The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care, the issue of who provides health care has evolved as individual rights have (...) trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a ‘negative right to health care’, to various forms of a ‘positive right to health care’. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a ‘right’, which is unconditional, a ‘privilege’ has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one’s health must for elevated. To have access to health care in the future will mean some loss of personal rights and an increase in personal responsibility for gaining or maintaining one’s health. (shrink)

Erratum to: Health Care Anal DOI 10.1007/s10728-013-0244-5In the original version of this paper, unfortunately, there happened to be a mistake in the paragraph “Several studies have compared health…better results or lower costs [7].” under the section “Health Care is NOT a Right?”The incorrect sentence is: For example, hip and knee replacements are not performed on Canadian and UK citizens after 77 .The correct sentence is: For example, hip and knee replacements in Canada and the UK are prioritized by age such (...) that older citizens are on a long waiting list. (shrink)

The concept of hysteria is traced from Hippocrates, where it was thought to be caused by a wandering uterus, through Galen and up to Freud. Throughout the history of medicine from the early Greeks up to the end of the nineteenth century, the definition and diagnosis of hysteria had a function similar to that found in the persecution of witchcraft: it sought to eradicate the outbursts of nonconforming and emotionally threatening conduct of women. At the beginning of the twentieth century, (...) however, the category virtually disappears from psychiatric nosologies. (shrink)

As part of a project to examine health care ethics consultation in Canada, we surveyed individuals who were considered by themselves or others to play a significant role in health care ethics consultation. Since one goal of the project was to examine the education and abilities necessary for consultants, we sought to determine the qualifications and skills currently possessed by persons considered to be ethics consultants. For the purposes of the questionnaire, health care ethics consultation was defined broadly to include (...) consultation on ethical issues in clinical care or in clinical research, ethics consultation to Clinical Ethics Committees, Research Ethics Committees, and policy formulation committees in health care institutions; clinical ethics work was defined more broadly still to include, in addition to the above, ethics education, administration, research and writing on bioethics other than the above, and public speaking.Three hundred and fifty questionnaires were sent to individuals and institutions across Canada that were thought to have some involvement in health care ethics consultation. Two hundred and fifty-three questionnaires were returned for a response rate of 72%. This report presents initial findings of the study and attempts to provide a comprehensive overview of the current state of ethics consultation within Canada. The survey examines demographics, educational background, time spent on ethics, institutional affiliations, approaches to the role of consultation, research related issues, and attitudes toward certification. (shrink)

Mood disorders, including major depressive disorder and bipolar disorder, are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research. These include issues of consent and decision-making capacity, including (...) patients’ motivations for participating in research. We also address drug withdrawals, placebo controls, and the overall safety of research. Finally, we examine the extant literature for studies discussing potential indirect benefits of clinical trials research to participants. Taken together, the evidence suggests that clinical trials research incorporating drug withdrawals and placebo controls can be conducted safely and ethically, even in patients with severe or treatment-resistant mood disorders. In fact, given the dearth of effective treatment options for this population, it is our opinion that a moral imperative exists to extend the offer of research participation to severely ill or treatment-resistant groups. (shrink)

Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

In Big Gods, Norenzayan (2013) presents the most comprehensive treatment yet of the Big Gods question. The book is a commendable attempt to synthesize the rapidly growing body of survey and experimental research on prosocial effects of religious primes together with cross-cultural data on the distribution of Big Gods. There are, however, a number of problems with the current cross-cultural evidence that weaken support for a causal link between big societies and certain types of Big Gods. Here we attempt to (...) clarify these problems and, in so doing, correct any potential misinterpretation of the cross-cultural findings, provide new insight into the processes generating the patterns observed, and flag directions for future research. (shrink)

Responding to research indicating unsettling results with regard to the ability of University students to recognize and reflect on questions of morality, this paper aims to discuss these issues and to introduce a promising mode of ethics instruction for overcoming such challenges. The Curricular Ethics Bowl (CEB) is a method of ethics education and assessment for a wide range of students and is a descendent of the Medical Ethics Bowl (MEB) (Merrick et al., “Introducing the Medical Ethics Bowl”). We seek (...) in this article to show the similarities of CEB to MEB and to distinguish this model from the Intercollegiate Ethics Bowl (ICEB) sponsored by the Association for Professional and Practical Ethics (Landenson 2001). The CEB institutionalizes this mode of ethics education at the program, rather than at the individual course level, and shows advantages over other ethics curricula. (shrink)

Responding to research indicating unsettling results with regard to the ability of University students to recognize and reflect on questions of morality, this paper aims to discuss these issues and to introduce a promising mode of ethics instruction for overcoming such challenges. The Curricular Ethics Bowl (CEB) is a method of ethics education and assessment for a wide range of students and is a descendent of the Medical Ethics Bowl (MEB) (Merrick et al., “Introducing the Medical Ethics Bowl”). We seek (...) in this article to show the similarities of CEB to MEB and to distinguish this model from the Intercollegiate Ethics Bowl (ICEB) sponsored by the Association for Professional and Practical Ethics (Landenson 2001). The CEB institutionalizes this mode of ethics education at the program, rather than at the individual course level, and shows advantages over other ethics curricula. (shrink)

This article seeks to develop theoretical convergences between the science of nostalgia and the science of heroism. We take four approaches in forging a conceptual relationship between these two phenomena. First, we examine the definitions of nostalgia and heroism from scholars, laypeople, and across cultures, noting how the history of defining the two phenomena has shaped current conceptualizations. Second, we demonstrate how nostalgic experiences consist of reminiscences about our own personal heroism and about cultural role models and heroes. A review (...) of heroism research, moreover, shows also that our recall of our heroes and of heroism is tinged with nostalgia. Third, we make linkages between heroism and nostalgia research focusing on functions, inspiration, sociality, and motivation. Nostalgia researchers have illuminated the functions of nostalgia implicating the self, existential concerns, goal pursuit, and sociality. Our review shows that heroism researchers invoke similar categories of hero functionality. Finally, we propose three areas of future research that can profit from the merging of nostalgia and heroism science, involving the mechanisms by which heroism can fuel nostalgia, nostalgia can promote heroic action, and wisdom results from nostalgic reverie. (shrink)

Given the growing public concern and attention placed on cases of research misconduct, government agencies and research institutions have increased their efforts to develop and improve ethics education programs for scientists. The present study sought to assess the impact of these increased efforts by sampling empirical studies published since the year 2000. Studies published prior to 2000 examined in other meta-analytic work were also included to provide a baseline for assessing gains in ethics training effectiveness over time. In total, this (...) quantitative review consisted of 66 empirical studies, 106 ethics courses, 150 effect sizes, and 10,069 training participants. Overall, the findings indicated that ethics instruction resulted in sizable benefits to participants and has improved considerably within the last decade. A number of specific findings also emerged regarding moderators of instructional effectiveness. Recommendations are discussed for improving the development, delivery, and evaluation of ethics instruction in the sciences. (shrink)

Requirements for business ethics education and organizational ethics trainings mark an important step in encouraging ethical behavior among business students and professionals. However, the lack of specificity in these guidelines as to how, what, and where business ethics should be taught has led to stark differences in approaches and content. The present effort uses meta-analytic procedures to examine the effectiveness of current approaches across organizational ethics trainings and business school courses. to provide practical suggestions for business ethics interventions and research. (...) Thus, the primary questions driving this research are as follows: what course characteristics moderate the effectiveness of ethics instruction?, and have ethics education and training efforts improved? Findings suggest that professional, focused, and workshop-based training programs are especially effective for improving business ethics. However, results also reveal considerable problems with many of the criteria used to evaluate the effectiveness of business ethics interventions. Practical suggestions for course design and evaluation in business ethics efforts are discussed along with future research needs. (shrink)

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

Requirements for business ethics education and organizational ethics trainings mark an important step in encouraging ethical behavior among business students and professionals. However, the lack of specificity in these guidelines as to how, what, and where business ethics should be taught has led to stark differences in approaches and content. The present effort uses meta-analytic procedures to examine the effectiveness of current approaches across organizational ethics trainings and business school courses. to provide practical suggestions for business ethics interventions and research. (...) Thus, the primary questions driving this research are as follows: what course characteristics moderate the effectiveness of ethics instruction?, and have ethics education and training efforts improved? Findings suggest that professional, focused, and workshop-based training programs are especially effective for improving business ethics. However, results also reveal considerable problems with many of the criteria used to evaluate the effectiveness of business ethics interventions. Practical suggestions for course design and evaluation in business ethics efforts are discussed along with future research needs. (shrink)

Predictive modeling in education draws on data from past courses to forecast the effectiveness of future courses. The present effort sought to identify such a model of instructional effectiveness in scientific ethics. Drawing on data from 235 courses in the responsible conduct of research, structural equation modeling techniques were used to test a predictive model of RCR course effectiveness. Fit statistics indicated the model fit the data well, with the instructional characteristics included in the model explaining approximately 85% of the (...) variance in RCR instructional effectiveness. Implications for using the model to develop and improve future RCR courses are discussed. (shrink)

Although education in the responsible conduct of research is considered necessary, evidence bearing on the effectiveness of these programs in improving research ethics has indicated that, although some programs are successful, many fail. Accordingly, there is a need for systematic evaluation of ethics education programs. In the present effort, we examine procedures for evaluation of ethics education programs from a multilevel perspective: examining both within-program evaluation and cross-program evaluation. With regard to within-program evaluation, we note requisite designs and measures for (...) conducting systematic program evaluation have been developed and multiple measures should be applied in program evaluation. With regard to cross-program evaluation, we argue that a meta-analytic framework should be employed where analyses are used to identify best practices in ethics education. The implications of this multilevel approach for improving responsible conduct of research educational programs are discussed. (shrink)

The King Report on Corporate Governance (1994) evoked unprecedented interest in corporate governance in South Africa. This does not mean that corporate governance was not an issue of concern before the release of this historical report. To the contrary, corporate governance in its broader sense has been at stake since the inception of the first publicly owned companies in South Africa. This article intends to give an overview of corporate governance in South Africa. It starts by making a distinction between (...) broad and narrow conceptions of corporate governance. Before applying this distinction to the practice of corporate governance in South Africa, a brief overview of the corporate landscape in South Africa is provided. Then the South African situation with regard to broad and narrow corporate governance respectively is analysed. The article ends with a discussion of the review of corporate governance that currently is in the making in South Africa. Throughout the article both the financial and ethical dimensions of corporate governance is attended to. (shrink)

The endoplasmic reticulum (ER) organelle is the key intracellular site of both protein and lipid biosynthesis. ER dysfunction, termed ER stress, can result in protein accretion within the ER and cell death; a pathophysiological process contributing to a range of metabolic diseases and cancers. ER stress leads to the activation of a protective signalling cascade termed the Unfolded Protein Response (UPR). However, chronic UPR activation can ultimately result in cellular apoptosis. Emerging evidence suggests that cells undergoing ER stress and UPR (...) activation can release extracellular signals that can propagate UPR activation to target tissues in a cell non‐autonomous signalling mechanism. Separately, studies have determined that the UPR plays a key regulatory role in the biosynthesis of bioactive signalling lipids including sphingolipids and ceramides. Here we weigh the evidence to combine these concepts and propose that during ER stress, UPR activation drives the biosynthesis of ceramide lipids, which are exported and function as cell non‐autonomous signals to propagate UPR activation in target cells and tissues. (shrink)

I have argued in other work that emotion, attentional functions, and executive functions are three interpenetrant global state variables, essentially differential slices of the consciousness pie. This paper will outline the columnar architecture and connectivities of the PAG (periaqueductal gray), its role in organizing prototype states of emotion, and the re-entry of PAG with the extended reticular thalamic activating system (“ERTAS”). At the end we will outline some potential implications of these connectivities for possible functional correlates of PAG networks that (...) are just starting to be mapped. Overall, we will look at many lines of evidence that PAG should be conceptualized as a peri-reticular structure that has a foundational role in emotion, in generating the meaningful organization of behavior by the brain through prototype emotional states, and in allowing the various emotional systems to globally influence and tune both the forebrain and brainstem. Finally, we address implications of these concepts for what is currently understood about consciousness, underlining the need for somewhat more humility within consciousness studies about our current level of understanding of consciousness in the brain, combined with a deeper appreciation of the intrinsic connections between emotion and consciousness. One hopes that more concerted empirical interest in structures underneath the thalamus, combined with a deeper appreciation for the fundamental role that organismic and social value must have in bootstrapping awareness in the developing brain, would begin more widely to influence the fundamental lines of neuroscientific research in both emotion studies and consciousness studies. (shrink)