Considerable attention has been paid recently to the gendering of organizations and occupations. Unfortunately, the gendered-organizations approach remains theoretically and empirically underdeveloped, as there have as yet been few clear answers to the question central to the perspective: What does it really mean to say that an organization itself, or a policy, practice, or slot in the hierarchy, is “gendered”? Reviewing literature in the gendered-organizations tradition, the author discusses three of the most common ways the perspective has been applied and (...) argues that all of these definitions pose potential problems for the project of meaningful social and organizational change. The article concludes with some suggestions about how a more useful conception of the gendered organization might be built. (shrink)

This article uses Acker's theory of gendered organizations to frame an analysis of the ways in which policies and practices in a men's and a women's prison reflect and reproduce gendered inequalities. The article offers a working definition of one of Acker's key theoretical concepts, the notion of “gendered organizational logic.” Then, using interview data collected from correctional officers in a men's and a women's prison, the article examines the ways in which officer training and assignments, although designed to be (...) nominally generic, assume a male worker and disproportionately benefit male officers working in men's institutions. These findings imply that the perspective could more usefully be conceived as a theory of “masculinized” organizations. (shrink)

The prevailing metaphor for understanding the persistence of gender inequalities in universities is the “chilly climate.” Women faculty sometimes resist descriptions of their workplaces as “chilly” and deny that gender matters even in the face of considerable evidence to the contrary. I draw on interviews with women academics to explore this apparent paradox, and I offer a theoretical synthesis that may help explain it. I build on insights from Ridgeway and Acker to demonstrate that women do experience gender at work, (...) but the contexts in which they experience it have implications for how they understand gender’s importance and whether to respond. Specifically, I find that women are likely to minimize or deny gender’s importance in interactions. When it becomes salient in structures and cultures, women understand it differently. Placing gender in organizational contexts can better inform our understanding of gender inequality at work and can help in crafting more effective efforts to foster gender equity. (shrink)

The study of anarchism as a philosophical, political, and social movement has burgeoned both in the academy and in the global activist community in recent years. Taking advantage of this boom in anarchist scholarship, Nathan J. Jun and Shane Wahl have compiled twenty-six cutting-edge essays on this timely topic in New Perspectives on Anarchism.

Hookups are uncommitted sexual encounters that range from kissing to intercourse and occur between individuals in whom there is no current dating relationship and no expressed or acknowledged expectations of a relationship following the hookup. Research over the last decade has begun to focus on hooking up among adolescents and young adults with significant research demonstrating how alcohol is often involved in hooking up. Given alcohol’s involvement with hooking up behavior, the array of health consequences associated with this relationship, as (...) well as its increasing prevalence from adolescence to young adulthood, it is important to determine the predictors and consequences associated with alcohol-related hooking up. The current review extends prior reviews by adding more recent research, including both qualitative and experimental studies (i.e. expanding to review more diverse methods), research that focuses on the use of technology in alcohol-related hookups (i.e. emerging issues), further develops prevention and intervention potentials and directions, and also offers a broader discussion of hooking up outside of college student populations (i.e., expanding generalization). This article will review the operationalization and ambiguity of the phrase hooking up, the relationship between hooking up and alcohol use at both the global and event levels, predictors of alcohol-related hooking up, and both positive and negative consequences, including sexual victimization, associated with alcohol-related hookups. Throughout, commentary is provided on the methodological issues present in the field, as well as limitations of the existing research. Future directions for research that could significantly advance our understanding of hookups and alcohol use are provided. (shrink)

To describe phenomena that occur at different time scales, computational models of the brain must incorporate different levels of abstraction. At time scales of approximately 1/3 of a second, orienting movements of the body play a crucial role in cognition and form a useful computational level embodiment level,” the constraints of the physical system determine the nature of cognitive operations. The key synergy is that at time scales of about 1/3 of a second, the natural sequentiality of body movements can (...) be matched to the natural computational economies of sequential decision systems through a system of implicit reference called deictic in which pointing movements are used to bind objects in the world to cognitive programs. This target article focuses on how deictic bindings make it possible to perform natural tasks. Deictic computation provides a mechanism for representing the essential features that link external sensory data with internal cognitive programs and motor actions. One of the central features of cognition, working memory, can be related to moment-by-moment dispositions of body features such as eye movements and hand movements. (shrink)

Indoleamine 2,3‐dioxygenase (IDO) is the rate‐limiting enzyme in conversion of tryptophan to kynurenines, feeding de novo nicotinamide synthesis. IDO orchestrates materno‐foetal tolerance, increasing human reproductive fitness. IDO mediates immune suppression through depletion of tryptophan required by T lymphocytes and other mechanisms. IDO is expressed by alternatively activated macrophages, suspected to play a key role in tuberculosis (TB) pathogenesis. Unlike its human host, Mycobacterium tuberculosis can synthesize tryptophan, suggesting possible benefit to the host from infection with the microbe. Intriguingly, nicotinamide analogues (...) are used to treat TB. In reviewing this field, it is postulated that flux through the nicotinamide synthesis pathway reflects switching between aerobic glycolysis and oxidative phosphorylation in M. tuberculosis‐infected macrophages. The evolutionary cause of such shifts may be ancient mitochondrial behavior related to reproductive fitness. Evolutionary perspectives on the IDO pathway may elucidate why, after centuries of co‐existence with the Tubercle bacillus, humans still remain susceptible to TB disease. (shrink)

The majority of commentators agree that the time to focus on embodiment has arrived and that the disembodied approach that was taken from the birth of artificial intelligence is unlikely to provide a satisfactory account of the special features of human intelligence. In our Response, we begin by addressing the general comments and criticisms directed at the emerging enterprise of deictic and embodied cognition. In subsequent sections we examine the topics that constitute the core of the commentaries: embodiment mechanisms, dorsal (...) and ventral visual processing, eye movements, and learning. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

ObjectivePrevious research has shown reduced interoceptive accuracy in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of IAcc on depression and attention.MethodsThirty-six depressed patients from the Psychosomatic Clinic in Windach were matched with 36 healthy controls according to age and sex and were assessed at Ulm University. All (...) participants completed the Beck Depression Inventory-II, the heartbeat perception task to examine IAcc, and the d2 test assessing selective attention.ResultsDepressed patients showed attention deficits—both for general visual attention and IAcc—compared to healthy controls. The mediation analyses revealed that the relationship between depression and attention is not mediated via IAcc. Furthermore, depression predicts IAcc and attention, but these effects are direct and largely unaffected by the respective other variable.DiscussionThe results of the present study highlight both interoceptive as well as attention deficits in depressed patients. No clear mediation between these variables could be shown in this study. More elaborative research is needed to clarify whether different approaches to improve IAcc are effective for these deficits in depressed patients and could therefore be of importance as an additional aspect of therapy in depression. (shrink)

Uncivil behavior by leaders may be viewed as an effective way to motivate employees. However, supervisor incivility, as a form of unethical supervision, may be undercutting employees’ ability to do their jobs. We investigate linkages between workplace incivility and perceived work ability, a variable that captures employees’ appraisals of their ability to continue working in their jobs. We draw upon the appraisal theory of stress and social identity theory to examine incivility from supervisors as an antecedent to PWA, and to (...) investigate job involvement and grit as joint moderators of this association. Results from data collected in two samples of working adults provided evidence for three-way interactions in relation to PWA. Among employees with high levels of grit, there was no significant relation between supervisor incivility and PWA, regardless of employee job involvement. However, we found some evidence that for those low in grit, having high job involvement was associated with a stronger relationship between supervisor incivility and PWA. Findings attest to the importance of unethical supervisor behavior, showing the potential for supervisor incivility to erode PWA, as well as the importance of grit as a potential buffer. (shrink)

We examine the influences of social capital, source credibility, and fairness perceptions on the judgments of experienced compensation committee members who are considering a proposal to reduce management’s performance targets in the middle of a compensation cycle due to difficult circumstances. Eighty-nine U.S. public company CC members participated in a 2 × 2 experiment with social capital and source credibility each manipulated as low or high, and outcome fairness to management, process fairness to shareholders, and outcome fairness to shareholders included (...) as measured variables. While social capital and source credibility are not significant, we find that outcome fairness to the CEO and outcome fairness to shareholders are significantly related to CC members’ support for reducing performance targets during a compensation cycle. In addition, we find that more experienced CC members are less supportive of changing the performance targets. The significant interactions include one between outcome fairness to shareholders and process fairness to shareholders, which suggests that CC member support for the proposal relies on both process and outcome fairness being present. Finally, the participants’ qualitative responses reflect arguments both for and against adjusting performance targets. Overall, the results highlight the important roles of fairness and director experience in boardroom decisions and provide important insights into factors affecting CC judgments. (shrink)

Feminist scholarship on the relative importance of working-class institutional strength in the economy and in the state has led to two divergent conclusions. Radical feminists argue that working-class institutions dominated by men produce male-biased outcomes; socialist feminists hold that working-class institutions promote classwide interests that benefit women as well as men. This article addresses this debate by applying generic and gendered working-class strength models of the welfare state in an examination of women's public pension quality. Quality is measured as women's (...) average pension compared with that of men, relative to women's average earnings, and compared with the average wage in the society. The authors find support for the socialist feminist view. Working-class institutions, having historically organized and represented the interests of working men, benefit women by improving the security and adequacy of their retirement incomes, but it is women's access to working-class economic and political institutions that brings greater economic equality with men in old age. (shrink)

Cognitive Science, Volume 46, Issue 6, June 2022.

Psychologists and philosophers who pose moral dilemmas to understand moral judgment typically specify outcomes as certain to occur in them. This contrasts with real-life moral decision-making, which is almost always infused with probabilities (e.g., the probability of a given outcome if an action is or is not taken). Seven studies examine sensitivity to the size and location of shifts in probabilities of outcomes that would result from action in moral dilemmas. We find that moral judgments differ between actions that result (...) in an equal increase in probability of harm (equal size), but have different end-states (e.g., an increase in harm probability from 25% to 50% or from 50% to 75%). This deviation from expected value is robust under separate evaluation, and increases when the comparison between shifts is made explicit under simultaneous evaluation. Consistent with the centrality of perceived harm in some models of moral judgment, perceived harm partially mediates sensitivity to location of harm probability shift. Unlike for shifts in harm probabilities, participants are insensitive to the location of shifts in probability of beneficial outcomes. They are also insensitive to the location of shifts in probability of analogous monetary losses and gains, suggesting an asymmetry between harm and benefit in moral reasoning, as well as an asymmetry between moral and monetary decision-making more broadly. Implications for normative philosophical theory and moral psychological theory, as well as practical applications, are discussed. (shrink)

Factors such as subsistence turnover, warfare, or interaction between different groups can be major sources of cultural change in human populations. Global demographic shifts such as the transition to agriculture during the Neolithic and more recently the urbanization and globalization of the twentieth century have been major catalysts for cultural change. Here, we test whether cultural traits such as patri/matrilocality and postmarital migration persist in the face of social upheaval and gene flow during the past 150 years in postcolonial South (...) Africa. The recent history of South Africa has seen major demographic shifts that resulted in the displacement and forced sedentism of indigenous Khoekhoe and San populations. During the expansion of the colonial frontier, the Khoe-San admixed with European colonists and enslaved individuals from West/Central Africa, Indonesia, and South Asia, introducing novel cultural norms. We conducted demographic interviews among Nama and Cederberg communities representing nearly 3,000 individuals across three generations. Despite the history of colonial expansion, and the subsequent incorporation of Khoe-San and Khoe-San-descendant communities into a colonial society with strong patrilocal norms, patrilocality is the least common postmarital residence pattern in our study populations today. Our results suggest that more recent forces of integration into the market economy are likely the primary drivers of change in the cultural traits examined in our study. Birthplace had a strong effect on an individual’s odds of migration, distance moved, and postmarital residence form. These effects are at least partially explained by the population size of the birthplace. Our results suggest that market factors local to birthplaces are important drivers of residence decisions, although the frequency of matrilocal residence and a geographic and temporal cline in migration and residence patterns also indicate the persistence of some historic Khoe-San cultural traits in contemporary groups. (shrink)

The view that ordinary objects are composites of form and matter ("hylomorphism") can be contrasted with the more common view that ordinary objects are composed of only material parts ("matter only"). On a matter-only view the hard question is modal: which modal profile does that (statue-shaped) object have? Does it have the modal profile of a statue, a lump, a mere aggregate? On a hylomorphic view the hard question is ontological: which objects exist? Does a statue (matter-m + statue-form), a (...) lump (matter-m + lump-form), and/or a mere aggregate (matter-m + mere aggregate-form) exist? I defend a novel answer to the hard question for hylomorphism. In particular, I argue that which ordinary objects exist depends, in part, on how subjects respond to the matter they encounter. I argue that, with regard to grounding the existence and modal properties of ordinary objects, response-dependent hylomorphism is superior to both matter only views and to non-response-dependent versions of hylomorphism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 39.1 (2006) 72-84 [Access article in PDF] "The Limbo of Ethical Simulacra": A Reply to Ron Greene Dana L. Cloud Department of Communication Studies University of Texas, Austin Steve Macek Department of Speech Communication North Central College James Arnt Aune Department of Communication Texas A&M University In two recent articles, "Another Materialist Rhetoric," and "Rhetoric and Capitalism" (1998, 2004), Ronald Walter Greene pays considerable attention (...) to Marxist rhetorical theory, especially the work of Dana L. Cloud (1994, 2001a, 2001b, 2002) and James Arnt Aune (1994, 2001). These essays usefully point up what is at stake in the debate between poststructuralist theory and Marxism: whether an instrumental, class-based, socialist critical and political project is still feasible and necessary in today's world. Rejecting both Aune's Marxist-humanist approach and Cloud's more economic vision of agency, Greene claims that the changing character of global capitalism and recognition of the "constitutive power" of discourse render rhetorical criticism and practical politics on a Marxist basis untenable. Although we appreciate Greene's engagement with Marxism, we contend that the arguments sketched out in his essays are theoretically and politically flawed.First, Greene's criticisms are directed against a crude caricature of Marxist epistemology that obscures the complexity of theories of representation and ideology in the historical materialist tradition. Second, underwriting Greene's entire project are confused, and in some cases demonstrably false, assessments of the nature and historical trajectory of world capitalism and of the current prospects for class-based social movements. Finally, Greene endorses something like a democratic project but offers no normative criteria for such a project beyond the immanence of always-already present communicative agency and the excesses of joy afforded (to some) by the capitalist system. We will examine each of these shortcomings in turn. [End Page 72] Real Lies: The Complexity of Marxist Epistemology Greene and other poststructuralists charge Marxist theorists in the field of rhetorical studies with holding a dubious representational theory of truth.1 In contrast, Greene embraces a critical approach that examines "how rhetorical practices create the conditions of possibility for a governing apparatus to judge and program reality" and that views "what is in the true" as rhetorically produced (1998, 22). At odds with Greene's approach, Marxists claim that, in a range of ways, ideological discourses reflect, distort, and/or negotiate with the objective social realities, interests, and lived experiences of contending classes in capitalist society. Moreover, we believe that—by means of interpretive, historical, and empirical research—Marxist scholars and activists may develop fuller and more accurate theoretical "representations" of such realities and interests and of the various ways they shape our lives and our political struggles.2This is not to say, however, that the process is simple or mechanistic. Marxist critical practice retains the evaluative power of realism without laying claim to absolute or unmediated empirical knowledge; moreover, we do not believe that ideas are mechanistically generated epiphenomena of economic motive. Discourses, as any communication scholar would agree and as Greene points out, do have effects or "effectivities." Yet anyone interested in a normative political project (which Greene wishes to escape, a point to which we shall return) must recognize the possibility of falsehood. However, as Raymond Geuss (1981) argues, falsehood is not only a matter of empirical misrepresentation. In addition to epistemic falsehood, ideological discourses may exhibit both functional falsehood (referring to how even plausible ideas can bolster oppressive power) and genetic falsehood (ideas promulgated by those with ulterior motives, or intentional mystification).Similarly, analytic Marxist Jon Elster (1985) offers a view of ideology that regards discourses as more than simple epiphenomena of economic situations and struggles.3 Elster describes three overlapping forms of ideological production: the interest-based dissemination of distorted ideas, the failure of social imagination associated with widespread support for the capitalist system and U.S. imperialism, and the psychological comfort of palliative discourses such as religion and patriotism.4 Understanding how widespread adherence to common-sense ideas is accomplished is a project central to... (shrink)

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

It has been suggested that early cry parameters are connected to later cognitive abilities. The present study is the first to investigate whether the acoustic features of infant cry are associated with cognitive development already during the first year, as measured by oculomotor orienting and attention disengagement. Cry sounds for acoustic analyses (fundamental frequency; F0) were recorded in two neonatal cohorts at the age of 0-8 days (Tampere, Finland) or at 6 weeks (Cape Town, South Africa). Eye tracking was used (...) to measure oculomotor orienting to peripheral visual stimuli and attention disengagement from central stimuli at 8 months (Tampere) or at 6 months (Cape Town) of age. Only a marginal positive correlation between fundamental frequency of cry (F0) and visual attention disengagement was observed in the Tampere cohort, but not in the Cape Town cohort. This correlation indicated that infants from the Tampere cohort with a higher neonatal F0 were marginally slower to shift their gaze away from the central stimulus to the peripheral stimulus. No associations between F0 and oculomotor orienting were observed in either cohort. We discuss possible factors influencing the current pattern of results suggesting a lack of replicable associations between neonatal cry and visual attention and suggest directions for future research investigating the potential of early cry analysis in predicting later cognitive development. (shrink)

The non-financial effects (NFE) antitakeover amendment addresses the duties of company directors and management when faced with a possible takeover bid. The NFE amendment either permits or requires managers to consider the interests of the company's stakeholders during takeover bids. Other types of antitakeover devices have been viewed as protecting either stockholder or management interests. The NFE amendment would appear to protect a broad spectrum of interests including those of company employees, creditors, and the community in which the company operates. (...) Positive market returns to the adoption of NFE amendments provide some evidence that investors approve. The percent of both management and institutional ownership are positively related to the market reaction to the NFE amendment adoption. To the extent that institutional ownership proxies for the broad spectrum of stakeholder interest, NFE devices, unlike some other amendments that have been studied, appear to be in the interests of more than a single interest group. (shrink)

The non-financial effects (NFE) antitakeover amendment addresses the duties of company directors and management when faced with a possible takeover bid. The NFE amendment either permits or requires managers to consider the interests of the company's stakeholders during takeover bids. Other types of antitakeover devices have been viewed as protecting either stockholder or management interests. The NFE amendment would appear to protect a broad spectrum of interests including those of company employees, creditors, and the community in which the company operates. (...) Positive market returns to the adoption of NFE amendments provide some evidence that investors approve. The percent of both management and institutional ownership are positively related to the market reaction to the NFE amendment adoption. To the extent that institutional ownership proxies for the broad spectrum of stakeholder interest, NFE devices, unlike some other amendments that have been studied, appear to be in the interests of more than a single interest group. (shrink)

A secret concealed for centuries, shrouded in myth, silenced by stone. A secret that if unleashed threatens to shake the very foundation of Western civilization. A secret that can remain hidden no longer. The quest begins in Rome, where a grizzly murder and a plundered tomb serve to ignite perhaps the most controversial conflict in human history. Inspector Domenico Conti is charged with the task of recovering the contents of the tomb, but as he delves deeper into the investigation, he (...) is thrust into the center of a centuries-old struggle between truth and those who would stop at nothing to conceal it. But he is not alone. Dr. Dana McCarter, newly appointed director of the Advanced Institute for the Study of Antiquity, finds herself at the heart of the mystery when her considerable expertise in ancient Greek philosophy and her suspect involvement with the black market take her on a journey beginning in her New York University offices and sweeping around the globe—from the dark alleys of Moscow, to the rolling hills of the Italian countryside and the enigmatic relics of an ancient civilization, alive with long-kept secrets. As the search for answers leads them through a labyrinth of conspiracy and intrigue, Dana and Domenico must question everything they believe in and decide how much they are willing to sacrifice to know the truth. (shrink)

Pojam politicke zajednice spada medju nedovoljno tematizovane pojmove u tradiciji politicke filozofije, a narocito liberalisticke teorije. Ovaj teorijski nedostatak nadoknadjivanja u poslednje dve decenije, kada su u sirokom opsegu istrazivani problemi odredjenja, znacaja, konstituisanja i mogucnosti politicke zajednice. U prvom delu ovog rada pokusao sam da ukazem na razloge za tematizovanje ovog pojma, kao i njegovu relevantnost u analizi savremenih zbivanja na ovim prostorima. U drugom delu nastojao sam da blize odredim pojam politicke zajednice. Treci deo posvecen je sporovima koji (...) su se vodili oko ovog pojma u okviru razlicitih teorija, a koji su ostali do danas aktuelni. U cetvrtom delu ovog rada pokusao sam da razmotrim perspektive politicke zajednice u savremenim uslovima pluralizma posebnih zajednica i etnokulturne heterogenosti. (shrink)

Contemporary philosopher Jacques Rancière has been criticized for a conception of “politics” that is insensitive to the diminished agency of the corporeally oppressed. In a recent article, Dana Mills locates a solution to this alleged problem in Rancière most recent book translated into English, Aisthesis, in its chapter on Mallarmé’s writings on modern dancer Loïe Fuller. My first section argues that Mills’ reading exacerbates an “homonymy” (Rancière’s term) in Rancière’s use of the word “inscription,” which means for him either (...) a vicious literal carving on living bodies, or else a virtuous figurative carving on nonliving bodies. The former, I call “bodily carving,” while the latter is the “corporeal writing” that I take Mallarmé to affirm in Fuller. My second section observes that Rancière himself misses a homonymy in Mallarmé on Fuller, namely “dance,” meaning either “ballet” or dance in general (including Fuller’s). My third section concludes that Rancière’s chapter on Fuller includes another “dance” homonymy, meaning either “concert dance” or what I term a new “art of meta-movement” in Fuller. The latter art, I conclude, is equivalent to Mallarmé’s “corporeal writing,” and can be understood as a new form of dance education, in pursuit of a new utopia of worker-dancers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction: Conflicting Interest in Medicine: Stories by Physicians on How Financing Affects Their WorkJames M. DuBois, Symposium EditorPhysicians frequently enter into special relationships that establish personal financial interests that could conflict with their patients’ best interests. Examples include receiving gifts from drug companies, sharing a patent on a medical device, or accepting funding from industry to conduct a drug study. In recent years, such “conflicts of interests” in medicine (...) have received growing attention from medical associations (Association of American Medical Colleges, 2008, 2010), policy bodies (Institute of Medicine, 2009), industry (Pharmaceutical Research and Manufacturers of America, 2008), journalists (Caputo, 2009; Nguyen, Ornstein, & Weber, 2010), and even Congress, which included in the 2010 Patient Protection Affordable Care Act a Physician Payment Sunshine provision requiring industry to report a wide variety of ties to physicians. All of these efforts appear motivated by a similar assumption: Gifts and financially beneficial relationships can unconsciously motivate physicians to prioritize their own or industry’s interests over patients’ interests when providing care, conducting medical research, or educating physicians (American Association of Medical Colleges, 2008; Dana & Loewenstein, 2003).The call for stories produced for this narrative symposium provided the following request:We are interested in hearing about positive and negative experiences associated with a variety of financial relationships. The stories should give readers a sense of what it is like to be a physician in the midst of complex relationships to industry, physician practices, and third–party payers—relationships that go beyond ordinary reimbursement for care or research expenses.Obtaining stories proved more challenging than anticipated for reasons related to our theme. Precisely because access to physicians is considered valuable, it is highly restricted. Listservs and blogs that serve physicians typically prohibit postings from anyone except physician members, and even they are sometimes not allowed to post messages freely. While at least one listserv circulated our call to members (at the request of a member), others rejected our request, and one blog offered to post our call as a 1–month ad for $20,000. This contrasts radically with the relatively easy access we have had to other groups, including mental health consumers and living organ donors, who have broad grass root communication systems, and bioethicists, who have several listservs and blogs that readily share news about relevant scholarly opportunities.The collection of stories obtained resulted from extensive personal networking and a small amount of arm twisting. The collection was not what we expected to obtain, but is in many ways even more interesting. One story (Hodges) explicitly addresses the impact that pharmaceutical representatives can have on prescribing patterns—the classic, voluntary, conflicted relationship, insofar as sales reps are [End Page 65] welcomed in facilities, often bearing free samples, free lunches, and glossy articles on their products, all in the hopes of influencing prescribing patterns. But most stories do not fit the typical mold found in discussions of conflicts of interest. Among those expressing concerns about the impact of financial factors on medical practice, one focuses on the insufficient management of bias within the Food and Drug Administration (Perlmutter); three focus on the bias that is introduced through our current fee–for–service reimbursement system (Mikulec, Nagaldine, and Zientek)—of these, two illustrate ways that third parties seek to manipulate physician practices to maximize profits; one notes how any kind of clinical trial—whether government or industry sponsored—may affect patient care decisions (Cruz); while two argue that worries over industry sponsorship of research are disproportionate (Bierut and Sofair), and two address widespread concerns about industry sponsorship of educational activities, with one illustrating how bias might be reduced (Seitz & Diao), and another illustrating the potential harms of prohibiting educational sponsorship (Peppin).To be clear, all of these narratives are responsive to our call for stories that “describe positive and negative experiences associated with a variety of financial relationships.” Yet they are not classic conflict of interest stories; rather, they represent the conflicting interests that concern physicians today—conflicts that are often intrinsic to our current healthcare and research systems rather than special relationships courted by physicians.While making no pretense of representativeness or comprehensiveness, these stories provide fertile ground for reflection, as seen in our... (shrink)