Background: Therapeutic misconception, the misunderstanding of differences between research and clinical care, is widely prevalent among non-incarcerated trial participants. However, little attention has been paid to its presence among individuals who participate in research while incarcerated. Methods: This study examined the extent to which 72 incarcerated individuals may experience therapeutic misconception about their participation in one of six clinical trials, and its correlation with participant characteristics and potential influences on research participation. Results: On average, participants endorsed 70% of items suggestive (...) of therapeutic misconception. The tendency toward therapeutic misconception was significantly higher among African Americans and Latinos compared to Whites, among older and less educated participants, and among enrollment in a substance-abuse-related trial; it was also correlated with a belief that the trial was the only way to obtain needed treatment. Conclusions: Therapeutic misconception may be particularly high among select incarcerated individuals and is associated with a perceived lack of treatment options. Further examination of therapeutic misconception among incarcerated research participants is needed. (shrink)

This groundbreaking handbook of character strengths and virtues is the first progress report from a prestigious group of researchers who have undertaken the systematic classification and measurement of widely valued positive traits. Character Strengths and Virtues classifies twenty-four specific strengths under six broad virtues that consistently emerge across history and culture. This book demands the attention of anyone interested in psychology and what it can teach about the good life.

As a 2006 Institute of Medicine report highlights, surprisingly little empirical attention has been paid to how prisoners arrive at decisions to participate in modern research. With our study, we aimed to fill this gap by identifying a more comprehensive range of factors as reported by prisoners themselves during semistructured interviews. Our participants described a diverse range of motives, both favoring and opposing their eventual decision to join. Many are well-recognized considerations among nonincarcerated clinical research participants, including a desire for (...) various forms of personal benefit, altruism, and concern about study risks and inconveniences. However, a number of influences seem unique to prisoners. Participants did not report that they were not coerced into enrolling, and they have even been under pressure not to enroll. However, many sought to enroll in order to obtain access to better health care, raising a concern about whether they were unfairly exploited. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychiatric Hospitalization—Bridging the Gap Between Respect and ControlPaul P. ChristopherIntroductionThis issue of Narrative Inquiry in Bioethics offers varied and somewhat unique perspectives on the experience of psychiatric hospitalization. This commentary highlights a number of salient themes that emerge from reading these essays and attempts to explore how they relate to the broader academic literature on psychiatric hospitalization, particularly with regard to ethical considerations. In reading these narratives, each several (...) times, I was repeatedly struck by the courage required of the authors, both to share their stories publicly and to endure the challenges that the writing process no doubt demanded of them—revisiting and suspending themselves in deeply emotional and, at times, traumatic experiences in order to share the most compelling narrative. Their hard work clearly paid off—the stories are at once intimate and indelible. Still, in many instances, I found myself wanting to know more; to enter the story and sit with the individual through these events; to ask what they were thinking or feeling in a particular situation; to see and hear the world in which they found themselves. Such is the nature of good story telling—the reader, left with the lingering vision created in his mind, turns over the last page, eagerly hoping for more.Narrative ThemesI. Loss of Autonomy or ControlPerhaps the most notable theme had to do with the loss of control or freedom that followed from hospitalization. On first consideration, it may seem odd that this issue appears so often since patient autonomy constitutes one of the fundamental principles of medical ethics. Only under specific circumstances—e.g., when there is a risk of imminent harm—may autonomy be curtailed, and even then only to the extent that is minimally necessary. Yet, as these narratives highlight, there are a multitude of ways in which psychiatric hospitalization engenders actual or perceived restrictions in freedom (Newton-Howes & Mullen, 2011).Consistent with prior research (Goodwin et al., 1999), many of the authors describe a fear or the actual experience of not being able to leave the hospital freely, even when the admission seems to have been voluntary. For example, one writer worries, “I was so afraid that if I ever went ‘in,’ I would never get ‘out’... I thought I would never taste freedom again... alive.” Another describes:When it came time for my possible discharge they told me that I might not get discharged because I was ‘acting up the previous evenings.’ My anxiety level at this point went through the roof. The only reason I was discharged was because my father knew some politicians. If not [End Page 29] for him I would have been a patient there for perhaps years and my life would have been ruined.A third gives this example: “When I asked to sign the form to leave after three days, [the psychiatrist] told me if I did that she would have me committed.” Another writer fears not having any control of how the psychiatrist might approach the treatment: “... I was totally vulnerable... would the doctors blame me, drug me, shock me, kill me?”Somewhat surprising, however, was the fact that so few of the narratives take issue with the decision to hospitalize. This omission is especially striking in light of the fact that prior reports consistently note that a substantial minority (up to nearly half) of voluntarily admitted patients nevertheless experience their admission as coerced (Bonsack & Borgeat, 2005; Hiday et al., 1997; Katsakou et al., 2010; Rogers et al., 1993; Sheehan & Burns, 2011). Because many of these narrators had been hospitalized more than once, the relative absence of expressed resistance to being hospitalized seems strange, particularly when earlier hospital experiences or their aftermath are often described as negative. For example, one individual characterized the time after being released from the hospital as, “My sense of self was questioned. I felt as if I lost my soul.” Another put it this way:When I got out of the private hospital, I felt like my soul had been ripped out of me. I felt like I had a gaping hole in the center of my body... I felt psychically raped, dazed, and confused.Given these... (shrink)

Open peer commentary on the target article “Who Conceives of Society?” by Ernst von Glasersfeld. Excerpt: I will focus on one crucial step in von Glasersfeld’s argumentation, viz. his view that every individual constructs his own private meanings for linguistic expressions, so that linguistic interaction and even communication in general is based on a notion of compatibility between different speakers’ private conceptual schemes. The central question here is: “Just what does it mean that different private conceptual schemes are compatible, or (...) what constitutes a viable criterion to this end?” As von Glasersfeld himself stresses twice , the criteria to be looked for can only be “public,” residing in properties of verbal and non-verbal actions of the interacting individuals, properties that can be sensed and processed by the participating system. (shrink)

Kathrin Koslicki argues that ordinary material objects like tables and motorcycles have formal proper parts that structure the material proper parts. Karen Bennett rejects a key premise in Koslicki's argument according to which the material ingredient out of which a complex material object is made is a proper part of that object. Koslicki defends this premise with a principle motivated by its power to explain three important phenomena of material composition. But these phenomena can be equally well explained by a (...) weaker principle that does not support the questioned premise in Koslicki's argument, Bennett argues. I show that Bennett's weaker principle, together with an appropriate strengthening of a different premise in Koslicki's original argument, still yields a sound argument for the existence of formal parts. (shrink)

Toward the end of his classic treatise An Essay on Free Will, Peter van Inwagen offers a modal argument against the Principle of Sufficient Reason which he argues shows that the principle “collapses all modal distinctions.” In this paper, a critical flaw in this argument is shown to lie in van Inwagen’s beginning assumption that there is such a thing as the conjunction of all contingently true propositions. This is shown to follow from Cantor’s theorem and a property of conjunction (...) with respect to contingent propositions. Given the failure of this assumption, van Inwagen’s argument against the Principle of Sufficient Reason cannot succeed, at least not without the addition of some remarkable and previously unacknowledged qualifications. (shrink)

One of the greatest challenges facing materialist theories of the human mind is the problem of intentionality. As many non-materialists of various stripes have pointed out, it is very difficult to say, if the human mind is a purely material thing, how this material thing can be about or represent another thing wholly distinct from itself. However, for their part, these same non-materialists have relied heavily or exclusively on this intuition that one material thing cannot be about another. In this (...) paper, that hole in the intentionality objection to materialist theories of mind is filled by way of providing the germ of a new theory of the metaphysics of intentionality. On this view, intentionality just is partial identity. Partial identity is a concept introduced by David Armstrong and used by Donald Baxter to give a metaphysics of instantiation. The aboutness exhibited by our mental activity is simply a partial identity relation between the mind and the object of thought. This thesis, I contend, is a faithful interpretation of Brentano’s “intentional inexistence,” which the objects of thought have in the mind and which he held to be characteristic exclusively of mental phenomena. Some interesting and fortuitous consequences, including an elucidation of precisely why one material thing can never be about something distinct from itself, are then examined, and finally a defense against some objections is given. (shrink)

Throughout his authorship, Kierkegaard appears remarkably uninterested in the tradition of Christian mysticism. Indeed, in the only two places in the authorship where he broaches the topic directly, the discussion is disclaimed in such a way as to suggest that Kierkegaard really has nothing to say about it at all. However, attending to the successive incarnations of the character(s) named “Ludvig” throughout the authorship – an appellation that harbors an especially self-referential dimension for Kierkegaard – the present paper attempts to (...) elucidate what may, with due reservation, be referred to as the mystical element in Kierkegaard’s thought. The ultimate yield of this endeavor is a vision of “mysticism” that is more act than thought oriented, and a vision of the author “Kierkegaard” that is more delightful than melancholy. (shrink)

The practice of paying prisoners to for their participation in research has long been debated, and the controversy is reflected in the differing policies in the U.S. prison systems. Empirical study of financial payments to inmates who enroll in research has focused on whether this practice is coercive. In this study, we examined whether monetary incentives have the potential to be unduly influential among fifty HIV‐positive prisoners. The majority of prisoners surveyed believed that inmates should receive some compensation for their (...) involvement in research and disagreed with statements suggesting that the offer of payment constitutes undue influence. However, a sense of potentially being susceptible to undue influence was significantly higher among participants who had spent a longer time in prison and had less education. Overall, our findings suggest that most prisoners feel that they would be able to make a decision about research enrollment that is not solely based on an offer of monetary payment. (shrink)

In their recent paper, Brandon Rickabaugh and Derek McAllister object to Paul Moser’s rejection of natural theology on the grounds that Moser is committed to a principle, Seek, which commits Moser to another principle, Access. Access in turn can be rationally motivated for at least some nonbelievers only by the arguments of natural theology. So Moser is in fact committed to the epistemic usefulness of natural theology. In this paper, we show that Seek by itself does not commit one to (...) Access, and that even if Moser is committed to Access, he is not thereby committed to the epistemic usefulness of natural theology for all nonbelievers. While we find this argument offered by Rickabaugh and McAllister lacking, we do not deny their conclusion that natural theology is epistemically useful to all nonbelievers. (shrink)

Lying to one’s patients is wrong. So obvious as to border on a platitude, this truism is one that bioethicists have heartily endorsed for several decades. Deception, the standard line holds, underc...

Despite the emphasis on moral intuition in the research literature, little attention has been given to the ways in which moral intuition can be educated within management settings (Dane & Pratt 2007). In this paper, I discuss an experiential learning approach that links Robin Hogarth’s (2001, 2008) work on the learning of intuition with Mary Gentile’s (2010) educational program on values-based leadership, Giving Voice To Values (GVV). Building on Hogarth’s proposal that intuitions are primarily acquired and thus shaped by our (...) experiences, GVV offers a pedagogical framework for reflective, experiential learning. Specific attention is given to the themes of learning environments, how these structures shape intuitions, and how students can identify these structures using the GVV emphasis on examination of past experiences. (shrink)

Although clinical ethics scholarship and practice has largely avoided assuming an activist stance, the many health care crises of the last eighteen months motivated a distinct change: On listserves, in blog postings, and in published essays, activist language has permeated conversations over such issues as the impact of triage policies on persons with disabilities and of color, and how the health care system has historically failed African Americans. In this paper, I defend this turn, arguing that clinical ethicists should embrace (...) activism—generally, and with particular emphasis on institutional, mesolevel concerns. Ethicists are often uniquely situated to understand the structural factors that regularly motivate clinical ethics cases, and they are often in a privileged position to be effective change agents. In making this case, I also stress the need not to overstep one's skills and to be acutely cognizant of the political risks associated with such work. (shrink)

Clinical ethical consultants are subject to an unavoidable conflict of interest. Their work requires that they be independent, but incentives attached to their role chip relentlessly at independence. This that they be independent, is a problem without any solution, but it can at least be ameliorated through careful management.

Objective reporting was once among the foundational norms of U.S. journalism. The emergence of alternative and economically successful partisan models exemplified by Fox News, talk radio, and a ran...

In the human quest for meaning, work occupies a central position. Most adults spend the majority of their waking hours at work, which often serves as a primary source of purpose, belongingness, and identity. In light of these benefits to employees and their organizations, organizational scholars are increasingly interested in understanding the factors that contribute to meaningful work, such as the design of jobs, interpersonal relationships, and organizational missions and cultures. In a separate line of inquiry, scholars of business ethics (...) have examined meaningful work as a moral issue concerning the management of others and ourselves, exploring whether there are definable characteristics of meaningful work to which we have moral rights, and whether there are moral duties to ourselves and others to fulfill those rights. In this article, we examine contemporary developments in both disciplines about the nature, causes, and consequences of meaningful work; we explore linkages between these disciplines; and we offer conclusions and research opportunities regarding the interface of ethical and organizational perspectives on performing and providing meaningful work. (shrink)

The goal of this article is to try to resolve two key problems in the duty-based approach of W. D. Ross: the source of principles and a process for moving from prima facie to actual duty. I use a naturalistic explanation for the former and a nine-step method for making concrete ethical decisions as they could be applied to journalism. Consistent with Ross's position, the process is complicated, particularly in tougher problems, and it cannot guarantee correct choices. Again consistent with (...) Ross, such complexity and uncertainty speak in the method's favor, given the difficulty—factual, motivational, and organizational—of ethics problems and decision making. (shrink)

(2008). The Framework of Essences in Spinoza's Ethics. British Journal for the History of Philosophy: Vol. 16, No. 3, pp. 489-509. doi: 10.1080/09608780802200489.

In this article I describe the theoretical underpinnings of 20th-century British philosopher W. D. Ross's approach to linking deontological and teleological decision making. I attempt to fill in what Ross left on the whole unanswered, that is, how to use his duties to resolve dilemmas. A case study in journalism demonstrates how to apply the theory. I conclude with an analysis of what I take to be the strengths and weaknesses in Ross's theory.

The proliferation of news and information sources has motivated a need to identify those providing legitimate journalism. One temptation is to go the route of such fields as medicine and law, namely to formally professionalize. This gives a clear method for determining who is a member, with an array of associated responsibilities and rewards. We argue that making such a formal move in journalism is a mistake: Journalism does not meet the traditional criteria, and its core ethos is in conflict (...) with the professional mindset. We thus shift the focus from whether the person is journalist to whether the work satisfies the conditions that characterize legitimate journalism. In explaining those conditions we also look at mechanisms for enhancing the power of persons doing journalism, drawing upon lessons from the labor movement. We also consider a self-declaration model while urging increased literacy from all participants in the news gathering and consuming enterprise. (shrink)

Despite the emphasis on moral intuition in the research literature, little attention has been given to the ways in which moral intuition can be educated within management settings. In this paper, I discuss an experiential learning approach that links Robin Hogarth’s work on the learning of intuition with Mary Gentile’s educational program on values-based leadership, Giving Voice To Values. Building on Hogarth’s proposal that intuitions are primarily acquired and thus shaped by our experiences, GVV offers a pedagogical framework for reflective, (...) experiential learning. Specific attention is given to the themes of learning environments, how these structures shape intuitions, and how students can identify these structures using the GVV emphasis on examination of past experiences. (shrink)