Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria. The references of eligible papers were (...) examined to identify further eligible studies. Forty two articles were identified as eligible. Seventeen used an implicit measure, to test the biases of healthcare professionals. Twenty five articles employed a between-subjects design, using vignettes to examine the influence of patient characteristics on healthcare professionals’ attitudes, diagnoses, and treatment decisions. The second method was included although it does not isolate implicit attitudes because it is recognised by psychologists who specialise in implicit cognition as a way of detecting the possible presence of implicit bias. Twenty seven studies examined racial/ethnic biases; ten other biases were investigated, including gender, age and weight. Thirty five articles found evidence of implicit bias in healthcare professionals; all the studies that investigated correlations found a significant positive relationship between level of implicit bias and lower quality of care. The evidence indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population. The interactions between multiple patient characteristics and between healthcare professional and patient characteristics reveal the complexity of the phenomenon of implicit bias and its influence on clinician-patient interaction. The most convincing studies from our review are those that combine the IAT and a method measuring the quality of treatment in the actual world. Correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care in some circumstances and need to be further investigated. Our review also indicates that there may sometimes be a gap between the norm of impartiality and the extent to which it is embraced by healthcare professionals for some of the tested characteristics. Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. More research in actual care settings and a greater homogeneity in methods employed to test implicit biases in healthcare is needed. (shrink)

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods. (...) -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider anticipated uses of (...) the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (shrink)

Ethical issues arise in the world’s first population-level treatment of severe lead poisoning caused by small-scale mining for gold in rural Nigeria. Emergency medical intervention and environmental cleanup have reduced the mortality in children younger than 5 years from lead poisoning from over 40 to 2.5 per cent leaving little evidence of the harms caused by lead poisoning. In the absence of obvious sequelae, family adherence to long-term intensive therapy to remove accumulated lead reservoirs in children wanes and some community (...) miners challenge safer mining interventions to prevent recontamination of the environment with lead. This letter raises questions regarding community versus individual rights in public health interventions and patient autonomy. (shrink)

There has long been interest in why languages are shaped the way they are, and in the relationship between sign language and gesture. In sign languages, entity classifiers are handshapes that encode how objects move, how they are located relative to one another, and how multiple objects of the same type are distributed in space. Previous studies have shown that hearing adults who are asked to use only manual gestures to describe how objects move in space will use gestures that (...) bear some similarities to classifiers. We investigated how accurately hearing adults, who had been learning British Sign Language for 1–3 years, produce and comprehend classifiers in locative and distributive constructions. In a production task, learners of BSL knew that they could use their hands to represent objects, but they had difficulty choosing the same, conventionalized, handshapes as native signers. They were, however, highly accurate at encoding location and orientation information. Learners therefore show the same pattern found in sign-naïve gesturers. In contrast, handshape, orientation, and location were comprehended with equal accuracy, and testing a group of sign-naïve adults showed that they too were able to understand classifiers with higher than chance accuracy. We conclude that adult learners of BSL bring their visuo-spatial knowledge and gestural abilities to the tasks of understanding and producing constructions that contain entity classifiers. We speculate that investigating the time course of adult sign language acquisition might shed light on how gesture became conventionalized during the genesis of sign languages. (shrink)

In this short note we prove that a definable set X over is superstable only if.

This paper begins with a recognition that questions of climate change, environmental degradation, and our relations to the natural world are increasingly significant and requiring of a response not only as philosophers of education but also as citizens of the planet. As such the paper explores five of the key journals in philosophy of education in order to identify the extent, range, and content of current discussions related to the environment. It then organizes and summaries the articles that were located (...) while seeking to identify the extent, possibilities, and limitations of current discussions relating to the environment in the philosophy of education community. The hope is that ultimately this work is an invitation to anyone, regardless of tradition, orientation, and expertise, to contribute to the expansion and deepening of both theory and practice in the face of this most serious of challenges. (shrink)

This article explores the propensity of Iliadic landscape similes to encourage reflections on human fragility. Landscape in the similes is usually interpreted as a medium which conveys a consistent symbolic value (for example storms as the hostility of nature); however, landscape is often a more flexible medium. By offering close readings of three Iliadic similes (winter torrents at 4.452–6, snowfall at 12.279–89 and clear night at 8.555–9), this article argues that landscape allowed the poet to frame the main narrative in (...) various ways, both helping the listener to imagine described events and interrupting the listener's immersion in the main narrative. While many have analysed how similes offer analogies to the main narrative, the ways in which the same simile can also disrupt and reframe the narrative are less understood. This article observes that shifts in narrative space and time played a key role in changing the perspective of the listener. Taking a broadly phenomenological approach, it proposes that embodied descriptions of space, which recreate the experience of the moving body in landscape, invite the listener to consider the temporal scale of the natural world. By looking at how landscape in select similes shifts the listener's spatial and temporal experience, this article argues that landscape contributes to the wider Iliadic theme of human fragility. In particular, it identifies the potential for landscape similes to minimize the scale of human experience, question the possibility of human agency, and reveal the limitations of human perspectives and knowledge. (shrink)

Arts and Humanities in Higher Education, Ahead of Print. Despite the growing interest of academia in public outreach, little is known about what university students, among who are future researchers, take away from their academic education in terms of research dissemination opportunities. In this study, we analyzed social science students’ discourses on creative dissemination practices in relation to standardized dissemination practices. Our findings reveal that student’s conceptions of creative research dissemination are diverse and influenced by varying perceptions of knowledge, the (...) public, and creativity. Discourses on CRD are also strongly linked with values such as innovation and impact on society, but the concrete meaning of these values often remains undefined. We propose rethinking the academic context at the educational level so it offers a platform for multimodal formats of research dissemination. This would require encouraging students to take a stance toward how they envision a progressive academic future. (shrink)

This commentary argues the case for developmental psychopathology in understanding social learning. Informed by work on “epistemic disruption,” we have described difficulties with social learning associated with many forms of psychopathology. Epistemic disruption manifests in an inability to move between innovation and conformity, and arises from poor mentalizing, which generates difficulties in identifying social cues that trigger the correct stance.

Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised (...) exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of “surgery schools” and detail practical recommendations that can be embedded in existing or emerging clinical settings. (shrink)

Research that engages the experiences and insights of autistics and their caregivers can be more ethical, less stigmatizing, and innovative. To avoid reproducing established assumptions, researchers should learn how autistics and their caregivers understand behavioral and communicative differences, and how they prioritize interventions and accommodations. Fostering “autistic flourishing” requires that researchers focus on similarities between autistics and neurotypical people while allowing for autistic differences. Consulting autistics helps ensure that their personhood is acknowledged.

Difficulties with executive function have often been identified in individuals with various neurodevelopmental disorders such as Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder, and Developmental Co-ordination Disorder. Additionally, in childhood and adolescence, executive functioning is an important predictor of academic achievement. However, less research has explored these relationships in adult students, and those with a high level of neurodevelopmental disorder traits but no clinical diagnosis. Therefore, the current study aimed to assess whether ASD, ADHD, and DCD traits can predict academic achievement (...) in university students, and whether traits of these neurodevelopmental conditions moderate the relationship between executive function and academic achievement. Both neurotypical students and those with a clinical diagnosis of a neurodevelopmental disorder were able to participate, with the majority being neurotypical. Participants completed four self-report questionnaires and provided a measure of academic achievement based on their university assignment results. Traits of ASD, ADHD, and DCD alone did not predict achievement, however, traits of ADHD and DCD significantly moderated the relationship between executive function and academic achievement. ASD traits did not significantly moderate this relationship. Implications and suggestions for future research are also discussed. (shrink)

Drawing on the work of Foucault and Western confessional writings, this book challenges the transhistorical and commonsense views of confession as an innate impulse resulting in the psychological liberation of the confessing subject. Instead, confessional desire is argued to be contingent and constraining, and alternatives to confessional subjectivity are explored.

The authors of the Target article, Shen and colleagues (2024) argue that there is a need for an ethical framework to help analyze when it is appropriate to return individualized research results (I...

An overview of the philosophical and bioethics literature on conscientious refusals by health care professionals to provide abortion and contraceptive services.

The conception of conscience that dominates discussions in bioethics focuses narrowly on private regulation of behaviour resulting from explicit attitudes. It neglects to mention implicit attitudes and the role of social feedback in becoming aware of one's implicit attitudes. But if conscience is a way of ensuring that a person's behaviour is in line with her moral values, it must be responsive to all aspects of the mind that influence behaviour. There is a wealth of recent psychological work demonstrating the (...) influence of implicit attitudes on behaviour. A necessary part of having a well-functioning conscience must thus be awareness and regulation of one's implicit attitudes in addition to one's explicit attitudes; this cannot be done by an individual in isolation. On my revised conception of conscience, heeding social feedback, being emotionally self-aware and engaging in self-monitoring are important for the possession of a well-functioning conscience. Health professionals may need specific training to help them develop and maintain a well-functioning conscience, which should involve cultivation of awareness of implicit attitudes, emphasis on social feedback and techniques to enable better control over them. (shrink)

Although the philosophical systems of G. W. Leibniz and David Lewis both feature possible worlds, the ways in which their systems are similar and dissimilar are ultimately surprising. At first glance, Leibniz’s modal metaphysics might strike us as one of the most contemporarily relevant aspects of his system. But I clarify in this paper major interpretive problems that result from understanding Leibniz’s system in terms of contemporary views (like Lewis’s, for instance). Specifically, I argue that Leibniz rejects the inference that (...) if something is possible, it therefore occurs in some possible world. This discussion highlights how Leibniz’s account of individual substance (with his strict notion of identity) constrains his modal theorizing and produces fatalistic threats. I then make an unexpected connection between Leibniz’s and Lewis’s systems by showing that Leibniz’s treatment of fatalism bears similarities to the response Lewis gives to the fatalist when considering the paradoxes of time travel. (shrink)

While many periods of history are popularly known by their 'great men',the Enlightenment stands out for the prominence of its 'great groups'. This volume assemblesleading scholars using data-driven scholarship to study the networks that madethe Enlightenment possible, and contributed to creating a new sense of Europeanidentity. From Voltaire's correspondence with Catherine the Great, to AdamSmith's travels on the European continent, mediated and unmediatedcommunication networks were the lifeline of the Enlightenment. What is particularly notable about theEnlightenment is how these different networks (...) were central to theirparticipants' identity. One could nottake part in the Enlightenment on one's own. Although some older historical studies highlightthe importance of social networks in the Enlightenment, data-driven approachesallow for a more comprehensive and granular understanding of the many differenttypes of networks that formed the intellectual and cultural infrastructure ofthe Enlightenment throughout Europe. The recent influx of metadata from thecorrespondences of major Enlightenment figures now allows scholars to studythese networks at both the micro and macro levels, and to explore the worlds ofthe philosophes and the "nodes" intheir networks in rich detail. It is at this intersection of Enlightenmenthistoriography, data capture, and social network analysis that the essayscollected in this volume all fall, taking advantage of new data sources,configurations, and modes of analysis to deepen our understanding of howEnlightenment sociability worked, who it included, and what it meant forparticipants. (shrink)

This article explores forms of haptic sociality in interspecies interaction. Data examined are taken from a corpus of equine assisted therapy sessions, in Finland and France. During these sessions, therapists invite clients to pay close attention to the horse’s behavioral displays of comfort or discomfort and to react accordingly. In this way, the horse is regarded as a living, sentient creature, whose body has haptic and kinesthetic properties, resulting in socialization practices that cultivate forms of care. The study discusses Merleau-Ponty’s (...) concept of “esthesiologic body”, in light of analytical instances, draws on contemporary re-examinations of phenomenological notions (such as intersubjectivity and intercorporeality) by ethnomethodologists and analysts of social interaction, and proposes to respecify them in the particular context of human–animal interactions. The argument is inspired by a conversation analytic approach, sensitive to the orderly character of social actions. Two formats, displaying diverse ways in which participants interact with the horse as an _esthesiologic_ body, are examined in detail. The analysis shows the fundamental role played by touch and haptic practices in the practical accomplishment of intercorporeality. (shrink)

L’anticipation est généralement conçue comme un phénomène qui, d’un point de vue temporel et logique, est antérieur à une action ou une situation donnée. Dans cet article, nous proposons d’interroger cette conception en nous intéressant en détail à ce que l’anticipation fait à l’action qu’elle anticipe. En détail c’est-à-dire, très littéralement, en observant dans des situations d’interactions ordinaires les effets que peut produire le fait d’anticiper une action. En l’occurrence, dans des situations d’apprentissage entre hommes et chiens comme celles que (...) nous examinons, anticiper une action en l’évaluant avant qu’elle n’ait eu lieu contribue en grande part à la configurer. Cette avancée nous conduit à développer une vision proprement pragmatiste de l’action, conçue comme un procès façonné de manière émergente et collaborative par l’ensemble des participants qui l’accomplissent. (shrink)

Building Abolition: Decarceration and Social Justice explores the intersections of the carceral in projects of oppression, while at the same time providing intellectual, pragmatic, and undetermined paths toward abolition. Prison abolition is at once about the institution of the prison, and a broad, intersectional political project calling for the end of the social structured by settler colonialism, anti-black racism, and related oppressions. Beyond this, prison abolition is a constructive project that imagines and strives for a transformed world in which justice (...) is not equated with punishment, and accountability is not equated with caging. Composed of sixteen chapters by an international team of scholars and activists, with a Foreword by Perry Zurn and an Afterword by Justin Piché, the book is divided into four themes: - Prisons and Racism - Prisons and Settler Colonialism - Anti-Carceral Feminisms - Multispecies Carceralities. This book will be of interest to undergraduate and postgraduate students, activists, and scholars working in the areas of Critical Prison Studies, Critical Criminology, Native Studies, Postcolonial Studies, Black Studies, Critical Race Studies, Gender and Sexuality Studies, and Critical Animal Studies, with particular chapters being of interest to scholars and students in other fields, such as, Feminist Legal Studies, Animal Law, Critical Disability Studies, Queer Theory, and Transnational Feminisms. (shrink)

In a 1983 interview, Michel Foucault contrasts our contemporary interest in sexual identity with the ancient Greek preoccupation with diet, arguing that sex has replaced food as the privileged medium of self-constitution in the modern West. In the same interview, Foucault argues that modern liberation movements should return to the ancient model of ethics, of which diet was a prime example, as aesthetics or self-transformative practice. In this paper I take up Foucault's argument with respect to the Animal Liberation Movement (...) and the dietetics of ethical vegetarianism. Contra Foucault, I suggest that diet has not been replaced by sexuality in the modern West, and that food choices, along with and intertwined with sexuality, continue to function as practices of self-constitution in both disciplinary and aesthetic fashions. I then consider the implications of this argument for the Animal Liberation Movement, exploring ways in which it might (and to some degree already does) take on aesthetic rather than moral strategies in order to pursue what Foucault once described as “an ethics of acts and their pleasures which would be able to take into account the pleasure of the other.”. (shrink)

Most mainstream feminist anti-rape scholarship and activism may be described as carceral feminism, insofar as it fails to engage with critiques of the criminal punishment system and endorses law-and-order responses to sexual and gendered violence. Mainstream feminist anti-rape scholars and activists often view increased conviction rates and longer sentences as a political goal—or, at the very least, are willing to collaborate with police and lament cases where perpetrators of sexual violence are given “light” or non-custodial sentences. Prison abolitionists, on the (...) other hand, have tended to insist that most lawbreakers are non-violent and that the “dangerous” are “few”, thus avoiding serious engagement with the widespread phenomenon of sexual violence. Despite the prevalence of carceral feminism, to my knowledge no feminist scholar has explicitly embraced this label, and the closest I have found to a defense of carceral feminism is feminist legal scholar Lise Gotell’s “critique of the critique of carceral feminism”. For this reason, it is with Gotell’s article that I primarily engage in defending anti-carceral feminism and prison abolitionism even in the difficult case of sexual assault. (shrink)