When hiring for an open position, the branch manager of Intermountain Trust Bancorp was challenged with an ethical dilemma he was not anticipating. An internal applicant challenged the hiring manager's ethical values by insisting that their friendship and other external employment factors be taken into consideration in the hiring decision. This is a classic case of a candidate using undue influence1 to manipulate a colleague and gain employment. In what started as a routine decision, the manager was faced with an (...) unforeseen ethical quagmire. This case describes a real situation that had local impact on the stakeholders of a regional bank, and provides a true example of the types of difficult situations that can affect candidate selection in hiring decisions. (shrink)

This article presents the case of an HIV-positive client who reported having sexual relations with an unknowing partner. The issue raised is whether the therapist was required to warn the unknowing partner, similar to the Tarasoff mandate that is imposed on therapists. The case is analyzed from an ethical framework similar to that presented by Beauchamp and Childress. Two opinions are presented, each leading to different conclusions about whether the therapist should inform the unknowing partner. It is concluded that although (...) such analysis is valuable in aiding the therapist in his or her decision-making process, no clear professional standard for the management of the problem is evident. (shrink)

Despite decades of research, remaining safety concerns regarding disease transmission, heterotopic tissue formation, and tumorigenicity have kept stem cell‐based therapies largely outside the standard‐of‐care for musculoskeletal medicine. Recent insights into trophic and immune regulatory activities of mesenchymal stem cells (MSCs), although incomplete, have stimulated a plethora of new clinical trials for indications far beyond simply supplying progenitors to replenish or re‐build lost/damaged tissues. Cell banks are being established and cell‐based products are in active clinical trials. Moreover, significant advances have also (...) been made in the field of pluripotent stem cells, in particular the recent development of induced pluripotent stem cells. Their indefinite proliferation potential promises to overcome the limited supply of tissue‐specific cells and adult stem cells. However, substantial hurdles related to their safety must be overcome for these cells to be clinically applicable. (shrink)

Graphical AbstractIdentifying the properties and molecules of the intestinal microbiome may help our understanding of various diseases and therefore facilitate their treatment; from excluding pathogens to manipulation of the immune system and regulation of non-intestinal sites.

Background: Emergency exception to informed consent regulation was introduced to provide a venue to perform research on subjects in emergency situations before obtaining informed consent. For a study to proceed, institutional review boards need to determine if the regulations have been met.Aim: To determine IRB members’ experience reviewing research protocols using emergency exception to informed consent.Methods: This qualitative research used semistructured telephone interviews of 10 selected IRB members from around the US in the fall of 2003. IRB members were chosen (...) as little is known about their views of exception to consent, and part of their mandate is the protection of human subjects in research. Interview questions focused on the length of review process, ethical and legal considerations, training provided to IRB members on the regulations, and experience using community consultation and notification. Content analysis was performed on the transcripts of interviews. To ensure validity, data analysis was performed by individuals with varying backgrounds: three emergency physicians, an IRB member and a layperson.Results: Respondents noted that: emergency exception to informed consent studies require lengthy review; community consultation and notification regulations are vague and hard to implement; current regulations, if applied correctly, protect human subjects; legal counsel is an important aspect of reviewing exception to informed-consent protocols; and IRB members have had little or no formal training in these regulations, but are able to access materials needed to review such protocols.Conclusions: This preliminary study suggests that IRB members find emergency exception to informed consent studies take longer to review than other protocols, and that community consultation and community notification are the most difficult aspect of the regulations with which to comply but that they adequately protect human subjects. (shrink)

Weiss, Propen, and Reid gather a diverse group of scholars to analyze the growing obsolescence of the human-object dichotomy in today's world. In doing so, Design, Mediation, and the Posthuman brings together diverse disciplines to foster a dialog on significant technological issues pertinent to philosophy, rhetoric, aesthetics, and science.

We have no patterns for relating across our human differences as equals.Advocating the mere tolerance of difference between women is the grossest reformism.... Differences must be not merely tolerated, but seen as a fund of necessary polarities.... Audre Lorde.

The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric (...) group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2= 52.66;p< 0.001) and had a high rate of unresolved loss/trauma (χ2= 18.64;p< 0.001). Comorbid psychiatric diagnoses (n= 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88;SD= 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2= 2.43;p= 0.30) and rates of unresolved loss and trauma (χ2= 0.70;p= 0.40).Post hocanalyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs. (shrink)