Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

There is little information about the content of ethics consultations in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance (...) in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is need.. (shrink)

Two ideas shape the epistemology of testimony. One is that testimony provides a unique kind of knowledge. The other is that testimonial knowledge is a social achievement. In traditional terms, those who affirm these ideas are anti-reductionists, and those who deny them are reductionists. There is increasing interest, however, in the possibility of affirming these ideas without embracing anti-reductionism. Thus, Sanford Goldberg uses the idea of epistemic buck-passing to argue that even reductionists can accept the uniqueness of testimonial knowledge, and (...) Jennifer Lackey gives both speaker and hearer an essential role in testimonial justification, rejecting both reductionism and anti-reductionism in favor of what she calls dualism. After distinguishing a weaker and a stronger notion of buck-passing, we show how anti-reductionists can use the stronger notion to motivate their position, and to answer Goldberg’s and Lackey’s challenges. (shrink)

In this paper I argue that Pereboom’s empirical objection to agent causation fails to undermine the most plausible version of agent-causal libertarianism. This is significant because Pereboom concedes that such libertarianism is conceptually coherent and only falls to empirical considerations. To substantiate these claims I outline Pereboom’s taxonomy of agent-causal views, develop the strongest version of his empirical objections, and then show that this objection fails to undermine what I consider the most plausible view of agent-causal libertarianism, namely, reconciliatory integrationist (...) agent-causalism. I then strengthen my criticism of Pereboom by responding to three objections to my view. I show that these objections, though initially challenging, fail to undermine my argument. I therefore conclude that, to this extent, agent-causal views remain a viable option in the contemporary free will debate. (shrink)

PURPOSE: There is an increasing demand for researchers to provide research results to participants. Our aim was to define an appropriate process for this, based on needs and attitudes of participants. METHODS: A multicenter survey in five sites in the United States and Canada was offered to parents of children with cancer and adolescents with cancer. Respondents indicated their preferred mode of communication of research results with respect to implications; timing, provider, and content of the results; reasons for and against (...) providing results; and barriers to providing results. RESULTS: Four hundred nine parents (including 19 of deceased children) and 86 adolescents responded. Most parents (n = 385; 94.2%) felt that they had a strong right to research results. For positive results, most wanted a letter or e-mail summary (n = 238; 58.2%) or a phone call followed by a letter (n = 100; 24.4%). If the results were negative, phone call (n = 136; 33.3%) or personal visits (n = 150; 36.7%) were preferred. Parents wanted the summary to include long-term sequelae and suggestions for participants (n = 341; 83.4%), effect on future treatments (n = 341; 83.4%), and subsequent research steps (n = 284; 69.5%). Understanding the researcher was a main concern about receiving results (n = 145; 35.5%). Parents felt that results provide information to support quality of life (n = 315; 77%) and raise public awareness of research (n = 282; 68.9%). Adolescents identified similar preferences. CONCLUSION: Parents of children with cancer and adolescents with cancer feel strongly that they have a right to be offered research results and have specific preferences of how and what information should be communicated. (shrink)

Background: Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer. Methods: This is a secondary analysis of data from validated questionnaires provided to adolescents (>12 years old) diagnosed with cancer and parents of children with cancer at 3 sites in Canada (...) (Halifax, Vancouver, and Montreal) and 2 in the United States (Atlanta, GA, and Memphis, TN). Respondents reported their own research participation and cited factors that would influence their own decision to participate in, or to provide parental authorization for their child to participate in health research. Results: Completed questionnaire rates for AYAs and parents were 86 (46.5%) of 185 and 409 (65.2%) of 627, respectively. AYAs (n = 86 [67%]) and parents (n = 409 [85%]) cited that they would participate in research because it would help others. AYAs perceived pressure by their family and friends (16%) and their physician (19%). Having too much to think about at the time of accrual was an impediment to both groups (36% AYAs and 47% parents). The main deterrent for AYAs was that research would take up too much time (45%). Nonwhite parents (7 of 56 [12.5%]) were more apt to decline than white parents (12 of 32 [3.7%]; P < .01). Conclusions: AYAs identified time commitment and having too much to think about as significant impediments to research participation. Addressing these barriers by minimizing time requirements and further supporting decision-making may improve informed consent and impact on enrollment in trials. (shrink)

In this paper I argue that reference to a developmental account of agency can help explain, and in cases also alter, our current practices when it comes to the non-consensual medical treatment of children. It does this through its explanation of how stages of development impact the types of interests we have.

7. The rights of immigrants: Joseph H. Carens.

This paper challenges the assumption that reasons are intrinsic to rational action. A great many actions are not best understood as ones in which the agent acted for reasons--and yet they can be understood as rational, and as open to rational criticism. The relative paucity of explicit reason-giving, practical arguments in daily life presents a general philosophical problem. It reflects the existence of a class of ways in which reason can regulate action, which goes far beyond producing reasons or applying (...) principles. Much practical reasoning takes the form of what H. P. Grice called 'thought-transitions'. These are neither in the form of standard practical arguments, nor can they be so reconstructed without distorting the ways in which an agent thinks. Some actions to which one is led by a thought transition are rational, namely when what Grice called a 'propension' towards a given class of actions--a standing inclination to act in certain ways--would itself stand up to rational evaluation. The paper examines two bases for such endorsement, one local and limited, and one much more speculative, due to Grice himself. (shrink)

In this paper I argue that excising a final end from accounts of virtue does them more harm than good. I attempt to establish that the justification of contemporary virtue ethics suffers if moved this one step too far from the resources in traditional accounts. This is because virtue, as we tend to describe it, rests on an account of practical rationality wherein the role of the final end is integral. I highlight the puzzles that are generated by the ellipsis (...) that is “the role of a final end” in contemporary theories of virtue. The authors of these theories devise ad hoc solutions for these puzzles, puzzles that do not exist for traditional final end-based accounts. Recent critics of virtue ethics have certainly not been satisfied the explanations being offer in lieu of references to a final end. As a remedy, I recommend that the role of a final end be reintroduced in contemporary virtue ethics. I hope to explain that there is nothing to be frightened of and much to be gained. (shrink)

Contemporary philosophers and scientists have done much to expand our understanding of the structure and neural mechanisms of joint action. But the phenomenology of joint action has only recently become a live topic for research.One method of clarifying what is unique about the phenomenology of joint action is by considering the alternative perspective of agents subsumed in group action. By group action we mean instances of individual agents acting while embedded within a group agent, instead of with individual coordination. Paradigm (...) examples are educational bureaucracies, corporations, and nation states. There is a phenomenological difference between agents whose actions are subsumed within a group action as compared to agents who act jointly. Attending to this difference clarifies what is phenomenologically distinctive about joint action.Appealing to an Aristotelian account of agency and to the metaphysical concept of weak emergence, we argue that what makes paradigmatic group action distinctive is the relative inaccessibility, un-revisability, and evaluative simplicity of the group agent’s goal from the perspective of individual agents. This suggests that a distinctive feature of joint agency is the maintenance of a greater sense of individual agency. Put simply, joint agency is often experienced as an enhancement of the individuals’ agency precisely because our paradigmatic agential powers are extended intersubjectively as we act together. In contrast, group agency often involves a loss of the sense of agency, precisely because it is the emergent group agent that maintains the agential powers. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page 18-20, October 2012.

In sport, perceptual skill training software is intended to assist tactical training in the field. The aim of this field study was to test whether ‘laboratory-based’ pattern recall training would augment tactical skill training performed on the field. Twenty-six soccer players between 14-16 years of age from a single team participated in this study and were divided into three groups. The first received field training on a specific tactical skill plus cognitive training sessions on the pattern recall task. The second (...) performed only the field training while the third group served as a control group and had field training on other topics. The task on the pre-, post- and retention tests was to recall specific soccer patterns displayed on a computer screen. Results showed significant changes between pre- to post-test performance. There was no significant interaction between groups and tests but the effect size was large. From pre- to retention-test, there was a significant difference between tests and an interaction between groups and tests, but no main effect difference between groups. On the basis of significance testing only retention was affected by the additional training, however, descriptive results and effect sizes from pre- to post-test were as expected and suggested there were learning benefits. Together these results indicate that augmented perceptual-cognitive training might be beneficial, but some limitations in our study design (e.g., missing field test, missing placebo group, etc.) need to be improved in future work. (shrink)

This chapter contains sections titled: Maybe It's Simple Sexism Do Not Go Gentle Universal Praise for the Natural? What About Natural Disasters? Focus on the Pain Recommending Pain Humble Mamas Praise Mama Notes.

In this essay I argue that contemporary accounts of virtue ought to incorporate methods ancient virtue ethicists used in addressing an audience whose members were interested in improving their behavior. Ancient examples of these methods, I argue, model how to represent practical rationality in ethical arguments. They show us that when we argue for virtue we ought to address common claims, refer to moral reasoning as a stepwise process, and focus on norms when making recommendations. Our own ethical arguments will (...) be improved if we do these things. To the extent that these methods are incorporated into our contemporary accounts of virtue, we will make important points of contact with the account of practical rationality that forms the very basis of the view. (shrink)

Over 40 years of research have shown that traumatic brain injury affects brain volume. However, technical and practical limitations made it difficult to detect brain volume abnormalities in patients suffering from chronic effects of mild or moderate traumatic brain injury. This situation improved in 2006 with the FDA clearance of NeuroQuant®, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. More recent strides were made with the introduction of NeuroGage®, commercially available software that is based (...) on NeuroQuant® and extends its utility in several ways. Studies using these and similar methods have found that most patients with chronic mild or moderate traumatic brain injury have brain volume abnormalities, and several of these studies found—surprisingly—more abnormal enlargement than atrophy. More generally, 102 peer-reviewed studies have supported the reliability and validity of NeuroQuant® and NeuroGage®. Furthermore, this updated version of a previous review addresses whether NeuroQuant® and NeuroGage® meet the Daubert standard for admissibility in court. It concludes that NeuroQuant® and NeuroGage® meet the Daubert standard based on their reliability, validity, and objectivity. Due to the improvements in technology over the years, these brain volumetric techniques are practical and readily available for clinical or forensic use, and thus they are important tools for detecting signs of brain injury. (shrink)

In this book Richard Foley formulates the problem of the authority of others’ testimony, and of the rationality of one’s own beliefs, in terms of trust. Part 1 discusses the appropriateness of trust in one’s own cognitive faculties and beliefs, while part 2 argues that those assessments provide a basis for trust in others’ beliefs as well as those of one’s earlier and later selves. He does not offer us an analysis of trust or what it is to speak of (...) trust as rational or reasonable. He simply uses the notion to discuss what is surely one form of the problem of the rationality of belief. Rationality, in this book as in his earlier works, The Theory of Epistemic Rationality and Working Without a Net, is understood from a strict internalist and first-person perspective. Assessments of the rationality of opinions, like assessments of decisions, are claims, from a particular perspective, about how effectively the belief or decision promotes a goal or set of goals. With respect to belief and rational belief, the goal is what Foley calls the traditional “epistemic goal” of accurate and comprehensive beliefs. On his view, the perspective from which the assessment is made is the individual’s, taken on reflection. From the start, Foley’s understanding of rationality involves the first-person perspective. Rational belief is belief that will stand up to an individual’s own self-criticism. (shrink)

This chapter, ‘Friendship and the Moral Life in Iris Murdoch’s Novels’ revisits the subject of sexual relationships, not from the problematic perspective brought to them in Anne Rowe’s earlier chapter, but in a positive light. In his analysis of the educational potential of friendship and sexuality Robert Baker contends that sexual intimacy teaches Murdoch’s characters not only about themselves and their own identity but also about the reality of the other person. It thus acts as a force for learning to (...) attend to the world outside the self which is the desideratum of Murdoch’s moral pilgrimage. He surveys the apparent acceptance by Murdoch scholars that such moral development is necessarily a solitary and lonely endeavour before juxtaposing that impression—given prominence in the M and D scenario Murdoch creates in The Sovereignty of Good (1970)—with the relationships she portrays in her novels. Close readings of the friendship of Tom MacCaffrey and Emmanuel Scarlett-Taylor in The Philosopher’s Pupil (1983) and of Harvey Blackett’s relationship with Sefton Anderson in The Green Knight support Baker’s contention that physical affection can be a guide to the good. Borrowing an image from the latter novel he claims that in her fiction ‘Murdoch represents the moral life not as a lonely pilgrimage toward reality, but as a passeggiata with others in which one gives way to a movement larger than and beyond oneself’ (177), a viable interpretation which reads the passeggiata with an interestingly different slant from other current critics such as Rebecca Moden, who regards it as Murdoch’s ‘metaphor for the nature of human existence’ and ‘a troubling image of the impoverished quality of human consciousness in the late twentieth century’. (shrink)