...) organizations, the fatherhood bonus is significantly larger for men with other markers of workplace hegemonic masculinity. Men who are white, married, in households with a traditional gender division of labor, college graduates, professional/managerial workers and whose jobs emphasize cognitive skills and deemphasize physical strength receive the largest fatherhood earnings bonuses. (shrink)

In the law of rape, consent has been and remains a gendered concept. Consent presumes female acquiescence to male sexual initiation. It presumes a man desires to penetrate a woman sexually. It presumes the woman willingly yields to the man's desires. It does not presume, and of course does not require, female sexual desire. Consent is what the law calls it when he advances and she does not put up a fight. I have argued elsewhere that the kind of thin (...) consent that the law focuses on is not enough ethically and it should not be enough legally to justify sexual penetration. I advocate sexual negotiation, where individuals discuss sexual desires and boundaries and agree to engage in penetration before it occurs, except under circumstances in which the partners have a reasonable basis to assess one another's nonverbal behavior. I argue that not only is verbal consultation about desire ordinarily ethically necessary before most acts of sexual penetration, it should be legally required. Consultation to ascertain sexual desires and boundaries assures that both parties desire penetration. (shrink)

PurposeTo examine the contribution of “values-based reasoning” in evaluating older adults’ capacity to make medical decisions.Design and MethodsOlder men with schizophrenia (n=20) or dementia (n=20), and a primary care comparison group (n=19), completed cognitive and psychiatric screening and an interview to determine their capacity to make medical decisions, which included a component on values. All of the participants were receiving treatment at Veterans Administration (VA) outpatient clinics.ResultsParticipants varied widely in the activities and relationships they most valued, the extent to which (...) religious beliefs would influence healthcare decisions, and in ratings of the importance of preserving quality versus length of life. Most participants preferred shared decision making with doctor, family, or both. Individuals with schizophrenia or dementia performed worse than a primary care comparison group in reasoning measured by the ability to list risks and benefits and compare choices. Individuals with dementia performed comparably to the primary care group in reasoning measured by the ability to justify choices in terms of valued abilities or activities, whereas individuals with schizophrenia performed relatively worse compared to the other two groups. Compared to primary care patients, participants with schizophrenia and with dementia were impaired on the ability to explain treatment choices in terms of valued relationships.ConclusionMedical decision making may be influenced by strongly held values and beliefs, emotions, and long life experience. To date, these issues have not been explicitly included in structured evaluations of medical decision-making capacity. This study demonstrated that it is possible to inquire of and elicit a range of healthcare related values and preferences from older adults with dementia or schizophrenia, and individuals with mild to moderate dementia may be able to discuss healthcare options in relation to their values. However, how best to incorporate a values assessment into a structured capacity evaluation deserves further research attention. (shrink)

This paper reviews common advertising claims by egg freezing companies and evaluates the medical evidence behind those claims. It then surveys legal standards for truth in advertising, including FTC and FDA regulations and the First Amendment right to free speech. Professional standards for medical advertising, such as guidelines published by the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, and the American Medical Association, are also summarized. A number of claims, many of which relate to the (...) targeting of younger women for eOC, are found to breach legal and ethical standards for truth in advertising. The ethical implications of misleading advertising claims are also discussed, and the central narrative woven by OC ads — that egg freezing is empowering to women — is examined. The paper concludes that a more balanced approach to the risks and benefits of OC is necessary to truly respect women's autonomy. Moreover, justice requires us to look beyond a medical procedure accessible only to a minority of women in order to address inequities in the workplace. (shrink)

The ongoing generation of expectations is fundamental to listeners’ experience of music, but research into types of statistical information that listeners extract from musical melodies has tended to emphasize transition probabilities and n‐grams, with limited consideration given to other types of statistical learning that may be relevant. Temporal associations between scale degrees represent a different type of information present in musical melodies that can be learned from musical corpora using expectation networks, a computationally simple method based on activation and decay. (...) Expectation networks infer the expectation of encountering one scale degree followed in the near (but not necessarily immediate) future by another given scale degree, with previous work suggesting that scale degree associations learned by expectation networks better predict listener ratings of pitch similarity than transition probabilities. The current work outlines how these learned scale degree associations can be combined to predict melodic continuations and tests the resulting predictions on a dataset of listener responses to a musical cloze task previously used to compare two other models of melodic expectation, a variable‐order Markov model (IDyOM) and Temperley's music‐theoretically motivated model. Under multinomial logistic regression, all three models explain significant unique variance in human melodic expectations, with coefficient estimates highest for expectation networks. These results suggest that generalized scale degree associations informed by both adjacent and nonadjacent relationships between melodic notes influence listeners’ melodic predictions above and beyond n‐gram context, highlighting the need to consider a broader range of statistical learning processes that may underlie listeners’ expectations for upcoming musical events. (shrink)

Using data from the 1979 to 1998 waves of the National Longitudinal Survey of Youth, the author explores how gender, family, and class alter the impact of self-employment on earnings. Fixed-effect regression results show that while self-employment positively influences men’s earnings, not all women similarly benefit. Professionals receive the same self-employment earnings premium, regardless of gender. However, self-employment in nonprofessional occupations negatively affects women’s earnings, with wives and mothers incurring the greatest penalties. The high concentration of nonprofessional self-employed women in (...) child care accounts for much of these penalties. Results are robust despite inclusion of controls for human capital and labor supply, job characteristics, occupational and industrial gender segregation, and demographic characteristics. The compensating differentials argument, that women with greater family responsibilities trade earnings for the family-friendly aspects of self-employment, is discussed in light of these findings. While this argument may explain women’s returns to nonprofessional self-employment, it is less persuasive for interpreting women’s returns to professional self-employment. (shrink)

This book is addresses a topic that has received little or no attention in orthodox epistemology. Typical epistemological investigation focuses almost exclusively on knowledge, where knowing that something is the case importantly implies that what is believed is strictly true. This condition on knowledge is known as factivity and it is, to be sure, a bit of epistemological orthodoxy. So, if a belief is to qualify as knowledge according to the orthodox view it cannot be false. There is also an (...) increasingly influential group of epistemologists who argue that one ought to act only on what one knows, because truth of belief is the surest way to guarantee that our actions work out as planned. They defend what is known as the knowledge norm for action. This view is typically justified in virtue of the idea that successful intentional action should stem from knowledge because knowledge is a factive propositional attitude and it is, as a result, success-prone with respect to intentional action. In other words, true beliefs that constitute knowledge are the rationally normative standard for successful acting. But, there are clearly multitudes of cases where epistemic agents operate successfully and even rationally on the basis of beliefs that are false. That this is the case is not especially controversial. Sometimes false beliefs facilitate successful action. Of course, this can be because the agent is simply lucky. However, there is something particularly important about some false beliefs that relates to successful action but not in virtue of luck. While not strictly true, the beliefs in question are close to the truth or approximately true. This gives rise to the possibility that there are knowledge-like states that play roles very similar to knowledge but which are only quasi-factive. That is to say such states imply approximate truth and do not imply strict truth. Moreover, often such beliefs facilitate successful action in virtue of their being approximately true and this suggests a much more plausible norm for successful action that encompasses both cases of rational action guided by such quasi-factive states as well as cases of rational action guided by knowledge. The thesis of this book is that quasi-factive knowledge-like states are far more common that epistemologists have acknowledge and the book introduces a theory of such states and how they give rise to a much more reasonable account of the norms for action. This involves some tricky issues concerning approximate truth, the rationality of believing not strictly true claims, the justification of approximately true beliefs, the nature of false but approximately true evidence, the norms of belief, knowledge and quasi-knowledge, etc. (shrink)

This commentary describes the use of ecological priming methods to address the limitations of the correlational research discussed in the target article. We provide examples from our own work on cultural tightness–looseness to illustrate how we can bring ecological and societal conditions into the laboratory in order to study the impact of ecological threats on psychological processes experimentally.

As scholars have rushed to either prove or refute cultural group selection, the debate lacks sufficient consideration of CGS's potential moderators. We argue that pressures for CGS are particularly strong when groups face ecological and human-made threat. Field, experimental, computational, and genetic evidence are presented to substantiate this claim.

In lieu of an abstract, here is a brief excerpt of the content:Consenting for Novel and Dangerous Surgical Procedures with Minimal Supporting EvidenceMichelle J. ClarkeFrank1 was a 19–year–old man referred to me after a workup for back pain led to the discovery of a large, aggressive tumor in his sacrum. The tumor wrapped around the nerves controlling bowel, bladder, and leg function. We performed a needle biopsy and learned that the tumor was an angiosarcoma, an extremely aggressive and usually deadly (...) form of cancer. However, the tumor was unique in that it theoretically could be cured if removed in one piece. But, to do so would necessitate sacrificing the nerves, leaving the patient irreversibly incontinent, lacking sexual function, and confined to a wheelchair.Once we knew the diagnosis, Frank came to the office with his family to discuss treatment options. He appeared terrified and was almost silent through the appointment, deferring most questions to his parents. Due to the speed of tumor growth, we discussed palliative therapy, conventional treatment, and the one–piece or “en bloc” surgery, which was new and unproven for his disease. Based on the remarkable tumor growth we noted during the work–up, with palliative treatment the patient would likely survive for less than six months. Conventional treatment, in which surgery is done to remove part of the tumor while sparing the nerves to bowel and bladder function, was known to have a high rate of recurrence and death. Further, this tumor didn’t respond well to radiation and chemotherapy, so chance of survival was limited, although his life might have been extended for a short period. Thus our conversation turned to the novel “en bloc” procedure.The en bloc procedure offered a hope of long–term survival unlike the other options. However, this came with an enormous cost. The surgery itself would be planned to occur over three days with five separate surgical teams and a very real chance of major complications or death. Nerves to bowel and bladder would be cut, irreversibly leaving the patient without sexual function, and completely incontinent with a urinary catheter and colostomy. Walking was expected to be disrupted or potentially impossible due to the nerve resection. We went to great lengths over the course of many visits to describe the impact of the surgery on the patient’s function, and the impact on his quality of life. To make matters more challenging, as this procedure was so new and the tumor so rare, research did not yet exist to quantify his likelihood of long–term survival.Personally I was very uncomfortable with the situation. From a medical standpoint, the surgery offered was the best distillation of research and professional experience. En bloc surgery offered the best—if not the only—chance for survival in [End Page 5] this young man. Additionally, having treated many spine–injured patients I was aware that many patients with similar deficits led happy and productive lives following an emotional and physical adjustment period. However the surgery was also extreme. I worried that we would not be able to accomplish the goal of a one–piece resection and would accidentally spill some of the tumor, creating all of the deficits but no survival benefit. Frankly, I thought there was a 25% chance that would happen, which was explained to the family preoperatively. Were we overreaching our abilities and making a dying patient’s life worse by proceeding?Second, I was uneasy about the social situation. The patient’s family was very supportive, traveling with him to all appointments and assisting with his care. The patient himself usually deferred all scheduling to his mother, which wasn’t entirely unusual for such a young man. However it was difficult to grasp how much the patient understood of his disease or supported the plan. We attempted to delve more deeply into his thoughts, including without his parents present, but got only short answers, which revealed little. While the family appeared to have accepted the diagnosis and wanted to get to the business of treatment, the patient seemed to me to still carry the shock of his recent cancer diagnosis. Pushed by the rapid tumor growth, we were limited in how long we could wait for... (shrink)

We would like to thank the authors of the excellent Open Peer Commentaries on our target article, “Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Ge...

PurposeThis paper sets out to offer a holistic perception of the information ecology in which disadvantaged communities of the so‐called third world operate with a view to contribute to overcoming its limitations in a more effective way.Design/methodology/approachThe authors briefly review the major social, economic and cultural characteristics of disadvantaged communities that balance the common place trust in the power of modern information products and infrastructures. Based upon a number of field studies the notion of information needs is reconsidered and combined (...) with concerns for information literacy, social autonomy and the role of indigenous knowledge. The authors then present a number of examples of innovative approaches to the delivery of information services that may support the role of information centers and libraries as change catalyst from within the communities rather than mere providers of ready made information.FindingsTo this end, information professionals have to be educated in order to become change agents and consider this role as essential for their practice to be rewarding for themselves and more importantly for the people they serve. There are numerous examples of information services and information professionals who make a difference in the life of their communities against the most severe circumstances. This however requires a radical shift in their value system and operation.Originality/valueThe authors hope that the paper will encourage information professionals and in first place those who educate them to give social responsibility toward disadvantaged communities the same emphasis and priority as alignment with the latest technological artifact or excellence in observance of standards. (shrink)

The degradation of modern sport--its commercialization, trivialization, widespread cheating, cult of athletic stars and celebrities, and manipulation by the media--has led to calls for its transformation. William J. Morgan constructs a critical theory of sport that shores up the weak arguments of past attempts and points a way forward to making sport more humane, compelling, and substantive. Drawing on the work of social theorists, Morgan challenges scholars and fans alike to explore new spaces in sport culture and imagine (...) the rich cultural and political possibilities to be found in the pastimes we follow with such passion. (shrink)

Engaging variously with the legacy of Paul L. Lehmann, these essays argue for a reorientation in Christian theology that better honours the formative power of ...

In ‘Discrimination Against the Dying’, Phillip Reed argues that terminally ill patients are subjected to a distinct form of discrimination called ‘terminalism’. One of Reed’s primary examples of terminalism is right to try laws, which offer terminally ill patients the option to request medications that are not FDA-approved and without IRB involvement. In this analysis, we consider additional contextual factors about right to try, suggesting that it may not neatly count as an exemplar of terminalism. When pursued with appropriate protocols (...) and oversight, right to try has the potential to broaden treatment opportunities for the terminally ill by bypassing FDA and IRB restrictions, functioning as a less stringent alternative to expanded access for patients with limited time and dwindling options. Reed acknowledges that differential treatment of patients is not inherently unjust. For instance, Reed praises expanded access laws that grant patients with severe or life-threatening diseases access to treatment options otherwise unavailable. Patients not afflicted by severe illness or who have found success with standard treatment options are unlikely to face discrimination for inability to access nonessential treatment. Conversely, availability of these treatments for the terminally ill could enhance their well-being and prolong their lifespan. It is also significant to highlight important …. (shrink)

Sociocultural influences on the development of child language skills have been widely studied, but the majority of the research findings were generated in Northern contexts. The current crosslinguistic, multisite study is the first of its kind in South Africa, considering the influence of a range of individual and sociocultural factors on expressive vocabulary size of young children. Caregivers of toddlers aged 16 to 32 months acquiring Afrikaans, isiXhosa, South African English, or Xitsonga as home language completed a family background questionnaire (...) and the MacArthur-Bates Communicative Development Inventory about their children. Based on a revised version of Bronfenbrenner’s ecological systems theory, information was obtained from the family background questionnaire on individual factors, microsystem-related factors, and exosystem-related factors. All sociocultural and individual factors combined explained 25% of the variance in expressive vocabulary size. Partial correlations between these sociocultural factors and the toddlers’ expressive vocabulary scores on 10 semantic domains yielded important insights into the impact of geographic area on the nature and size of children’s expressive vocabulary. Unlike in previous studies, maternal level of education and SES did not play a significant role in predicting children’s expressive vocabulary scores. These results indicate that there exists an interplay of sociocultural and individual influences on vocabulary development that requires a more complex ecological model of language development to understand the interaction between various sociocultural factors in diverse contexts. (shrink)

East Asians and Westerners differ in various aspects of perception and cognition. For example, visual memory for East Asians is believed to be more influenced by the contextual aspects of a scene than is the case for Westerners (Masuda & Nisbett, 2001). There are also differences in visual search: for Westerners, search for a long line among short is faster than for short among long, whereas this difference does not appear to hold for East Asians (Ueda et al., submitted). However, (...) it is unclear how these group-level differences originate. To investigate the extent to which they depend upon environment, we tested visual search and visual memory in East Asian immigrants who had lived in Canada for different amounts of time. Recent immigrants were found to exhibit no search asymmetry, unlike Westerners who had spent their lives in Canada. However, immigrants who had lived in Canada for more than two years showed performance comparable to that of Westerners. These differences could not be explained by the general analytic/holistic processing distinction believed to differentiate Westerners and East Asians, since all observers showed a strong holistic tendency for visual recognition. Results instead support the suggestion that exposure to a new environment can significantly affect the particular processes used to perceive a given stimulus. (shrink)

The use of Big Data—however the term is defined—involves a wide array of issues and stakeholders, thereby increasing numbers of complex decisions around issues including data acquisition, use, and sharing. Big Data is becoming a significant component of practice in an ever-increasing range of disciplines; however, since it is not a coherent “discipline” itself, specific codes of conduct for Big Data users and researchers do not exist. While many institutions have created, or will create, training opportunities to prepare people to (...) work in and around Big Data, insufficient time, space, and thought have been dedicated to training these people to engage with the ethical, legal, and social issues in this new domain. Since Big Data practitioners come from, and work in, diverse contexts, neither a relevant professional code of conduct nor specific formal ethics training are likely to be readily available. This normative paper describes an approach to conceptualizing ethical reasoning and integrating it into training for Big Data use and research. Our approach is based on a published framework that emphasizes ethical reasoning rather than topical knowledge. We describe the formation of professional community norms from two key disciplines that contribute to the emergent field of Big Data: computer science and statistics. Historical analogies from these professions suggest strategies for introducing trainees and orienting practitioners both to ethical reasoning and to a code of professional conduct itself. We include two semester course syllabi to strengthen our thesis that codes of conduct can be harnessed to support the development of ethical reasoning in, and a sense of professional identity among, Big Data practitioners. (shrink)