Since 1991, the Patient Self-Determination Act (PSDA) has required all health care institutions that receive Federal funds to inform patients upon admission of their rights to make decisions about medical care and to execute advance directives. Implementation of the PSDA presents a special challenge for state mental hospitals. The relevance and possible negative therapeutic impact of discussing end of life decisions at the time of an acute psychiatric admission has recently been raised in the literature. Other ethical dilemmas arising from (...) the interplay between mental illness and informed consent for medical treatment, particularly for older patients committed to state mental hospitals, have been highlighted by the PSDA. In this article we discuss some of the issues raised by implementation of the PSDA in this setting. (shrink)

In this study, we test the interactive effect on ethical decision-making of (1) personal characteristics, and (2) personal expectanciesbased on perceptions of organizational rewards and punishments. Personal characteristics studied were cognitive moral developmentand belief in a just world. Using an in-basket simulation, we found that exposure to reward system information influenced managers’ outcome expectancies. Further, outcome expectancies and belief in a just world interacted with managers’ cognitive moral development to influence managers’ ethical decision-making. In particular, low-cognitive moral development managers who (...) expected that their organization condoned unethical behavior made less ethical decisions while high cognitive moral development managers became more ethical in this environment. Low cognitive moral development managers also behaved less ethically when their belief in a just world was high. (shrink)

In this study, we test the interactive effect on ethical decision-making of (1) personal characteristics, and (2) personal expectanciesbased on perceptions of organizational rewards and punishments. Personal characteristics studied were cognitive moral developmentand belief in a just world. Using an in-basket simulation, we found that exposure to reward system information influenced managers’ outcome expectancies. Further, outcome expectancies and belief in a just world interacted with managers’ cognitive moral development to influence managers’ ethical decision-making. In particular, low-cognitive moral development managers who (...) expected that their organization condoned unethical behavior made less ethical decisions while high cognitive moral development managers became more ethical in this environment. Low cognitive moral development managers also behaved less ethically when their belief in a just world was high. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

Within psychiatry, patients, family, and professionals are involved and interrelated. Yet it is not easy for healthcare professionals to involve family actively in patient care. Taking a feminist perspective, we investigate why health-care professionals experience ambivalence in involving family in attempts to reduce seclusion, suggesting how they can improve family involvement by adopting a relational view on autonomy. Professionals should view patients not only in terms of individual autonomy and rights, but also in terms of relations and dependencies that need (...) to be considered in fostering patient care. (shrink)

In this volume, Brakel raises questions about conventions in the study of mind in three disciplines—psychoanalysis, philosophy of mind, and experimental philosophy. She illuminates new understandings of the mind through interdisciplinary challenges to views long-accepted. Here she proposes a view of psychoanalysis as a treatment that owes its successes largely to its biological nature—biological in its capacity to best approximate the extinction of problems arising owing to aversive conditioning. She also discusses whether or not "the mental" can have any real (...) ontological standing, arguing that a form of reductive physicalism can be sufficient ontologically, but that epistemological considerations require a branch of non-reductive physicalism. She then notes the positive implications of this view for psychiatry and psychoanalysis, Finally, she investigates the role of "consistency" in method and content, toward which experimental philosophers strive. In essence, Brakel articulates the different sets of challenges pertaining to: a) ancient dilemmas such as the mind/body problem; b) longstanding debates about the nature of therapeutic action in psychoanalysis; and c) new core questions arising in the relatively young discipline of experimental philosophy. (shrink)

Although virtually all comparative research about risk perception focuses on which hazards are of concern to people in different culture groups, much can be gained by focusing on predictors of levels of risk perception in various countries and places. In this case, we examine standard and novel predictors of risk perception in seven sites among communities affected by a flood in Mexico (one site) and volcanic eruptions in Mexico (one site) and Ecuador (five sites). We conducted more than 450 interviews (...) with questions about how people feel at the time (after the disaster) regarding what happened in the past, their current concerns, and their expectations for the future. We explore how aspects of the context in which people live have an effect on how strongly people perceive natural hazards in relationship with demographic, well-being, and social network factors. Generally, our research indicates that levels of risk perception for past, present, and future aspects of a specific hazard are similar across these two countries and seven sites. However, these contexts produced different predictors of risk perception—in other words, there was little overlap between sites in the variables that predicted the past, present, or future aspects of risk perception in each site. Generally, current stress was related to perception of past danger of an event in the Mexican sites, but not in Ecuador; network variables were mainly important for perception of past danger (rather than future or present danger), although specific network correlates varied from site to site across the countries. (shrink)

A number of recent papers have described the successful derivation of egg and sperm precursor cells from mouse embryonic stem cells—so-called “artificial” gametes. Although many scientific questions remain, this research suggests numerous new possibilities for stem cell research and assisted reproductive technology, if a similar breakthrough is achieved with human embryonic stem cells. The novel opportunities raised by artificial gametes also prompt new ethical questions, such as whether same-sex couples should be able to access this technology to have children who (...) are genetically related to them both.THE CREATION OF “ARTIFICIAL” GAMETESOver the past two years, a number of papers have been published detailing the first successful attempts at differentiating mouse embryonic stem cells into egg1 and sperm2 precursor cells. Previously, researchers had used embryonic stem cells to generate tissues such as brain, liver, and pancreatic cells, but not germ cells of any kind. Production of gamete precursor cells was achieved initially through allowing stem cell lines to differentiate more or less randomly, but recent research has focused on identifying the precise ways in which differentiation into gametes can be precipitated and controlled. These breakthroughs make it seem likely that ongoing research on human stem cells will yield similar possibilities,3 raising questions over the practicalities of what might be achieved with such “artificial” gametes. In turn, the novel opportunities presented by artificial gametes raise a number of ethical concerns.The initial breakthrough, namely the obtaining of egg cells from mouse stem cells, was achieved by means of relatively simple science. Rather than coaxing stem cells to develop into eggs using complicated cocktails of growth factors, researchers adopted standard cell culture conditions, but grew the cells at higher density than usual.3–6 Growing the cells in this way led to the formation of ovary-like cell aggregates, which (when separated and stimulated with …. (shrink)

ObjectivePeer victimization is a substantial early life stressor linked to psychiatric symptoms and poor academic performance. However, the sex-specific cognitive or behavioral outcomes of bullying have not been well-described in preadolescent children.MethodsUsing the baseline dataset of the Adolescent Brain Cognitive Development Study 2.0.1 data repository, we evaluated associations between parent-reported bullying victimization, suicidality, and non-suicidal self-injury, as well as internalizing and externalizing behavioral problems, cognition, and academic performance.ResultsOf the 11,015 9-10-year-old children included in the analyses, 15.3% experienced bullying victimization, as (...) reported by the primary caregiver. Of these, boys were more likely to be bullied than girls. Children who were bullied were more likely to display NSSI or passive suicidality and active suicidality. Bullied children also had lower cognitive scores, greater behavioral problems, and poorer grades. Across all participants, boys had poorer grades and greater behavioral problems than girls; however, bullied boys had greater behavioral problems than girls in several areas. Compared to their non-bullied peers, bullied children with greater non-suicidal self-injury or suicidality also had greater behavioral problems and poorer grades.ConclusionThese findings highlight the sex-specific effects of bullying, and the negative associations of bullying victimization with cognitive performance, behavioral problems, and academic performance. Future longitudinal studies will identify the natural history and neural correlates of these deficits during adolescence. (shrink)

The essays in this volume present versions of feminism that are explicitly liberal, or versions of liberalism that are explicitly feminist. By bringing together some of the most respected and well-known scholars in mainstream political philosophy today, Amy R. Baehr challenges the reader to reconsider the dominant view that liberalism and feminism are 'incompatible.'.

Recently, there has been increased interest in the involvement of family members in treating psychiatric patients who are involuntarily admitted into mental hospitals (Goodwin and Happel 2006; Wilkinson and McAndrew 2008). Family is, for instance, expected to be of use in preventing escalations and aggression on the wards by giving information about patient needs and providing support to the patient. Yet, in practice, family is not routinely involved in the treatment process, and is not even regularly informed about situations (Marshall (...) and Solomon 2003). Professionals mention privacy and confidentiality as issues that constrain collaboration with family (Goodwin and Happel 2006; Wynaden and Orb 2005). .. (shrink)

Contrary to the popular belief that feminism has gained a foothold in the many disciplines of the academy, the essays collected in Theorizing Backlash argue that feminism is still actively resisted in mainstream academia. Contributors to this volume consider the professional, philosophical, and personal backlashes against feminist thought, and reflect upon their ramifications. The conclusion is that the disdain and irrational resentment of feminism, even in higher education, amounts to a backlash against progress.

Telling Our Lives explores how three working-class women-from Jewish, African-American, and Irish-American backgrounds connect across their differences through storytelling and conversation.

The popular view of non-directive genetic counseling limits the counselor's role to providing information to clients and assisting families in making decisions in a morally neutral fashion. This view of non-directive genetic counseling is shown to be incomplete. A fuller understanding of what it means to respect autonomy shows that merely respecting client choices does not exhaust the duty. Moreover, the genetic counselor/client relationship should also be governed by the counselor's commitment to the principle of beneficience. When non-directive counseling is (...) reexamined in light of both these principles, it becomes clear that there are cases in which counselors should attempt to persuade clients to reconsider their decisions. Such attempts are consistent with non-directive counseling because, while respecting the clients' decision-making authority, they insure that clients act with full knowledge of the moral consequences of their decisions. (shrink)

With over 10 000 bases of DNA being sequenced around the world per minute, it is vital that ethical discussion continues to keep pace with genetic research. This contribution by four top theorists in bioethics carefully considers the implications of the many ways genetic information will influence human health and reproduction, by considering “the most basic moral principles that would guide public policy and individual choice concerning the use of genetic interventions in a just and humane society” (4–5). Proceeding with (...) the themes of rights, justice, and harm, problems addressed by the authors include: the significance of the moral difference between treating genetic disease and altering personality characteristics; whether the utilisation of prenatal interventions to avoid disability discriminates against the disabled, and who should have control …. (shrink)

These books will prove valuable to philosophy teachers and their students as well as to other readers who share a general interest in philosophy.

The distinction between a type and its tokens is auseful metaphysical distinction. In §1 it is explained what itis, and what it is not. Its importance and wide applicability inlinguistics, philosophy, science and everyday life are brieflysurveyed in §2. Whether types are universals is discussed in§3. §4 discusses some other suggestions for what types are,both generally and specifically. Is a type the sets of its tokens?What exactly is a word, a symphony, a species? §5 asks what atoken is. §6 considers (...) the relation between types and theirtokens. Do the type and all its tokens share the same properties? Mustall the tokens be alike in some or all respects? §7 explains someproblems for the view that types exist, and some problems for the viewthat they don’t. §8 elucidates a distinction often confused withthe type-token distinction, that between a type and anoccurrence of it. It also discusses some problems thatoccurrences might be thought to give rise to, and one way to resolvethem. (shrink)

In this book, Linda Wetzel examines the distinction between types and tokens and argues that types exist (as abstract objects, since they lack a unique ...

Wrong beliefs, known by some as ‘alternative facts’, have proliferated lately in important areas of human life, including social, political, and public health domains. This can be and has been damaging. This brief article proposes an epistemological category classification of these wrong beliefs, with the following mappings: a) ‘No-Information’ marked by willful blindness produces ‘Empty Beliefs’; b) ‘Mis-Information’ yields ‘Mis(taken) Beliefs’; and c) ‘Dis-Information’ predicated on blatant distortions produces ‘Dis(torted) Beliefs’. This simple classification system, is perhaps epistemologically satisfying, and moreover (...) could have positive policy implications. (shrink)

The distinction between a type and its tokens is a useful metaphysical distinction. In §1 it is explained what it is, and what it is not. Its importance and wide applicability in linguistics, philosophy, science and everyday life are briefly surveyed in §2. Whether types are universals is discussed in §3. §4 discusses some other suggestions for what types are, both generally and specifically. Is a type the sets of its tokens? What exactly is a word, a symphony, a species? (...) §5 asks what a token is. §6 considers the relation between types and their tokens. Do the type and all its tokens share the same properties? Must all the tokens be alike in some or all respects? §7 explains some problems for the view that types exist, and some problems for the view that they don't. §8 elucidates a distinction often confused with the type-token distinction, that between a type (or token) and an occurrence of it. It also discusses some problems that occurrences might be thought to give rise to, and one way to resolve them. (shrink)

In this article, we review empirical evidence regarding the relationship between facial expression and emotion during infancy. We focus on differential emotions theory’s view of this relationship because of its theoretical and methodological prominence. We conclude that current evidence fails to support its proposal regarding a set of pre-specified facial expressions that invariably reflect a corresponding set of discrete emotions in infants. Instead, the relationship between facial expression and emotion appears to be more complex. Some facial expressions may have different (...) meanings in infants than in children and adults. In addition, nonemotion factors may sometimes lead to the production of “emotional” facial expressions. We consider alternative perspectives on the nature of emotion and emotional expression in infancy with particular focus on differentiation and dynamical systems approaches. (shrink)

With over 10 000 bases of DNA being sequenced around the world per minute, it is vital that ethical discussion continues to keep pace with genetic research. This contribution by four top theorists in bioethics carefully considers the implications of the many ways genetic information will influence human health and reproduction, by considering “the most basic moral principles that would guide public policy and individual choice concerning the use of genetic interventions in a just and humane society” (4–5). Proceeding with (...) the themes of rights, justice, and harm, problems addressed by the authors include: the significance of the moral difference between treating genetic disease and altering personality characteristics; whether the utilisation of prenatal interventions to avoid disability discriminates against the disabled, and who should have control …. (shrink)

Five experiments explored how source reliability influences people’s tendency to rate statements as more credible when they were encountered earlier . Undergraduates read statements from one reliable source and one unreliable source. Statements read multiple times were perceived as more valid and were more often correctly identified on a general knowledge test than statements read once or not at all. This occurred at varying retention intervals whether the statements originated from a reliable or unreliable source, when people had little memory (...) for the statements themselves or their source, and when the discrediting information about the sources came either before or after reading the facts. While repetition aided recognition and source accuracy, both were unaffected by the reliability of the source. Consistent with the source monitoring framework, familiarity may create an illusion of truth for statements when people lack source-specifying cues, especially cues regarding the reliability of the source. (shrink)

Moving beyond the traditional feminist ethics of care, Linda A. Bell places an existentialist conception of liberation at the heart of ethics and argues that only an ethics of freedom sufficiently allows for feminist critique and opposition ...

Just what sort of a theory is psychoanalytic theory? -- Did Kant precede Freud on a-rational thought? -- Why primary process is hard to know -- Representational a-rational thinking : a proper function account for phantasy and wish -- Drive theory and primary process -- Phantasies, neurotic-beliefs, and beliefs-proper -- Desire and the readiness-to-act -- Compare and contrast : Gardner, Lear, Cavell, and Brakel.

In recent decades, considerable progress has been made in our understanding of emotional development. Yet no single current theory can fully encompass all of the empirical findings. Herein I propose that aspects of several theoretical approaches can be incorporated into a novel view that is informed by the dynamical systems perspective.

Coiled‐coils are found in proteins throughout all three kingdoms of life. Coiled‐coil domains of some proteins are almost invariant in sequence and length, betraying a structural and functional role for amino acids along the entire length of the coiled‐coil. Other coiled‐coils are divergent in sequence, but conserved in length, thereby functioning as molecular spacers. In this capacity, coiled‐coil proteins influence the architecture of organelles such as centrioles and the Golgi, as well as permit the tethering of transport vesicles. Specialized coiled‐coils, (...) such as those found in motor proteins, are capable of propagating conformational changes along their length that regulate cargo binding and motor processivity. Coiled‐coil domains have also been identified in enzymes, where they function as molecular rulers, positioning catalytic activities at fixed distances. Finally, while coiled‐coils have been extensively discussed for their potential to nucleate and scaffold large macromolecular complexes, structural evidence to substantiate this claim is relatively scarce. (shrink)

In this commentary on Stanovich & West (S&W) we call attention to two points: (1) Freud's original dual process theory, which antedates others by some seventy-five years, deserves inclusion in any consideration of dual process theories. His concepts of primary and secondary processes (Systems 1 and 2, respectively) anticipate significant aspects of current dual process theories and provide an explanation for many of their characteristics. (2) System 1 is neither rational nor irrational, but instead a-rational. Nevertheless, both the a-rational System (...) 1 and the rational System 2 can each have different roles in enhancing evolutionary fitness. Lastly, System 1 operations are incorrectly deemed “rational” whenever they increase evolutionary fitness. (shrink)

While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)