Policy‐makers, bioethicists, and patient advocates have been engaged in a fierce battle about the merits and potential harms of a federal right‐to‐try law. This debate about access to investigational medical products has raised profound questions about the limits of patient autonomy, appropriate government regulation, medical paternalism, and political rhetoric. For example, do patients have a right to access investigational therapies, as the right‐to‐try movement asserts? What is government’s proper role in regulating and facilitating access to drugs that are still in (...) development? In this review, we analyze the history of the right‐to‐try movement, review the arguments put forth by supporters and opponents of the legislation, and consider the movement’s consequences. Two possible scenarios may emerge. One is that the right‐to‐try pathway may fail to meaningfully increase patient access to investigational products. Alternatively, certain companies may attempt to rely on the federal right‐to‐try legislation to sell investigational products, taking advantage of the provision that allows for direct costs, as there is currently no clear mechanism for enforcement or monitoring of cost calculations. (shrink)

In late 2021, tennis star Chris Evert learned new genetic information about her sister, who died from ovarian cancer in January 2020. As Evert has explained in posts published by ESPN, her sister had a variant in the BRCA1 gene that was reclassified—upgraded—from a variant of uncertain significance (VUS) to pathogenic. Hearing about the variant’s reclassification likely saved Evert’s life. After getting genetic testing that showed she also carried the variant, Evert underwent prophylactic surgery. Clinical testing associated with the procedure (...) revealed she already had stage 1c ovarian cancer. The Wall Street Journal reported on a different variant reclassification story in 2019. Seven female relatives had prophylactic surgeries after cascade genetic testing indicated they each carried the same pathogenic variant in BRCA2. However, there was significant distress and confusion when one of the women received notice that the variant had been downgraded from pathogenic to a VUS. As these cases illustrate, reclassification of the clinical significance of genetic variants—which ranges from pathogenic, likely pathogenic, uncertain, likely benign and benign—can have profound impacts on individuals and families. Although genetic testing often provides valuable information, many identified variants are of uncertain significance, even in genes associated with disease. Many of these VUS will be reclassified as genomic data …. (shrink)

People who believe they have greater efficacy to address climate change are more likely to engage in pro-environmental behaviour. To confront the climate crisis, it will therefore be essential to understand the processes through which climate change efficacy is promoted. Some interventions in the literature assume that efficacy emerges from analytic reasoning processes: that it is deliberative, verbal, conscious, and influenced by information and education. In the current paper, we critique this notion. We review evidence showing that climate change efficacy (...) perceptions are (a) associated with climate-related distress and threat, (b) prescribed by social norms, (c) associated with social desirability and identity-expressive concerns, (d) surprisingly difficult to change through explicit, verbal instruction, but (e) responsive to imagery. We conclude by examining applied implications of these five propositions and discuss why non-analytic processes might (ironically) be beneficial for sustaining green activism. (shrink)

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In (...) addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self. (shrink)

In the U.S., there is no requirement for research sponsors to compensate human research subjects who experience injuries as a result of their participation. In this article, we review the moral justifications that compel the establishment of a better research-related injury compensation system. We explore how other countries and certain institutions within the U.S. have adopted various systems of compensation. The existence of these systems demonstrates both that the U.S. lags behind other nations in its protection of human research subjects (...) and that the establishment of a compensation system is both practical and feasible. We then examine factors which have prevented the U.S. from establishing its own compensation system. We consider possible alternatives for the U.S. by examining the advantages and disadvantages of both established and proposed systems. We offer a new proposal that addresses the justice concerns which compel the establishment of a national compensation system, distributes the burdens of such a system on multiple stakeholders that benefit from research, and has the additional advantage of minimizing the administrative and logistical challenges associated with initiating such a system. (shrink)

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In (...) addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self. (shrink)

Harms and risks to groups and third-parties can be significant in the context of research, particularly in data-centric studies involving genomic, artificial intelligence, and/or machine learning technologies. This article explores whether and how United States federal regulations should be adapted to better align with current ethical thinking and protect group interests. Three aspects of the Common Rule deserve attention and reconsideration with respect to group interests: institutional review board (IRB) assessment of the risks/benefits of research; disclosure requirements in the informed (...) consent process; and criteria for waivers of informed consent. In accordance with respect for persons and communities, investigators and IRBs should systematically consider potential group harm when designing and reviewing protocols, respectively. Research participants should be informed about any potential group harm in the consent process. We call for additional public discussion, empirical research, and normative analysis on these issues to determine the right regulatory and policy path forward. (shrink)

The measurement of pain depends upon subjective reports, but we know very little about how research subjects or pain patients produce self-reported judgments. Representationalist assumptions dominate the field of pain research and lead to the critical conjecture that the person in pain examines the contents of consciousness before making a report about the sensory or affective magnitude of pain experience as well as about its nature. Most studies to date have investigated what Fechner termed “outer psychophysics”: the relationship between characteristics (...) of an external stimulus and the magnitude and nature of pain experience. In contrast, Fechner originally envisioned that “inner psychophysics” should investigate the relationship between physiological states and subjective experience. Despite the lack of established research tradition, inner psychophysics has a potential utility in elucidating underlying mechanisms for the production of phenomenal self-report. We illustrate this, using causal modeling analyses of the accuracy of self-reported pain ratings from our laboratory. We submit that the results are inconsistent with representationalist assumptions. Converging trends from several domains of consciousness studies seem to suggest that we need to abandon the unquestioned doctrine of representationalism and search for a more viable framework for understanding the generation of subjective self-report. (shrink)

He notes that parallel to this phenomenon have been developments in the common law of malpractice that give patients a better chance than ever of winning compensation. While these developments benefit patients, Dr. Chapman describes how they have also pointed out a major flaw in malpractice law: the enormous amounts of time and money it takes to bring such cases to court. To overcome these difficulties, Dr. Chapman maintains, the medical profession needs to reconsider the basic concepts on which its (...) ethics rest. No less important is a revision of malpractice law so that it finally begins to serve, fairly and equitably, the purposes for which it originally came into being. Literate, thoughtful, and thought-provoking, Physicians, Law, and Ethics is an important contribution to today's medical care debate. (shrink)

This article focuses on 'improving' schools in difficult or disadvantaged contexts. It explores the contemporary policy discourse and intervention strategies aimed at improving schools in such circumstances. It argues that contemporary approaches to improvement are unlikely to succeed because the approaches adopted are not sufficiently differentiated or context specific. Drawing on two recent empirical studies, the article offers an alternative perspective on school improvement within this group of schools. It argues against standardised solutions in favour of a differentiated approach to (...) school improvement that recognises and respects the diversity, variability and complexity of schools in difficult contexts. (shrink)

Boyer's formulation neglects that humans are embodied agents. It is a biological imperative to distinguish self from other. Ownership of ideas, bodies, objects, and locations is an inevitable extension of this. We argue that (1) the body's capability influences the inputs that guide future actions, and (2) bodies in action influence all of cognition, from perception to decision making.

A brief survey of events and movements from the first century to the present day provides the background for understanding the complexity of questions relating to the presence of Christians in the Middle East at the present time. Some of these issues affect all Christians, while others are specific to particular countries in the region. Given the steep decline in the numbers of Christians for a variety of reasons over the centuries, is it possible to have any optimism about their (...) future in the region? (shrink)

The capture of Mosul in Iraq by ISIS in June 2014 focused the world’s attention on Islamism, or political Islam. In addition to all the political issues faced by the rest of the world, Christians are faced with some special challenges and have not always responded with a single voice. If we are to think in a distinctively Christian way about Islamism and violence carried out in the name of Islam, what are the key questions that we need to be (...) asking? (shrink)

Pain is not a primitive sensory event but rather a complexperception and a process by which a person interacts with theinternal and external environments, constructs meaning, andengages in action. Because folk beliefs are central to meaning,folk concepts of pain play multiple causal roles in a painpatient's interaction with health care providers and others.In every case, the notion of pain is linked to a goal-directedbehavior that is useful to the person. The wide variation inconcepts of pain across individuals suffering with painunderscores (...) the richness and complexity of the pain experience.In some cases involving chronic pain, the patient may form amaladaptive cluster of behaviors around the concept of pain.Patient beliefs and expectations are an important part of manychronic pain syndromes, and patients can benefit fromintervention directed at revising the individual's folk model of pain. Memetics offers a framework for identifying the memesthat patients hold and determining whether patient memes fitor clash with provider memes. (shrink)

Volume 19, Issue 6, June 2019, Page 22-25.

Book 1. How can we know if Christianity is true? Book 2. Questions of God, man and the universe. Book 3 Questions about Jesus Christ.

The facial expression of pain is the end product of a complex process that is, in part, emotional. The evolutionary study of facial expression must account for the social nature of human consciousness and should address the questions of why empathy exists, the adaptive importance of empathy, and whether facial expression is a mechanism of empathy and second-person consciousness.

We tested whether the impact of an organizational transgression on consumer sentiment differs depending on whether the organization is a nonprofit. Competing hypotheses were tested: that people expect higher ethical standards from a nonprofit than a commercial organization, and so having this expectation violated generates a harsher response and that a nonprofit’s reputation as a moral entity buffers it against the negative consequences of transgressions. In three experiments participants were told that an organization had engaged in fraud, exploitation of women, (...) or unethical labor practices. Consistent with the moral disillusionment hypothesis, decreases in consumer trust post-transgression were greater when the organization was described as nonprofit, an effect that was mediated by expectancy violations. This drop in trust then flowed through to consumer intentions and consumer word of mouth intentions. No support was found for the moral insurance hypothesis. Results confirm that nonprofits are penalized more harshly than commercial organizations when they breach consumer trust. (shrink)

Book reviewed in this article: Doctors' Dilemmas: Moral Conflict and Medical Care. By Samuel Gorovitz.

Back in 1978, Louise Brown made international headlines simply for being born, the first to do so after in vitro fertilization (IVF). One ethicist acknowledged fears that IVF “might move us toward...