Surveillance is a core function of all public health systems. Responses to the COVID-19 pandemic have deployed traditional public health surveillance responses, such as contact tracing and quarantine, and extended these responses with the use of varied technologies, such as the use of smartphone location data, data networks, ankle bracelets, drones, and big data analysis. Applying Foucault’s (1979) notion of the panopticon, with its twin focus on surveillance and self-regulation, as the preeminent form of social control in modern societies, we (...) examine the increasing levels of surveillance enacted during this pandemic and how people have participated in, and extended, this surveillance, self-regulation, and social control through the use of digital media. Consideration is given to how such surveillance may serve public health needs and/or political interests and whether the rapid deployment of these extensive surveillance mechanisms risks normalizing these measures so that they become more acceptable and then entrenched post-COVID-19. (shrink)

Changes in health care have created a variety of new roles and opportunities for nurses in advanced practice. One of these changes is the increasing number of advanced practice nurses carrying out independent consultation. Differences in goals between business and health care may create ethical dilemmas for nurse consultants. The purpose of this article is to describe possible ethical pitfalls that nurse consultants may encounter and strategies to prevent or solve these dilemmas. Three themes related to nursing codes of ethics (...) will be discussed: the duty to uphold human rights, the duty to fulfill commitments, and the duty to practice the profession competently. (shrink)

Background: Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. Methods: We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car (...) from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. Results: This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. Conclusions: The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of their dying members is undermined, there are long lasting negative consequences. The social fabric of rural life is frayed. These findings offer one way to re-conceptualize healthcare decision making through consideration of critical values to support ethically good palliative care in rural settings. (shrink)

A growing body of research has demonstrated significant heterogeneity of hospital ethics committee (HEC) size, membership and training requirements, length of appointment, institutional support, clinical and policy roles, and predictors of self identified success. Because these studies have focused on HECs at a single point in time, however, little is known about how the composition of HECs changes over time and what impact these changes have on committee utilization. The current study presents 20 years of data on the evolution of (...) the Massachusetts General Hospital HEC. Between 1993 and 2012, the average number of committee members per year was 38 ± 3 and the average length of membership was 4.8 ± 0.4 years. During that time, the committee performed 934 consults, averaging 47 ± 3 per year. Attendance rates fell from 61.5 to 23.8 % over the study period and were inversely correlated with the total number of members. Between 1993 and 2012, the committee saw substantial growth in the diversity of the professional backgrounds of its members. Multivariate analysis, however, suggests that substantial changes in committee composition did not impact its utilization and that other factors are more likely to explain fluctuations in consultation volume. (shrink)

Anxiety and stress-related disorders constitute a large global health burden, but are still poorly understood. Prior work has demonstrated clear impacts of stress upon basic cognitive function: biasing attention toward unexpected and potentially threatening information and instantiating a negative affective bias. However, the impact that these changes have on higher-order, executive, decision-making processes is unclear. In this study, we examined the impact of a translational within-subjects stress induction (threat of unpredictable shock) on two well-established executive decision-making biases: the framing effect (...) ( N = 83), and temporal discounting ( N = 36). In both studies, we demonstrate (a) clear subjective effects of stress, and (b) clear executive decision-making biases but (c) no impact of stress on these decision-making biases. Indeed, Bayes factor analyses confirmed substantial preference for decision-making models that did not include stress. We posit that while stress may induce subjective mood change and alter low-level perceptual and action processes ( Robinson et al., 2013c ), some higher-level executive processes remain unperturbed by these impacts. As such, although stress can induce a transient affective biases and altered mood, these need not result in poor financial decision-making. (shrink)

In the third of his Essays on the Intellectual Powers of Man, Reid devotes the fourth chapter to the concept of‘identity’, and the sixth chapter to Locke’s theory of ‘personal identity’. This latter chapter is widely regarded as a definitive refutation of the thesis that personal identity is no more than memories of a certain sort. It is interesting that the terms ‘identity’ and ‘personal identity’ do not appear as chapter or section titles elsewhere in any of Reid’s works; and (...) Hume is neither mentioned nor his theory of personal identity discussed in the two chapters specifically addressed to the matter. Moreover, while Locke, Reid, and Hume are often anthologized in works on personal identity, Reid is always presented as replying only to Locke. (shrink)

In the third of his Essays on the Intellectual Powers of Man, Reid devotes the fourth chapter to the concept of‘identity’, and the sixth chapter to Locke’s theory of ‘personal identity’. This latter chapter is widely regarded as a definitive refutation of the thesis that personal identity is no more than memories of a certain sort. It is interesting that the terms ‘identity’ and ‘personal identity’ do not appear as chapter or section titles elsewhere in any of Reid’s works; and (...) Hume is neither mentioned nor his theory of personal identity discussed in the two chapters specifically addressed to the matter. Moreover, while Locke, Reid, and Hume are often anthologized in works on personal identity, Reid is always presented as replying only to Locke. (shrink)

Many situations require the simultaneous processing of auditory and visual information, however, stimuli presented to one sensory modality can sometimes interfere with processing in a second sensory modality (i.e., modality dominance). The current study further investigated modality dominance by examining how task demands and bimodal presentation affect speeded auditory and visual discriminations. Participants in the current study had to quickly determine if two words, two pictures, or two word-picture pairings were the same or different, and we manipulated task demands across (...) three different conditions. In an immediate recognition task, there was only one second between the two stimuli/stimulus pairs and auditory dominance was found. Compared to the respective unimodal baselines, pairing pictures and words together slowed down visual responses and sped up auditory responses. Increasing the interstimulus interval to four seconds and blocking verbal rehearsal weakened auditory dominance effects, however, conflicting and redundant visual cues sped up auditory discriminations. Thus, simultaneously presenting pictures and words had different effects on auditory and visual processing, with bimodal presentation slowing down visual processing and speeding up auditory processing. These findings are consistent with a proposed mechanism underlying auditory dominance, which posits that auditory stimuli automatically grab attention and attenuate/delay visual processing. (shrink)

This paper traces the origins of the concept of personalisation in public sector services, and applies it to school education. The original conceptualisation stressed the need for 'deep' rather than shallow, personalisation, if radical transformation of services were to be achieved. It is argued that as the concept has been disseminated and implemented through policy documents, notably the 2005 White Paper, it has lost its original emphasis on deep personalisation. The focus in this article is particularly upon gifted and talented (...) students whose education provides the best case example of how the theory of personalisation might work in practice. Two examples of the lessons in a sixth form college are used to illustrate the character ofpersonalised pedagogy in practice. The implications for theory and practice are discussed. (shrink)

Currently more than half of the world’s population lives in cities. This is expected to rise to more than two-thirds by mid-century. Thus, our economic, social, and environmental challenges mostly and increasingly play out in urban settings. How can cities be strengthened to address the growing challenges they face? This special issue addresses the ethical implications of revitalizing urban environments, and the roles that diversity and inclusion, as well as social innovation, play in this process. The five papers herein show (...) that it is not easy to strengthen our cities, but with the right policies, political and corporate leadership, and depth of community grounding in ethical principles, it is possible. In this editorial essay, we summarize the contributions of each of these papers to this important conversation, clarify the questions that remain, and offer directions for future research. (shrink)

Background Investigative genetic genealogy (IGG) is a technique that involves uploading genotypes developed from perpetrator DNA left at a crime scene, or DNA from unidentified remains, to public genetic genealogy databases to identify genetic relatives and, through the creation of a family tree, the individual who was the source of the DNA. As policymakers demonstrate interest in regulating IGG, it is important to understand public perspectives on IGG to determine whether proposed policies are aligned with public attitudes.Methods We conducted eight (...) focus groups with members of the public (N = 72), sampled from four geographically diverse US regions, to explore general attitudes and perspectives regarding aspects of IGG practices, applications, and policies. Five major topics were explored in each focus group: when IGG should be used; who should perform IGG; how to approach consent for genetic database users; what systems of oversight should govern IGG practitioners; and whether to notify database users if their data are involved in law enforcement (LE) matching.Results Participants were supportive of IGG in most scenarios, especially for cold and violent cases. The favorable attitudes toward IGG were, however, tempered by distrust of law enforcement among some participants. All participants agreed that databases must inform users if IGG is allowed, but they did not agree on how individual database users should be allowed to opt out or whether to notify them if their data are involved in specific investigations. All participants agreed that IGG should be subject to some prescriptive guidelines, regulations, or accountability mechanisms.Conclusions These findings suggest broad public support for IGG, and interest in developing systems of accountability for its practice. Our study provides useful insight for policy makers, genomic database stewards, law enforcement, and other stakeholders in IGG’s practice, and suggests multiple directions for future research. (shrink)

The literature on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises concerns that these technologies may affect personality, mood, and behavior. We conducted semi-structured interviews with researchers (n = 23) involved in developing next-generation DBS systems, exploring their perspectives on ethics and policy topics including whether DBS/aDBS can cause such changes. The majority of researchers reported being aware of personality, mood, or behavioral (PMB) changes in recipients of DBS/aDBS. Researchers offered varying estimates of the frequency of PMB changes. A (...) smaller majority reported changes in personality specifically. Some expressed reservations about the scientific status of the term ‘personality,’ while others used it freely. Most researchers discussed negative PMB changes, but a majority said that DBS/aDBS can also result in positive changes. Several researchers viewed positive PMB changes as part of the therapeutic goal in psychiatric applications of DBS/aDBS. Finally, several discussed potential causes of PMB changes other than the device itself. (shrink)

Approach and avoidance motivation may represent important explanatory constructs in understanding how individuals differ. Such constructs have primarily been assessed in self-reported terms, but there are limitations to self-reports of motivation. Accordingly, the present review concentrates on the potential utility of implicit cognitive-behavioral probes of approach and avoidance motivation in modeling and understanding individual differences. The review summarizes multiple lines of research that have documented the utility of such probes to the personality-processing interface. Although multiple gaps in our knowledge exist, (...) and are acknowledged, the value of such implicit cognitive-behavioral assessments is emphasized both in modeling multiple subcomponents of approach and avoidance motivation and in showing that such tendencies matter in ways that transcend momentary experiences or manipulations. (shrink)

The current study used cross-modal oddball tasks to examine cardiac and behavioral responses to changing auditory and visual information. When instructed to press the same button for auditory and visual oddballs, auditory dominance was found with cross-modal presentation slowing down visual response times more than auditory response times (Experiment 1). When instructed to make separate responses to auditory and visual oddballs, visual dominance was found with cross-modal presentation decreasing auditory discrimination and participants also made more visual-based than auditory-based errors on (...) cross-modal trials (Experiment 2). Experiment 3 increased task demands while requiring a single button press and found evidence of auditory dominance, suggesting that it is unlikely that increased task demands can account for the reversal in Experiment 2. Auditory processing speed was the best predictor of auditory dominance, with auditory dominance being stronger in participants who were slower at processing the sounds, whereas, auditory and visual processing speed and baseline heart rate variability did not predict visual dominance. Examination of cardiac responses that were time-locked with stimulus onset showed cross-modal facilitation effects, with auditory and visual discrimination occurring earlier in the course of processing in the cross-modal condition than in the unimodal conditions. The current findings showing that response demand manipulations reversed modality dominance and that time-locked cardiac responses show cross-modal facilitation, not interference, suggest that auditory and visual dominance effects may both be occurring later in the course of processing, not from disrupted encoding. (shrink)

Increasingly, palliative care is being referred to as an essential programme and in some cases as a human right. Once it is recognized as such, it becomes part of the lexicon of social justice in that it can be argued that all members of society should have access to such care. However, this begs the question of how that care should be enacted, particularly in rural and remote areas. This question illustrates some of Friedrich Hayek's critiques of social justice. Hayek (...) has likened social justice to a ‘moral stone’ arguing that social justice is meaningless to the extent that society is impersonal and as such cannot be just, only those individuals who make up that society can be just. When responsibility for justice is assigned to an impersonal society, ideas of social justice can become a clarion call for whom no one is directly accountable. This opens the door for questionable macro‐level political agendas that have no capacity to enact the ideal, and worse, may suppress individual moral acts towards the desired end. Further, acts of interference at the macro level with the ideal of equal opportunity run the risk of disadvantaging other members of society. Instead, he has argued that a better approach lies in finding ways to induce and support individual moral acts that promote the human good. Hayek's arguments are particularly compelling for rural palliative care. In this paper we draw upon data from an ethnographic study in rural palliative care to illustrate the potential misfit between the ethical ideal of palliative care as expressed by rural participants and the narratives of social justice. (shrink)

A quick mental survey of one's friends or acquaintances reveals an important difference between them. On the one hand, there are seemingly stoic people for whom emotional events (e.g., having a pap...

Peace is a hallmark of human societies. However, certain ant species engage in long-term intergroup resource sharing, which is remarkably similar to peace among human groups. We discuss how individual and group payoff distributions are affected by kinship, dispersal, and age structure; the challenges of diagnosing peace; and the benefits of comparing convergent complex behaviours in disparate taxa.