With a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing robust decision rules or guidelines to allocate a finite number of public resources. The objective of this study was to gain Canadian genetic health providers' perspectives on factors and criteria that influence and shape resource allocation decisions for publically funded predictive genetic testing in Canada. The authors conducted semi-structured interviews with 16 senior (...) lab directors and clinicians at publically funded Canadian predictive genetic testing facilities. Participants were drawn from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. Given the community sampled was identified as being relatively small and challenging to access, purposive sampling coupled with snowball sampling methodologies were utilized. Surveyed lab directors and clinicians indicated that predictive genetic tests were funded provincially by one of two predominant funding models, but they themselves played a significant role in how these funds were allocated for specific tests and services. They also rated and identified several factors that influenced allocation decisions and patients' decisions regarding testing. Lastly, participants provided recommendations regarding changes to existing allocation models and showed support for a national evaluation process for predictive testing. Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate. (shrink)

Why do consumers who profess to be concerned about the environment choose not to buy greener products more regularly or even at all? This study explores how consumers’ perceptions towards green products, consumers and consumption practices contribute to our understanding of the discrepancy between green attitudes and behaviour. This study identified several barriers to ethical consumption behaviour within a green consumption context. Three key themes emerged from the study, ‘it is too hard to be green’, ‘green stigma’ and ‘green reservations’. (...) There is currently a perception, based on a number of factors, that it is too hard to be green, which creates a barrier to purchasing green products. Furthermore, some consumers were reluctant or resistant to participate in green consumption practices due to their unfavourable perceptions of green consumers and green messages. This article suggests that green perceptions may influence consumers’ intention to purchase green products. Accordingly, it discusses the implications, and suggests avenues for future research. (shrink)

Se revendiquer d’un art « engagé » est devenu, dans le paysage artistique mondialisé, une posture si communément empruntée qu’elle semble presque s’être vidée de son sens. Les artistes revendiquant cette étiquette se mobilisent de manière explicite et visible en faveur d’une cause, entendant ainsi participer à lutter contre l’injustice sociale. On examine ici la manière dont se construit aujourd’hui dans le Sud global l’ ethos de l’artiste engagé, entre engagement sociopolitique et quête de la singularité, la subtile conjonction des (...) deux pouvant donner lieu à des formes d’entrepreneuriat de soi ou bien à des conflits de loyauté entre systèmes de valeurs antagonistes. (shrink)

The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors’ clinical information for research and regulatory purposes, and existing practices that limit research participants’ ability to control what (...) is done with their genetic data, amplify the privacy concerns. (shrink)

Why and how have lay people participated in scientific observation? And on what terms have they collaborated with experts and professionals? We have become accustomed to the involvement of lay observers in the practice of many branches of science, including both the natural and human sciences, usually as subordinates to experts. The current surge of interest in this phenomenon, as well as in the closely related topic of how expertise has been constructed, suggests that historians of science can offer a (...) valuable contribution to these vital questions. A historical approach to lay participation allows us to better understand the making of expert-lay relations in science, and it offers a broader, long-term perspective on contemporary debates about that boundary. (shrink)

What is the role of lay deliberation – if any – in health-care rationing, and administration more generally? Two potential answers are suggested by recent debates on the subject. The one, which I will call the technocratic answer, suggests that there is no distinctive role for lay participation once ordinary democratic politics have set the goals and priorities which reform should implement. Determining how best to achieve those ends, and then actually achieving them, this view suggests, is a matter (...) for experts, armed with the best evidence available to them, both of the subject area involved, and of management and administrative excellence. -/- By contrast, the second, deliberative, view holds that lay deliberation has an important role in the administration and execution of government policy, both because these latter inevitably have a political element which needs to reflect democratic norms and values, and because lay people are, themselves, a source of information, even of wisdom, that experts will want to use in fulfilling their professional responsibilities. Recent debates on the value of lay participation in healthcare provision can illuminate the strengths and weaknesses of both approaches, as can the experience of NICE. So, I will start by examining two articles by Albert Weale, which attempt to clarify the role that lay deliberation should have in healthcare, before turning to the dilemmas for both the technocratic and deliberative views which emerge from the experience of NICE. (shrink)

Augustine of Hippo understands the lay faithful in virtue of their regal-sacerdotal anointing at Baptism to exercise, always in unison with the ordained ministry, an indispensable twofold role in the sinner’s reconciliation. In Peter, not only the clergy but indeed all the saintly members of the community receive the spiritual commission to bind and loose. According to their particular vocation, the lay faithful bind the sinner through fraternal correction and loose him through their intercessory prayer. As members of the Totus (...) Christus, they participate in Christ’s unique remissive mediation. A mixed society where saints live among sinners provides the necessary context for this ecclesial reconciliation. (shrink)

‘I’ll tell you what suits me best if you don’t mind me saying’: ‘lay participation’ in health‐careIncreasing ‘lay participation’ in healthcare has become a popular notion in recent years and is generally considered to be a good thing in both nursing and wider policy circles. Yet despite the widespread acceptance of this overall idea, there is a dearth of theorising in this area. This has resulted in a lack of conceptual clarity which has not only hamstrung the development (...) of empirical work in the field, but has also led to a tendency by both nurses and policy‐makers to assume that greater ‘lay participation’ in health will lead to a concomitant increase in lay power vis‐à‐vis health professionals. The data presented in this paper indicate that this is, at best, an over‐simplistic assumption and, at worst, an erroneous one. Drawing on sociological theories of the division of labour, I suggest that one way in which we might begin to clarify our thinking in this area is by differentiating between the ‘role’ and ‘task’ components of ‘lay participation’. I illustrate my argument with reference to two separate ethnographic studies undertaken between 1994 and 1998 in which participation at the level of the individual was examined. (shrink)

This paper examines what can be learnt from analysing attempts to give lay people more involvement in the administration of state schools. Although devolving more responsibility to schools and lay governors has been an important feature of school reform in several countries, it is not immediately apparent if this shift is the product of globally similar social and political forces or nationally specific cultural, ideological and economic factors. In considering this issue, the paper describes recent changes in school governance in (...) England, New Zealand, USA, Scotland and Catalunya, Spain. It is argued that some of these changes can best be characterised as attempts to increase the democratic participation of citizens in the running of schools. Other changes, however, seem rather to represent on attempt to bring the culture of business to schools and reduce the power of professional educators over education. (shrink)

Intuitively, there is a difference between knowledge and mere belief. Contemporary philosophical work on the nature of this difference has focused on scenarios known as “Gettier cases.” Designed as counterexamples to the classical theory that knowledge is justified true belief, these cases feature agents who arrive at true beliefs in ways which seem reasonable or justified, while nevertheless seeming to lack knowledge. Prior empirical investigation of these cases has raised questions about whether lay people generally share philosophers’ intuitions about these (...) cases, or whether lay intuitions vary depending on individual factors (e.g. ethnicity) or factors related to specific types of Gettier cases (e.g. cases that include apparent evidence). We report an experiment on lay attributions of knowledge and justification for a wide range of Gettier Cases and for a related class of controversial cases known as Skeptical Pressure cases, which are also thought by philosophers to elicit intuitive denials of knowledge. Although participants rated true beliefs in Gettier and Skeptical Pressure cases as being justified, they were significantly less likely to attribute knowledge for these cases than for matched true belief cases. This pattern of response was consistent across different variations of Gettier cases and did not vary by ethnicity or gender, although attributions of justification were found to be positively related to measures of empathy. These findings therefore suggest that across demographic groups, laypeople share similar epistemic concepts with philosophers, recognizing a difference between knowledge and justified true belief. (shrink)

In science and environmental studies, there is a general concern for the democratization of the expert-lay interplay. However, the democratization of expertise does not necessarily lead to more sustainable decisions. If citizens do not take the sustainable choice, what should experts and decision makers do? Should the expert-lay interplay be dissolved? In thinking about how to shape the expert-lay interplay in a better way in agro-biodiversity conservation, I take the case of the MST (Movimento Sem Terra/Landless People’s Movement), possibly the (...) largest rural movement in Latin America. The MST is in a process of turning towards environmentalism. It has adopted agroecology, a democratically oriented knowledge field. However, not all of the farmers were willing to adopt new environmentalist ideas and practices. Through ethnographic research, I analyze how expertise was recognized and redistributed within the MST, attending particularly to the role of MST coordinators and technicians. I explore how participation was framed and put into action. The adoption of agroecology brought to the MST a new and more inclusive map of expertise, but it also influenced new social distinctions within the communities. In part, farmers’ knowledge was labeled as ignorance. This may close down possibilities for dialogue as well as for sustainability. The paper suggests that experts’ power for discriminating among lay knowledges should come together with a responsibility for opening spaces for dialogue and action. One way of doing so could be by adding “interactional reflexivity” to experts’ expertise. (shrink)

The objective of the paper is to present the differences in the grounds of appeal and the appeal proceedings against judgments issued by a court composed of representatives of the public in a criminal trial at first instance. At present, citizens are allowed to adjudicate most often in one of three forms: persons adjudicating independently without the participation of a professional factor, who are not professionals in the field of law and criminal procedure (e.g. judges of the peace in (...) the common law system); a jury composed of citizens and adjudicating mostly on guilt of the accused; or lay judges adjudicating all aspects of the case in one panel together with professional judges. However, the participation of laymen in adjudication is not a prevailing rule. Many countries legal systems do not allow the citizens to co-decide in criminal cases. The paper also indicates the arguments for the democratization of the judiciary through a wider admission of citizens to participate in criminal justice. This issue has been examined on the background of three aspects of democracy: representative, deliberative and participatory. (shrink)

Background: There is a lack of empirical data on lay attitudes toward different sorts of deception in medicine. However, lay attitudes toward deception should be taken into account when we consider whether deception is ever permissible in a medical context. The objective of this study was to examine lay attitudes of U.S. citizens toward different sorts of deception across different medical contexts. Methods: A one-time online survey was administered to U.S. users of the Amazon “Mechanical Turk” website. Participants were asked (...) to answer questions regarding a series of vignettes depicting different sorts of deception in medical care, as well as a question regarding their general attitudes toward truth-telling. Results: Of the 200 respondents, the majority found the use of placebos in different contexts to be acceptable following partial disclosure but found it to be unacceptable if it involved outright lying. Also, 55.5% of respondents supported the use of sham surgery in clinical research, although 55% claimed that it would be unacceptable to deceive patients in this research, even if this would improve the quality of the data from the study. Respondents supported fully informing patients about distressing medical information in different contexts, especially when the patient is suffering from a chronic condition. In addition, 42.5% of respondents believed that it is worse to deceive someone by providing the person with false information than it is to do so by giving the person true information that is likely to lead them to form a false belief, without telling them other important information that shows it to be false. However, 41.5% believed that the two methods of deception were morally equivalent. Conclusions: Respondents believed that some forms of deception were acceptable in some circumstances. While the majority of our respondents opposed outright lying in medical contexts, they were prepared to support partial disclosure and the use of placebos when it is in the patient's interests or when it is what the person would want. These results support the position that physicians should be allowed a greater degree of authority to make a professional judgment about whether deception might be morally warranted by the circumstances, provided that it doesn't involve outright lying. (shrink)

Perhaps more than most professions, law depends on a corpus of specialized terms of art that are familiar to the practitioners who use them regularly in legal contexts but less familiar to lay people. Apart from the importance of enhancing transparency and public access for a key domain, making legal terms understandable to non-professionals may be crucial when non-professionals are involved in legal processes, such as civil litigation. However, simplifying terms risks changing their meaning, while explaining them in plain language (...) entails the difficulty of assessing how much of the legal content lay people need or are prepared to know. An initial step to making legalese more understandable to non-lawyers is to evaluate what lay people actually understand by the terms they come across, and so this study compared the responses of lay participants when asked about key terms form the Japanese Civil Code with the definitions and explanations given by a legal expert. One of the key findings that emerged was that there is particular difficulty with terms that lay people have some understanding of because of their use in non-legal contexts. It will be argued that supplying some background in legal theory would help facilitate educating the public about the legal meaning of terms. (shrink)

Laypersons serve at critical junctures in the legal process. This article provides an overview of research about layperson roles and draws attention to the research methodologies used in studying them. It also discusses the jury system because, in addition to the fact that this institution has attracted the greatest quantity of empirical research on lay participation in legal processes, the studies have also involved the greatest range of methodological approaches, thus allowing exploration of their various strengths and weaknesses. Research (...) on mixed tribunals, lay magistrates, justices of the peace and other forms of lay participation are also discussed in the article. There are literally hundreds of empirical studies bearing on jury competence and behavior. More systematic research surveying the extent of layperson roles in different cultures and countries is needed and studies of how laypersons actually perform in these roles is crucial. (shrink)

In an unusual instance of lay participation in biomedical research, U.S. AIDS treatment activists have constituted themselves as credible participants in the process of knowledge construction, thereby bringing about changes in the epistemic practices of biomedical research. This article examines the mechanisms or tactics by which these lay activists have constructed their credibility in the eyes of AIDS researchers and government officials. It considers the inwlications of such interventions for the conduct of medical research; examines some of the ironies, (...) tensions, and limitations in the process; and argues for the importance of studying social movements that engage with expert knowledge. (shrink)

ABSTRACT Persons generally must give their informed consent to participate in research. To provide informed consent persons must be given information regarding the study in simple, lay language. Consent must be voluntary, and persons giving consent must be legally competent to consent and possess the capacity to understand and appreciate the information provided. This paper examines the relationship between the obligation to disclose information regarding risks and the requirement that persons have the capacity to understand and appreciate the information. There (...) has been insufficient attention to the extent to which persons must be able to understand and appreciate study information in order to have their consent deemed valid when the information is provided in simple, lay language. This paper argues that (1) the capacity to understand and appreciate information that should be deemed necessary to give valid consent should be defined by the capacity of the typical, cognitively normal adult and (2) the capacity of the typical, cognitively normal adult to understand and appreciate the concept of risk is limited. Therefore, (3) all things being equal, potential subjects must possess a limited capacity to understand and appreciate risk to be deemed competent to consent to research participation. (4) In some cases investigators ought to require that persons possess a greater than typical capacity to understand and appreciate risk. (shrink)

Making better choices about future technologies that are being researched or developed is an important motivator behind lay ethics interventions. However, in practice, they do not always succeed to serve that goal. Especially authors who have noted that lay ethicists sometimes take recourse to well-known themes which stem from old, even ‘archetypical’ stories, have been criticized for making too little room for agency and decision-making in their approach. This paper aims to contribute to a reflection on how lay ethics can (...) acquire more practical relevance. It will use resources in narrative ethics to suggest that in order to be relevant for action, facilitators of lay ethics interventions need to invite participants to engage in a narrative quest. As part of a quest, lay ethicists should be asked to reflect on a specific question or choice, use diverse input which is informative about the heterogeneity of viewpoints that are defended in society and argue for their standpoints. (shrink)

Making better choices about future technologies that are being researched or developed is an important motivator behind lay ethics interventions. However, in practice, they do not always succeed to serve that goal. Especially authors who have noted that lay ethicists sometimes take recourse to well-known themes which stem from old, even ‘archetypical’ stories, have been criticized for making too little room for agency and decision-making in their approach. This paper aims to contribute to a reflection on how lay ethics can (...) acquire more practical relevance. It will use resources in narrative ethics to suggest that in order to be relevant for action, facilitators of lay ethics interventions need to invite participants to engage in a narrative quest. As part of a quest, lay ethicists should be asked to reflect on a specific question or choice, use diverse input which is informative about the heterogeneity of viewpoints that are defended in society and argue for their standpoints. (shrink)

During a pandemic, demand for intensive care often exceeds availability. Experts agree that allocation should maximize benefits and must not be based on whether patients could have taken preventive measures. However, intensive care units are often overburdened by individuals with severe COVID-19 who have chosen not to be vaccinated to prevent the disease. This article reports an experiment that investigated the German public's prioritization preferences during the fourth wave of the coronavirus pandemic. In a series of scenarios, participants were asked (...) to decide on ICU admission for patients who differed in terms of health condition, expected treatment benefits, and vaccination status. The results reveal an in-group bias, as vaccinated individuals preferred to allocate more resources to the vaccinated than to the unvaccinated. Participants also favored admitting a heart attack patient rather than a COVID-19 patient with the same likelihood of benefiting from ICU admission, indicating a preference for maintaining regular ICU services rather than treating those with severe COVID-19. Finally, participants were more likely to admit a patient to intensive care when this meant withholding rather than withdrawing care from another patient. The results indicate that lay prioritizations violate established allocation principles, presaging potential conflicts between those in need of intensive care and those who provide and allocate it. It is therefore recommended that allocation principles should be explained to enhance public understanding. Additionally, vaccination rates should be increased to relieve ICUs and reduce the need for such triage decisions. (shrink)

Recent empirical work on non-philosophers’ intuitions about epistemic normativity reveals patterns that cannot be fully accounted for by direct epistemic consequentialism. On the basis of these results, one might picture participants as “epistemic deontologists.” We present the results of two new experiments that support a more nuanced picture. We examine intuitions about guesses and hypotheses, and about beliefs. Our results suggest a two-factor model of intuitions, wherein both consequentialist and non-consequentialist considerations affect participants’ judgments about epistemic permissibility.

Background Factors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons’ understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care. Methods This was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6–8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The (...) study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis. Results Respondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making. Conclusions Respondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent. (shrink)

Since the 1988 Cartwright Inquiry, lay members of ethics committees have been tasked with ensuring that ordinary New Zealanders are not forgotten in ethical deliberations. Unlike Institutional Review Boards in North America, where lay members constitute a fraction of ethics committee membership, 50% of most New Zealand ethics committees are comprised of lay members. Lay roles are usually defined in very broad terms, which can vary considerably from committee to committee. This research queries who lay representatives are, what they do, (...) and what if anything they represent. Our findings are based on data collection with 12 participants: eight semi-structured interviews with lay members from diverse types of ethics committees who described their roles, and commentary from four ethics committee chairs, three of these lay members who commented on this article’s final draft. Findings indicate that the role of New Zealand lay persons – although distinctively valued – is otherwise similar to the documented role of lay persons within North American ethics committees. Lay members see their role as primarily protecting the research participant and at times offering a corrective to non-lay members’ views and the interests of their institutions. However, in spite of their numbers, most lay members do not see themselves as representing any particular constituent groups or institutionally unaffiliated areas of concern. On tertiary education committees especially, there is a good deal of ambiguity in the lay role. (shrink)

In this article, we philosophically reflect on the nature of business management. We move beyond the political paradigm of the conceptualization of management in order to lay the ground for a philosophy of business management. First, we open-up the self-evident conceptualization of business management in contemporary management practices by comparing ancient and contemporary definitions of management. Second, we develop a framework with six dimensions of the nature of business management that can guide future philosophical and empirical work on the nature (...) of business management: management control, people management, asset management and entrepreneurial action, management as participation, management as responsive action and management as constituting meaning. (shrink)

In practice, the role of lay members of research ethics committees (RECs) often involves checking the accessibility of written materials, checking that the practical needs of participants have been considered and ensuring that a lay summary of the research will be produced. In this brief report, I argue that all these tasks would be more effectively carried out through a process of patient involvement (PI) in research projects prior to ethical review. Involving patients with direct experience of the topic under (...) investigation brings added value beyond the contributions typically made by lay REC members, who are often not patients themselves. This is because PI tailors the design and conduct of research to the specific interests and concerns of the people who will actually take part in a project and make use of its findings. If a project has PI in its early stages, then a similar input from lay REC members could at best result in duplication of effort and at worst create the potential for conflict. The rationale for lay REC membership will therefore need to change from ‘contributing a patient perspective’ to ‘ensuring transparency and public accountability in REC decisions’. This has implications for addressing more strategic questions about lay REC membership, including who is best recruited to the role and how they should be expected to contribute in practice. (shrink)

Objective: To determine under what conditions lay people and health professionals find it acceptable for a physician to breach confidentiality to protect the wife of a patient with a sexually transmitted disease .Methods: In a study in France, breaching confidentiality in 48 scenarios were accepted by 144 lay people, 10 psychologists and 7 physicians. The scenarios were all possible combinations of five factors: severity of the disease ; time taken to discuss this with ; intent to inform the spouse about (...) the disease ; intent to adopt protective behaviours ; and decision to consult an expert in STDs , 2×2×3×2×2. The importance and interactions of each factor were determined, at the group level, by performing analyses of variance and constructing graphs.Results: The concept of breaching confidentiality to protect a wife from her husband’s STD was favoured much more by lay people and psychologists than by physicians . The patient’s stated intentions to protect his wife and to inform her of the disease had the greatest impact on acceptability. A cluster analysis showed groups of lay participants who found breaching confidentiality “always acceptable” , “depending on the many circumstances” , requiring “consultation with an expert” and “never acceptable ”.Conclusions: Most people in France are influenced by situational factors when deciding if a physician should breach confidentiality to protect the spouse of a patient infected with STD. (shrink)

An ongoing trend in technology policy has been to advocate participation. However, the author claims that lay citizens’ participation typically materializes in the form of a laboratory experiment at present. That is, lay participation as currently organized by professional participation experts under controlled conditions rarely is linked to public controversies, to the pursuit of political participation or to individual concerns. Derived from qualitative research on two citizen conferences, the author shows empirically that in practice, this (...) laboratory participation leads to paradoxical effects: successfully carrying out the experiment results in a systematic disappointment of the hope for gains in rationality typically attached to lay participation. Finally, the author relates this result to sociological debates about new modes of knowledge production. Under such a perspective, the author sees a paradoxical development: while society at large is becoming a laboratory in which knowledge is produced, participation practice is retreating from society into the lab. (shrink)

Appraisal research based on participants' self-report of emotional experiences is predicated on the assumption that the academic community and the lay public share comparable meanings of the emotion terms used. However, this can be a risky assumption to make, as in the case of the emotion disgust which appears in common usage to reflect irritation, or anger, as often as repulsion. To examine the theoretical versus the lay meaning of disgust, 140 undergraduates were asked to recall a time when they (...) felt either angry, disgust, disgusted, revulsion, or grossed out. Analysis of event recall responses and emotional experience measures suggests that the common understanding of the word disgust reflects a combination of the conceptual meanings of disgust and anger whereas the slang term grossed out more closely captures the theoretical construct of disgust. Implications of these findings for emotion research based on self-report are discussed. (shrink)

In spite of extensive research on theory of mind, lay theories about the unconscious have scarcely been investigated. Three questionnaire studies totaling 689 participants, examined to what extent they thought that a range of psychological processes could be unconscious. It was found that people are less willing to countenance unconscious processes in themselves than in others, regardless of the time period considered – present, past or future. This is especially true when specific experience-like situations are envisioned, as opposed to considering (...) the question in abstract or generic terms. In addition, the notion of unconscious psychological processes is resisted for certain domains in particular: intending, sensing, believing, and thinking. We interpret this pattern by positing the existence of two conceptions about the unconscious that are differentially applied according to circumstances: one originating in prevalent social representations about the unconscious, the other based on self-model of the person as an intentional actor. (shrink)

The theory-theory is not supported by evidence in the everyday actions of infants and toddlers whose lives a Theory of Mind is meant radically to transform. This paper reviews some of these challenges to the theory-theory, particularly from communication and deception. We argue that the theory’s disconnection from action is both inevitable and paradoxical. The mind–behaviour dualism upon which it is premised requires a conceptual route to knowing minds and disallows a real test of the theory through the study of (...) action. Taking engagement seriously avoids these problems and requires that both lay people and psychologists be participants rather than observers in order to know, and indeed to create, minds. (shrink)

In philosophy of religion, there are few more frequently visited topics than the problem of evil, which has attracted considerable interest since the time of Epicurus. It is well known that the problem of evil involves responding to the apparent tension between 1) belief in the existence of a good, all powerful, all knowing God and 2) the existence of evil—such as personal suffering embodied in the experience of cancer. While a great deal has been written concerning abstract philosophical theories (...) that academics use to explain the existence of evil, much less has been written about how religious lay people make sense of evil and suffering. What explanations, meanings, and perceptions do they hold concerning the religious significance of evil? What can theologians and philosophers learn from these lay experiences? Our interdisciplinary team designed an experiment to identify the religious significance that personal suffering held for a group of religious cancer sufferers. We interviewed twenty-nine self-identified evangelical Christians who had received a cancer diagnosis at some point in their lives for our experiment. Since all interviewees identified as Christians, it was expected that they would assent to belief in a theistic God. It was also expected that each interviewee would assent the existence of evil and see their cancer experience as a dramatic and personal instance of an evil event. The explicit existential threat of cancer guarantees that the individual has much at stake in the experience. Furthermore, the pain and suffering that typically accompanies either the cancer itself or cancer treatments make it a compelling example of evil experienced in a very personal way. Finally, even when successfully treated, the ongoing threat of potentially fatal recurrence looms over the sufferer for years to come. We asked 17 questions related to the religious significance of their cancer experience in each interview and coded these interviews looking for five distinct types of explanations for/meaning of evil: trusting God in mystery, free will, moral development, spiritual growth, and growth in human relationships/community. These categories were meant to correspond loosely to five philosophical responses to the existence of evil.Our interviews included several important results. First, 79% of interviewees had at least one answer that fit into the ‘trust God in mystery’ category of responses with 48% using this category of responses as their most frequently cited theme. This result could be interpreted as a kind of generic theodical response: God has a good, but unknown reason for allowing evil/suffering. Alternatively, another possible interpretation is that at least some of these interviewees intuited something similar to skeptical theism, since it claims that if one understands the type of God proposed by theism and possesses an accurate view of human cognitive capacities, it is apparent that there is no real tension to be resolved between theism and the existence of evil. Some of our interviewees seemed to believe not only that the answer to why evil exists is mysterious, but that they simply could not have the necessary perspective to judge what kinds of purposes God might have for allowing this painful episode in their lives.While it was unsurprising that religious sufferers would find it important to trust God in ambiguous difficult circumstances, more surprisingly, we found that 52% of our respondents did not judge that their cancer experience was at all in tension with their religious beliefs. Whereas a broad range of philosophers and theologians acknowledge that there is at least an apparent conflict between the existence of a good, all-powerful God and the existence of evil, most of our interviewees did not even perceive an apparent tension between theistic beliefs and their painful cancer experiences that would be in need of additional reconciliation.There are at least two ways this result might be interpreted. First, our interviewees might hold additional beliefs that make the existence of evil easier for them to accept. After all, these interviewees were not ‘bare theists’ who held only to the existence of God, but presumably held a broad range of religious beliefs which may already serve to reconcile the existence of evil: that growing closer to God is more important than earthly life itself, that in evil in this life allows us a greater appreciation of a blessed eternity, or simply that ‘God works for our good in mysterious ways.’ Thus, a fully developed Christian worldview may already accommodate the existence of evil in a way not fully appreciated by philosophers.Another possible interpretation is that at least some of our interviewees were not adequately reflective to perceive the tension between their religious beliefs and their experience of suffering. There is at least some reason to doubt this explanation as an overarching interpretation of this result since our interviewees were generally well educated with the median participant holding at least a Bachelor’s degree, and most were ongoing participants in a cancer support group ensuring long-term ongoing engagement with their cancer experience.A final significant finding is that a high portion of our interviewees, 83% reported specific examples of beneficial personal growth—moral, spiritual, or relational— that resulted from their cancer experience. When asked about their cancer experience’s broad effect upon their lives in these areas they volunteered at least one example of a benefit they received in these areas. Depending on one’s accompanying value theory and whether such benefits might have been otherwise achieved, they might provide a morally sufficient reason for the existence of suffering. Our interviewees frequently described experiencing the kind of benefits at the heart of John Hick’s soul making theodicy and Eleonore Stump’s ‘spiritual growth’ theodicy, providing at least some corroborating evidence for such views. Experiences common to our interviewees were similar to what such theodicies would predict. (shrink)

Standard approaches to defining and evaluating environmental risk tend to reflect technocratic rather than democratic values. One consequence is that institutional mechanisms for achieving citizen participation in risk decisions rarely are studied or evaluated. This article presents a survey of five institutional mechanisms for allowing the lay public to influence environmental risk decisions: public hearings, initiatives, public surveys, negotiated rule making, and citizens review panels. It also defines democratic process criteria for assessing these and other participatory mechanisms.

Many important decisions depend on unknown states of the world. Society is increasingly relying on statistical predictive models to make decisions in these cases. While predictive models are useful, previous research has documented that (a) individual decision makers distrust models and (b) people’s predictions are often worse than those of models. These findings indicate a lack of awareness of how to evaluate predictions generally. This includes concepts like the loss function used to aggregate errors or whether error is training error (...) or generalisation error. To address this gap, we present three studies testing how lay people visually evaluate the predictive accuracy of models. We found that (a) participant judgements of prediction errors were more similar to absolute error than squared error (Study 1), (b) we did not detect a difference in participant reactions to training error versus generalisation error (Study 2), and (c) participants rated complex models as more accurate when comparing two models, but rated simple models as more accurate when shown single models in isolation (Study 3). When communicating about models, researchers should be aware that the public’s visual evaluation of models may disagree with their method of measuring errors and that many may fail to recognise overfitting. (shrink)

This investigation examined how people’s beliefs about the functionality of emotion shape their emotional response and regulatory strategies when encountering distressing events. In Study 1, we present data supporting the reliability and validity of an 8-item instrument, the Help and Hinder Theories about Emotion Measure (HHTEM), designed to assess an individual’s beliefs about the functionality of emotion. Participants who more strongly endorsed a Help Theory reported greater wellbeing, emotional acceptance, and use of reappraisal to regulate emotion. Participants who more strongly (...) endorsed a Hinder Theory reported less wellbeing and more expressive suppression and substance use. In Study 2, we demonstrate that encouraging participants to view emotion as helpful affected their physiological and regulatory response to a distressing event. Participants in the Help Theory condition showed greater physiological reactivity (SCL) during a distressing film than control participants but were more accepting of their emotional response. Shortly after the film, SCL decreased for participants in the Help Theory condition. Compared to control participants, they engaged in less suppression and reported less lingering effect of the film on their mood. Together, these studies suggest that people’s theories about the functionality of emotion influence their reactivity, the strategies they adopt to regulate emotion, and their ability to rebound after distressing events. (shrink)

Background: Lay persons’ judgements of the acceptability of the not uncommon practice of ending the life of a damaged neonate have not been studied. Methods: A convenience sample of 1635 lay people in France rated how acceptable it would be for a physician to end a neonate’s life—by withholding care, withdrawing care, or active euthanasia—in 54 scenarios in which the neonate was diagnosed either with perinatal asphyxia or a genetic abnormality. The scenarios were all combinations of four factors: three levels (...) of maturity or immaturity, three levels of severity of the health problem, three levels of parents’ preference concerning prolonging care and two levels of decision-making (with or without consulting the other caregivers). Analyses: Analyses of variance of the participants’ responses were performed to determine the importance of each factor; the interactions among factors, with methods of ending life and with other patient characteristics; and the differences between asphyxia and genetic abnormality. A cluster analysis was performed to look for groups with different patterns of responses. Results: Lay people assigned most importance to the parents’ request and to the severity of the problem. Except for a small group (12%) always opposed to ending life, they used a simple additive-type rule in integrating the information. Implications: Most of this sample of French lay people are not categorically for or against ending the life of a damaged neonate, but judge its degree of acceptability by adding up those factors that seem most salient to them. (shrink)

Vocational Education and Training policies are paying increasing attention towards the need to develop quality career guidance processes. Career guidance plays an essential role in this challenge by enabling people to develop the career management skills that allow them to become aware of their full potential and to construct life projects that facilitate the emotional management of uncertainty and complexity, participating as responsible agents in their environment. After conducting a literature review on each of these key elements, we set out (...) to identify best practices in VET as “building blocks” for the construction of an integrated career guidance plan in VET. This study adopts an approach based on qualitative methodology, specifically a documentary type of research has been carried out. The documents analysed correspond to 88 best practices identified in Andalusia. The analysis strategy used was a content analysis. For this purpose, a system of categories has been designed, from a deductive perspective, which has contributed to a systematic analysis of them. One of the first conclusions of the study is the uneven development o best practices in the different VET professional pathways. The practices carried out in the centres begin to incorporate different elements and thus facilitate the creation of a suitable context for the development of comprehensive career guidance plans in VET. The article closes by offering implications for the development of guidance in the education system and discusses lines of future research. (shrink)

BackgroundWhether patients in the vegetative state (VS), minimally conscious state (MCS) or the clinically related locked-in syndrome (LIS) should be kept alive is a matter of intense controversy. This study aimed to examine the moral attitudes of lay people to these questions, and the values and other factors that underlie these attitudes.MethodOne hundred ninety-nine US residents completed a survey using the online platform Mechanical Turk, comprising demographic questions, agreement with treatment withdrawal from each of the conditions, agreement with a series (...) of ethical principles and three personality tests.ResultsMore supported treatment withdrawal from VS (40.2 % agreed, 17.6 % disagreed) than MCS (20.6 %, 41.2 %) or LIS (25.3 %, 35.8 %). Agreement with treatment withdrawal was negatively correlated with religiosity (r = −0.272, P < 0.001), though showed no significant relationship with need for cognition or empathy, and only a partial association with utilitarian judgment in a standard moral dilemma. Support for treatment withdrawal was most strongly associated with endorsement of the importance of patient autonomy, dignity, suffering, best interests. Distributive justice was not given significant weight by most. Importantly, agreement with treatment withdrawal was noticeably higher when considered from a first as opposed to third person perspective for VS (Z = −6.056, P < 0.001), MCS (Z = −6.746, P < 0.001) and LIS (Z = −6.681, P < 0.001).ConclusionLay attitudes to withdrawal of treatment in brain damaged patients are largely shaped by values similar to those central to the secular ethical debate. Neither traditional values such as the sanctity of life nor utilitarian values relating to resource allocation seem to play a central role. Far greater weight is given to autonomy, which may explain why participants were far more willing to endorse withdrawal of treatment when the issue was presented in the first person, or in relation to a concrete case involving a patient’s explicit wishes. Surveys focusing on abstract cases presented in the third person may not provide an accurate picture of lay attitudes to these critical ethical questions. (shrink)

Even if we know all relevant descriptive facts about an act, we can still be uncertain about its moral acceptability. Most literature on how to act under such normative uncertainty operates on moral realism, the metaethical view that there are objective moral facts. Lay people largely report anti-realist intuitions, which poses the question of how these intuitions affect their interpretation and handling of normative uncertainty. Results from two quasi-experimental studies (total N = 365) revealed that most people did not interpret (...) normative uncertainty as referring to objective moral facts but rather as uncertainty regarding one’s own view, uncertainty regarding the culturally accepted view or as the result of ambivalence. Especially the anti-realist majority of participants interpreted normative uncertainty different to how it is described in the literature on choice under normative uncertainty. Metaethical views were also associated with lay peoples’ choice of uncertainty reduction strategies and with assumptions about the intended aim of such strategies. The current findings suggest that empirical investigations of normative uncertainty might benefit from considering folk metaethical pluralism, as the lay public largely disagrees with the metaethical assumptions underlying the current discourse on choice under normative uncertainty. (shrink)

Qualitative research carried out within human science must provide justification for its findings. However, the justification of empirical claims concerning human meanings has to be approached in new ways: Quantitative procedures of validation or the use of experimental control are inappropriate. Many researchers have attempted to follow Schutz's ''postulate of adequacy," which lays down as a condition of acceptability of a scientific account of human action that it be understandable by the actor in terms of commonsense interpretation of everyday life. (...) For instance, Harré suggests "validating" descriptions by ensuring that subjects of the research approve them. Against this approach, it is insisted that human science research is essentially an interpersonal process, and that therefore research activities cannot avoid such Goffmanesque features of self-presentation as resistance to being understood and eager acceptance of understanding, which are both pervasive possibilities of all social interaction. Thus, the research participant's agreement or disagreement cannot be taken as evidence as to the adequacy of a qualitative research description or interpretation. (shrink)

In this paper, we explore and discuss the use of the concept of being affected in biomedical decision making processes in Germany. The corresponding German term ‘Betroffenheit’ characterizes on the one hand a relation between a state of affairs and a person and on the other an emotional reaction that involves feelings like concern and empathy with the suffering of others. An example for the increasing relevance of being affected is the postulation of the participation of people with disabilities (...) and chronic or acute diseases in the discourse, as partly realized in the German National Ethics Council or the Federal Joint Committee. Nevertheless, not only on the political level, the resistance against the participation of affected people is still strong; the academic debate seems to be cross-grained, too. Against this background, we explore the meaning and argumentative role of the concept of being affected as it is used by affected and lay people themselves. Our analysis is based on four focus group discussions in which lay people, patients and relatives of patients discuss their attitudes towards biomedical interventions such as organ transplantation and genetic testing. This setting allows for a comparison of how affected and non-affected people are concerned and deliberate about medical opportunities, but also of how they position themselves as being affected or non-affected with respect to (scientific) knowledge and morality. On this basis, we discuss the normative relevance of being affected for the justification of political participation. (shrink)

This paper discusses the discourse of ‘participation’ in the context of genetic databases. Focusing on UK Biobank, it suggests that this discourse can be seen as a reflexive institutional response to public ambivalence towards science and expertise. Drawing on empirical evidence from focus groups, I explore how people from various backgrounds constructed and contested two different kinds of participation in UK Biobank. The first relates to people providing research materials to genetic databases and the second to people becoming (...) ‘co-decision makers’ in these projects. My analysis highlights how focus groups positioned themselves and others in relation to UK Biobank and drew on a variety of ‘discursive repertoires’, such as altruism, public ignorance, expertise, and lay empowerment. I conclude that discourses of participation reflect the way people position themselves and others - as experts, publics, patients, or research subjects - in relation to the opportunities and uncertainties of new biomedical research. (shrink)

BackgroundResuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit, meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people regarding resource allocation decisions in the NICU.MethodsThe study design was a cross-sectional quantitative survey, consisting of 20 hypothetical rationing scenarios. There were (...) 119 respondents who entered the questionnaire, and 109 who completed it. The respondents were adult US and Indian participants of the online crowdsourcing platform Mechanical Turk. Respondents were asked to decide which of two infants to treat in a situation of scarce resources. Demographic characteristics, personality traits and political views were recorded. Respondents were also asked to respond to a widely cited thought experiment involving rationing.ResultsThe majority of respondents, in all except one scenario, chose the utilitarian option of directing treatment to the infant with the higher chance of survival, higher life expectancy, less severe disability, and less expensive treatment. As discrepancy between outcomes decreased, however, there was a statistically significant increase in egalitarian responses and decrease in utilitarian responses in scenarios involving chance of survival, life expectancy, and cost of treatment. In the classic ‘lifeboat’ scenario, all but two respondents were utilitarian.ConclusionsThis survey suggests that in situations of scarcity and equal clinical need, non-health professionals support rationing of life-saving treatment based on probability of survival, duration of survival, cost of treatment or quality of life. However, where the difference in prognosis or cost is very small, non-health professionals preferred to give infants an equal chance of receiving treatment. (shrink)