This paper draws from the fields of history, sociology, psychology, moral philosophy, and organizational theory to establish a theoretical connection between a social/organizational influence (ethical work climate) and an individual cognitive element of moral behavior (moral awareness). The research was designed to help to fill a gap in the existing literature by providing empirical evidence of the connection between organizational influences and individual moral awareness and subsequent ethical choices, which has heretofore largely been merely assumed. Results of the study provide (...) evidence that ethical work climate (EWC) is a primary predictor of individual moral awareness, and that the influence of social factors often overrides the effects of individual differences in a work group setting. Implications for future research are provided. (shrink)

As capitalist economies have shifted their primary focus from providing goods and services for all, to concentrating wealth at the top echelons of societies, social entrepreneurs have been one source of re-capturing the original intent of capitalism. Social entrepreneurs have combined the efficiency and effectiveness of business organizations with the social concerns of many non-profit and governmental agencies. As a result, social entrepreneurship is viewed as having significant potential for alleviating many of the social ills we now face. To accomplish (...) this mission, however, will require expansion of social enterprises beyond their current footprints. We explore alternate methods of expansion, scaling and replication, and then examine potential catalysts, which can enable social entrepreneurs to attain their goals of social improvement. The catalysts we identify are effectual logic, enhanced legitimacy through appropriate reporting metrics, and information technology. We conclude with two brief case studies that exemplify how these catalysts are currently working to enhance the effectiveness of social start-ups. (shrink)

This paper explores common elements of problem-based learning (PBL) and some of its benefits in management classes. We then argue that PBL is a pedagogy more suited to the learning environment that our students will face in the workplace, and should therefore be more widely utilized in management education. We conclude by providing a brief description of a class in which PBL is employed as the primary instructional method.

This paper explores the psychological and sociological underpinnings of ethical behavior and their implications for ethics training. The author relies on priorwork done in the cognitive moral development field to point out that expectations for individual behavior defying corporate unethical practices are unrealistic. He suggests, instead, that the focus on improving ethical behavior in organizations should be on creating organizational cultures that support and demand moral behavior from members.

In spite of extensive study and efforts to improve business ethics and increase corporate social responsibility, a quick review of almost any business publication will show that breaches of ethics are a common occurrence in the business community. In this paper we explore reasons for potential discrepancies or gaps between organizational and individual ethical standards, the consequences of such discrepancies, and possible methods of reducing the detrimental effects of these differences. The concept of self-leadership, as constructed through social learning theory (...) is examined, and shown to be a potentially valuable tool for employees'' use in making reasoned decisions in varying organizational ethical climates. Specifically, the authors will show how the practice of self-leadership can be employed as an important means to improve moral action within the firm. (shrink)

A relatively small segment of business, known as social entrepreneurship (SE), is increasingly being acknowledged as an effective source of solutions for a variety of social problems. Because society tends to view "new" solutions as "the" solution, we are concerned that SE will soon be expected to provide answers to our most pressing social ills. In this paper we call into question the ability of SE, by itself, to provide solutions on a scope necessary to address large-scale social issues. SE (...) cannot reasonably be expected to solve social problems on a large scale for a variety of reasons. The first we label the orga nizational legitimacy argument. This argument leads to our second argument, the isomorphism argument. We also advance three other claims, the moral y political and structural arguments. After making our arguments, we explore ways in which SE, in concert with other social institutions, can effectively address social ills. We also present two examples of successful ventures in which SEs partnered with governments and other institutions. (shrink)

While investigating the role of business and accepting that profitable partnerships are the primary solution for poverty alleviation, we voice certain concerns that we hope will extend the authors’ discourse in Alleviating Poverty through Profitable Partnerships . We present a model that we believe can serve as an effective framework for addressing these issues. We then establish the imperative of inclusive growth. Here, we engage with the necessity of formulating strategies that focus on the pace and, importantly, the pattern of (...) economic growth, including its social and cultural dimensions. We also deliberate on the parameters of inclusive growth with the overriding objective of ensuring that multiple strata of society share the benefits of globalization. Turning to the critical role of institutions in promoting social welfare, we explore the impact of government policy vis-à-vis the leverage enjoyed by other social institutions. Despite the reality that state and private interests often operate at cross purposes, we argue that government must still be an integral part of the solution matrix. With direction from other social institutions, entrepreneurial forces can be unleashed to tackle endemic poverty prevalent in the base of the pyramid. We then provide an in-depth case study in which the availability of telecommunications in rural areas was utilized as a means to foster development and ensure inclusive growth. The conclusion examines lessons learned while operationalizing the model, and spells out the impact of our enablers at ground level. (shrink)

The authors argue that a free market paradigm facilitates wealth creation but does little to distribute that wealth in a just manner. In order to achieve the social goal of distributive justice, the concept of a fair market is introduced and explored. The authors then examine three drivers that can help improve the lives of all people, especially the poor: civil society, its institutions, and business. After exploring the roles these drivers might play in developing fair markets, we describe three (...) enablers that serve as catalysts for change: the effects of globalization, the impact of technology, and the emergence of entrepreneurial activity. We conclude by making recommendations for establishing fair markets and provide exemplars of two firms that embody the arguments made in the article. (shrink)

This paper investigates a structural void that, especially in the context of poor or developing nations, prevents economic growth from being more inclusive and benefiting wider sections of society. The authors initially examine the imperative for inclusive growth, one encompassing a focus on poverty and development. Utilizing social choice theory, and a capability deprivation perspective, we observe that the poor experience deprivations due to a deficiency in their personal autonomy. This in turn is deeply interwoven with the concept of identity. (...) Legally recognizing the poor as individuals, and providing them with proof of their identity, will empower them and facilitate inclusive growth and poverty alleviation. These conceptual arguments are illustrated with the description of a biometric-linked developmental initiative that is providing proof of identity to 1.2 billion residents of India. By establishing a robust identity management system, the project aims to ensure more inclusive growth and efficiently target welfare programs. The authors further investigate how the establishment of identity rights facilitates financial inclusion, property ownership, and necessity-driven entrepreneurial action. Biometric identification on this scale is, however, fraught with dangers to civil liberties and has other serious ethical consequences. In the last section, issues around privacy and security are debated while highlighting the need for external review and independent monitoring to define the project’s boundaries and usages. (shrink)

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. (...) In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. (shrink)

Employers must determine the types of health care plans to offer and also set employee premiums for each plan provided. Depending on the structure of the employee share of premiums across different health insurance plans, the incentives to choose one plan over another are altered. If employees know premiums do not fully reflect the risk differences among workers, such pricing can give rise to a so-called “death spiral” due to adverse selection. This paper uses longitudinal information from a natural experiment (...) in the management of health benefits for a large employer to explore the impact of moving from a fixed-dollar contribution policy to a partially risk-adjusted employer contribution policy. Our results show that implementing a significant risk adjustment had no discernable effect on adverse selection against the most generous indemnity insurance policy. This stands in stark contrast to previous studies, which have tended to estimate large impacts attributed to selection when employers move to a fixed-dollar policy from one with some risk adjustment. Further analysis suggests that previous studies, which appeared to detect plans in the throes of a death spiral, may instead have been reflecting an inexorable movement away from a non-preferred product, one that would have been inefficient for nearly all workers even in the absence of adverse selection. (shrink)

An ongoing argument often made by business ethicists is that a singular preoccupation on profitability, will lead, in the long run, to disvalue for all the stakeholders and the communities it affects, and often, economic challenges for the company. On the other hand, we argue, a preoccupation with ethics and CSR as the primary aims of a for-profit company, it is, on its own, like a preoccupation with profitability, unsustainable. Indeed, without economic viability, a company will fail. Both of these (...) contentions point to our conclusion that one must take care in changing habits and rethinking business models. We illustrate through case examples, that merely being ethical and socially responsible is insufficient for the long-term well-being of business just as a preoccupation with profits for their own sake also is insufficient. What is realistic, practical, pragmatic, sustainable and profitable for corporations, and what also serves the interests of multiple stakeholders including those in the communities they serve, is a true balance of ethics, CSR, and economic value-added. Expanding on the recent work of Husted and Allen, we call this a strategic global strategy approach. (shrink)

This workshop brought together people who are interested in or concerned about the course syllabus. Participants’ concerns and discussion centered on issues such as: 1) the purpose of the syllabus; 2) writing objectives for the course; and 3) evaluation of a syllabus.

We propose that firms that engage in morally imaginative sensemaking will manage society's changing ethical expectations more effectively than those engaging in habituated sensemaking. Specifically, we argue that managers engaging in habituated sensemaking will tend to view changes in expectations as threats and respond to them defensively. In contrast, morally imaginative managers will tend to see these same changes as opportunities and address them by proactively or interactively engaging stakeholders in learning processes. We contribute to the literature on moral imagination (...) by highlighting the value of moral imagination relative to conventional sensemaking, and by positioning moral imagination as an ongoing mode of sensemaking. While we recognize that managers' capacity to continuously address changing ethical expectations using moral imagination is constrained by cognitive limitations, we posit that morally imaginative sensemaking may economize on cognitive resources over time by enabling managers to avoid managing ethical issues unproductively based on habit. We also contribute to the issues management literature by calling attention to two underlying factors, managerial sensemaking mode and firm enterprise strategy, that drive companies' approaches to issues management. (shrink)

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

Current models of cortical speech and language processing include multiple regions within the temporal lobe of both hemispheres. Human communication, by necessity, involves complex interactions between regions subserving speech and language processing with those involved in more general cognitive functions. To assess these interactions, we utilized an ecologically salient conversation-based approach. This approach mandates that we first clarify activity patterns at the earliest stages of cortical speech processing. Therefore, we examined high gamma (70-150 Hz) responses within the electrocorticogram (ECoG) recorded (...) simultaneously from Heschl’s gyrus (HG) and lateral surface of the superior temporal gyrus (STG). Subjects were neurosurgical patients undergoing evaluation for treatment of medically intractable epilepsy. They performed an expanded version of the Mini-mental state examination (MMSE), which included additional spelling, naming, and memory-based tasks. ECoG was recorded from HG and the STG using multicontact depth and subdural electrode arrays, respectively. Differences in high gamma activity during listening to the interviewer and the subject's self-generated verbal responses were quantified for each recording site and across sites within HG and STG. The expanded MMSE produced widespread activation in auditory cortex of both hemispheres. No significant difference was found between activity during listening to the interviewer's questions and the subject's answers in posteromedial HG (auditory core cortex). A different pattern was observed throughout anterolateral HG and posterior and middle portions of lateral STG (non-core auditory cortical areas), where activity was significantly greater during listening compared to speaking. No systematic task-specific differences in the degree of suppression during speaking relative to listening were found in posterior and middle STG. Individual sites could, however, exhibit task-related variability in the degree of suppression during speaking compared to listening. The current study demonstrates that ECoG recordings can be acquired in time-efficient dialog-based paradigms, permitting examination of language and cognition in an ecologically salient manner. The results obtained from auditory cortex serve as a foundation for future studies addressing patterns of activity beyond auditory cortex that subserve human communication. (shrink)

Facial race and sex cues can influence the magnitude of the happy categorisation advantage. It has been proposed that implicit race or sex based evaluations drive this influence. Within this account a uniform influence of social category cues on the happy categorisation advantage should be observed for all negative expressions. Support has been shown with angry and sad expressions but evidence to the contrary has been found for fearful expressions. To determine the generality of the evaluative congruence account, participants categorised (...) happiness with either sadness, fear, or surprise displayed on White male as well as White female, Black male, or Black female faces across three experiments. Faster categorisation of happy than negative expressions was observed for female faces when presented among White male faces, and for White male faces when presented among Black male faces. These results support the evaluative congruence account when both positive and negative expressions are presented. (shrink)

This study investigates the performance of psychopathic individuals on tasks believed to be sensitive to dorsolateral prefrontal and orbitofrontal cortex (OFC) functioning. Psychopathic and non-psychopathic individuals, as defined by the Hare psychopathy checklist revised (PCL-R) [Hare, The Hare psychopathy checklist revised, Toronto, Ontario: Multi-Health Systems, 1991] completed a gambling task [Cognition 50 (1994) 7] and the intradimensional/extradimensional (ID/ED) shift task [Nature 380 (1996) 69]. On the gambling task, psychopathic participants showed a global tendency to choose disadvantageously. Specifically, they showed an (...) impaired ability to show learning over the course of the task. On the ID/ED task, the performance of psychopathic individuals was not significantly different from incarcerated controls on attentional set-shifting, but significant impairments were found on response reversal. These results are interpreted with reference to an OFC and amygdala dysfunction explanation of psychopathy. (shrink)

This study investigates the ability of individuals with psychopathy to perform passive avoidance learning and whether this ability is modulated by level of reinforcement/punishment. Nineteen psychopathic and 21 comparison individuals, as defined by the Hare Psychopathy Checklist Revised (Hare, 1991), were given a passive avoidance task with a graded reinforcement schedule. Response to each rewarding number gained a point reward specific to that number (i.e., 1, 700, 1400 or 2000 points). Response to each punishing number lost a point punishment specific (...) to that number (i.e., the loss of 1, 700, 1400 or 2000 points). In line with predictions, individuals with psychopathy made more passive avoidance errors than the comparison individuals. In addition, while the performance of both groups was modulated by level of reward, only the performance of the comparison population was modulated by level of punishment. The results are interpreted with reference to a computational account of the emotional learning impairment in individuals with psychopathy. (shrink)

Aberrant consumer behaviour costs firms millions of pounds a year, and the Internet has provided young techno-literate consumers with a new medium to exploit businesses. This paper addresses Internet related ethics and describes the ways in which young consumers misdemean on the Internet and their attitudes towards these. Using a sample of 219 generation Y consumers, the study identified 24 aberrant behaviours which grouped into five factors; illegal, questionable activities, hacking related, human Internet trade and downloading. Those perceived as least (...) wrong were; "Downloading movie and music files from the Internet for free". The consequences of these behaviours have implications for educators, consumer policy and marketers. (shrink)

Facial attributes such as race, sex, and age can interact with emotional expressions; however, only a couple of studies have investigated the nature of the interaction between facial age cues and emotional expressions and these have produced inconsistent results. Additionally, these studies have not addressed the mechanism/s driving the influence of facial age cues on emotional expression or vice versa. In the current study, participants categorised young and older adult faces expressing happiness and anger or sadness by their age and (...) their emotional expression. Age cues moderated categorisation of happiness vs. anger and sadness in the absence of an influence of emotional expression on age categorisation times. This asymmetrical interaction suggests that facial age cues are obligatorily processed prior to emotional expressions. Finding a categorisation advantage for happiness expressed on young faces relative to both anger and sadness which are negative in valence but different in their congruence with old age stereotypes or structural overlap with age cues suggests that the observed influence of facial age cues on emotion perception is due to the congruence between relatively positive evaluations of young faces and happy expressions. (shrink)

Evaluative conditioning (EC) refers to the change in the valence of a conditioned stimulus (CS) due to its pairing with a positive or negative unconditioned stimulus (US). To the extent that core affect can be characterised by the two dimensions of valence and arousal, EC has important implications for the origin of affective responses. However, the distinction between valence and arousal is rarely considered in research on EC or conditioned responses more generally. Measuring the subjective feelings elicited by a CS, (...) the results from two experiments showed that (1) repeated pairings of a CS with a positive or negative US of either high or low arousal led to corresponding changes in both CS valence and CS arousal, (2) changes in CS arousal, but not changes in CS valence, were significantly related to recollective memory for CS–US pairings, (3) subsequent presentations of the CS without the US reduced the conditioned valence of the CS, with conditioned arousal being less susceptible to extinction and (4) EC effects were stronger for high arousal than low arousal USs. The results indicate that the conditioning of affective responses can occur simultaneously along two independent dimensions, supporting evidence in related areas that calls for a consideration of both valence and arousal. Implications for research on EC and the acquisition of emotional dispositions are discussed. (shrink)

Past research demonstrates that emotion recognition is influenced by social category cues present on faces. However, little research has investigated whether holistic processing is required to observe these influences of social category information on emotion perception, and no studies have investigated whether different visual sampling strategies (i.e. differences in the allocation of attention to different regions of the face) contribute to the interaction between social cues and emotional expressions. The current study aimed to address this. Participants categorised happy and angry (...) expressions on own- and other-race faces, and male and female faces. In Experiments 1 and 2, holistic processing was disrupted by presenting inverted faces (Experiment 1) or part faces (Experiment 2). In Experiments 3 and 4 participants’ eye-gaze to eye and mouth regions was also tracked. Disrupting holistic processing did not alter the moderating influence of sex and race cues on emotion recognition (Experiments 1, 2, 4). Gaze patterns differed as a function of emotional expression, and social category cues, however, eye-gaze patterns did not reflect response time patterns (Experiments 3 and 4). Results indicate that the interaction between social category cues and emotion does not require holistic processing and is not driven by differences in visual sampling. (shrink)

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In (...) this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing. (shrink)

Pronoun interpretation is often described as relying on a comprehender's mental model of discourse. For example, in some psycholinguistic accounts, interpreting pronouns involves a process of retrieval, whereby a pronoun is resolved by accessing information from its linguistic antecedent. However, linguistic antecedents are neither necessary nor sufficient for interpreting a pronoun, and even when an antecedent has been introduced in earlier discourse, there is little evidence for the retrieval of linguistic form. The current study extends our understanding of pronoun interpretation (...) by examining whether the semantics of antecedent expressions are retrieved from representations of past discourse. Participants were instructed to move displayed objects in a Visual World eye-tracking task. In some cases, the semantics of the antecedent were no longer viable after an instruction was completed (e.g., “Move the house on the left to area 12,” where the result was that a different house is now the leftmost one). In this case, retrieving antecedent semantics at the point of hearing a subsequent pronoun (“Now, move it…”) should entail a processing penalty. Instead, the results showed that antecedent semantics have no direct effect on interpretation, raising additional questions about the role that retrieval might play in pronoun interpretation. (shrink)

This article addresses five research questions: What specific behaviors are described in the literature as ethical or unethical? What percentage of business people are believed to be guilty of unethical behavior? What specific unethical behaviors have been observed by bank employees? How serious are the behaviors? Are experiences and attitudes affected by demographics? Conclusions suggest: There are seventeen categories of behavior, and that they are heavily skewed toward internal behaviors. Younger employees have a higher level of ethical consciousness than older (...) employees. The longer one works for a company, the more one may look to job security as a priority; this can lead to rationalizing or overlooking apparently unethical behaviors. More emphasis is needed on internal behaviors with particular attention on the impact that external behaviors have on internal behaviors. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

This study investigated the performance of boys with psychopathic tendencies and comparison boys, aged 9 to 17 years, on two tasks believed to be sensitive to amygdala and orbitofrontal cortex func- tioning. Fifty-one boys were divided into two groups according to the Psychopathy Screening Device (PSD, P. J. Frick & R. D. Hare, in press) and presented with two tasks. The tasks were the gambling task (A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) and the Intradimensional/ (...) Extradimensional (ID/ED) shift task (R. Dias, T. W. Robbins, & A. C. Roberts, 1996). The boys with psychopathic tendencies showed impaired performance on the gambling task. However, there were no group differences on the ID/ED task either for response reversal or extradimensional set shifting. The implications of these results for models of psychopathy are discussed. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

Though emotional faces preferentially reach awareness, the present study utilised both objective and subjective indices of awareness to determine whether they enhance subjective awareness and “blindsight”. Under continuous flash suppression, participants localised a disgusted, fearful or neutral face (objective index), and rated their confidence (subjective index). Psychopathic traits were also measured to investigate their influence on emotion perception. As predicted, fear increased localisation accuracy, subjective awareness and “blindsight” of upright faces. Coldhearted traits were inversely related to subjective awareness, but not (...) “blindsight”, of upright fearful faces. In a follow-up experiment using inverted faces, increased localisation accuracy and awareness, but not “blindsight”, were observed for fear. Surprisingly, awareness of inverted fearful faces was positively correlated with coldheartedness. These results suggest that emotion enhances both pre-conscious processing and the qualitative experience of awareness, but that pre-conscious and conscious processing of emotional faces rely on at least partially dissociable cognitive mechanisms. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male (...) participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

In modern law medical paternalism no longer rules. Respect for patient autonomy is now a fundamental principle of both medical law and bioethics. As a result of these developments, and cases such as Rees v Darlington Memorial NHS Trust and Chester v Afshar, there have been suggestions that the law of clinical negligence should be developed so as to recognise diminished autonomy as a form of actionable damage in this area of tort law. Yet in order for the tort of (...) negligence to recognise this new interest, it is first necessary to determine how autonomy should be understood in this context. The purpose of this article is to shed light on this issue and arrive at a suitable definition of the concept. After outlining the different theories of autonomy it is argued that the traditional liberal definition is the most philosophically and legally coherent. (shrink)