This article reconstructs the reception of Fichte’s philosophy in the works of the physician and philosopher A.K.A. Eschenmayer between 1796 and 1801. In 1796/97, Eschenmayer was working on his project of a metaphysics of nature which would be capable of constituting a middle term between the empirical sciences and the transcendental philosophy. In doing so, he explicitly engaged with Kant, on the one hand, and with scientists of the time, on the other hand, while the influence of Fichte is comparatively (...) slight and less easily discerned. In 1798, however, he introduced into his studies of magnetism an explicit recognition of Fichte and a reference to the third principle of the Wissenschaftslehre. In 1799, Eschenmayer adopted a higher standpoint from which it was possible to conceive the genesis of the concepts which up to that point had been merely analysed. This change of viewpoint coincided with a deeper engagement with the works of Fichte. The analysis of the Dedukzion and of Eschenmayer’s explicit references to Fichte that is attempted in the present study leads to the conclusion that Eschenmayer not only adopted some terminology typical of Fichtean philosophy but also integrated into his deduction several theoretical elements developed by Fichte. The reconstruction of the influences that Fichte exercised on Eschenmayer’s thought is fundamental to an understanding of the theoretical position of Eschenmayer and the point of view from which in 1801 he formulated his criticism of Schelling’s idea of nature as autarchic and as its own legislator.Der Beitrag rekonstruiert die Rezeption der Philosophie Fichtes in den Werken des Arztes und Philosophen A.K.A Eschenmayer aus den Jahren 1796 bis 1801. 1796/97 verfolgt Eschenmayer das Ziel, eine Naturmetaphysik zu entwickeln, die als Mittelglied zwischen den empirischen Wissenschaften und der Transzendentalphilosophie fungieren soll. Dabei setzt er sich einerseits mit Kant und andererseits mit den Wissenschaftlern seiner Zeit auseinander. Der Einfluss von Fichte auf Eschenmayer ist hingegen vergleichsweise gering und nicht leicht festzustellen. Dennoch erkennt Eschenmayer bereits in seiner Studie zum Magnetismus aus dem Jahr 1798 das Verdienst Fichtes an und verweist auf den dritten Grundsatz der Wissenschaftslehre. Im Jahr 1799 erhebt sich Eschenmayer insofern zu einem höheren Standpunkt, als er nun die Genese der Begriffe entfaltet, die er vorher bloß analysiert hatte. Diese Änderung des Standpunktes führt Eschenmayer zu einer tieferen Auseinandersetzung mit den Werken Fichtes. Die in diesem Beitrag durchgeführte Untersuchung der Passagen aus Eschenmayers Dedukzion, in denen sich explizite Verweise auf Fichte finden, hat zu dem Schluss geführt, dass Eschenmayer sich nicht nur Fichtes Terminologie zu eigen macht, sondern auch mehrere von Fichte aufgestellte Theorien in seine eigene Deduktion integriert. Die Rekonstruktion der Einflüsse Fichtes auf Eschenmayer ist nicht nur für ein besseres Verständnis der Philosophie Eschenmayers unentbehrlich, sondern trägt auch zum Verständnis des Standpunktes bei, von dem aus Eschenmayer im Jahre 1801 Kritik an Schellings Idee der Natur als ihrer eigenen Gesetzgeberin übt. (shrink)

Purpose The purpose of this paper is to report on empirical work conducted to open up algorithmic interpretability and transparency. In recent years, significant concerns have arisen regarding the increasing pervasiveness of algorithms and the impact of automated decision-making in our lives. Particularly problematic is the lack of transparency surrounding the development of these algorithmic systems and their use. It is often suggested that to make algorithms more fair, they should be made more transparent, but exactly how this can be (...) achieved remains unclear. Design/methodology/approach An empirical study was conducted to begin unpacking issues around algorithmic interpretability and transparency. The study involved discussion-based experiments centred around a limited resource allocation scenario which required participants to select their most and least preferred algorithms in a particular context. In addition to collecting quantitative data about preferences, qualitative data captured participants’ expressed reasoning behind their selections. Findings Even when provided with the same information about the scenario, participants made different algorithm preference selections and rationalised their selections differently. The study results revealed diversity in participant responses but consistency in the emphasis they placed on normative concerns and the importance of context when accounting for their selections. The issues raised by participants as important to their selections resonate closely with values that have come to the fore in current debates over algorithm prevalence. Originality/value This work developed a novel empirical approach that demonstrates the value in pursuing algorithmic interpretability and transparency while also highlighting the complexities surrounding their accomplishment. (shrink)

No presente trabalho apresentamos e traduzimos o texto “O Perigo da confirmação não-empírica", de Carlo Rovelli, cosmólogo italiano, um dos proponentes da gravitação quântica em loop. Trata-se do texto apresentado por Rovelli em 2015 durante o chamado “Debate de Munich” sobre o problema da base empírica do método científico. Rovelli analisa – e se contrapõe – à proposta do filósofo da ciência Richard Dawid, que em String Theory and the Scientific Method, defende que teorias científicas podem ser avaliadas, aceitas e (...) defendidas a partir de critérios não-empíricos. Rovelli, a despeito de concordar com Dawid quanto a importância histórica dos argumentos não-empíricos no desenvolvimento de teorias físicas, sustenta que a confirmação empírica deve permanecer sendo considerada indispensável para a prática científica e o sucesso cumulativo da ciência. (shrink)

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

We study logical systems for reasoning about equations involving recursive definitions. In particular, we are interested in "propositional" fragments of the functional language of recursion FLR [18, 17], i.e., without the value passing or abstraction allowed in FLR. The "pure," propositional fragment FLR 0 turns out to coincide with the iteration theories of [1]. Our main focus here concerns the sharp contrast between the simple class of valid identities and the very complex consequence relation over several natural classes of models.

We study logical systems for reasoning about equations involving recursive definitions. In particular, we are interested in "propositional" fragments of the functional language of recursion FLR [18, 17], i.e., without the value passing or abstraction allowed in FLR. The "pure," propositional fragment FLR$_0$ turns out to coincide with the iteration theories of [1]. Our main focus here concerns the sharp contrast between the simple class of valid identities and the very complex consequence relation over several natural classes of models.

Cognitive Science, Volume 45, Issue 11, November 2021.

A prefrontal control system that is less mature than the limbic reward system in adolescence is thought to impede self-regulatory abilities, which could contribute to poor dietary choices and obesity. We, therefore, aimed to examine whether structural morphology of the prefrontal cortex and the amygdala are associated with dietary decisions and obesity in children and adolescents. Seventy-one individuals between the ages of 8–22 years participated in this study; each participant completed a computer-based food choice task and a T1- and T2-weighted (...) structural brain scans. Two indices of obesity were assessed, including age- and sex-specific body mass index and waist-to-height ratio. The behavioral task included rating 60 food stimuli for tastiness, healthiness, and liking. Based on each participant’s self-ratings, 100 binary food choices were then made utilizing a computer mouse. Dietary “self-control” was calculated as the proportion of trials where the individual chose the healthier food item over the total number of trials. Cortical thickness and amygdala subnuclei volumes were quantified using FreeSurfer 6.0 and CIT168 atlas, respectively. We found that WHtR was negatively associated with the thickness of bilateral superior frontal, left superior temporal, right insula, and right inferior temporal regions. We also found WHtR to be positively associated with the volume of the central nucleus region of the amygdala, after adjusting for the hemisphere, age, sex, and intracranial volumes. A similar data pattern was observed when BMIz was used. Moreover, we found that across all participants, thinner right superior frontal cortex and larger left CEN volumes predicted lower dietary self-control. These results suggest that differential development of the PFC and amygdala relate to obesity and dietary self-control. Further longitudinal studies are merited to determine causal relationships among altered PFC to amygdala neural circuitry, dietary self-control, and obesity. (shrink)

The chapter explores comparatively the attention to the practical dimension that—each in his own way—Michel Foucault, Friedrich Nietzsche, and the classic pragmatist thinker William James pay when confronted with the challenge of providing a non-skeptical response to the relativist stance on truth that arose in the post-Kantian age. Particular focus will be given to the extent to which these three authors conceived of the practical framework as the only one that allows us to meaningfully address and determine truth.

In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications.We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study) and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice).Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its inherent risks (...) makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar risks and benefits. The principle of autonomy poses a challenge in case of disagreement between the pregnant woman and the physician. Improved communication aimed to enable better informed choice may overcome some instances of disagreement. The principle of justice prohibits unfair discrimination, and broadly favours optimising resource utilisation.Available evidence supports vaginal birth in uncomplicated term pregnancies as the standard of care. The principlist approach offered a useful framework for ethical analysis of cesarean delivery on maternal request, identified the rights and duties of those involved, and helped reach a conclusion, although conflict at the individual level may remain challenging. (shrink)

Quality and service improvement (QSI) research employs a broad range of methods to enhance the efficiency of healthcare delivery. QSI research differs from traditional healthcare research and poses unique ethical questions. Since QSI research aims to generate knowledge to enhance quality improvement efforts, should it be considered research for regulatory purposes? Is review by a research ethics committee required? Should healthcare providers be considered research participants? If participation in QSI research entails no more than minimal risk, is consent required? The (...) lack of consensus on answers to these questions highlights the need for ethical guidance. Three distinct approaches to classifying QSI research in accordance with existing ethical principles and regulations can be found in the literature. In the first approach, QSI research is viewed as distinct from other types of healthcare research and does not require regulation. In the second approach, QSI research falls within regulatory guidelines but is exempt from research ethics committee review. In the third approach, QSI research is deemed to be part of the learning healthcare system and, as such, is subject to a different set of ethical principles entirely. In this paper, we critically assess each of these views. While none of these approaches is entirely satisfactory, we argue that use of the ethical principles governing research provides the best means of addressing the numerous questions posed by QSI research. (shrink)

California has focused on health equity in the state’s COVID-19 reopening plan. The Blueprint for a Safer Economy assigns each of California’s 58 counties into 1 of 4 tiers based on 2 metrics: test positivity rate and adjusted case rate. To advance to the next less-restrictive tier, counties must meet that tier’s test positivity and adjusted case rate thresholds. In addition, counties must have a plan for targeted investments within disadvantaged communities, and counties with more than 106 000 residents must (...) meet an equity metric. California's explicit incorporation of health equity into its reopening plan underscores the interrelated fate of its residents during the COVID-19 pandemic and creates incentives for action. This article evaluates the benefits and challenges of this novel health equity focus, and outlines recommendations for other US states to address disparities in their reopening plans. (shrink)

In the context of the current heated debate surrounding the pervasive influence of the English language and Anglo-American culture on other languages, as well as the widespread purist attitude towards some contact-induced language change phenomena, both abroad and in Romania, our article discusses the situation of English lexical borrowings in present-day Romanian, focusing on the perception and processing of the so-calledluxury Anglicisms(Sections 2and3) by young Romanian native speakers, in an attempt to see whether such an analysis can help clarify their (...) acceptability and diffusion across our target population. We propose an alternative cognitive, psycholinguistic approach to the study of contact-induced lexical borrowings, aiming to show that there is no difference in the young Romanian native speakers’ processing of sentences containing luxury Anglicisms and their established Romanian counterparts. Such findings may support our claim that the acceptability and diffusion of such Anglicisms are pervasive across our target population, even if the official position generally condemns such uses, considering them gratuitous and a burden in communication, even making it unintelligible sometimes.Our analysis starts from the observation that most (but not all) Romanian academics, whether linguists or not, tend to embrace a purist attitude, while on the other hand young Romanians accept such Anglicisms and tend to use them extensively. In fact, such uses are not limited to young people, who have been the subjects of our research, but are the ‘norm’ in daily conversations and elsewhere across the general population (Stoichițoiu Ichim 2006). Thus, there seems to be a gap between the actual acceptability and diffusion of luxury Anglicisms among Romanians and the ‘official’ recommendations. Based on the results of a sensicality task, meant to show how 188 Romanians, aged 18–22, process and perceive sentences with or without luxury Anglicisms (seeSection 6), we will try to show that luxury Anglicisms are accepted and, by recurrent use, diffused among the Romanian community. For a more accurate picture of their diffusion, the findings will be further correlated with data fromCoRoLa, the only official corpus ofpresent-day Romanian (beginning 1989) made available under the auspices of the Romanian Academy, as well as a corpus currently in the making, and the Internet (seeSection 7).Besides showing that luxury Anglicisms cannot really be blamed for burdening or impairing processing, and thus communication, and explaining why such uses should not be censured or disapproved, we hope that our study of acceptability and diffusion will demonstrate that we are dealing with a complex, multi-layered phenomenon that can be better understood by going beyond a diachronic and synchronic analysis of particular words and a frequency count, and should incorporate more experimental data.Last but not least, we suggest that, on the practical side, such experimental studies as the one described here could be used as an additional criterion for the lexicographic inclusion of lexical borrowings. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

The self- vs. external-regulation behavior theory, SR-ER Theory model has postulated the Self-Regulation /Non or De-Regulation/Dys-regulation continuum in the person and in their context. The model also generates a behavioral heuristic that allows us to predict and explain the variability of other dependent behavioral variables in a range of scenarios. Consequently, the objective of this study was to validate the different scales prepared on the basis of the theory presented. A total of 469 students voluntarily completed at different times the (...) five questionnaires presented, to give a total of 1,385 completed questionnaires. Using an ex post facto design, descriptive, correlational, confirmatory factorial analysis, reliability, and concurrent validity analyses were carried out. The scales were analyzed individually and as a whole. The results showed the acceptable structure of scale and consistent levels of reliability. The five levels generated by the SR-NR-DR combinatory heuristic that arises from the theoretical model determined significant differences in the levels of the variables analyzed for each psychological context. We discuss the theoretical implications and the implications for the assessment and improvement of the behaviors analyzed in function of the personal and contextual regulation levels evaluated. (shrink)

The paper aims to investigate some aspects of Ernst Mach’s epistemology in the light of the problem of human orientation in relation to the world (Weltorientierung), which is a main topic of Western philosophy since Kant. As will be argued, Mach has been concerned with that problem, insofar as he developed an original pragmatist epistemology. In order to support my argument, I firstly investigate whether Mach defended a nominalist or a realist account of knowledge and compare his view to those (...) elaborated by other pragmatist thinkers, such as W. James, H. Vaihinger and H. Poincaré. Secondly, the question of what does it mean, for Mach, to orient ourselves in science is addressed. Finally, it will be argued that, although Mach tried to keep his epistemology restricted to a mere operational and economical account of science, that question involves the wider plane of practical philosophy. (shrink)

In his 1676 text De Quadratura Arithmetica, Leibniz distinguished infinita terminata from infinita interminata. The text also deals with the notion, originating with Desargues, of the point of intersection at infinite distance for parallel lines. We examine contrasting interpretations of these notions in the context of Leibniz’s analysis of asymptotes for logarithmic curves and hyperbolas. We point out difficulties that arise due to conflating these notions of infinity. As noted by Rodríguez Hurtado et al., a significant difference exists between the (...) Cartesian model of magnitudes and Leibniz’s search for a qualitative model for studying perspective, including ideal points at infinity. We show how respecting the distinction between these notions enables a consistent interpretation thereof. (shrink)

Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making and information (...) attainment. Decision-making comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. Information ascertainment comprised: professional responsibilities ; parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs. (shrink)

Caracterización de un grupo de comités de ética en investigación en Colombia Caracterização de um grupo de comitês de ética em pesquisa na Colômbia In the last decades, controlled clinical trials sponsored by the pharmaceutical industry have increased considerably. This has led to the need for greater control and assistance by regulators and ethics committees to ensure appropriate compliance with established ethical standards and good clinical practices in general. In Colombia, the National Food and Drug Surveillance Institute, the regulator in (...) the country, controls and monitors the operation of clinical research with drugs. In 2008, this entity issued Resolution 2378, which provides and regulates research actors in Colombia, including ethics committees. After being in force for several years, it is necessary to know whether research ethics committees in Colombia operate in accordance with this regulation and to determine the status of implementation of the requirements therein. For this purpose, a survey was designed to be voluntarily answered and a response was obtained from 25 of the 69 certified committees in Colombia. Twenty-two of them could be analyzed because their information was complete. Compared with previous studies, favorable changes in development and organization were observed in accordance with the current proposed regulation. Para citar este artículo / To reference this article / Para citar este artigo Suárez-Obando F, Reynales H, Urina M, Camacho J, Viteri M. Caracterización de un grupo de comités de ética en investigación en Colombia. pers. bioét. 2018; 22: 303-318. DOI: 10.5294/pebi.2018.22.2.8. (shrink)

BackgroundMediation analysis is important to test the theoretical framework underpinning an intervention. We therefore aimed to investigate if the healthy body image intervention’s effect on eating disorder symptomatology and use of muscle building supplements was mediated by the change in risk and protective factors for ED development and muscle building supplement use.MethodsThis study used data from the HBI intervention: a cluster randomized controlled universal intervention aiming to promote positive body image and embodiment and reduce the risk for ED development including (...) 30 schools in Norway. A total of 1,713 participants were included in the analyses. Conditional latent growth curve analyses were performed to test for indirect effects on ED symptomatology and weekly frequency of protein and creatine supplement use measured at the 12-month follow-up via change in the proposed mediators.ResultsIn girls, the reduction in ED symptomatology was mediated by positive changes in protective factors and reductions in risk factor scores. Comparable changes in protective and risk factors among boys played no mediating role.ConclusionInterventions aiming to reduce the risk of ED development in girls may benefit from aiming to enhance self-esteem and body image flexibility and reduce perceived media pressure and thin appearance internalization. Future studies should investigate the casual relationship between muscle building supplement use and risk and protective factors for ED development in both girls and boys. (shrink)

The text is part of the investigative concerns from the authors with regard to the dialogue between literature and science teaching. It starts from several theoretical approaches around the general didactics, university or superior didactics, science’s didactics and for last, literature’s didactics. This is largely due to our search which is focused in articulate the university didactics with science and literature’s didactics, meanwhile, we pretend to answer to the questions ¿How are the specific didactics of science and literature going to (...) contribute to the university didactics and how is the last one going to contribute to these specific didactics? ¿Is it the dialogue between science and literature possible? The paper has been made in middle education, in Educative Institution José Miguel de Restrepo y Puerta, from Copacabana and also in university education, in the academic unities of Dietetics and Nutrition School, Agricultural Sciences and Medicine, from the University of Antioquia. Finally, the partial results indicate: i) the necessity of general Didactics as a discipline focused on teaching and learning processes to ask itself for its internal problems and establish relations with specific didactics. (shrink)

Due to the recent gains in biomedical sciences, the fetus1 is more exposed and subjected to increasing possibilities of intervention, becoming a full-fledged patient, and entering more often into a...

Josefa Amar y Borbón, une intellectuelle espagnole du XVIIIe siècle, défendit dans ses ouvrages et dans sa vie la raison des femmes, à partir de sa propre tradition culturelle mais simultanément avec d’autres intellectuelles européennes de son temps. Elle se forgea un prestige intellectuel et intervint publiquement dans le débat sur l’admission des femmes dans les sociétés réformistes, contre l’opinion négative d’une partie des hommes des élites éclairées espagnoles. La lecture de ses textes et leur comparaison avec la pensée de (...) sa contemporaine Mme d’Épinay montre que, dans des contextes sociaux et culturels différents, ces deux femmes avait des idées concordantes sur la raison, l’éducation et la condition social des femmes, loin des opinions plus répandues, celles des auteurs comme Thomas, Rousseau et d’autres contemporains espagnols. Elles avaient aussi des stratégies vitales communes, qui visaient à occuper et à revendiquer pour les femmes des possibilités et des espaces dans l’activité culturelle et la sociabilité des Lumières. (shrink)

For much of 2021, allocating the scarce supply of Covid‐19 vaccines was the world's most pressing bioethical challenge, and similar challenges may recur for novel therapies and future vaccines. In the United States, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) identified three fundamental ethical principles to guide the process: maximize benefits, promote justice, and mitigate health inequities. We argue that critical components of the recommended protocol were internally inconsistent with these principles. Specifically, the ACIP (...) violated its principles by recommending overly broad health care worker priority in phase 1a, using being at least seventy‐five years of age as the only criterion to identify individuals at high risk of death from Covid‐19 during phase 1b, failing to recommend place‐based vaccine distribution, and implicitly endorsing first‐come, first‐served allocation. More rigorous empirical work and the development of a complete ethical framework that recognizes trade‐offs between principles may have prevented these mistakes and saved lives. (shrink)

Key messages The research environment has changed since clinical equipoise was first proposed 30 years ago New trial designs—such as umbrella and basket trials, adaptive platform trials, and cluster randomised trials—raise new ethical challenges for evaluating the state of scientific uncertainty and communicating about risks with patients and participants Clinical equipoise needs to evolve We propose the design of specific guidelines to provide ethics committees and trialists with instructions for how to evaluate equipoise in the context of new designs and (...) biomarkers and how to optimise communication with participants. (shrink)

We propose 4 equity-advancing operational improvements to eligibility and sign-up processes at mass vaccination sites: (1) preregistration using existing information, (2) eligibility rules that recognize the greater burden of COVID-19 in underserved neighborhoods, (3) appointment assignment that prioritizes those with disadvantage, and (4) socioculturally informed outreach to lottery selectees.

IntroductionRheumatologists are the primary healthcare professionals responsible for patients with rheumatic diseases and should acquire medical ethical competencies, such as the informed consent process. The objective clinical structured examination is a valuable tool for assessing clinical competencies. We report the performance of 90 rheumatologist trainees participating in a station designed to evaluate the ICP during the 2018 and 2019 national accreditations.MethodsThe station was validated and represented a medical encounter in which the rheumatologist informed a patient with systemic lupus erythematosus with (...) clinically active nephritis about renal biopsy. A trained patient–actor and an evaluator were instructed to assess ICP skills in obtaining formal informed consent, delivering bad news and overall communication with patients. The evaluator used a tailored checklist and form.ResultsCandidate performance varied with ICP content and was superior for potential benefit information but significantly reduced for potential complications and biopsy description. Only 17.8% of the candidates mentioned the legal perspective of ICP. Death was omitted by the majority of the candidates ; after the patient–actor challenged candidates, only 57.1% of them gave a clear and positive answer. Evaluators frequently rated candidate communications skills as superior, but ≥1 negative aspect was identified in 69% of the candidates.ConclusionsEthical competencies are mandatory for professional rheumatologists. It seems necessary to include an ethics competency framework in the curriculum throughout the rheumatology residency. (shrink)