Research into epistemic injustice, the practice of discrediting people as knowers based on their social identity, has gained broad popularity in ethics. Racism in medicine often mani...

As a 2006 Institute of Medicine report highlights, surprisingly little empirical attention has been paid to how prisoners arrive at decisions to participate in modern research. With our study, we aimed to fill this gap by identifying a more comprehensive range of factors as reported by prisoners themselves during semistructured interviews. Our participants described a diverse range of motives, both favoring and opposing their eventual decision to join. Many are well-recognized considerations among nonincarcerated clinical research participants, including a desire for (...) various forms of personal benefit, altruism, and concern about study risks and inconveniences. However, a number of influences seem unique to prisoners. Participants did not report that they were not coerced into enrolling, and they have even been under pressure not to enroll. However, many sought to enroll in order to obtain access to better health care, raising a concern about whether they were unfairly exploited. (shrink)

Randomised placebo-controlled trials (RPCTs) are the gold standard for evaluating novel treatments. However, this design is rarely used in the context of orthopaedic interventions where participants are assigned to a real or placebo surgery. The present study examines attitudes towards RPCTs for orthopaedic surgery among 687 orthopaedic surgeons across the USA. When presented with a vignette describing an RPCT for orthopaedic surgery, 52.3% of participants viewed it as ‘completely’ or ‘mostly’ unethical. Participants were also asked to rank-order the value of (...) five different types of evidence supporting the efficacy of a surgery, ranging from RPCT to an anecdotal report. Responses regarding RPCTs were polarised with 26.4% viewing it as the least valuable (even less valuable than an anecdote) and 35.7.% viewing it as the most valuable. Where equipoise exists, if we want to subject orthopaedic surgeries to the highest standard of evidence (RPCTs) before they are implemented in clinical practice, it will be necessary to educate physicians on the value and ethics of placebo surgery control conditions. Otherwise, invasive procedures may be performed without any benefits beyond possible placebo effects. (shrink)

Background: Therapeutic misconception, the misunderstanding of differences between research and clinical care, is widely prevalent among non-incarcerated trial participants. However, little attention has been paid to its presence among individuals who participate in research while incarcerated. Methods: This study examined the extent to which 72 incarcerated individuals may experience therapeutic misconception about their participation in one of six clinical trials, and its correlation with participant characteristics and potential influences on research participation. Results: On average, participants endorsed 70% of items suggestive (...) of therapeutic misconception. The tendency toward therapeutic misconception was significantly higher among African Americans and Latinos compared to Whites, among older and less educated participants, and among enrollment in a substance-abuse-related trial; it was also correlated with a belief that the trial was the only way to obtain needed treatment. Conclusions: Therapeutic misconception may be particularly high among select incarcerated individuals and is associated with a perceived lack of treatment options. Further examination of therapeutic misconception among incarcerated research participants is needed. (shrink)

The estimation of causal effects is fundamental in situations where the underlying system will be subject to active interventions. Part of building a causal inference engine is defining how variables relate to each other, that is, defining the functional relationship between variables entailed by the graph conditional dependencies. In this article, we deviate from the common assumption of linear relationships in causal models by making use of neural autoregressive density estimators and use them to estimate causal effects within Pearl’s do-calculus (...) framework. Using synthetic data, we show that the approach can retrieve causal effects from non-linear systems without explicitly modeling the interactions between the variables and include confidence bands using the non-parametric bootstrap. We also explore scenarios that deviate from the ideal causal effect estimation setting such as poor data support or unobserved confounders. (shrink)

According to Suetonius, Nero Claudius Drusus, the younger of Augustus' two stepsons, was said to have aspired to win spolia opima, that is, spoils taken from an enemy commander killed in battle. The aim of this paper is to consider what substance there may be in this claim and what light it may throw on Augustus’ relationship with the princes of the imperial family.

Clarifying the mission of the American high school / Ernest L. Boyer--Educational goals and curricular decisions in the new Carnegie Report / John Martin Rich--Essential schools : a first look / Theodore R. Sizer--Teaching and learning : the dilemma of the American high school / Chester E. Finn, Jr.--The paideia proposal : rediscovering the essence of education / Mortimer Adler--The paideia proposal : noble amibitions, false leads, and symbolic politics / Willis D. Hawley--Cultural literacy : let's get specific / E.D. (...) Hirsch, Jr.--Cultural literacy : what every educator needs to know / Thomas H. Estes, Carol J. Gutman, and Elise K. Harrison--A blueprint for public education / John E. Chubb--Should market forces control educational decision making / Jack Tweedie--Teachers as transformative intellectuals / Henry A. Giroux--Dilemma language / Colin Lacey--Rich schools, poor schools : the persistence of unequal education / Arthur E. Wise and Tamar Gendler--Partial privatization of publice school finance / Thomas G. Fox and John Riew--Quality and equality in American education : public and Catholic schools / James S. Coleman--Oranges plus apples, Dr. Coleman, give you oranges plus apples / James Rogers--Synthesis of research on school-based management / Jane L. David--Unfulfilled promises / Betty Malen, Rodney T. Ogawa, and Jennifer Kranz--Effective high schools--What are the common characteristics? / Joseph Murphy and Philip Hallinger--Effective schools : a friendly but cautionary note / Larry Cuban--In education, magnets attract controversy / Mary Haywood Metz--Schools of choice : a path to educational quality or 'Tiers of inequity'? / Kathleen Sylvester--Interesting times / Alan H. Jones--Making a difference in educational quality through teacher education / Carolyn M. Evertson, Willis D. Hawley, and Marilyn Zlotnik--Developing a career ladder : getting down to the basics / Thomas Deering--The career ladder and lattice : a new look at the teaching career / Timothy J.L. Chandler, Stacey L. Lane, Janice M. Bibik, and Bernard Oliver--Equity, quality, and effectiveness in bilingual education / George M. Blanco--Bilingual--No! / Muriel Paskin Carrison--Multiethnic education and the quest for equality / James A. Banks--The limits of pluralism / M. Donald Thomas--The case for keeping mentally retarded children in your regular classrooms / Martin Tonn--Mainstreaming : a formative consideration / Harry N. Chandler--Reflections on three decades of eduction of the gifted / A. Harry Passow--Equity vs. excellence : an eductional drama / James J. Gallagher. (shrink)