Children and adolescents with an intellectual disability and autistic traits often attend special needs schools where they are surrounded by peers with diverse characteristics. Given the role that peers can play in social development, we examined whether autistic traits development in students with ID and high levels of such characteristics are influenced by the level of autistic traits among the schoolmates they like most. Furthermore, we investigated the degree to which this peer influence susceptibility depends on students’ gender. A longitudinal (...) design, with data collection points at the beginning and the end of a school year, was used. Staff reported on 330 students with high levels of autistic traits who attended 142 classrooms in 16 Swiss special needs schools. Results showed that students’ future individual level of autistic traits was not predicted by the autistic traits level of preferred peers, controlling for individual autistic traits at T1, level of general functioning, gender, and age. However, the peer effect was significantly moderated by students’ gender, indicating that girls but not boys were susceptible to peer influence. These findings are discussed in terms of implications for understanding autistic traits development and directions of support for children and adolescents in their peer context. (shrink)

As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of (...) ethical issues associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are ‘fit for reallocation’ have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated. (shrink)

On the surface, dreams and activity tracking seem to have little in common. We see dream reports as subjective and memory-dependent, whereas activity data is objective and measured using technology. However, as a psychologist interested in wearable technology and activity tracking, and a philosopher interested in dreams, we noticed a striking parallel in our work. We like to be seen as hardworking and healthy, which can be conveyed by sharing our activity data. We also want to be seen as interesting, (...) creative or funny, which motivates dream reporting. Through sharing this information with each other we attempt to subtly display our positive characteristics, even if it can mean making things up. (shrink)

In the present research, we validated a new scale developed from self-determination theory to assess the functional meaning of cash rewards offered in the workplace. According to SDT, rewards can take on different meanings based on the way they are perceived by individuals. In a series of three studies in different socioeconomic contexts, we replicated the two-factorial structure of the scale measuring respectively workplace cash rewards’ informative and controlling meanings. In Study 1, we validated the English version of the scale (...) by exploring and then confirming its two-factor structure with two English-speaking employee samples. We further replicated its two-factor structure in a French-speaking employee sample of employees in Study 2 and in a Greek-speaking employee sample in Study 3, allowing us to validate its French and Greek version. Results from our three studies show how distinct meanings attributed to cash rewards, i.e., informative or controlling, relate differently to autonomous and controlled forms of motivation based on SDT. These findings suggest that workplace cash rewards differently influence employees’ motivation depending on whether they are perceived as informative or controlling, thus providing empirical evidence for the theoretical and practical implications of SDT’s concept of functional meaning of cash rewards. Our research contributes to the assessment and understanding of employees’ experience of workplace cash rewards and provides empirical evidence that the concept of the functional meaning of cash rewards is a distinct concept from other money-related concepts such as subjective pay satisfaction, performance-contingent rewards, and financially contingent self-worth. (shrink)

Staff reported paranormal experiences in connection with the outpatient Medical Assistance in Dying room at the hospital. This case study reports on staff experiences and illustrates how the Ethics team’s role expanded to deal with this novel situation by facilitating an interdisciplinary response.

The use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified is related to professionals’ normative attitudes regarding the use of coercion. This paper describes an explorative statistical analysis based on a cross-sectional survey across seven wards in three Norwegian mental health care institutions. Descriptive analyses showed that in general the 379 respondents a) were not so sure whether coercion should be seen as (...) offending, b) agreed with the viewpoint that coercion is needed for care and security, and c) slightly disagreed that coercion could be seen as treatment. Staff did not report high rates of moral doubt related to the use of coercion, although most of them agreed there will never be a single answer to the question ‘What is the right thing to do?’. Bivariate analyses showed that the more they experienced general moral doubt and relative doubt, the more one thought that coercion is offending. Especially psychologists were critical towards coercion. We found significant differences among ward types. Respondents with decisional responsibility for coercion and leadership responsibility saw coercion less as treatment. Frequent experience with coercion was related to seeing coercion more as care and security. This study showed that experiencing moral doubt is related to some one’s normative attitude towards coercion. Future research could investigate whether moral case deliberation increases professionals’ experience of moral doubt and whether this will evoke more critical thinking and increase staff’s curiosity for alternatives to coercion. (shrink)

This paper reports the key findings from two student surveys undertaken at our institution in the academic years 2020-21 and 2021-22. The research was based on the Bretag et al. (2018) student survey undertaken in various Australian universities. After discussions with both Bretag and Harper, we adapted the questions to our context – a Russell Group university in the UK – but included similar questions to enable a comparison, and to find out if there were common themes. The main aim (...) of the surveys was to understand our students’ awareness of what is meant by the term ‘academic integrity’, defined as ‘being honest in your work, acknowledging the work of others and giving credit where you have used other people’s ideas/data’ https://secretariat.leeds.ac.uk/wp-content/uploads/sites/109/2022/12/academic_integrity.pdf. The responses provided an important insight into student attitudes to academic integrity, their understanding of academic malpractice, and their awareness of the penalties if found to have plagiarised, and if found guilty of contract cheating (Medway et al., 2018; Morris, 2018; Harper et al., 2019). The surveys also identified what students would find useful in developing their understanding of academic integrity, and this underlines the importance of consulting our students. Key findings include gaps in the information provided to students, the need for regular and timely reminders of the principles of academic integrity, and the need for guidance to be written using student-friendly language. The findings informed our recommendations in terms of teaching and learning at School/Faculty level and to policy at University level, to further support student success. In the context of the key issues raised by the Quality Assurance Agency for Higher Education (QAA) Academic Integrity Charter (2020), we discuss examples of best practice currently undertaken at the University of Leeds, on-going discussions regarding developments, and our recommendations for further embedding a culture of academic integrity. We argue that all students should have the same baseline experience and therefore promoting this ethos is the responsibility of all staff who teach and support students. (shrink)

Background It has been well documented that patients can feel abused in health care and that many patients suffer from these experiences. Insight lacks into contributing factors behind such events. Silence surrounding the abuse has been suggested as a possible mechanism. The present study explores silence surrounding the abuse as a possible contributing factor. We have explored whether this silence is connected with the staff’s hierarchical position and with the staff’s own experiences as patients abused in health care. (...) Methods During January 2008, a paper questionnaire was sent to all staff members at a Swedish women’s clinic. The questionnaire included questions on sociodemography and profession and multiple questions about abuse in health care. After univariate testing, a binary logistic regression model including variables concerning profession and staff’s own experiences of abuse was built. Results Our data show that in contrast to midwives and gynaecologists, auxiliary nurses seldom report hearing about cases of abuse in health care. Staff who themselves experienced abuse in health care as patients, so-called wounded healers, were more likely to have heard about abuse in health care during the last 12 months. Conclusions This study suggests that a form of silence reigns over events of abuse in health care that is not randomly distributed over staff. Professional hierarchies and staff’s own experiences of abuse as patients could be considered in the design of interventions to break the silence surrounding patients’ experiences of abuse in health care. (shrink)

BackgroundObtaining consent has become a standard way of respecting the patient’s rights and autonomy in clinical research. Ethical guidelines recommend that the child’s parent/s or authorised legal guardian provides informed consent for their child’s participation. However, obtaining informed consent in paediatric research is challenging. Parents become vulnerable because of stress related to their child’s illness. Understanding the views held by guardians and researchers about the consent process in Malawi, where there are limitations in health care access and research literacy will (...) assist in developing appropriate consent guidelines.MethodsWe conducted 20 in-depth interviews with guardians of children and research staff who had participated in paediatric clinical trial and observational studies in acute and non-acute settings in the Southern Region of Malawi. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Interviews were compared across studies and settings to identify differences and similarities in participants’ views about informed consent processes. Data analysis was facilitated by NVIVO 11 software.ResultsAll participants across study types and settings reported that they associated participating in research with therapeutic benefits. Substantial differences were noted in the decision-making process across study settings. Guardians from acute studies felt that the role of their spouses was neglected during consenting, while staff reported that they had problems obtaining consent from guardians when their partners were not present. Across all study types and settings, research staff reported that they emphasised the benefits more than the risks of the study to participants, due to pressure to recruit. Participants from non-acute settings were more likely to recall information shared during the consent process than participants in the acute setting.ConclusionThe health care context, culture and research process influenced participants’ understanding of study information across study types and settings. We advise research managers or principal investigators to define minimum requirements that would not compromise the consent process and conduct study specific training for staff. The use of one size fits all consent process may not be ideal. More guidance is needed on how these differences can be incorporated during the consent process to improve understanding and delivery of consent.Trial registration Not applicable. (shrink)

Abstract:Recently the scope of protections afforded those healthcare professionals and institutions that refuse to provide certain interventions on the grounds of conscience have expanded, in some instances insulating providers (institutional and individual) from any liability or sanction for harms that patients experience as a result. With the exponential increase in the penetration of Catholic-affiliated healthcare across the country, physicians and nurses who are not practicing Catholics are nevertheless required to execute documents pledging to conform their patient care to the Ethical (...) and Religious Directives for Health Care Services as a condition of employment or medical staff privileges. In some instances, doing so may result in patient morbidity or mortality or violate professional standards for respecting advance directives or surrogate decisionmaking. This article challenges the ethical propriety of such institutional mandates and argues that legal protections for conscientious refusal must provide redress for patients who are harmed by care that falls below the prevailing clinical standards. (shrink)

There is a long-standing debate in philosophy about whether it is morally permissible to harm one person in order to prevent a greater harm to others and, if not, what is the moral principle underlying the prohibition. Hypothetical moral dilemmas are used in order to probe moral intuitions. Philosophers use them to achieve a reflective equilibrium between intuitions and principles, psychologists to investigate moral decision-making processes. In the dilemmas, the harms that are traded off are almost always deaths. However, the (...) moral principles and psychological processes are supposed to be broader than this, encompassing harms other than death. Further, if the standard pattern of intuitions is preserved in the domain of economic harm, then that would open up the possibility of studying behavior in trolley problems using the tools of experimental economics. We report the results of two studies designed to test whether the standard patterns of intuitions are preserved when the domain and severity of harm are varied. Our findings show that the difference in moral intuitions between bystander and footbridge scenarios is replicated across different domains and levels of physical and non-physical harm, including economic harms. (shrink)

There is a long-standing debate in philosophy about whether it is morally permissible to harm one person in order to prevent a greater harm to others and, if not, what is the moral principle underlying the prohibition. Hypothetical moral dilemmas are used in order to probe moral intuitions. Philosophers use them to achieve a reflective equilibrium between intuitions and principles, psychologists to investigate moral decision-making processes. In the dilemmas, the harms that are traded off are almost always deaths. However, the (...) moral principles and psychological processes are supposed to be broader than this, encompassing harms other than death. Further, if the standard pattern of intuitions is preserved in the domain of economic harm, then that would open up the possibility of studying behaviour in trolley problems using the tools of experimental economics. We report the results of two studies designed to test whether the standard patterns of intuitions are preserved when the domain and severity of harm are varied. Our findings show that the difference in moral intuitions between bystander and footbridge scenarios is replicated across different domains and levels of physical and non-physical harm, including economic harms. (shrink)

This first-of-its-kind national survey of 485 psychiatrists in nine states and the District of Columbia finds substantial evidence of clinicians being uninformed, misinformed, and misinforming patients of their gun rights regarding involuntary commitments and voluntary inpatient admissions. A significant percentage of psychiatrists did not understand that an involuntary civil commitment triggered the loss of gun rights, and the majority of psychiatrists in states with prohibitors on voluntary admissions and emergency holds were unaware that patients would lose gun rights upon voluntary (...) admission or temporary commitment. Moreover, the survey found evidence that psychiatrists may use gun rights to negotiate “voluntary” commitments with patients: 15.9% of respondents reported telling patients they could preserve their gun rights by permitting themselves to be voluntarily admitted for treatment, in lieu of being involuntarily committed. The results raise questions of whether psychiatrists obtained full informed consent for voluntary patient admissions, and suggest that some medical providers in states with voluntary admission prohibitor laws may unwittingly deprive their patients of a constitutional right. The study calls into question the fairness of state prohibitor laws as policy, and — at minimum — indicates an urgent need for psychiatrist training on their state gun laws. (shrink)

I analyzed 298 open-ended responses of undergraduate students who have been reported for cheating to the question, “What, if anything, would have stopped you from committing your act of academic dishonesty?” These responses included a few major themes: students pled ignorance of what constitutes academic dishonesty and the consequences/seriousness associated with violations; students tended to deflect blame, usually by saying that their professor could have done something differently (neutralization); students did not feel they had enough time, resources, and/or skills (...) to get the desired result without taking responsibility for this lack of time, resources, and/or skills (strain); students felt they did not manage their time well with accepting the blame for the poor time management; and that a bad grade was not an option. These data and results are discussed in relation to the extant literature on the topic. (shrink)

A Scientific Approach The facts detailed in this briefing are the results of scientific exploration of terror networks and sacred values and their association to political violence. The research is sponsored by the Air Force Office of Scientific Research and the National Science Foundation.

Hospital ethics committees (HECs) are expected to play extremely broad and pivotal roles such as case consultation, education of staffs on healthcare ethics, and institutional policy formation. Despite the growing importance of HECs, there are no standards for setup and operation of HECs, and composition and activities of HECs at each institution are rarely disclosed in Japan. In addition, there is also a lack of information sharing and collaboration among HECs. Therefore, the authors established the Consortium of Hospital Ethics Committees (...) (CHEC) in October 2020, which has been regularly hosting a couple of core activities. One is the Healthcare Ethics Forum, held monthly online for CHEC members to freely discuss HECs and healthcare ethics consultation. The other is the Collaboration Conference of Hospital Ethics Committees, intended to provide a place for HEC members and administrative officers from across Japan to exchange information of their HECs, learn from each other, and cooperate to operate HECs appropriately. In this paper, the authors introduced CHEC as well as reported the results of a questionnaire survey conducted at the first conference among participating facilities, suggesting the diverse structures and activities of HECs in Japan. (shrink)

It can sound absurd to report that you have forgotten a moral truth. Described cases in which people who have lost moral beliefs exhibit the behavioural and phenomenological symptoms of forgetting can seem similarly absurd. I examine these phenomena, and evaluate a range of hypotheses that might be offered to explain them. These include the following proposals: that it is hard to forget moral truths because they are believed on the basis of intuition; that moral forgetting seems puzzling for the (...) same reason that forgetting what you approve or disapprove of seems puzzling; and that moral truths matter too much to us to be easily forgotten. I conclude that the best explanation for the phenomena is a non-cognitivist one: moral forgetting seems puzzling because moral judgements are attitudes of a sort that cannot be lost through forgetting. (shrink)

This article presents a radical claim: American medical ethics is broken, and it needs love to be healed. Due to a unique set of cultural and economic pressures, American medical ethics has adopted a mechanistic mode of ethical reasoning epitomized by the doctrine of principlism. This mode of reasoning divorces clinicians from both their patients and themselves. This results in clinicians who can ace ethics questions on multiple‐choice tests but who fail either to recognize a patient's humanity or to navigate (...) the ethical quandaries into which they are frequently thrown. Drawing on personal experience as well as the philosophical work of Augustine of Hippo, Simone Weil, and Iris Murdoch, we propose a novel ethical approach grounded in a conception of neighbor love, specifically, the virtue of love understood as attention to a sufferer's humanity. We conclude with five practical recommendations for reimagining medical ethics education oriented around the virtue of love. (shrink)

ObjectivesWuhan is the city where coronavirus disease was first reported and developed into a pandemic. However, the impact of the prolonged COVID-19 pandemic on medical staff burnout remains limited. We aimed to identify the prevalence and major determinants of burnout among medical staff 1 year after the beginning of the COVID-19 pandemic in Wuhan, China.Materials and MethodsA total of 1,602 medical staff from three hospitals in Wuhan, China, were included from November 1–28, 2021. Chi-square tests were conducted (...) to compare the prevalence of burnout across groups based on sociodemographic and professional characteristics. A multivariate analysis was performed using a forward stepwise logistic regression model.ResultsApproximately 37.39% of the medical staff experienced burnout 1 year after COVID-19 pandemic. Emotional exhaustion was the most common symptom of burnout, with 1,422 participants reporting a severe EE. Burnout was associated with insufficient social support and “neutral” or “dissatisfied” patient-physician relationships. Respondents who participated in the care of COVID-19 patients had a higher risk of burnout symptoms than those who did not participate. In particular, mental resilience was negatively associated with burnout among the medical staff.ConclusionNearly two-fifths of the participants had symptoms of burnout, with reduced personal accomplishment being the predominant symptom 1 year after COVID-19. Healthcare organizations should regularly measure and monitor burnout among the medical staff. In addition, creating positive work environments and improving the mental resilience of medical staff may be effective ways to reduce burnout. (shrink)

This study investigated the emotional and behavioural effects of looming threats using both recalled (self-reported valence) and real-time response measurements (facial expressions). The looming bias refers to the tendency to underestimate the time of arrival of rapidly approaching (looming) stimuli, providing additional time for defensive reactions. While previous research has shown negative emotional responses to looming threats based on self-reports after stimulus exposure, facial expressions offer valuable insights into emotional experiences and non-verbal behaviour during stimulus exposure. A face reading experiment (...) examined responses to threats in motion, considering stimulus direction (looming versus receding motion) and threat strength (more versus less threatening stimuli). We also explored the added value of facial expression recognition compared to self-reported valence. Results indicated that looming threats elicit more negative facial expressions than receding threats, supporting previous findings on the looming bias. Further, more (vs. less) threatening stimuli evoked more negative facial expressions, but only when the threats were looming rather than receding. Interestingly, facial expressions of valence and self-reported valence showed opposing results, suggesting the importance of incorporating facial expression recognition to understand defensive responses to looming threats more comprehensively. (shrink)

In the present study, we explored the role of liking in the social induction of affect. Dispositional likeability was manipulated by written reports describing a sender as a likeable or dislikeable character. Afterwards participants watched short videos presenting the sender displaying happy or sad emotional expressions. We expected that exposure to the likeable sender would lead to reactions concordant with his emotional expression, whereas exposure to the dislikeable sender would result in discordant reactions. The results indicated that dispositional likeability influenced (...) the social induction of affect when the sender expressed positive emotions. Moreover, liking mediated the effects of the happy sender’s dispositional likeability on participants’ affective state. Exposure to the sad sender, however, led to assimilation regardless of the sender’s dispositional likeability. (shrink)

An article by Melissa Gymrek and colleagues, published this January in Science, described how the researchers used surname inferences from commercial genealogy databases and Internet searches to deduce the identity of nearly fifty research participants whose supposedly private data were stored in large, publicly available datasets. This news comes just months after the Presidential Commission for the Study of Bioethical Issues published a report that expressed serious concerns about personal privacy and security in whole genome sequencing. The bioethics commission (on (...) which we serve as chair and vice‐chair) highlighted the importance of reconciling the enormous public benefits anticipated from research in this area with the potential risks to individuals’ privacy, and it offered several policy proposals to help balance the potential of scientific progress with privacy and respect for persons. The human subjects research protections laid out in the federal regulations are triggered by the identifiability of data. The participants in the Gymrek et al. study were not “readily identifiable”; however, the data proved far more easily identifiable than expected. With rapidly evolving technology, a precise definition of that notion may be impossible. But if we move the debate from the rhetoric of identifiability to the ethical principles of public beneficence and the centrality of respecting all persons, we find that the real ethical focus must be on promoting generalizable progress while at all times respecting individual privacy. (shrink)

These days many gyms and fitness centers are closed to reduce transmission of the SARS-CoV-2 virus in society. The gym is an environment rich in microorganisms, and careful hygiene is a necessity to keep infections at bay. Exercise centers strive for better hygiene compliance among their members. This effort has become essential in light of the current pandemic. Several experimental studies show that others’ physical presence, or the “illusion” of being watched, may alter behavior. This article reports on a natural (...) field experiment testing one specific social nudge intended to increase gym members’ hygienic behavior. The study was conducted before the SARS-COV-2 pandemic. A picture of “observing eyes” was attached to paper dispensers and cleanser spray bottles at two different gyms in Norway. A reversal design, also called an ABA design, with and without the nudge’s presence, was used to investigate the impact on gym members’ hygienic behavior. A follow-up study was conducted in one of the centers to investigate whether the nudge stimuli would function over time. The study included 254 individual choice situations during nine observation sessions conducted over 9 weeks. The results from both centers provide evidence of a strong effect of the nudge. However, the effect decreased during the follow-up study. These findings support previous research indicating that human behavior is influenced by the presence of implicit observation cues – in this case – observing eyes. However, insights into the long-term effect of implicit observation cues are still needed since the salience of the stimuli faded over time. (shrink)

In this article, we explore the ethical issues related to the reporting of suspected abuse or neglect in research involving children. Ethical dilemmas related to reporting child maltreatment are often complex because the rights of children and their adult caregivers may conflict and determinations of abuse or neglect are socially constructed judgments that depend on particular circumstances. We argue that when reporting is legally mandated, investigators must follow the law and report their suspicions to Child Protective Services. When reporting is (...) not legally mandated, investigators still have an ethical obligation to report to help prevent additional maltreatment and allow children to obtain access to services needed to recover from abuse or neglect. We also argue that investigators should include plans and procedures in the research protocol for making reports and training research staff in recognising evidence of child abuse or neglect. Although investigators should report evidence of abuse or neglect that is discovered incidentally, they have no mandate to actively search for such evidence when it is not related to the study’s objectives. Investigators should also inform parents and children about their obligations to report suspected abuse or neglect. (shrink)

In earlier studies we have shown that abuse in health care (AHC) is commonly reported among both male and female patients. In this study, we present an evaluation of an intervention against AHC based on Forum Play. The evaluation was conducted by means of pre- and postintervention interviews with the staff at a woman's clinic. The interviews were analysed using the constant comparative method. The results of this postintervention study stand out in loud contrast to the results of the (...) preintervention studies. Staff had moved from a distant and fluctuating awareness of AHC to a standpoint characterized by both moral imagination and a sense of responsibility. (shrink)

In this Matters Arising article, we outline how the recent article “The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers’ perceptions” (White et al., 2023 Mar 13;24(1):22) informed Voluntary Assisted Dying (VAD) implementation in our large Australian public health setting, where objections do not emanate from, but within, the institution. In reporting the harms to patients and caregivers created by institutional objection, White et al. provide an evidenced-based road map for potential potholes (...) or risks associated with VAD implementation. We discuss the complexities emerging from the diverse views of health professionals and the ethical tensions arising from such, especially within certain specialties, and how we developed systemic strategies that support patients, caregivers and staff alike. We highlighted the need to shift from “Do you support VAD?“ to “How can we support you as healthcare professionals to integrate VAD into your practice, in a way that complies with the legislation, meets the needs of patients and caregivers, and feels safe and does not compromise your moral stance?“. (shrink)

We develop a theoretical model of income and pay comparison satisfaction with two mediators, examine the direct and the indirect paths of our model, and treat culture as a moderator. Based on 311 professors in the US and Spain, we demonstrate a positive direct path and a negative indirect path. Our subsequent multi-group analysis illustrates: For American professors, their direct path shows that income is directly related to high pay comparison satisfaction. Their indirect path reveals the following new insights: Professors (...) with high income have a strong love of money orientation, set their pay equity comparison standards significantly higher than their own salary, and as a consequence, have low pay comparison satisfaction. For Spanish professors, love of money is not related to their pay comparison standards which are slightly higher than their own self-reported income. Neither the direct nor the indirect path is significant. The standardized total effect of income to pay satisfaction is positive for American professors, but negligible for Spanish professors. Are you satisfied with your pay when you compare? Our results demonstrate that pay comparison satisfaction depends on not only one’s income but also one’s love of money and pay equity comparison standards which may vary across cultures. (shrink)

Philosophical orthodoxy holds that pains are mental states, taking this to reflect the ordinary conception of pain. Despite this, evidence is mounting that English speakers do not tend to conceptualize pains in this way; rather, they tend to treat pains as being bodily states. We hypothesize that this is driven by two primary factors—the phenomenology of feeling pains and the surface grammar of pain reports. There is reason to expect that neither of these factors is culturally specific, however, and thus (...) reason to expect that the empirical findings for English speakers will generalize to other cultures and other languages. In this article we begin to test this hypothesis, reporting the results of two cross-cultural studies comparing judgments about the location of referred pains between two groups—Americans and South Koreans—that we might otherwise expect to differ in how they understand pains. In line with our predictions, we find that both groups tend to conceive of pains as bodily states. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 12.4 (2002) 389-390 [Access article in PDF] IOM Report on the System for Protecting Human Research Participants Tom L. Beauchamp* In response to society's concerns about the use of human subjects in research, the Department of Health and Human Services commissioned the Institute of Medicine to perform a comprehensive assessment of current systems of research participant protection in the U.S., including recommendations for reform (...) (Committee 2002). Although the committee declared its frustration over the lack of data, it found ample evidence to indicate that there are pivotal weaknesses in the current system. First, it discovered dissatisfaction with the current system from virtually every quarter and at virtually every level. Second, it found evidence that IRBs are under severe strain and performing inadequately. Third, it found that the existing regulatory framework—the IRB system and the Common Rule—has not and probably now cannot react adequately to the constantly evolving research environment. Some of these problems might be handled through federal agencies, but the committee holds that the problems are more extensive and will require additional institutional support and professional attention.The committee found that federal protection requirements should be extended to every research project—private, public, or otherwise. Subjects should be, in this respect, equally protected in privately sponsored research.The committee found that the IRB system is in important respects a failure, especially when it alone is relied upon for ethics reviews in institutions. One set of problems concerns the proper education of IRB members. The committee recommends that all members henceforth be given a specialized knowledge of human research ethics. It finds that IRB deliberations commonly have been dominated by scientists, who often marginalize the perspectives of nonscientist members. It therefore recommends that unaffiliated members, nonscientists, local community representatives, and those representing the participant-perspective comprise at least 25 percent of the membership. It also recommends that no protocol be approved without three-quarters of the voting members concurring. [End Page 389]The committee recommends that institutions distinguish review aimed at (1) scientific merit, (2) conflict of interest, and (3) general Ethics Review. The distinction should more evenly distribute the work of institutional ethics review. The IRB should not conduct the initial scientific review nor should it be spending the bulk of its time purely in examining either scientific merit—as many IRBs now do—or conflict of interest. Instead, the conclusions of the scientific review should be submitted to the IRB for ethics-focused deliberations. Problems of both financial and nonfinancial conflicts of interest should be handled similarly, preferably by a committee properly distanced from the institution's interests.The committee underscores that consent must be understood on the model of an interactive dialogue between research staff and participants and not merely as a signed form or single-disclosure event. Conversations between the participant and the research staff should begin even prior to the point of enrollment and should be reinforced during each stage of the research. The committee finds that informed consent conversations and documents too often are being conceived as risk management tasks gauged to protect the institution from liability.The committee also believes that the system of protections established by a research program should be open to the public in order to foster and maintain the community's trust. Open communication should occur among all relevant stakeholders. The committee notes that currently no centralized system exists for the dissemination of information about clinical trials and other research activities.It urges reconsideration of present policies regarding compensation, finding that many research organizations provide at least short-term medical care for those who are injured, but that few organizations cover all potential risks and that many organizations have no effective policy of compensation. The report holds that providing reasonable compensation for bona fide instances of research harm is the only just system and is necessary to avoid diminished public trust.The committee holds that establishing the appropriate culture in research institutions will require sustained efforts to educate researchers, research administrators, IRB members, and... (shrink)

This paper investigates differences in the prevalence of self-reported examination cheating behaviours and perception of peer cheating between enrolled students and graduates. A convenience sample of 344 respondents selected from a Ghanaian polytechnic completed self-administered questionnaires. Data were analysed using descriptive statistics, Chi-square test of independence and Mann Whitney test. “Permitting another student to copy your answers during an exam” was the topmost exam cheating method among students. Graduates were more likely than enrolled students to self-report higher examination cheating (...) behaviours. Enrolled students were less likely than graduates to perceive higher levels of peer cheating. Future studies should consider using graduates in students’ cheating studies in order to validate the results of the study. This study extends the extant literature on academic dishonesty as it provides insight on self-reported cheating between students and graduates. (shrink)

Nonprofit organizations (NPOs), are quite complex in terms of organizational structure, diversity at the workplace, as well as motivational mechanisms and values rationality. Nevertheless, from an Organizational Psychology perspective, the systematic analysis of this context is scarce in the literature, particularly regarding conflicts. This qualitative study analyzes types, prevalence and consequences of conflicts in a large NPO organization considering as theoretical framework several consolidated Organizational Psychology theories: Conflict Theory, Social Comparison Theory and the Equity Theory. Conflicts were analyzed taking into (...) account volunteers’ perspective, who has been consistently protagonist on NPOs research, but also considering paid staff’s perspective, as one of the main stakeholders in these organizations, whose relative power has increase in the past decade due the professionalization of the NPO’s sector. Results confirmed the existence of four types of conflicts: task, process, status and relationship conflicts. Relationship conflict is the least reported type, revealing the protection factor that values and engagement with a social aim have on this organizational context. The most relevant finding is the strong difference between paid staff and volunteers in conflict perceptions, showing paid staff, overall, higher levels of conflicts than volunteers. Findings also show stronger negative consequences for paid staff compared to volunteers. Theoretical and practical implications are discussed. (shrink)

If you will be teaching a course in bioethics in the near future, you might want to assign the books here under review, even if you haven't yet read them. All three authors will be familiar to those working in the field of bioethics: Howard Brody (author of The Future of Bioethics) and Daniel Callahan (In Search of the Good: A Life in Bioethics) as long‐time, significant contributors to the profession, and John Evans (The History and Future of Bioethics: A (...) Sociological View) as a sociologist outsider with a keen eye for the cultural and political currents that helped shape the field. What distinguishes these works is that all three take stock of the history of the field of bioethics and all three imagine or advocate for a particular future. (shrink)

This paper explores by means of content analysis the extent to which the Finnish biggest companies have adapted socially responsible reporting practices. The research focuses on Human Resource (HR) reporting and covers corporate annual reports. The criteria has been set on the basis of the analysis of the documents published at the European level in the context of corporate social responsibility (CSR), paying special attention to the European Council appeal on CSR in March 2000. As CSR is a relatively new (...) concept in Finland, the paper also contributes to the discussion on interface between HR reporting (especially as based on measurements such as Human Resource Accounting and Intellectual Capital schools) and corporate social reporting practices. The results of the content analysis indicate that social reporting practices are still at an early stage of development in Finland. The most reported theme was ‘training and staff development’. A positive sign was that the majority also disclosed themes ‘participation and staff involvement’ and ‘employee health and well-being’. Furthermore, nearly one-third made references to their work atmosphere or job satisfaction survey. However, disclosures lacked overall consistency and comparability with each other and especially quantitative indicators were disclosed by few. Further concern was lack of information related to the theme equal opportunities and going beyond a sheer disclosure of age or gender structure. The other issues rarely disclosed were those related to employee work–life balance and integration of disadvantaged groups in the labour markets. (shrink)

To what extent do I have a sense of agency over my thoughts while I dream? The sense of agency in dreams can alter in a variety of interesting ways distinct from normal, waking experience. In fact, dreams show many similarities to the experiences of individuals with schizophrenia. In this paper I analyze these alterations with a focus on distinguishing between reduced sense of agency and other cognitive features such as metacognition, confabulation and attention. I argue that some dream reports (...) demonstrate two interesting commonalities with schizophrenia: thought insertion (TI) and auditory hallucination (AH). This line of research has the potential to further our understanding of TI and AH in schizophrenia through the analysis of similar experience in a different conscious state. Through the analysis of dream reports, I found that although TI and AH both occur in dreams, TI is very rare. This is an interesting result since TI is common in patients with schizophrenia. I propose two speculative lines of explanation for the rarity of TI in dreams: first, the cognitive differences between the symptoms of schizophrenia and dreams, and second, the problem of dream reporting conditions. Dream reporting conditions are particularly important, as without controls, reports can be vague. Analysis of dream reports reveals that it is often unclear whether 'hearing voices' indicates sound phenomenology or thought phenomenology. I propose that dream reports could be disambiguated given the right experimental conditions and I suggest how this could be achieved in future experimental research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LettersMaxwell J. Mehlman, Susan R. Massey, Ronald M. Green, and Fred RosnerPhysicians and the Allocation of Scarce ResourcesMadam: We read with interest Dr. Pellegrino's commentary on our article in the December 1994 issue of the Kennedy Institute of Ethics Journal, and commend him for pointing out so well the different ways that law and ethics approach the issue of physician allocation of scarce resources.We wish to make one clarification. (...) Dr. Pellegrino states that we propose that fiduciary duties be abolished. Quite the contrary, our position is that fiduciary obligations are essential to the maintenance of trust—which we believe to be an efficient as well as an ethical element of the patient-provider relationship. If fiduciary duties are undercut, as we pointed out they are by the Oregon Medicaid legislation, then some other method of promoting trust must be established, and, as we point out in the article, it is difficult to identify what that method could be.Maxwell J. MehlmanandSusan R. MasseyThe Law Medicine CenterArter & HaddenCase Western Reserve UniversityCleveland, OHSchool of LawCleveland, OHReport of the Human Embryo Research PanelMadam: In the December 1994 issue of the Kennedy Institute of Ethics Journal, I reported on the controversy surrounding the work of the NIH Human Embryo Research Panel and the conclusions reached in its report, which was formally presented to NIH Director Harold Varmus on September 27, 1994. At that time, the report was to be reviewed by the Advisory Committee to the Director (ACD) until its next meeting in early December. I am writing to update your readers on the fate of the Panel's report.On the morning of December 2, 1994, following a previous afternoon of animated discussion, the ACD unanimously accepted the Report of the Human Embryo Research Panel. Panel members and members of the NIH staff who were present and had worked for nearly a year on the Report were gratified by this vote of confidence and by the strong support of NIH Director Harold Varmus.We had little time to enjoy this success. Within a matter of hours, the White House issued a press release in which President Clinton thanked the committee for its work and then, in a remark overruling one of the key recommendations in our report, stated: "I do not believe that federal funds should be used to support the creation of human embryos for research purposes, and I have directed that NIH not allocate any resources for such research." [End Page 83]As a Panel member and active participant in that day's events, my initial response was one of shock. I was particularly distressed that the President and his advisors chose a moment so late in the process to make their views known. Why had we worked for months, I asked, without a word of concern from the White House? Although Panel members were guided primarily by our perceptions of the ethical and scientific issues involved, some were close to the political realities of Washington and would have introduced these concerns into the Panel's deliberations.Within a matter of days, my own sense of outrage had diminished. First of all, it was clear that whatever the personal sources of the President's objections to the Panel's recommendations, this high level political intervention was inevitable. Less than a month before, on November 8, with the election of a majority House and Senate, the political environment for embryo research had changed dramatically. The previous June, 32 congressmen, most of them members of a minority Republican party, had signed a letter protesting the Panel's work. Now, one of the signers of that letter, Newt Gingrich, was destined to be Speaker of the House.Second, it became clear that the damage was not total. The President has forbidden NIH to support work involving the deliberate creation of embryos for research. Without exception, members of the Panel had come to the conclusion that some development of "research embryos" must be permitted to reduce the risks of new assisted reproductive technologies, to enhance scientific knowledge, and to develop new therapies for a range of serious diseases. All these... (shrink)

There are two widespread beliefs about the use of metaphors in clinical medicine. The first is that military metaphors are harmful to patients and should be discouraged in medical practice. The second is that the metaphors of clinical practice can be judged by and standardized in reference to neutral criteria. In this article, I evaluate both these beliefs, exposing their shared flawed logic. This logic underwrites the false empiricist assumptions that metaphorical language and literal language are fundamentally distinct, play separate (...) roles in communication, and therefore can be independently analyzed, systematized, and prescribed. Next, using the resources of ordinary language philosophy, I lay out a theoretical view of medical metaphors that is grounded in metaphor use within clinician‐patient relationships. Finally, drawing on the work of philosopher Max Black, I diagram a practical conceptual framework for clinicians to use when they consider whether a metaphor is appropriate for a specific patient encounter. (shrink)

To encourage altruistic behavior, we need to develop programs in which patients can offer to others the costs of medical care they have a right to claim.