Researchers in the areas of prehistoric art, anthropology of art, psychology, philosophy, feminist art theory, histories of visual arts education, and the emerging field of neuroaesthetics have created new interest within education in the writings of John Dewey related to art and experiential learning as found in Art as Experience and Experience and Nature. Thus, another look at Dewey’s life experience and his philosophy of experiential art may bring renewed support for visual arts education in the twenty-first century. Dewey has (...) influenced the public education system through his philosophy of experience and his less well-known theory of aesthetics. The definition that Dewey provided for education centers on the.. (shrink)

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Arrogance as a specific constellation of affect, fantasy, and behavior has received little attention in psychoanalysis. This is striking in light of the enormous amount of literature accumulated on the related phenomenon of narcissism. Rectifying this omission, the book in your hands addresses arrogance from multiple perspectives. Among the vantage points employed are psychoanalysis, evolutionary psychology, cross-cultural anthropology, fiction, as well as clinical work with children and adults. The result is a harmonious gestalt of insight that is bound to enhance (...) the clinician's attunement to the covert anguish of those afflicted with arrogance. (shrink)

Thinking Through Breast Cancer is a philosophical analysis of breast cancer inspired by the author's journey as a breast cancer patient. It sets out to show the relevancy of philosophical thinking in medicine today and shares advice about how to navigate the uncertainty of breast cancer diagnosis, treatment, and survival.

In this essay, and in his honor, I focus on two of physician-philosopher H. Tristram Engelhardt, Jr.’s many contributions, namely, his view that biomedical ethics cannot offer a singular content-driven theoretical approach and requires an appreciation of epistemologies of knowing in medicine. While these two positions remain controversial, because we all want definitive answers to our questions concerning what we ought to do in medicine and elsewhere, Dr. Engelhardt’s view makes possible discussion and debate in medicine to include diverse, defensible (...) ways of knowing. In the end, Dr. Engelhardt’s approach in biomedical ethics is one of shared decision making and negotiation. This is an important model if we take respect for patients seriously in the clinical setting. (shrink)

Current advances in connectivity, sensor technology, computing power and the development of complex algorithms for processing health-related data are paving the way for the delivery of innovative long-term health care services in the future. Such technological developments will, in particular, assist the elderly and infirm to live independently, at home, for much longer periods. The home is, in fact, becoming a locus for health care innovation that may in the future compete with the hospital. However, along with these advances come (...) valid privacy and security questions arising from the fact that the data collected and transmitted through these technologies could also allow for individual monitoring as well as unauthorized access to critical diagnostic and other health data. (shrink)

Recently, we reported that melanoma risk in redheads is linked not only to pale skin, but also to the synthesis of the pigment – called pheomelanin – that gives red hair its color. We demonstrated that pheomelanin synthesis is associated with increased oxidative stress in the skin, yet we have not uncovered the chemical pathway between the molecule pheomelanin and the DNA damage that drives melanoma formation. Here, we hypothesize two possible pathways. On one hand, pheomelanin might generate reactive oxygen (...) species (ROS) that directly or indirectly cause oxidative DNA damage. On the other hand, pheomelanin synthesis might consume cellular antioxidant stores and make the cell nucleus more vulnerable to other endogenous ROS. Uncovering the mechanistic pathway between pheomelanin and oxidative DNA damage will be an important step in developing strategies to lower melanoma risk in redheads. (shrink)

BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

In the midst of the recent Ebola outbreak, scientific developments involving infection challenge experiments on nonhuman primates (NHPs) sparked hope that successful treatments and vaccines may soon become available. Yet these studies pose a stark ethical quandary. On the one hand, they represent an important step in developing novel therapies and vaccines for Ebola and the Marburg virus, with the potential to save thousands of human lives and to protect whole communities from devastation; on the other hand, they intentionally expose (...) sophisticated animals to severe suffering and a high risk of death. Other studies that infect NHPs with a lethal disease in order to test interventions that may prove beneficial for humans pose the same ethical difficulty. Some advocates have argued that all research on primates should be phased out, and ethicists have questioned whether a moral justification of primate research is possible. A 2010 European Union directive banned virtually all research on great apes, and 2013 guidelines from the National Institutes of Health (NIH), based upon recommendations in an influential 2011 Institute of Medicine (IOM) report, eliminated most biomedical research with chimpanzees in the United States. But studies involving other NHPs face no comparable restrictions.Should research on NHPs other than great apes be subject to tighter restrictions than it currently is? In this article, we explore this general question in the context of one particular type of biomedical research: infection challenge studies. We advocate a presumptive prohibition on infection challenge experiments in NHPs, but we also argue that exceptions to this prohibition are permissible, subject to strict substantive and procedural safeguards, when necessary to avert substantial loss of human life or severe morbidity for a substantial number of people. (shrink)

In a recent article in this Journal, Shlomo Cohen and Haim Shapiro introduce the concept of “comparable placebo treatments” —placebo treatments with biological effects similar to the drugs they replace—and argue that doctors are not being deceptive when they prescribe or administer CPTs without revealing that they are placebos. We critique two of Cohen and Shapiro’s primary arguments. First, Cohen and Shapiro argue that offering undisclosed placebos is not lying to the patient, but rather is making a self-fulfilling prophecy—telling a (...) “lie” that, ideally, will become true. We argue that offering undisclosed placebos is not a “lie” but is a straightforward case of deceptively misleading the patient. Second, Cohen and Shapiro argue that offering undisclosed CPTs is not equivocation. We argue that it typically is equivocation or deception of another sort. If justifiable, undisclosed placebo use will have to be justified as a practice that is deceptive in most instances. (shrink)

Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the “presenting problem” may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution’s ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral (...) distress. (shrink)

A survey form sent to psychologists (Pope, Keith-Spiegel, & Tabachnick, 1986) was adapted and sent to 1,000 clinical social workers (return rate = 45%). Most participants reported sexual attraction to a client, causing (for most) guilt, anxiety, or confusion. Some reported having sexual fantasies about a client while engaging in sex with someone other than a client. Relatively few (3.6% men; 0.5% women) reported sex with a client; training was related to likelihood of offending, though the effect is small and (...) complex. An analysis of eight national studies (data from 5,148 therapists) found significant effects for gender (more male offenders) and year of study (about 10% annual decrease in reported offenses since 1977) but not profession (i.e., no difference among psychiatrists, psychologists, and social workers). Most social workers reported no graduate training whatsoever about sexual attraction; only 10% reported adequate training. (shrink)

Little is known about the mechanisms by which psychology graduate programs transmit responsible conduct of research (RCR) values. A national sample of 968 current students and recent graduates of mission-diverse doctoral psychology programs completed a Web-based survey on their research ethics challenges, perceptions of RCR mentoring and department climate, whether they were prepared to conduct research responsibly, and whether they believed psychology as a discipline promotes scientific integrity. Research experience, mentor RCR instruction and modeling, and department RCR policies predicted student (...) RCR preparedness. Mentor RCR instruction, department RCR policies, and faculty modeling of RCR behaviors predicted confidence in the RCR integrity of the discipline. Implications for training are discussed. (shrink)

The agricultural communicator is a key link in transmitting information to farmers. If agricultural communicators' ethics are compromised, the resulting biases in news production could have serious detrimental effects on the quality of information conveyed to farmers. But, to date, agricultural communicators' perceptions of ethical problems they encounter at work has not been examined. This study looks at the dimensions of ethical concerns for topics area (agricultural) journalists as defined by practitioners. To determine these dimensions, we sent open ended questionnaires (...) (50 percent response rate) to members of two professional agricultural journalist associations: the Newspaper Farm Editors of America and the American Agricultural Editors' Association.Agricultural communicators overwhelmingly focus on one specific threat to objectivity—advertising pressure. Both NFEA and AAEA respondents indicated that agricultural journalists' responses to advertising pressure adversely affected the entire profession. The responses indicated that agricultural writers were concerned with the different types of pressures and the effects of advertising pressure on the industry as a whole. NFEA and AAEA respondents mentioned both indirect pressure, “freebies,” conferences, trips and press releases from advertising or public relations sections of agri-business firms, and direct pressures from advertisers, salesmen and publishers. The respondents were clearly more comfortable when newspaper policy protected them from advertising pressure and when they had techniques to reduce this pressure. The editors' and reporters' perceptions of advertising pressure clearly indicates that advertising abuses are a clear and present danger and one worthy of far more attention than it has previously received. (shrink)