A collection of original comics engaging fundamental issues in medical ethics, including patient autonomy, informed consent, unconscious bias, mandated reporting of suspected abuse, confidentiality, medical mistakes, surrogate decision-making, and futility.

This essay explores key concerns surrounding “coming out” as a person with illness and addresses important professional and social considerations for those who are closeted in various kinds of illness. Using central tenets of Queer Theory and Disability and Cultural Studies as a theoretical base, I examine the politics of coming out in the specific context of my lived experience during the 2002 NEH Summer Institute, “Medicine, Literature, and Culture” While such an environment might foster unusual candor about personal illness (...) experience, I discovered that the choice to come out as a person with chronic, non-infectious disease (Inflammatory Bowel Disease) was nevertheless complicated in interesting ways. (shrink)

The existence of free will has been both an enduring presumption of Western culture and a subject for debate across disciplines for millennia. However, little empirical evidence exists to support the almost unquestioned assumption that, in general, Westerners endorse the existence of free will. The few studies that measure belief in free will have methodological problems that likely resulted in underestimating the true extent of belief. Recently, Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ) found a stronger endorsement (...) of free will when demand characteristics were eliminated. The current study builds on this work by sampling incarcerated adolescents and adults, whose freedom to act is externally constrained. Belief in free will as well as attitudes toward punishment, self-esteem, and locus of control were measured. The results indicate that free will is strongly endorsed in Western society even when freedom to act is severely restricted. However, incarcerated adolescents endorsed free will to a slightly lesser extent than their nonincarcerated counterparts from Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ), while incarcerated and nonincarcerated adults offered equally strong endorsements. The comparable endorsement by adults is consistent with the hypothesis that the belief in agency is an evolutionary adaptation. The small decrease found for incarcerated adolescents may reflect the interaction between developmental factors and the expression of an evolutionary adaptation. Additionally, incarcerated adolescents and adults associated beliefs in free will with viewing punishment as a means of deterrence, rehabilitation, and retribution. Incarcerated adults, but not incarcerated adolescents, associated beliefs in free will with greater self-esteem and with an external locus of control. Finally, though both incarcerated adults and adolescents endorsed free will strongly, the former manifested the belief by emphasizing free agentic choice whereas the latter focused on the personal responsibility that is interwoven with free choice. The implications of these findings are discussed in the context of evolutionary, cultural, and developmental factors. (shrink)

This study investigates the reactions of graduate students to perceived gender bias in their classes, using survey data from 254 social science graduate students in seven Ph.D.-granting departments in three universities. In addition to summarizing reported rates of gender-biased behavior in classrooms, we test hypotheses connecting perceptions of sexist behavior with students' emotional reactions, levels of distraction, and subsequent performance. Results are mixed, depending on students' perceptions of professors as either sensitive or insensitive to gender issues. Second, we use a (...) model of social influence to test for negative effects of reported sexist behavior on students' perceptions of professors' expertness, attractiveness, and trustworthiness. Strong support is demonstrated for these hypotheses. (shrink)

Allthough small business accounts for over 90% of businesses in U.K. and indeed elsewhere, they remain the largely uncharted area of ethics. There has not been any research based on the perspective of small business owners, to define what echical delemmas they face and how, if at all, they resolve them. This paper explores ethics from the perspective of small business owner, using focus groups and reports on four clearly identifiable themes of ethical delemmas; entrepreneurial activity itself, conflicts of personal (...) values with business needs, social responsibility and the impact of owners' personality on business ethics. The mechanisms for resolving ethical dilemmas is not at all clear, as there appears to be a web of filters which are used in an inter-connected way. However a common starting point for resolving an ethical delemma which involves others is based on identifying who it is (e.g., a friend or institution) and the quality of the relationship with that person. The research yielded a rich source of material on business ethics and it is clear that future researchers must focus on this sector if business ethics is to make significant advances. (shrink)

Three and 4-year-old children were tested on matched versions of Zaitchik's (1990) photo task and Wimmer and Perner's (1983) false belief task. Although replicating Zaitchik's finding that false belief and photo task are of equal difficulty, this applied only to mean performance across subjects and no substantial correlation between the two tasks was found. This suggests that the two tasks tap different intellectual abilities. It was further discovered that children's performance can be improved by drawing their attention to the back (...) of the photo but not by drawing attention to the person holding the false belief. Results are interpreted as showing that children's difficulty with the photo task is due to referential confusion about which scene the question refers to (the picture or reality) while the hurdle in the false belief task is to understand that the believer misrepresents reality. (shrink)

BackgroundResearchers are working to identify dynamic factors involved in the shift from behavioral initiation to maintenance—factors which may depend on behavioral complexity. We test hypotheses regarding changes in factors involved in behavioral initiation and maintenance and their relationships to behavioral frequency over time, for a simple vs. complex behavior.MethodsData are secondary analyses from a larger RCT, in which young adult women, new to both behaviors, were randomly assigned to take daily calcium or to go for a daily, brisk walk, for (...) 4-weeks. Factors were measured weekly. Multi-level modeling evaluated their change over time. Bivariate correlations and multiple regression determined the relationships between factors and the subsequent-week behavioral frequency.FindingResults were partly in-line with expectations, in that individuals’ intentions and self-efficacy predicted initial behavioral engagement for both behaviors, and habit strength increased for both behaviors, becoming a significant predictor of behavioral frequency in later weeks of the study in some analyses. However, results depended on whether the outcome was self-reported or objectively measured and whether analyses were bivariate or multivariate.DiscussionThe factors theorized to play a role in behavioral maintenance started to develop, but only habit strength predicted behavioral frequency by study-end, for both behaviors. Differences in initiation and maintenance between behaviors of differing complexity may not be as stark as theorized, but longer follow-up times are required to evaluate maintenance factors. (shrink)

IntroductionLifestyle modifications are part of comprehensive treatment plans to help manage the symptoms of pre-existing chronic conditions. However, behavior change is notoriously difficult as patients often lack the necessary support. The present manuscript outlines the development of a Green Health Prescription pathway that was designed to link patients with appropriate lifestyle interventions and to support attendance. Strengths, Weaknesses, Opportunities, and Threats analysis was undertaken in three focus groups to highlight areas of strength and weakness within the proposed pathway prior to (...) delivery. The SWOT analyses revealed that the pathway was supported by all three focus groups. Weaknesses and threats were identified including sustainability of nature-based interventions in terms of funding, the need to connect patients with appropriate interventions based on their physical and mental health needs, and the requirement to have a “one-stop shop” for information to ensure that the pathway was accessible for all service-users and healthcare professionals. Results were addressed and considered throughout the development of the pathway.DiscussionThe Green Health Prescription pathway was launched in 2019 and gave patients the ability to receive a prescription from a healthcare professional, community service, or to self-refer. The pathway allows patients to contact a consultant, via a telephone service, who is trained to match them with a programme that the patient believes will be enjoyable and that fits their treatment needs. Data collection to assess the efficacy of the pathway is ongoing. (shrink)

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. (...) Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors. (shrink)

The product of a Kickstarter fundraising campaign, "Clear and Present Thinking" is a college-level textbook in logic and critical thinking. Chapters: 1. Questions, Problems, and World Views 2. Good and Bad Thinking Habits 3. Basics of Argumentation 4. Fallacies 5. Reasonable Doubt 6. Moral Reasoning In an effort to reduce the cost of education for students, this textbook was funded by over 700 people through the Kickstarter online crowd-funding platform.

In order to illuminate the similarities and differences between science and theology, we consider an epistemology and methodology for each that can be characterised as a dialectical critical realism. Our approach is deeply indebted to the work of the great Swiss theologian, Karl Barth. Key points are that the object under study determines the method to be used, the community of investigators and the nature of the possible knowledge to be gained; the necessity of a posteriori, rather than a priori (...) reasoning; and that the dialogue between theology and science should account for both the similarities and differences between the two disciplines. The counterintuitive nature of quantum physics is used to illustrate how in science the dialectic element should lead to a critical dimension to realism, and one is forced to engage with reality on its own terms. (shrink)

We examine ethical considerations in access to facial transplantation, with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in need. (...) This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

The use of aggregated quality of life estimatesin the formation of public policy and practiceguidelines raises concerns about the moralrelevance of variability in values inpreferences for health care. This variabilitymay reflect unique and deeply held beliefs thatmay be lost when averaged with the preferencesof other individuals. Feminist moral theorieswhich argue for attention to context andparticularity underline the importance ofascertaining the extent to which differences inpreferences for health states revealinformation which is morally relevant toclinicians and policymakers. To facilitatethese considerations, we present (...) an empiricalstudy of preferences for the timing andoccurrence of health states associated withhormone replacement therapy (HRT). Sixteenwomen between the ages of 45 and 55 wereenrolled in this pilot study. Theirpreferences regarding five health statesassociated with HRT (menopausal symptoms, sideeffects of HRT, breast cancer, myocardialinfarction, and osteoporosis) were assessed inquantitative terms known as utilities. Twostandard methods, the visual analog scale (VAS) and the standard gamble (SG), were used toassess utility and time preference (calculatedas a discount rate). The wide variability ofresponses underlines the importance oftailoring health care to individual women'spreferences. Policy guidelines whichincorporate utility analysis must recognize thenormative limitations of aggregatedpreferences, and the moral relevance ofindividual conceptions of health. (shrink)

In recent years, there has been a surge in popularity of the fair-trade industry, which seeks to improve trading conditions and to promote the rights of marginalized workers. Although research suggests that fair-trade products are perceived as promoting social and economic responsibility, some individuals—namely, those who seek to maintain existing group inequalities or those induced to think inequality is a good thing—may not share this perception. Across three studies, we found that SDO relates negatively to fair-trade consumption, and this relationship (...) is mediated by the tendency for high-SDO individuals to see fair-trade products as less compatible with their conception of social justice. Our findings held after controlling for related individual-differences variables, and regardless of whether SDO was measured or manipulated. Implications for how to maximize the likelihood that people will perceive fair-trade products as “fair” are discussed. (shrink)

According to the practicality requirement, there could be truths about what people have reason to do only if people’s motivating states could be, in an appropriate sense, either correct or incorrect. Yet according to the Humean theory of motivation, people’s motivating states are a species of desire, and these desires are not a species of belief, being neither identical to nor entailed by them; and according to the standard view of desire, P’s desire to is, at bottom, a disposition to (...) act in whatever ways she believes will increase her chances of -ing. As there is no obvious sense in which such disposition are aiming to get P’s reasons right, they seem incapable of satisfying the practicality requirement and scepticism about normative truths seems to follow. I argue, first, that this sceptical conclusion is best avoided, not by rejecting either the practicality requirement or the Humean theory of motivation, but rather by rejecting the standard view of desire, and, second, that this is best done by endorsing a holistic view, according to which the contents of people’s desires depend importantly, though not essentially, on the contents of their normative beliefs. (shrink)

For more than a century, phenomenology’s relation to history has remained a problem for phenomenological analysis. This can in part be attributed to the circumstances surrounding the beginnings of phenomenology. As Europe moved increasingly toward world war at the turn of the 20th century, a growing consciousness of the historical relativity of all values and knowledge spread throughout the continent, leading Ernst Troeltsch to speak of the “crisis of historicism”. In this same context, Edmund Husserl framed phenomenological analysis in opposition (...) to history. While Husserl recognized the “tremendous value” that history has to offer philosophical thinking, he believed that a purely historical reduction of consciousness necessarily results in the relativity of historical understanding itself, like a serpent that bites its own tail. If phenomenology was to be a genuine science, it had to attempt a phenomenological reduction which would seize upon the essence of our historical being, i.e., our essence as beings that exist within history and are inseparable from it. What was required over and beyond a historical understanding of lived experience was an analysis of the structure of historicity itself. (shrink)

According to Thomas Nagel, morality's authority is determined by the extent to which its way of balancing agent-neutral and agent-relative values resembles reason's. He himself would like to think that the resemblance is close enough to ensure that it will always be reasonable to act as morality demands. But his attempts to establish this never really get off the ground, in large part because he never makes it very clear how these two perspectives on value are to be characterized. My (...) goal in this paper is to show how we might flesh out Nagel's conception of these matters by construing reason as a kind of self-governance and morality as involving a certain kind of cooperation. The challenge will therefore be to determine what self-governance and cooperation require of peoplegiven the assumption that there are objective values and that they take both the agent-neutral and the agent-relative forms. What we shall find is that their requirements differ rather more than Nagel allows, but perhaps not enough to prevent morality from being in some significant sense inescapable. (shrink)

According to Thomas Nagel, morality's authority is determined by the extent to which its way of balancing agent-neutral and agent-relative values resembles reason's. He himself would like to think that the resemblance is close enough to ensure that it will always be reasonable to act as morality demands. But his attempts to establish this never really get off the ground, in large part because he never makes it very clear how these two perspectives on value are to be characterized. My (...) goal in this paper is to show how we might flesh out Nagel's conception of these matters by construing reason as a kind of self-governance and morality as involving a certain kind of cooperation. The challenge will therefore be to determine what self-governance and cooperation require of people given the assumption that there are objective values and that they take both the agentneutral and the agent-relative forms. What we shall find is that their requirements differ rather more than Nagel allows, but perhaps not enough to prevent morality from being in some significant sense inescapable. (shrink)