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

Despite the growing body of literature on training in the responsible conduct of research, few studies have examined the effectiveness of delivery formats used in ethics courses. The present effort sought to address this gap in the literature through a meta-analytic review of 66 empirical studies, representing 106 ethics courses and 10,069 participants. The frequency and effectiveness of 67 instructional and process-based content areas were also assessed for each delivery format. Process-based contents were best delivered face-to-face, whereas contents delivered online (...) were most effective when restricted to compliance-based instructional contents. Overall, hybrid courses were found to be most effective, suggesting that ethics courses are best delivered using a blend of formats and content areas. Implications and recommendations for future development of ethics education courses in the sciences are discussed. (shrink)

ABSTRACT Research examining ethical decision-making has focused on how people engage in EDM, leading many researchers to focus on sensemaking models of EDM. Although the merits of a sensemaking approach with respect to EDM are evident in the literature, less is known about the specific cognitive processes by which sensemaking impacts EDM. This study examines the impact of three late-cycle cognitive processes – idea generation, evaluation, and revision – as well as the timing of these processes on EDM. Results indicate (...) that information gathering early on is critical to EDM; a finding which supports an active sensemaking model over an intuitive one. (shrink)

These essays critically reassess the widely accepted view that statistical methods of analysis can, and do, yield causal understanding of social phenomena. They emphasize the historical, philosophical and conceptual perspectives that underlie and inform current methodological controversies.

The history of the recovery movement began with a pushback against treatment, and the philosophies that it was founded upon still have relevant applications to contemporary social work practice. Financial aspects of service provision for people with serious mental illnesses have enabled other actors in the medical model of psychosis treatment to benefit, while disempowering and dehumanizing the consumers of those services. Since then, other movements like Psychopolitics and the Mad Movement have helped empower psychosis survivors to advocate for their (...) right to self-determination amid the epistemological pressure to identify as disabled. Social workers would like to believe that the field has moved beyond the philosophies that perpetuated institutionalization of people with serious mental illnesses. Contemporary examples, however, reveal how social services in the US maintain the status quo of sanism for psychosis survivors. (shrink)

This research examined the role of thought suppression in the formation of mental blocks. In Experiment 1, participants were asked to generate a series of creative associates for two target words after initially suppressing a word that was semantically related to one of the two target words. Participants produced fewer responses, and experienced a greater sensation of being mentally blocked, when attempting to produce associates for the target word that was semantically related to the suppressed word. In Experiment 2, participants (...) either thought about or suppressed a series of words prior to completing a word fragment completion task. Each word either corresponded exactly to one of the word fragment solutions or resembled one of the solutions but was slightly different in its orthographic properties. Participants performed most poorly on the items for which they had initially suppressed negative primes. (shrink)

The concept of meaning, since Frege initiated the linguistic turn in 1884, has been the subject of numerous theories, hypotheses, methodologies and distinctions. One distinction of considerable strategic value relates to the location of meaning: some aspects of meaning can be found in language and are modelled with semantic values of various kinds; some aspects of meaning can be found in communicative processes and are modelled with pragmatic inferences of one sort or another. One hypothesis of great heuristic utility concerns (...) the relationship that is assumed between the semantic and the pragmatic. This collection of especially commissioned papers examines current thinking on the plausible nature of the semantic, the possible character of the pragmatic and the mechanics of their intersection. (shrink)

BackgroundThe proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.MethodsWe conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following (...) electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.ResultsOf the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in researchConclusionResearchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV. (shrink)

Traditional whistleblowing theories have purported that whistleblowers engage in a rational process in determining whether or not to blow the whistle on misconduct. However, stressors inherent to whistleblowing often impede rational thinking and act as a barrier to effective whistleblowing. The negative impact of these stressors on whistleblowing may be made worse depending on who engages in the misconduct: a peer or advisor. In the present study, participants are presented with an ethical scenario where either a peer or advisor engages (...) in misconduct, and positive and the negative consequences of whistleblowing are either directed to the wrongdoer, department, or university. Participant responses to case questions were evaluated for whistleblowing intentions, moral intensity, metacognitive reasoning strategies, and positive and negative, active and passive emotions. Findings indicate that participants were less likely to report the observed misconduct of an advisor compared to a peer. Furthermore, the findings also suggest that when an advisor is the source of misconduct, greater negative affect results. Post-hoc analyses were also conducted examining the differences between those who did and did not intend to blow the whistle under the circumstances of either having to report an advisor or peer. The implications of these findings for understanding the complexities involved in whistleblowing are discussed. (shrink)

Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...) interact —impacts such patients’ access to research.Such persons may be under guardianship because they have lost decisional capacity (i.e., those in a coma or... (shrink)

This research examined the role of thought suppression in the formation of mental blocks. In Experiment 1, participants were asked to generate a series of creative associates for two target words after initially suppressing a word that was semantically related to one of the two target words. Participants produced fewer responses, and experienced a greater sensation of being mentally blocked, when attempting to produce associates for the target word that was semantically related to the suppressed word. In Experiment 2, participants (...) either thought about or suppressed a series of words prior to completing a word fragment completion task. Each word either corresponded exactly to one of the word fragment solutions or resembled one of the solutions but was slightly different in its orthographic properties . Participants performed most poorly on the items for which they had initially suppressed negative primes. (shrink)

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

The announcement of the birth of Dolly the cloned sheep evoked widespread response from the Christian Churches. These responses are identified, organized thematically, and discussed critically. The churches have viewed reproductive human cloning either with unqualified opposition or with grave suspicion. Some statements have discussed animal cloning, generally granting limited approval, and nonreproductive human cloning, either in opposition or expressing an openness to entertain specific proposals as the technology develops.

Background. The concept of empathy in students has gained significant attention in medical education. Whether implementing formal educational interventions to promote long-term and effective empathy levels leads to sustained increased empathy levels in students, is however less clear. Objectives. The study aimed to evaluate the trajectory of medical students’ self-perceived empathy levels during their 6-year MB ChB degree. Methods. A longitudinal, prospective study was conducted over 4 years. A cohort of 292 medical students was invited to participate. Participants completed the (...) Jefferson Scale of Empathy for Students (JSE-S) at three intervals during their studies. The students attended two workshops related to empathic patient interactions during this time. The JSE-S mean score by age and gender was compared, making use of a linear regression model. Results. A total of 119 students completed the study. Students’ total empathy levels were similar during the first and the last measuring point (110), but there was a significant rise in the intermediate measuring point (113.3). When the male and female cohorts’ scores were interpreted separately, both genders demonstrated a similar pattern to the total score, although females’ JSE-S scores were higher than the males. Conclusion. The results of the study confirm that educational interventions can increase students’ self-perceived empathy levels; however, we suggest that students require reinforcement and multiple opportunities to practise and observe empathic communication with patients to sustain high levels of empathy. Follow-up sessions to specifically target the promotion of empathy should be implemented; otherwise the long-term effect of educational interventions might be limited. (shrink)

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

Traditional whistleblowing theories have purported that whistleblowers engage in a rational process in determining whether or not to blow the whistle on misconduct. However, stressors inherent to whistleblowing often impede rational thinking and act as a barrier to effective whistleblowing. The negative impact of these stressors on whistleblowing may be made worse depending on who engages in the misconduct: a peer or advisor. In the present study, participants are presented with an ethical scenario where either a peer or advisor engages (...) in misconduct, and positive and the negative consequences of whistleblowing are either directed to the wrongdoer, department, or university. Participant responses to case questions were evaluated for whistleblowing intentions, moral intensity, metacognitive reasoning strategies, and positive and negative, active and passive emotions. Findings indicate that participants were less likely to report the observed misconduct of an advisor compared to a peer. Furthermore, the findings also suggest that when an advisor is the source of misconduct, greater negative affect results. Post-hoc analyses were also conducted examining the differences between those who did and did not intend to blow the whistle under the circumstances of either having to report an advisor or peer. The implications of these findings for understanding the complexities involved in whistleblowing are discussed. (shrink)

Deaths of Despair (DoD), or mortality resulting from suicide, drug overdose, and alcohol-related liver disease, have been rising steadily in the United States over the last several decades. In 2020, a record 186,763 annual despair-related deaths were documented, contributing to the longest sustained decline in US life expectancy since 1915–1918. This forum feature considers how health humanities disciplines might fruitfully engage with this era-defining public health catastrophe and help society better understand and respond to the crisis.

As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using a stratified (...) purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

Within the past ten years, the discussion of the nature of folk psychology and its role in explaining behavior and thought has become central to the philosophy of mind. However, no comprehensive account of the contemporary debate or collection of the works that make up this debate has yet been available. Intending to fill this gap, this volume begins with the crucial background for the contemporary debate and proceeds with a broad range of responses to and developments of these works (...) -- from those who argue that "folk theory" is a misnomer to those who regard folk theory as legitimately explanatory and necessary for any adequate account of human behavior. Intended for courses in the philosophy of mind, psychology, and science, as well as anthropology and social psychology, this anthology is also of great value in courses focusing on folk models, eliminative materialism, explanation, psychological theory, and -- in particular -- intentional psychology. It is accessible to both graduate students and upper-division undergraduate students of philosophy and psychology as well as researchers. As an aid to students, a thorough discussion of the field and the articles in the anthology is provided in the introduction; as an aid to researchers, a complete bibliography is also provided. (shrink)

The use of cost-benefit analysis (CBA) in environmental decision-making and the contingent valuation (CV) technique as input into traditional CBA to elicit environmental values in monetary terms has stimulated an extensive debate. Critics have questioned the appropriateness of both the method and the technique. Some alternative suggestions for the elicitation of environmental values are based on a social process of deliberation. However, just like traditional economic theory, these alternative approaches may be questioned on their implicit value judgements regarding the legitimacy (...) of the social-political organisation of the process of value elicitation. Instead of making assumptions a priori, research efforts should be focused on the processes by which actual public attitudes and preferences towards the environment can best be elicited and fed into environmental or other public policy decision-making. In the study presented in this paper, support was found for both the individual WTP based approach and a participatory social deliberation approach to inform the environmental decision-making process, suggesting that a combination of both approaches is most appropriate. (shrink)