A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

With growing concerns over children's suggestibility and how it may impact their reliability as witnesses, there is increasing interest in determining the long-term effects of induced memories. The goal of the present research was to learn whether source misattributions found by Ceci, Huffman, Smith, and Loftus caused permanent memory alterations in the subjects tested. When 22 children from the original study were reinterviewed 2 years later, they recalled 77% of all true events. However, they only consented to 13% of (...) all false events, compared to the 22% false consent rate found by Ceci et al. . Additionally, while children remained accurate in their recall of true events , they “recanted” their earlier false consents 77% of the time, after the 2-year delay. Implications of these findings for child witnesses and the legal system are discussed. (shrink)

Physicists regularly invoke universal laws, such as those of motion and electromagnetism, to explain events. Biological and medical scientists have no such laws. How then do they acquire a reliable body of knowledge about biological organisms and human disease? One way is by repeatedly returning to, manipulating, observing, interpreting, and reinterpreting certain subjects—such as flies, mice, worms, or microbes—or, as they are known in biology, “model systems.” Across the natural and social sciences, other disciplinary fields have developed canonical examples that (...) have played a role comparable to that of biology’s model systems, serving not only as points of reference and illustrations of general principles or values but also as sites of continued investigation and reinterpretation. The essays in this collection assess the scope and function of model objects in domains as diverse as biology, geology, and history, attending to differences between fields as well as to epistemological commonalities. Contributors examine the role of the fruit fly Drosophila and nematode worms in biology, troops of baboons in primatology, box and digital simulations of the movement of the earth’s crust in geology, and meteorological models in climatology. They analyze the intensive study of the prisoner’s dilemma in game theory, ritual in anthropology, the individual case in psychoanalytic research, and Athenian democracy in political theory. The contributors illuminate the processes through which particular organisms, cases, materials, or narratives become foundational to their fields, and they examine how these foundational exemplars—from the fruit fly to Freud’s Dora—shape the knowledge produced within their disciplines. Contributors Rachel A. Ankeny Angela N. H. Creager Amy Dahan Dalmedico John Forrester Clifford Geertz Carlo Ginzburg E. Jane Albert Hubbard Elizabeth Lunbeck Mary S. Morgan Josiah Ober Naomi Oreskes Susan Sperling Marcel Weber M. Norton Wise. (shrink)

Numerous studies have documented the detrimental impact of age-based stereotype threat on older adults' cognitive performance and especially on veridical memory. However, far fewer studies have investigated the impact of ABST on older adults' memory distortion. Here, we review the subset of research examining memory distortion and provide evidence for the role of stereotype threat as a powerful socio-emotional factor that impacts age-related susceptibility to memory distortion. In this review we define memory distortion as errors in memory that are associated (...) with gist-based errors or source misattributions. Whereas, some of the reviewed experiments support the conclusion that ABST should be considered in the context of age-related differences in memory distortion, others reported little or no impact of stereotype threat. These discrepancies suggest that the role of ABST, and socio-emotional processes generally, in age-related changes in memory distortion are less clear. In this review, we argue that ABST does play an important role in age-related changes in memory distortion. We present evidence suggesting that discrepancies in the reviewed literature may be reconciled when evaluated in the context of the leading theories about stereotype threat: the Executive Resource Depletion hypothesis and the Regulatory Focus theory. We also discuss how differences in methodology and participant characteristics can account for a priori contradictory results in the literature. Finally, we propose some recommendations for researchers and practitioners when assessing memory in older adults. (shrink)

In this paper, we consider three arguments for the irrelevance of the doctrine of double effect in end-of-life decision making. The third argument is our own and, to that extent, we seek to defend it. The first argument is that end-of-life decisions do not in fact shorten lives and that therefore there is no need for the doctrine in justification of these decisions. We reject this argument; some end-of-life decisions clearly shorten lives. The second is that the doctrine of double (...) effect is not recognized in UK law ; therefore, clinicians cannot use it as the basis for justification of their decisions. Against this we suggest that while the doctrine might have dubious legal grounds, it could be of relevance in some ways, e.g. in marking the boundary between acceptable and unacceptable practice in relation to the clinician's duty to relieve pain and suffering. The third is that the doctrine is irrelevant because it requires there to be a bad effect that needs justification. This is not the case in end-of-life care for patients diagnosed as dying. Here, bringing about a satisfactory dying process for a patient is a good effect, not a bad one. What matters is that patients die without pain and suffering. This marks a crucial departure from the double-effect doctrine; if the patient's death is not a bad effect then the doctrine is clearly irrelevant. A diagnosis of dying allows clinicians to focus on good dying and not to worry about whether their intervention affects the time of death. For a patient diagnosed as dying, time of death is rarely important. In our conclusion we suggest that acceptance of our argument might be problematic for opponents of physician-assisted death. We suggest one way in which these opponents might argue for a distinction between such practice and palliative care; this relies on the double-effect doctrine's distinction between foresight and intention. (shrink)

This paper reports a literature review on the topic of ethical issues in in-depth interviews. The review returned three types of article: general discussion, issues in particular studies, and studies of interview-based research ethics. Whilst many of the issues discussed in these articles are generic to research ethics, such as confidentiality, they often had particular manifestations in this type of research. For example, privacy was a significant problem as interviews sometimes probe unexpected areas. For similar reasons, it is difficult to (...) give full information of the nature of a particular interview at the outset, hence informed consent is problematic. Where a pair is interviewed (such as carer and cared-for) there are major difficulties in maintaining confidentiality and protecting privacy. The potential for interviews to harm participants emotionally is noted in some papers, although this is often set against potential therapeutic benefit. As well as these generic issues, there are some ethical issues fairly specific to in-depth interviews. The problem of dual role is noted in many papers. It can take many forms: an interviewer might be nurse and researcher, scientist and counsellor, or reporter and evangelist. There are other specific issues such as taking sides in an interview, and protecting vulnerable groups. Little specific study of the ethics of in-depth interviews has taken place. However, that which has shows some important findings. For example, one study shows participants are not averse to discussing painful issues provided they feel the study is worthwhile. Some papers make recommendations for researchers. One such is that they should consider using a model of continuous (or process) consent rather than viewing consent as occurring once, at signature, prior to the interview. However, there is a need for further study of this area, both philosophical and empirical. (shrink)

Making data broadly accessible is essential to creating a medical information commons. Transparency about data-sharing practices can cultivate trust among prospective and existing MIC participants. We present an analysis of 34 initiatives sharing DNA-derived data based on public information. We describe data-sharing practices captured, including practices related to consent, privacy and security, data access, oversight, and participant engagement. Our results reveal that data-sharing initiatives have some distance to go in achieving transparency.

Advances in technologies and biomedical informatics have expanded capacity to generate and share biomedical data. With a lens on genomic data, we present a typology characterizing the data-sharing landscape in biomedical research to advance understanding of the key stakeholders and existing data-sharing practices. The typology highlights the diversity of data-sharing efforts and facilitators and reveals how novel data-sharing efforts are challenging existing norms regarding the role of individuals whom the data describe.

Recently, a number of philosophers have begun to question the commonly held view that choice or voluntary control is a precondition of moral responsibility. According to these philosophers, what really matters in determining a person’s responsibility for some thing is whether that thing can be seen as indicative or expressive of her judgments, values, or normative commitments. Such accounts might therefore be understood as updated versions of what Susan Wolf has called “real self views,” insofar as they attempt to ground (...) an agent’s responsibility for her actions and attitudes in the fact (when it is a fact) that they express who she is as a moral agent. As such, they seem to be open to some of the same objections Wolf originally raised to such accounts, and in particular to the objection that they cannot license the sorts of robust moral assessments involved in our current practices of moral responsibility. My aim in this paper is to try to respond to this challenge, by clarifying the kind of robust moral assessments I take to be licensed by (at least some) non-volitional accounts of responsibility and by explaining why these assessments do not in general require the agent to have voluntary control over everything for which she is held responsible. I also argue that the limited applicability of the distinction between “bad agents” and “blameworthy agents” on these accounts is in fact a mark in their favor. (shrink)

A number of philosophers have recently argued that we should interpret the debate over moral responsibility as a debate over the conditions under which it would be “fair” to blame a person for her attitudes or conduct. What is distinctive about these accounts is that they begin with the stance of the moral judge, rather than that of the agent who is judged, and make attributions of responsibility dependent upon whether it would be fair or appropriate for a moral judge (...) to react to the agent in various (negative) ways. This is problematic, I argue, because our intuitions about whether and when it would be fair to react negatively to another are sensitive to a host of considerations that appear to have little or nothing to do with an agent’s responsibility or culpability for her attitudes or behavior. If this is correct, then theories which make attributions of responsibility dependent upon the appropriateness of our reactions as moral judges will turn out to be fundamentally misguided. (shrink)

ABSTRACTIt has recently become fashionable among those who write on questions of moral responsibility to distinguish two different concepts, or senses, of moral responsibility via the labels ‘responsibility as attributability’ and ‘responsibility as accountability’. Gary Watson was perhaps the first to introduce this distinction in his influential 1996 article ‘Two Faces of Responsibility’ , but it has since been taken up by many other philosophers. My aim in this study is to raise some questions and doubts about this distinction and (...) to argue that it has led to confusion rather than clarification in debates over moral responsibility. In place of the attributability/accountability distinction, I propose that there is a single concept of moral responsibility underlying our actual moral practices. This core notion of moral responsibility, which I call ‘responsibility as answerability’, is well positioned to explain thos.. (shrink)

Meaningful participant engagement has been identified as a key contributor to the success of efforts to share data via a “Medical Information Commons”. We present findings from expert stakeholder interviews aimed at understanding barriers to engagement and the appropriate role of MIC participants. Although most interviewees supported engagement, they distinguished between individual versus collective forms. They also noted challenges including representation and perceived inefficiency, prompting reflection on political aspects of engagement and efficiency concerns.

There is an apparent tension in our everyday moral responsibility practices. On the one hand, it is commonly assumed that moral responsibility requires voluntary control: an agent can be morally responsible only for those things that fall within the scope of her voluntary control. On the other hand, we regularly praise and blame individuals for mental states and conditions that appear to fall outside the scope of their voluntary control, such as desires, emotions, beliefs, and other attitudes. In order to (...) resolve this apparent tension, many philosophers appeal to a tracing principle to argue that agents are morally responsible for those attitudes whose existence can be traced back, causally, to a voluntary action or omission in the past. My aim in this article is to critically evaluate this tracing strategy and to argue that it gives us a misguided picture of when and why we are morally responsible for our attitudes. I argue that we should accept a ‘judgment sensitivity’ condition of moral responsibility rather than a ‘voluntary control’ condition, and defend this account against various objections. (shrink)

_Everyday Life and the Sacred_ offers gender sensitive interdisciplinary perspectives from the fields of feminist theology and religious studies on the everyday and the sacred. The volume aims to re-configure the current domain of religion and gender studies.

_Everyday Life and the Sacred_ offers gender sensitive interdisciplinary perspectives from the fields of feminist theology and religious studies on the everyday and the sacred. The volume aims to re-configure the current domain of religion and gender studies.

Este artigo objetivou investigar a síndrome de burnout em estudantes de um curso técnico de enfermagem. Procurou identificar também a existência de associação entre variáveis demográficas e escolares e fatores de estresse numa amostra de 255 estudantes. Como instrumentos de pesquisa foi utilizado um..

Apoptosis is now widely recognized as a common form of cell death and represents a mechanism of cell clearance in many physiological situations where deletion of cells is required. Peptide growth factors, initially characterised as stimulators of cell proliferation, have now been shown to inhibit death in many cell types. Deprivation of growth factors leads to the induction of apoptosis, i.e. condensation of chromatin and degradation in oligonucleosomesized fragments, formation of plasma and nuclear membrane blebs and cell fragmentation into apoptotic (...) bodies which can be taken up by neighbouring cells. Here we discuss the mechanism(;s) by which growth factors may inhibit apoptosis. (shrink)

Volume 25, Issue 3, September 2019, Page 203-206.

Although very young children have unprecedented access to touchscreen devices, there is limited research on how successfully they operate these devices for play and learning. For infants and toddlers, whose cognitive, fine motor, and executive functions are immature, several basic questions are significant: Can they operate a tablet purposefully to achieve a goal? Can they acquire operating skills and learn new information from commercially available apps? Do individual differences in executive functioning predict success in using and learning from the apps? (...) Accordingly, 31 2-year-olds were compared with 29 3-year-olds using two commercially available apps with different task and skill requirements: a shape matching app performed across 3 days, and a storybook app with performance compared to that on a matched paper storybook. Children also completed the Minnesota Executive Functioning Scale. An adult provided minimal scaffolding throughout. The results showed: toddlers could provide simple goal-directed touch gestures and the manual interactions needed to operate the tablet after controlling for prior experience with shape matching, toddlers’ increased success and efficiency, made fewer errors, decreased completion times, and required less scaffolding across trials, they recognized more story content from the e-book and were less distracted than from the paper book, executive functioning contributed unique variance to the outcome measures on both apps, and 3-year-olds outperformed 2-year-olds on all measures. The results are discussed in terms of the potential of interactive devices to support toddlers’ learning. (shrink)

In his recent book, In Praise of Blame, George Sher argues (among other things) that a bad act can reflect negatively on a person if that act results in an appropriate way from that person's "character," and defends a novel "two-tiered" account of what it is to blame someone. In these brief comments, I raise some questions and doubts about each of these aspects of his rich and thought-provoking account.

This article aims to deconstruct the concept of dignity in a way that is meaningful, in particular to nurses and other health workers who seek to promote the dignity of children in their care. Despite the emphasis in a variety of codes and policies to promote dignity, there is a lack of a clear definition of dignity in the literature. In particular there is little reference to dignity, theoretically or empirically, as it relates to children. Without clarity it is not (...) possible to act in an ethical way on behalf of children whose dignity could otherwise be compromised. The theoretical position taken has evolved from the medico-nursing and philosophical discourse concerning the nature of human dignity and more recent sociological texts that discuss the social construction of the child and childhood. The article is further influenced by additional insights derived from an ethnographic pilot study at a large district general hospital. This study was undertaken in an attempt to appreciate the subjective experience of dignity by children, and to begin to address the empirical gap in the literature and promote discussion. The concept of a macro and a micro dignity is discussed, together with the role of the nurse in articulating the relationship between the two. The importance of control and witnesses in the experience of dignity is discussed and, finally, also the ethical implications when seeking to promote the dignity of children. (shrink)

It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients’ medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees (...) in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation. (shrink)